A middle aged man presents to the ED after almost 2days of penile pain and swelling. The sx started suddenly, during intercourse and he didn’t present until now 2/2¬†embarrassment. ¬†But now the pain has not abated, the condition has not improved and he hasn’t been able to urinate. He recalls missing the introitus and the hitting the perineum; he heard a snap and had sudden loss of erection. Diagnosis? Management?

 

Penile fracture.

Pain control, urology consult (STAT); also call for an MRI if possible.

Ref: http://www.medscape.org/viewarticle/752697_2