Duarsa Gede Wirya Kusuma, Yusuf Muhlis, Kloping Yudhistira Pradnyan, Rahman Ilham Akbar
Department of Urology, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia.
Department of Urology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General-Academic Hospital, Surabaya, East Java, Indonesia.
Int J Surg Case Rep. 2022 Aug;97:107351. doi: 10.1016/j.ijscr.2022.107351. Epub 2022 Jun 25.
Penile fracture is defined as a tear of tunica albuginea that covers the corpus cavernosum during an erection. It is a rare finding that both the corpora cavernosum and corpora spongiosum are involved in penile fracture. Herewith, we reported a rare case of 44 years old presented with penile fracture during woman on top sex position with both corpora cavernosum and corpus spongiosum rupture with urethral disruption. On clinical examination, the penis was swollen, and there was a sudden loss of erection and ecchymosis. Cystoscopy examination revealed urethral rupture. Emergent surgical repair was then performed. During emergency surgery, we found a defect of 3 cm in bicorporal cavernosa with urethral and corpus spongiosum disruption. The penis was degloved, and debridement with water-tight suturing of tunica albuginea was performed to repair the tear in corpora cavernosa. End-to-end anastomosis urethroplasty with spatulation was also performed to repair the urethra. After 21 days following surgery, erectile function was good and no difficulties in voiding function as shown in uroflowmetry result with Qmax >15 mL/s. The patient had a favorable recovery. This was a rare case report, and with early and prompt surgical intervention, this case could result in a good outcome in preserving erectile function and voiding function.
阴茎骨折被定义为勃起时覆盖海绵体的白膜撕裂。阴茎骨折累及海绵体和尿道海绵体是一种罕见的情况。在此，我们报告一例44岁罕见病例，该患者在女上位性交时发生阴茎骨折，海绵体和尿道海绵体均破裂并伴有尿道中断。临床检查时，阴茎肿胀，勃起突然消失且有瘀斑。膀胱镜检查显示尿道破裂。随后进行了急诊手术修复。在急诊手术中，我们发现双侧海绵体有3厘米的缺损，伴有尿道和尿道海绵体中断。阴茎脱套后，对白膜进行清创并进行水密缝合以修复海绵体撕裂。还进行了带斜面的端端吻合尿道成形术以修复尿道。术后21天，勃起功能良好，尿流率结果显示排尿功能无困难，最大尿流率>15毫升/秒。患者恢复良好。这是一例罕见病例报告，通过早期及时的手术干预，该病例在保留勃起功能和排尿功能方面可取得良好结果。
