Rupture of Dorsal Vein Mimicking Penile Fracture: a Case Series Report and Literature Review

Case Report

Austin J Urol. 2021; 7(1): 1067.

Rupture of Dorsal Vein Mimicking Penile Fracture: a Case Series Report and Literature Review

Ba Z¹*, Ziba OJD²*, Khatraty CSB¹, Kanza R² and Overs C¹

¹Urology Division Centre Hospitalier Métropole Savoie, France

²Urology Division Centre Hospitalier Universitaire Hassan 2, Fez, Maroc

*Corresponding author: Zackaria Ba, Urology Division Centre Hospitalier Métropole Savoie, France

Ouima Justin Dieudonne Ziba, Urology Division Centre Hospitalier Universitaire Hassan 2, Fez, Maroc

Received: May 15, 2021; Accepted: June 07, 2021; Published: June 14, 2021


Penile fracture is a rare and traumatic emergency in andrology. Immediate surgical repair is widely accepted as the therapy of choice in penile fracture. But some situations mimic penile fracture such as superficial dorsal vein rupture. There are few cases reported in the literature.

Aim: To present a case series of injuries of the penile dorsal vein that occurred during sexual intercourse.

Methods: A 48-year-old and 45-year-old patients both received in emergency for suspected penile fracture after one hour of vigorous sexual intercourse, the clinical examination and ultrasound were performed and the penile fracture was suspected. Surgical management in an emergency was indicated.

Results: Per-operative diagnosis was a dorsal vein injury. The surgical management which consisted of early exploration, evacuation of hematoma, and ligation of the bleeding vessel in this case was good with preserving erectile function after surgery, without abnormal curvature erection.

Conclusions: Vascular injuries of the penis can mimic perfectly penile fractures. The medical history and clinical examination can lead to prompted exploration for suspected penile fracture. The ultrasound exploration can be limited for detection of penile vascular injury and final surgical exploration offers final diagnosis and repairment of the trauma. Clinical evolution is favorable, without painful nocturnal erections or deviation of the penis or hypoesthesia of the glans.

Keywords: Dorsal vein; Penis; Fractures; Wounds and Injuries; Hematoma; Coitus; Sexual intercourse


Penile fracture remains an andrology emergency, responsible for anxiety for the patient and urologic care is requested to repair the fracture. It is defined as a rupture of the corpus cavernosum caused by blunt trauma to an erect penis. Injuries to a flaccid penis or in the suspensor ligament of the penis are not included in this definition [1]. According to the literature review, the main predisposing factors are vigorous sexual intercourse or forceful manipulation of the erected penis. Others situations like vascular penile injuries are another cause of penile trauma which may mimic a penile fracture but without the tunic tear. They include rupture of the penile superficial dorsal vein, deep dorsal vein, dorsal artery, and non-specific dartos bleeding [2,3]. Dorsal vein injury is the most frequent entity and is clinically characterized by sudden onset hematoma and swelling of the penis [4].

Case 1

A 48-year-old patient with no specific history of pathology received in urological emergencies for brutal per coital, painless swelling of the penis without trauma. The clinical examination found: a voluminous oedematized penis in an uncircumcised patient with a hematoma beyond the dorsal face at the mid-point of the rod (Figure 1A). There was no associated uretrorrhagia. The ultrasound performed found an 8 cm hematoma with a fracture at the middle third of the length of the right cavernous body. An indication of emergency surgical exploration was given and the patient was warned of the risk of erectile dysfunction, hypoesthesia of the glans, and penile deviation. In the operating room, the patient was under general anesthesia in a supine position. A peripheral circumferential incision at 1cm beyond the corona was performed, then progressive release in contact with the cavernous bodies, respecting the vascularisation as well as the nerve strips laterally. Progressive dissection did not find any fracture. Cavernous bodies were visualized with the presence of a hematoma that fuses all along with them, but without fracture. Two erection tests were performed showing no fluid leakage. A U-stitches with PDS thread 3/0 was performed to close the two puncture points of the bilateral erection test. However, it was noticed that the superficial dorsal vein of the penis seems to be spontaneously disrupted (Figure 1B) and was hemorrhagic during the erection test. It was ligated with vicryl 3/0. Satisfactory control of hemostasis with bipolar clamp was added. Cutaneous mucosal closure was performed by separate points with rapid Monosyn, after having put bilateral blades to allow drainage, and installation of an 18Fr urinary catheter (to improve the urinary comfort of the patient).

Citation: Ba Z, Ziba OJD, Khatraty CSB, Kanza R and Overs C. Rupture of Dorsal Vein Mimicking Penile Fracture: a Case Series Report and Literature Review. Austin J Urol. 2021; 7(1): 1067.