A Man Fractured His Penis in a Most Unusual Way

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Sometime last year, a 40-year-old man visited a hospital in the United Kingdom with pain and swelling in his penis. While having sex with his partner, the man's erect penis buckled against his partner's perineum and gradually 'deflated'. Doctors suspected that it was fractured, a not-unheard-of risk of lively sexual intercourse. According to a 2020 review of the scientific literature, up to 88.5% of penile fractures occur during sex.

Doctors were surprised, however, that the man apparently didn't feel a 'popping' sensation that characteristically accompanies a penile fracture. They ordered an MRI to shed some light on the injury. What they saw was apparently new to science.

The tunica albuginea is the white structure.

A penile fracture is a tear of the tunica albuginea, a fibrous layer composed of collagen and elastin that envelopes the penis' erectile tissue. According to the published literature, every reported instance of the tunica albuginea tearing has been in a transverse manner - crosswise. But the MRI revealed that the man had a vertical tear (pictured top).

"Not only does this highlight the rarity of this case, but it also raises the question: Does a vertical penile fracture pattern alter either the presentation or long-term outcomes following operative repair?" the researchers wondered.

The good news is that six months after the man's repair surgery he was able to resume normal sexual activity, "achieving erections of the same quality to those prior to the injury, denying any penile curvature or significant palpable scarring."

The incident was recorded in the journal BMJ Case Reports.

Source: Hughes S, Elbaroni W, O'Donoghue J, et al. Atypical presentation of a vertical penile fracture. BMJ Case Reports CP 2021;14:e243353.

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