1/21/2024 0 Comments Penile fracture symptomsIf surgical exploration finds an intact albuginea, logically, this suggests an unidentified vascular trauma, The location of the hematoma (above or below the Buck fascia) directs the diagnosis of the rupture site (superficial or deep dorsal vein). 1 If in doubt, surgical exploration is required. however arterial injuries or albuginea tunica rupture require surgical repear. This includes the use of compressive dressing, application of ice and analgesics. Venous ruptures can be resolved without surgery when the practitioner is certain that there is no lesion of the corpus cavernosum. Ultrasound may help locate the hematoma, but the accuracy of the results depends on the competence of the ultrasound specialist, 4 and even in case of diagnostic doubt the lack of visualization of a rupture of the albuginea does not formally eliminate a penile fracture, MRI gives the best results for soft tissue assessment, but it is expensive and unavailability limits its use. A very evocative sign is the ecchymosis in addition pubic and distal, this sign is due to the retraction of the proximal and distal segments of the ruptured vein However this sign was absent in our patient, this can be explained by the fact that it was a breach of the vein and not a complete rupture, there was therefore no retraction of both ends and the ecchymosis was localized at the middle part of the penis. Patients with superficial dorsal vein rupture may have a bleeding of the ruptured vein with a dorsal swelling of the penis bound to the hematoma, which usually occurs within 24 hours of sexual intercourse. 2, 3 However, patients with superficial dorsal vein rupture do not necessarily describe the classic ‘slam’ or rapid detumscence 2 This was the case with our patient. Most patients with a fracture of the corpus cavernosum report hearing a “slam”, followed by pain, rapid detumescence, and later onset of edema with hematoma as well as a deviation of the penis. However, the typical picture of the latter is quite distinct. Patients with a superficial dorsal vein rupture may have symptoms that mimic a penile fracture. The rupture of the superficial dorsal vein occurs following a brutal trauma on an erect penis which is responsible for a laceration or a complete rupture of the vein although there are not yet long series to study risk factors, some authors suggest that circumcision may be incriminated, 1, 2 It is possible that the tauter penile skin in the circumcised male is a contributing factor to the high rate of venous tears, by causing the penile vasculature to be more vulnerable to injury 1 during intercourse. The highest number (18 cases) was recorded by Bar-Yosef 1 where 9 of the 17 interventions performed for false fractures of the penis had recovered a rupture of the superficial dorsal vein. Coital lesions of the superficial dorsal vein of the penis are rare and are usually reported individually.
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