URETHROGRAPHY AND CAVERNOSOGRAPHY IMAGING IN A SMALL SERIES OF PENILEFRACTURES - A COMPARISON WITH SURGICAL FINDINGS

Objectives. To compare our results of preoperative corporal cavernosog raphy and retrograde urethrography in penile fractures with the clinic al and intraoperative Findings. Methods. From January to October 1996, 7 cases of penile fracture were diagnosed at our inner city trauma ce nter. All cases were associated with sexual activity and patients unde rwent preoperative retrograde urethrography and corpus cavernosography with immediate surgical intervention, Results. We found that 2 patien ts who presented with blood at the meatus had intact urethras, whereas 2 of the 3 patients who had urethral lacerations did not have a blood y meatus. in 2 cases the urethrogram and cavernosogram revealed lacera tions that were not initially detected surgically. However, in another 2 cases, the urethrogram and cavernosogram were falsely negative. Two of the seven corporal fractures were bilateral and five were unilater al. Conclusions. On the basis of this small sample, it appears that pr eoperative cavernosography and retrograde urethrography may show addit ional sites of tears in the corpora and urethra because hematoma forma tion may mask some ruptures. However, the presence or absence of a blo ody meatus may not necessarily correlate with the status of the urethr a, and the urologist also should be wary of a false-negative imaging s tudy. We suggest that: all cases of penile fracture be explored surgic ally, but preferably by a subcoronal degloving incision that allows ca reful examination of the urethra and corpora. Results of a larger seri es may determine if the routine use of these imaging modalities is jus tified intraoperatively. (C) 1998, Elsevier Science Inc. All rights re served.