Contemporary management of penile fracture

Penile fracture (PF) is an uncommon injury defined as the rupture of the tunica albuginea and corpus cavernosum of the penis, usually resulting from direct blunt trauma to the erect penis during sexual intercourse or masturbation. PF is one of the few urologic emergencies. This article reviews the status, contemporary management, and the controversies of the diagnostic approaches and therapeutic modalities of penile fractures. It is usually diagnosed only clinically with the history of the patient, inspection, and physical examination. However, additional imaging procedures such as cavernosography, ultrasonography, magnetic resonance imaging, and retrograde ureterography may also be indicated whenever the diagnosis or the extent of the severity and location of the rupture is not clear, and/or when an accompanying urethral injury is suspected. Although the diagnosis of PF is usually easily recognized, optimal therapy remains controversial. The most widely accepted approach for the treatment of PF is early surgical treatment, but some investigators still advocate nonoperative conservative management.