Penile fracture and concomitant severe urethral trauma—a case report and discussion of surgical approach

BACKGROUND: Penile fracture is a rare urological emergency, especially when it involves a urethral injury. CASE DESCRIPTION: Here, we report the case of a 41-year-old male patient with penile trauma during sexual intercourse, presenting with typical clinical signs of corpus cavernosum rupture and gross hematuria. Emergency surgical exploration revealed an additional partial urethral injury (approximately 1.5 cm in length), which was primarily closed. Surgical management included a vertical penoscrotal incision, evacuation of hematoma, double-layer re-approximation of the urethra, closure of the tunica albuginea, and placement of both transurethral and suprapubic catheters. The postoperative course was uneventful, with diazepam administered to suppress erections and full functional recovery at 6-month follow-up. CONCLUSION: This case highlights the importance of prompt diagnosis, a tailored surgical approach, and urinary diversion in the setting of urethral trauma.