Bello Journal of Medical Case Reports 2012, 6:321 http://www.jmedicalcasereports.com/content/6/1/321 Page 2 of 4 Figure 1 Penile fracture. Clinical photograph showing a swollen penis with ‘egg plant’ deformity and deviation to the right side. without urethral distension. A 16Fr Foley catheter was then placed at the urethral meatus with its balloon inflated with 2mL of water at the fossa navicularis. Retro- grade urethral distension using normal saline was achieved via the catheter and sonographic images were obtained as above. The penile ultrasound showed a tear of the TA covering the ventrolateral aspect of left CC with associated hematoma in the proximal third of the penile shaft, and the real-time sonourethrography add- itionally revealed an intact urethra (Figures 2 and 3A,B). He also had retrograde urethrography performed, which also showed an intact urethra (Additional file 1). Three hours after presenting to the hospital he had penile sur- gery via a subcoronal circumferential degloving incision. A Foley urethral catheter was placed pre-operatively to identify and avoid injury to the urethra. A 1.5cm tear of the TA in the ventrolateral aspect of the proximal third of the left CC just adjacent to the urethra was seen (Additional file 2). The hematoma was evacuated and the tear repaired with 2/0 silk with burying of the knots. An artificial erection created with intra-cavernosal injection of normal saline revealed an intact repair with no lea- kages. The wound was closed with 3/0 vicryl (Additional file 3). He was discharged 24 hours after surgery and advised to abstain from sexual activity for six weeks. At one-week follow-up, he reported return of good noctur- nal erections and normal voiding. Discussion Blunt trauma to the erect penis may generate pressures in excess of 1500mmHg within the CC, resulting in rup- ture of the TA [1]. The TA thins out to 0.25mm during Figure 2 Penile ultrasound of the proximal third of the penile shaft. The penile ultrasound was performed an hour after presentation and shows a normal right corpus cavernosum, a ruptured left corpus cavernosum and associated hematoma. The corpus spongiosum appears normal.