Penile injury

A penile injury is a medical emergency that afflicts the penis. Common injuries include fracture, avulsion, strangulation, entrapment, and amputation. A penile injury is a medical emergency that afflicts the penis. Common injuries include fracture, avulsion, strangulation, entrapment, and amputation. Penile fractures are the result of rupture of the tunica albuginea. They are fairly rare and can co-occur with partial or complete urethral rupture, though this is rare. Urethral damage occurs in 10–38% of cases. Fractures are treated with emergency surgery, and can be diagnosed with ultrasound, especially in pediatric cases. Penile fractures are caused by trauma to the erect penis, typically by suddenly bending it laterally during penetrative intercourse with the receptive partner on top of the penetrating partner, or during masturbation. They can be diagnosed by the 'eggplant sign' and are characterized by a loud popping sound at the time of the injury, the result of the tunica albuginea rupturing. Other symptoms include severe pain, loss of erection, and swelling. Symptoms of urethral injury include hematuria, blood at the meatus, and dysuria. If left untreated, complications result in 28–53% of cases; these include permanent curvature of the penis, fistula, urethral diverticulum, priapism, and erectile dysfunction. Degloving and avulsion injuries involve the removal of the penis skin, which is a serious medical emergency. Treatment of these injuries involves either closure of the torn skin, or a skin graft to replace the skin lost in the injury. Skin grafts are constructed to attempt to preserve erectile function and sensation. Strangulation injuries to the penis, also called incarceration injuries, caused by hair, rubber bands, or other objects are the second most common soft tissue injury in children. Hair strangulation may be hard to diagnose due to the anatomy of the penis; the hair causing the strangulation may be hidden under the coronal sulcus if it is swollen. In adults, strangulation injuries that require medical treatment can be caused by a variety of objects typically used for the purpose of sexual gratification, extending the time of an erection, or enuresis, including metal rings, which must be removed by specialized cutting instruments. The object can also be removed by decompressing the penis. Because the vasculature of the penis is compressed, a variety of complications can result from strangulation injuries, depending on whether the veins, arteries, or both are compressed, including mild, reversible vascular obstruction; ischemic necrosis; gangrene and kidney damage; lymphedema; ulceration; urethrocutaneous fistula, loss of sensation; urethral injury; sepsis; and autoamputation. Penile strangulation injuries that require medical attention are rare: since their first description in 1755, there have been approximately 60–120 reported cases. Though usually acute, cases of chronic strangulation and acute cases lasting up to one month have been reported.