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Integrity is the lifeblood of democracy. Deceit is a poison in its veins. See the link below for more info. I read your blog. I thought it was great. Hope you have a great day. God bless. Rica www. Tuesday, January 4, Rupture of superficial Dorsal vein of penis.

Introduction Deep dorsal vein of penis fracture is the most common cause of acute penis. Rarely, rupture of the superficial or deep dorsal veins of the penis can mimic penis fracture. In such cases the diagnosis is by exclusion of penis fracture, usually by surgical exploration. I present a case where Deep dorsal vein of penis was doubt regarding the diagnosis of penis fracture and radiological investigations confirmed this suspicion.

Case report A year-old man was referred complaining of swelling of the penis for 1 day. The patient had had intercourse, some 36 h previously, in the normal position. He had no pain during or after intercourse.

There was normal ejaculation. The only point he stressed was that his movements were faster and more vigorous than normal. He was not under the influence of alcohol; neither had he taken any drugs, including any erection-enhancing drugs. When he got up in the morning he noticed swelling over the penis. There was no pain. He had no difficulty with micturition. The patient consulted a local surgeon who referred him to our center.

On examination there was swelling and ecchymosis of the entire penis, which was extending over the pubic symphysis and into the scrotum.

There was no tenderness or defect that could be palpated over the corpora cavernosa. Email: drgrsharma hotmail. Hence the patient was evaluated further. The basic biochemical parameters were normal. Urine routine was normal. The coagulation profile was normal. Cavernosography was done which showed intact corpora cavernosa with no extravasation of the contrast Fig. Magnetic resonance imaging MRI of the penis also showed no defect in the tunica albuginea Fig.

A diagnosis of rupture of the superficial dorsal vein of the penis was made. The patient was kept under observation. The swelling decreased over the next couple of days. Now with a follow up of 2 months the patient has a normal penis with no swelling and normal erections. There is no chordee on erection.

Abstinence was advised for 6 weeks after which he has had normal intercourse. Discussion Injuries to the penis are uncommon because of the well- protected location and a high degree of genital mobility. Penile fracture is the most common presentation of acute penis. The events and findings following this injury are characteristic and include a cracking or popping sound accompanied by immediate pain, rapid detumescence, swelling and ecchymosis and deviation of the penis to the side opposite the injury.

A corporal defect may be palpable but this can be obscured by the swelling and hematoma. The mechanism of injury to the deep dorsal vein is presumed to be basically the same as for the rupture of the cavernosum. It is strongly recommended by some to localize the site of Deep dorsal vein of penis and to plan the treatment.

In Fig. Subcutaneous hyperintense soft tissue swelling over the penis with intact tunica albuginea. Despite this finding, these patients were surgically explored on the assumption that Deep dorsal vein of penis radiological examination was misinterpreted. Deep dorsal vein rupture was not considered before surgery. Magnetic resonance imaging has also been used as a modality to image the injured corpora cavernosa. It has been recommended in patients with an atypical presentation to confirm the diagnosis.

He even had erection after the Deep dorsal vein of penis of penile swelling. These made us suspect that it was Deep dorsal vein of penis not penile fracture. Cavernosography was done and was normal. Keeping in mind the possibility of a false negative result, MRI was done.

As it was also normal, with no rupture of tunica albuginea, and as the ecchymosis was extending into the scrotum and above the pubic symphysis, the diagnosis of rupture of the superficial dorsal vein of the Deep dorsal vein of penis was made. A conservative approach was preferred with good results. Karadeniz et al. Conservative therapy should be chosen when one is sure that the cavernosal bodies are intact.

I feel that a high index of clinical suspicion would help in picking up such atypical cases. Conservative treatment in such cases would be desirable. The erect penis: injury prone organ. Trauma ; —6.

The elasticity and the tensile strength of tunica albuginea of the corpora cavernosa. Review of Cleveland Clinic experience with penile fracture. Penile fracture in Kermanshah, Iran: report of cases. Penile fracture: differential diagnosis, management and outcome. Fracture of the penis. Rupture of the deep dorsal vein of the penis during sexual intercourse.

Penile fracture: operative management and cavernosography. Urology ; —6. Magnetic Resonance imaging of penile fracture: An aid to diagnosis. The value of magnetic resonance imaging in the diagnosis of suspected penile fracture with atypical clinical findings.

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