Most patients with penile fracture would report hearing a "snap" sound, which is followed by pain, penile detumescence
, and late appearing swelling, hematoma and penile deformity.[sup.3,4] When there is associated urethral injury, we sometimes notice concurrent urethral bleeding, difficulty voiding and hematuria.[sup.5] However, patients with rupture of the superficial dorsal vein of the penis may not describe the classic "snap-pop" or rapid detumescence
.[sup.4] Patients with superficial penile dorsal vein rupture can experience bleeding from the ruptured vein and can present with a dorsally-swollen and mildly painful penis, which usually occurs within 24 hours following sexual intercourse.
In the Middle East, a common cause of penile fracture is self-inflicted injury.[sup.4] This practice of taghaandan occurs when the erect penis is bent or struck to achieve rapid detumescence
.[sup.4] The increased risk of penile rupture during tumescence is partially due to the fact that the tunica albuginea stretches and thins when the penis is erect.
All patients presented with the typical clinical picture of a characteristic sound at the time of injury, pain, detumescence
and moderate to severe hematoma.
Taqaandan may be performed to achieve detumescence
In North America, it is most commonly associated with sexual intercourse and occurs when the rigid penis slips from the vagina striking the partner's perineum or pubic bone.[sup.1] In Middle East countries, a common cause of penile fracture is self-inflicted injury.[sup.2] This is a practice termed taghaandan and occurs when the erect penis is bent or struck to achieve rapid detumescence
The patient was admitted for watchful expectancy and conservative treatment, but no detumescence
happened for 2 weeks.
I must say that this detumescence
in sexual activity among over-25s and especially those in long-term, stable relationships is no real surprise.
Despite the removal of approximately 150 cc venous blood within 30 min, no detumescence
was achieved (Figure 1a).
He had aspiration without achieving sustained detumescence
. The patient underwent an emergency irrigation and decompression of priapism by a consultant urologist.
The patient reported a cracking sound and severe penile pain followed by immediate detumescence
after striking his erect penis against his partner's perineum.
Priapism, or persistent erection without sexual arousal, occurs when detumescence
of the engorged corpus cavernosum penis (CCP) fails because of disturbances of arterial inflow or venous outflow.
Stuttering priapism entails repeated, distinct episodes of persistent penile erection despite interval periods of detumescence
. While individual episodes are acutely treated, overall management of the patient with recurrent priapism focuses on prevention of future incidents.