Possible penis fracture

[skhk]

A few days ago while sleeping a rolled over on my erection and heard a pop/crack.  I thought I had fractured my penis.  I did have an immediate loss of erection but no hematoma developed until later in the day.  There was no pain when I heard the pop/crack.  My penis was not sore or tender to the touch as I tried to feel for the break or clot at the possible fracture site, there was no swelling, there was no blood in my urine and my penis seemed to be straight with no curvature or kink.  Later that evening there was an expanding hematoma developing.  But still no pain, no swelling, no uncomfort, and no deformity, and I was also able to get a pretty strong erection.  The hematoma was pretty much just contained to the shaft of my penis dorsally.  The next day the hematome expanded ever so slightly to the superior portion of the left side of my scrotum.  I was away from home when this happened and called my urologist the next day.  He saw me on day three and examined me.  Mind you I live in a large metropolitain city with some of the very best Urologists who have seen penile fractures before. I read a bunch of liturature and was extremely concerned with the complication rates.  The surgeon examined me and upon physical examination found no blood in my urine as I suspected and by feel found that my tunica was intact.  The only thing evident to him was the hematoma and maybe some very very mild swelling.  He suggested I not use my penis for at least 2 weeks.  I asked him if there was anyway to be certain there was not a fracture.  He told me the only was was to do a penile exploration by degloving my penis. He assured me that from his physical exam there were more risks associated with the exploation then with the "fractured penis" I supposedly presented with.  (To be honest the most pain I felt was him poking around hard deep at the base of my penis)  I was not very comfortable with the answer.  I asked if an MRI would rule out a tear.  He said he thought it was not nessecary but would order one if I wanted.  I asked to see a senior partner one of the most well respecteed Urologists in town practicing over 22 years.  The senior partner agreed with his partner on all accounts except upon exam he said he said it may have not been a fracture?  My question is what else could have caused the hematome and the pop or slight crack I think I heard?

[Dr Smitha Mathews]

Hi,

Traumatic injury to the penis in a state of erection can cause the development of hematoma or arteriovenous fistula.

It is obvious that there was some amount of trauma to the penis and that it may have disrupted the continuity of the corpora of the penis even though it has not caused any tear or injury to the urethra, hence no blood in the urine.

In cases where there is formation of a fistula following injury, intervention should be undertaken within 6 hours for best results. Diagnosis is aided by a penile doppler ultrasound. Degloving is not required to estimate the extent of the injury as an ultrasound can pick up the size, extent, and type of injury and can be followed up with other radiological investigations, if required.

Do keep us posted on any further doubts in this regard.