2008, Number 3
Rev Mex Urol 2008; 68 (3)
Flores TJE, Ugarte RF, Torres SJJ, Campos SJG
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ABSTRACTBackground: Penile fracture is a rare urological emergency.
Objective: To present both a literature review and a case of phimosis and priapism in a patient with penile fracture.
Materials and Methods (case report): The case of a patient with psoriasic arthritis managed with long-term anti-inflammatory analgesics with sudden onset of penis edema, hematoma and development of severe phimosis and priapism. Patient had not engaged in sexual activity or experienced pain immediately prior to lesion. A dorsal incision on the penis was performed and priapism was managed with intracavernous vasoconstrictor. Circumcision was carried out 10 days later and penile fracture was identified and repaired with 2-zero Vicryl.
Results: Patient evolution is good. There is normal sexual activity with no pain or penile curvature during erection.
Discussion: Penile fracture associated with priapism and severe phimosis in a patient not having engaged in sexual activity and not experiencing pain can make diagnosis difficult.
Conclusions: Penile fracture, priapism and phimosis are urological complications rarely found together in a single patient. Early fracture repair is ideal. Non-surgical conservative management is a viable alternative for some patients. Research studies should be carried out to determine if there is an association between psoriasic arthritis and riapism and fracture of the tunica albuginea.