Atypical Presentation of Penile Fracture : A Case Report

Abstract

Penile fracture is a rare urological emergency caused by rupture of the tunica albuginea of the corpora cavernosa. Although typically associated with classic symptoms such as a cracking sound, immediate pain, and rapid loss of erection, atypical presentations occur. We present a case of a 21-year-old male with distal penile swelling following masturbation, without classical signs. Ultrasound suggested a partial penile shaft injury. This case emphasizes the need for clinical suspicion even in mild presentations and highlights the role of imaging in diagnosis. Early identification is essential to prevent complications such as erectile dysfunction, curvature, and fibrosis.

Keywords

Introduction

Penile fracture is a rare but important clinical emergency involving a tear in the tunica albuginea surrounding the corpora cavernosa. It usually results from a sudden bending force on an erect penis. Though typically accompanied by a “snap” sound, severe pain, and detumescence, many cases present with subtle or atypical symptoms. Delayed presentation is common due to embarrassment.

Imaging, especially ultrasonography or MRI, supports the diagnosis in uncertain cases. Early recognition and treatment are essential to avoid long-term complications such as erectile dysfunction and penile curvature.

MATERIALS & METHODS

Study Design: Single-patient case report

Diagnostic Tool Used: Penile ultrasonography

Data Sources: Clinical presentation, physical examination, imaging findings

Ethical Considerations: Patient identity not disclosed

CASE PRESENTATION

A 21-year-old male presented with distal penile swelling after vigorous masturbation. He denied hearing a snap sound or experiencing intense pain. Examination revealed localized swelling and mild tenderness, with normal urination and no hematoma.

Ultrasound imaging showed findings suspicious for a partial penile shaft injury, suggesting an early or incomplete penile fracture.

DISCUSSION

Although classical penile fracture presents with a popping sound, severe pain, hematoma, and immediate loss of erection, atypical presentations like this one have been documented (1). Partial or incomplete tears may not show classic signs, making diagnosis more challenging for clinicians.

Ultrasonography played a crucial role in this case, consistent with studies showing its effectiveness in identifying tunica albuginea defects and associated hematomas (4). Early diagnosis is essential because delayed management significantly increases the risk of complications such as penile curvature, erectile dysfunction, fibrosis, and painful erections (2,5,6).

The patient's past history of orchiectomy for an undescended testis does not contribute to penile fracture risk but remains important to document for clinical completeness

RESULT

This case demonstrates that penile fracture should be suspected in young males presenting with penile swelling after trauma, even without classic symptoms. Ultrasonography is a helpful diagnostic tool in subtle cases. Early identification and proper management are crucial to prevent long-term functional complications and psychological distress.

REFERENCES

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