Management of urethral lesions in penile blunt trauma

Background: Traumatic lesions to the penis may extend into the corpus spongiosum, causing laceration or complete transection of the urethra. Blunt penile trauma is usually related to sexual intercourse or manipulation. The aim of this paper was to report the authors experience with the management of urethral injuries in patients with penile blunt trauma. Methods: The charts from 77 patients with penile blunt trauma were retrospectively reviewed, and the cases associated with urethral injuries associated were selected. Patient age ranged from 18 to 63 years (mean 33 years). Results: From 77 cases assessed, 11 (14.2%) patients had urethral injury, 62 (80.5%) had injury of the corpora cavernosa and four (5.2%) had injury of the dorsal vein. The etiology of urethral injuries was sexual intercourse in 10 patients (91%) and direct trauma to the flaccid penis in one patient (9%). A partial urethral disruption was presented in eight patients (72.8%) and a total disruption in three patients (27.2%). Preoperative urethrogram was performed in seven patients with a suspicion of urethral trauma. When a partial injury was present the urethra was closed over the catheter, and in the presence of a total injury an end-to-end anastomosis was performed. Conclusion: The data support the reported incidence of urethral injury associated with blunt penile trauma. No clinically apparent urethral structures were appreciated with primary urethral repair after a follow up of more than 6 months.