Penile fracture repair: assessment of early results and complications using color Doppler ultrasound

The aim of this study was to determine early results and complications of p enile fracture treated with immediate surgical repair by means of color Dop pler ultrasound study. Four patients with the clinical features of penile f racture were submitted to immediate surgical exploration via a subcoronal i ncision with repair of the torn cavernosal albuginea (unilateral in three c ases, bilateral in one case) and anastomosis of the transected urethra tone case), Color Doppler ultrasound (CDUS) was performed by means of an Acuson 128XP/10 using a 7 - 10 MHz extended frequency linear array transducer. Er ectile function at five months follow-up was reported as normal by two pati ents (age 59 and 55 y), slightly decreased in one case (bilateral partial c avernous fracture + total urethral transection in a 32 y old) and weak in o ne case (51 y old). In the latter two, the investigation included a dynamic phase following a 10 meg PGE injection, B-mode ultrasound showed no fibrotic changes in relation to the long-term a bsorbable suture material. Baseline CDUS demonstrated full length integrity of the cavernous arteries in all patients, The CDUS dynamic study was enti rely normal in the patient with weak erection while showed a continuos veno us leak in the patient with bilateral cavernosal rupture and transected ure thra. We conclude that despite the onset of erectile failure in two out of four p atients, there was no evidence of arteriogenic impotence in any patients wi th major penile fracture and thus we advocate early simple repair without a ny microsurgical exploration of the cavernosal arteries.