In fracture of penis involving rupture of tunicaalbuginea with intact Buch's fascia following would be noted clinically
Hematoma involving only the shaft of penis Penile fracture is the disruption of the tunica albuginea with rupture of the corpus cavernosum.Penile fracture is most commonly seen during sexual intercourse (when the rigid penis slips out of the vagina and strikes the perineum or pubic bone), however it is also seen with masturbation, rolling over or falling on the erect penis and few other conditions.Patient describes a cracking or popping sound as the tunica tears, followed by immediate loss of penile rigidity and discoloration and swelling of penile shaft.If Buch's fascia remains intact, the hematoma involves the penile shaft only. This results in typical 'eggplant' deformityIf Buch's fascia is disrupted, hematoma can extend to the scrotum, perineum & suprapubic regions.The swollen, ecchymotic phallus often detes to the side opposite the tunical tear because of hematoma and mass effect.The fracture line in the tunica albuginea may be palpable.Urethral injury may be seen with penile fracture.Management- Pt. with typical history should be immediately explored and surgically repaired.- A distal circumcising incision is used to expose all the three penile compaments.- Tunica defect is closed with interrupted absorbable sutures.- Deep corporal vascular ligation or excessive debridement of the delicate underlying erectile tissue must be avoided.Anatomy of penis: Brief reviewThe penis is composed of 3 cylindrical bodies of erectile cavernous tissue: the paired corpora cavernosa dorsally and single corpus spongiosum ventrally.Each cavernous body has an outer fibrous covering, the tunica albuginea.Superficial to the tunical albuginea the deep fascia of the penis, the Buch's fascia. The Buch's fascia forms a strong membranous covering for the corpora cavernosa & spongiosum, binding them together.The corpus spongiosum contains the urethra.
Hematoma involving only the shaft of penis
Hematoma involving scrotum & perineal region
Penis, scrotum and abdominal wall
Penis scrotum & thighs.