Gazzah Wael, Najjai Yassine, Lahouar Rayen, Mzoughi Mahdy, Mansi Zied, Braiek Salem
University of Sousse, Faculty of Medicine, Department of Urology, Ibn El Jazzar Hospital, Kairouan, Tunisia.
University of Sousse, Faculty of Medicine, Department of Urology, Ibn El Jazzar Hospital, Kairouan, Tunisia.
Int J Surg Case Rep. 2024 May;118:109623. doi: 10.1016/j.ijscr.2024.109623. Epub 2024 Apr 6.
Penile fractures, though rare, demand urgent surgical attention due to their potentially severe consequences. This case report illustrates the significance of prompt and comprehensive imaging with surgical exploration in managing a delayed presentation of a double penile fracture.
A 27-year-old male sustained a penile injury during sleep, presenting to our department 36 h post-trauma. His clinical symptoms included significant penile swelling, deviation, and the characteristic 'eggplant' deformity. Ultrasonography revealed extensive subcutaneous edema and a substantial hematoma at the penile base, with a disruption in the tunica albuginea. Surgical exploration identified two distinct fractures in the corpora cavernosa, which were successfully repaired. The patient experienced a rapid and complication-free recovery, regaining full erectile function within four days.
This case underlines the anatomical complexity of penile fractures. Despite the delay in seeking medical attention, the outcome was favorable, challenging the notion that immediate surgery is crucial for avoiding long-term complications. The literature suggests that delayed surgery might not significantly impact long-term outcomes, especially in the absence of urethral involvement, a perspective supported by our case findings.
Penile fracture requires a nuanced approach to diagnosis and treatment. The case demonstrates that while immediate surgical intervention is ideal, delayed repair can also result in positive outcomes under certain conditions. This report contributes to the growing body of evidence suggesting the potential for re-evaluating current clinical guidelines for penile fracture management.
阴茎骨折虽罕见，但因其可能产生的严重后果，需要紧急手术治疗。本病例报告说明了在处理延迟就诊的双侧阴茎骨折时，及时且全面的影像学检查及手术探查的重要性。
一名27岁男性在睡眠中阴茎受伤，外伤后36小时就诊于我院。其临床症状包括阴茎明显肿胀、弯曲以及典型的“茄子”样畸形。超声检查显示阴茎根部广泛皮下水肿及大量血肿，白膜破裂。手术探查发现海绵体有两处不同骨折，均成功修复。患者恢复迅速且无并发症，4天内恢复完全勃起功能。
本病例突显了阴茎骨折的解剖复杂性。尽管就医延迟，但结果良好，这对立即手术对于避免长期并发症至关重要这一观点提出了挑战。文献表明，延迟手术可能不会显著影响长期结果，特别是在无尿道损伤的情况下，我们的病例结果支持这一观点。
阴茎骨折需要细致入微的诊断和治疗方法。该病例表明，虽然立即手术干预是理想的，但在某些情况下延迟修复也可取得良好效果。本报告为越来越多的证据做出了贡献，表明有可能重新评估目前阴茎骨折治疗的临床指南。
