Features:
(1) manner of injury to the erect penis
(2) description of the event
(3) gross appearance of the penis
Manner of injury:
(1) direct blow
(2) bending
(3) rolling over in bed
(4) sexual intercourse or masturbation
Description of the event:
(1) cracking, snapping or popping sound
(2) immediate pain
(3) rapid detumescence
Clinical evaluation:
(1) penile swelling from hematoma, with or without ecchymosis
(2) palpable defect in shaft
(3) focal tenderness
(4) deviation of shaft to side away from the injury (i.e., a deviation to the right indicates a left-sided injury)
(5) gross or microscopic hematuria may be present
Management issues:
(1) Urethral injury may be present in 15-22% of patients.
(2) Conservative therapy may be followed by fibrosis, pain and normal penile angulation.
(3) Prompt surgical exploration with evacuation of the hematoma, repair of the tear in the tunica, and evaluation of the urethra.
