Delhi man fractures penis with ‘snapping sound’ during vigorous sex

A strange case of a fractured penis has been reported from New Delhi, according to the British Medical Journal. The man has not been identified.

Dr. Sahil Gupta, author of the BMJ Case Reports 2016; doi:10.1136/bcr-2016-215385, wrote that “A 32-year-old man presented to our emergency department, with pain, swelling and a dorsal curvature in his penis. He had severe pain and lost tumescence with a snapping sound during vigorous sexual intercourse.

The doctors who attended to the patient were Dr. Anurag Chahal and Dr. Chandan Das of the Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi and Dr. Sahil Gupta of the Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi.

 “On examination, he had a swelling with ecchymosis on the ventral aspect of his penis causing an acute dorsal angulation. There was no blood at the meatus/haematuria. Taking the typical history and examination findings into account, the diagnosis of penile fracture was made. Ultrasound showed a focal tear in the medial wall of the right corpora cavernosa with haematoma tracking ventrally and displacing the corpora spongiosa to the other side.”

The doctor said images of the penis showed “dorsal penile angulation with a ventral swelling and ecchymoses of the shaft. He described it as an ‘eggplant deformity’.

The patient was taken for emergent haematoma evacuation and corporal repair,  Dr  Gupta said.

The journal explained that “Penile fracture occurs when an erect penis undergoes a blunt trauma during sexual intercourse or otherwise, bending the penile shaft and causing a tear/rupture of the tunica albuginea, and tracking of blood from cavernosal sinuses into the subcutaneous plane”

“A urethral injury should always be ruled out by asking about any voiding difficulty, history of blood per meatus or haematuria. The diagnosis is usually clinical and requires prompt surgical intervention.  Sometimes, the presentation may be occult and the patient may present with pain with or without swelling. Point of care ultrasound helps in confirming the diagnosis, aiding the surgeon to locate the site of incision with the least chance of neurovascular injury and skin necrosis. Ruptures of the dorsal penile artery and veins are the most common mimics of penile fracture, and can easily be ruled out by an ultrasound, thus avoiding negative exploration.” – CINEWS

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