What are the causes of corpus cavernosum injury?

The corpus cavernosum of the urethra is for male friends. It is the part of the penis of male friends. If there is any damage, it may be caused by strong bending, collision with hard objects or violent sexual intercourse. For elderly friends, the elasticity of the corpus cavernosum will be worse, and the probability of damage will be relatively higher. Therefore, you must pay attention to it in daily life and try not to collide with it when the penis is erect.

1. Causes of urethral corpus cavernosum injury

Corpus cavernosum rupture often occurs when the penis is erect due to blunt external force. Common causes are forceful bending, rough sexual intercourse, or collision with hard objects. The typical injury mechanism is that during sexual intercourse or masturbation, the erect penis is suddenly bent by external force. Most of the time, during sexual intercourse, the penis slips out of the vagina and suddenly hits the woman's thigh, perineum, or pubic symphysis.

Phimosis is an important potential factor for penile fracture, because it not only limits the sliding of the penis and increases its surface tension, but also changes the direction of the force, which can easily lead to damage to the erect penis. The elasticity of the tunica albuginea of ​​the corpus cavernosum decreases and its brittleness increases in the elderly, and sexual intercourse errors can easily cause damage.

2. Clinical manifestations of corpus cavernosum injury

Generally speaking, any part of the penis may fracture, but the most common fracture is in the proximal 1/3 of the penis. The incidence rate is similar on the left and right sides, with transverse fractures being more common and ruptures on both sides at the same time being rare. The corpus cavernosum of the urethra is less congested during penis erection and has a lower hardness than the corpus cavernosum of the penis, so the probability of rupture is low.

The vast majority of patients have a typical history of injury during penile erection, and the patient or his sexual partner can usually hear a "crackling" sound. After the injury, the penis will experience severe local pain, and the penis will quickly become soft, followed by swelling and bruising. The penis will bend and deform, and may swell to the opposite side, in an "S" shape, or droop downward. If the penile fascia is intact, the hematoma is limited to the penis. If the penile fascia is ruptured, the penile hematoma will spread to the scrotum and perineum. Penile "fracture" will cause difficulty in urination due to the hematoma pressing on the urethra, but it generally does not damage the urethra. If accompanied by urethral injury, hematuria or bleeding from the urethral opening will occur. Local palpation can feel a firm, swollen, isolated mass at the penile fracture site, over which the penile skin can slide back and forth.

3. Treatment of corpus cavernosum injury

1.Surgery

In recent years, early surgical treatment is advocated. Surgery can be performed under local anesthesia, spinal anesthesia or epidural anesthesia.

(1) Surgical treatment without urethral injury: A local incision, a circular incision, or a penoscrotal incision is performed. After finding the ruptured site, the hematoma is completely removed and the ruptured tunica albuginea is sutured with absorbable sutures. For recurrent cases, the tunica albuginea needs to be sutured with non-absorbable sutures. A pressure bandage is routinely applied after the operation.

(2) Surgical treatment of combined urethral injury: choose penile circular incision, remove blood swelling, explore the corpus cavernosum of the penis and urethra, find the broken and damaged parts, and repair the ruptured tunica albuginea and urethra. Place a urinary catheter. Apply pressure bandage to the penis for 2-3 days. Preventive use of antibiotics, estrogen, sedatives, etc. after surgery.

2. Conservative treatment

Conservative treatment is suitable for patients with small tunica albuginea fissures and no penis curvature. The main measures include local cold compress, pressure bandage, hemostasis, anti-inflammatory, thrombolysis, anti-androgen erection prevention, etc., and antibiotics can be used preventively. However, after conservative treatment, hematoma organization is easy to form induration, which may affect future erectile function.