Isolated Rupture of Corpus Spongiosum Associated a Partial Rupture of the Urethra during a False Step of the Coitus: A Case Reported at the University Hospital Sanou Souro

Penile fracture is a rare urological emergency. It occurs mainly in young adults during sexual intercourse. In many instances, one of the corpora carvanosus is involved though bilateral injuries with or without corpus spongiosus involvement is not uncommon. However, isolated injury to corpus spongiosus is extremely rare. We report a case of isolated rupture of corpus spongiosum secondary to penile injury during coitus in a 43-year-old man that presented to University Hospital Souro Sanou of Bobo Dioulasso. He presented with history of persistence bleeding per urethra following penile injury during sexual intercourse. The Retrograde urethrography (RUG) showed a partial rupture of urethra, Moore type 3. Complementary penile ultrasound revealed extensive contusion of the urethra with circumferential hematoma and rupture of the distal 1/3 of the corpus spongiosus. He had gentle per urethral catheterization which was left for one month. Penile ultrasound sound done after removal of catheter showed residual injury and narrowing of the urethra.

Application and efficacy of reconstructing forked corpus spongiosum in distal/midshaft hypospadias repair

We reviewed our experience in reconstructing forked corpus spongiosum(FCS)in distal/midshaft hypospadias repair and analyzed the efficacy of this surgical technique.From August 2013 to December 2018,137 consecutive cases of distal/midshaft hypospadias operated by the same surgeon in Urology Department,Children’s Hospital of Fudan University(Shanghai,China),were retrospectively analyzed.Sixty-four patients who underwent routine tubularized incised plate(TIP)or onlay island flap(ONLAY)surgery were included in the nonreconstructing group,and 73 patients who underwent reconstructing FCS during TIP or ONLAY surgery were included as the reconstructing group.Thirty-eight cases underwent TIP,and 26 underwent ONLAY in the nonreconstructing group,with a median follow-up of 44(range:30-70)months.Twenty-seven cases underwent TIP,and 46 underwent ONLAY in the reconstructing group,with a median follow-up of 15(range:6-27)months.In the nonreconstructing/reconstructing groups,the mean age at the time of surgery was 37.55(standard deviation[s.d.]:29.65)/35.23(s.d.:31.27)months,the mean operation duration was 91.95(s.d.:12.17)/93.84(s.d.:14.91)min,the mean neourethral length was 1.88(s.d.:0.53)/1.94(s.d.:0.53)cm,and the mean glans width was 11.83(s.d.:1.32)/11.56(s.d.:1.83)mm.Twelve(18.8%)/5(6.8%)postoperative complications occurred in the nonreconstructing/reconstructing groups.These included fistula(5/2),glans dehiscence(3/0),diverticulum(1/2),residual chordee(3/0),and meatus stenosis(0/1)in each group.There was a significant difference in the overall rate of complications(P=0.035).These results indicate that the technique of reconstructing FCS provides excellent outcomes with fewer complications in distal/midshaft hypospadias repair.

Isolated penile urethral injury:A rare case following male coital trauma

Penile fractures are an uncommon urological emergency.Typically,penile fractures involve the corpus cavernosum and are sometimes associated with urethral injury.Isolated corpus spongiosum and urethral injuries without concomitant corpus cavernosum injury are,however,rare.With proper knowledge of the management of penile fractures and urethral injuries,this distinct entity can be diagnosed,assessed and managed successfully without complications.