Magnetic resonance diagnosis of traumatic penile fracture

PURPOSE: To report our experience with MRI in the preoperative evaluation of patients with traumatic penile fractures. MATERIALS AND METHODS: Between January 1998 and December 2001, we performed MRI examinations on five patients (aged 29-48 years; mean age 40 years) with suspected traumatic fracture of the penis occurred during sexual intercourse. In all cases, T1-weighted SE, T2-weighted FSE and GRE sequences in the axial, coronal and sagittal planes were acquired. The study was performed without IV administration of paramagnetic contrast agents and in conditions of detumescence. A small-sized surface coil was used in four cases and a body coil was used in one case. All patients had suspected penile fracture with indications for surgical repair. The MR examination was performed within 12 to 48 hours of the trauma and was requested to aid surgical planning. RESULTS: The MR image quality was adequate in all cases. The examination documented unilateral rupture of the corpus cavernosum in all patients. This finding was associated with haematoma located both subcutaneously and inside the corpus cavernosum itself. In no case was there rupture of both corpora cavernosa. In only one patient was there a suspicion of injuries to the urethral corpus spongiosum, which was confirmed by surgery along with the other MR findings. DISCUSSION AND CONCLUSIONS: Many imaging methods are available to evaluate traumatic penile lesions: ultrasound, colour-Doppler ultrasound, urethrography, cavernosography, angiography and MRI. In agreement with the literature, our experience shows that MRI is useful in evaluating penile injuries owing to its multiplanar capabilities, its good spatial resolution and its excellent tissue contrast resolution. These characteristics enabled a more adequate surgical approach. In our view, MRI can be regarded as an emerging method to obtain helpful diagnostic information, with no risks for the patient.