A penile fracture is the rupture of the tunica albuginea (fibrous layer that covers the corpora cavernosa) of one or both corpora cavernosa due to direct trauma to the erect penis. (¹)
• It’s characterized by a crunching sound, pain, and immediate detumescence. (²)
• On physical examination, penile hematoma is evident (97.5%) (³) and may be accompanied by urethral rupture in 20-30% of cases, with urethrorrhagia. (⁵)
• The most common cause is sexual intercourse in 80% of cases. (³)
• When the penis is erect the tunica albuginea decreases in thickness and elasticity, with increased intracarvernosal pressure, making it more vulnerable to traumatic injuries. (¹) Additionally in this state, the penis is less resistant to angulation. (⁵)
• Treatment consists of immediate surgical exploration through a subcoronal (deglovin) incision, evacuation of the hematoma, and repair of the tunica tear. (⁴)
• Among the most common long-term complications are erectile dysfunction, fibrous plaques, painful erections, penile curvature (10-30% of delayed treatments), urethral stricture if there was urethral compromise. (⁶)

References:

1. https://pubmed.ncbi.nlm.nih.gov/17922859/
2. https://uroweb.org/guidelines/urological-trauma
3. https://pubmed.ncbi.nlm.nih.gov/28874325/
4. https://pubmed.ncbi.nlm.nih.gov/17619699/
5. https://bit.ly/3LjRmsG
6. https://bit.ly/3VgWTEZ