Accuracy of Ultrasound and Magnetic Resonance Imaging (MRI) in Penile Fracture Mapping for Modified Surgical Repair

Abstract

Background: Penile fracture is a relatively rare urologic emergency. It is defined as traumatic rupture in tunica albuginea of corpus cavernosum. Traditionally, surgeon explores the penis in full-length by complete degloving of its skin and repairs any defect in the tunica. Imaging modalities such as ultrasound and MRI may be of help to reveal the exact site of tunica defect preoperatively for tailoring the surgical repair by making a direct incision over the defect. Tunica albuginea is a hyperechoic layer in ultrasound covering corpora cavernosa, and its tear appears as a hypoechoic defect in this band. In MRI, tunica is seen as a low-signal intensity layer in all conventional pulse sequences around the corpora cavernosa, and its tear is evident as a discontinuity in this layer. In addition, imaging modalities may demonstrate associated injuries such as hematoma, urethral rupture, and corpus spongiosum injury.