Fracture du corps caverneux de la verge

Abstract

Penile fracture is a rare urological emergency requiring immediate surgery, ideally in the first 24h, to prevent complications which are dominated by erectile dysfunction and penile curvature. The highest rates are reported in the Middle East and the Maghreb, most often secondary to false step in coitus or penile manipulations during erection such as the "taqaandan" maneuver. We report the case of a 34-year-old patient with no specific pathological history presenting to the Emergency Department with penile pain associated with swelling and deformity. The patient reported cracking sound during false step in coitus followed by acute penile pain with complete detumescence of the penis, with no associated urinary signs. Clinical examination revealed swollen penis, the seat of a hematoma, suggesting aubergine sign and a small painful induration on the dorsal side of the right corpus cavernosum on palpation. Emergency ultrasound confirmed the presence of a fracture line in the albuginea of the corpus cavernosum at 5 cm from the suspensory ligament of the penis. Direct approach based on elective incision of the induration was performed, which revealed longitudinal fracture measuring 18 mm in length involving the albuginea of the dorsal face of the right corpus cavernosum. After evacuation of hematoma, suture of the edges of the fracture line was performed with separate stitches of Vicryl 3-0. The post-operative suite was simple. At the follow-up visit the patient had recovered normal erectile function, with no induration or fibrosis at the level of the incision or penile curvature.