Abstract

Introduction

Penile fracture is a urological emergency. The most common aetiology is due to coital activities and that is the reason it is usually under reported.⁽¹⁾ It  is the traumatic rupture of the tunica albuginea in the tumescent state. The usual presentation is acute pain in the penis after sudden popping sound, swelling, and detumescence. On examination, the patient will have penile swelling and discolouration (secondary to the haematoma), termed as “aubergine sign”, or ‘egg plant deformity (figure 1)^(2,3). Additionally, gross evidence of urethral injury may also be present, such as blood at the meatus, haematuria, or difficulty voiding⁽³⁾. Diagnosis is usually clinical but imaging has a role in atypical or delayed presentation of fracture penis.  Historically, cavernosography and urethrography have been tried. However, these investigations have their problems. Others used ultrasonography but it was unhelpful^[4]. MRI was used recently to evaluate penile fracture, and was found to be effective^[5]. MRI is the most accurate modality in the diagnosis or exclusion of penile fracture. Associated urethral injuries may be found in around a quarter of patients, and can be diagnosed on MRI. In the present study we report our experience in managing penile fracture, using MRI as a noninvasive documentary tool, in addition to its efficacy in depicting the anatomical details of the condition, which not only facilitates surgical intervention but also minimizes its morbidity.