A loud snap and excruciating pain always follows, as well as the rapid development of a hematoma or bruise. Roughly 20 percent of the men will have an associated urethral injury as well. These injuries are not difficult to diagnose, and symptoms will depend upon the severity of the fracture. The urologist or radiologist places a fine needle into the corporal body of the penis and injects contrast material in order to examine the shape of the corporal bodies and to look for leakage. If there is a question of urethral injury, a retrograde urethrogram is also performed in which contrast material is instilled down the urethra via a small tube or catheter to look for leakage.
Urethral injury is usually evident with blood in the urine at the time of the workup.
Surgery is the best treatment for fractures. The faster the torn tissues can be reapproximated, the better the healing process. The problem with conservative management is that fibrosis of the lining of the corporal body can create a bend and poor healing, as with a broken arm. Additionally, complications from expanding blood clots, such as a blood clot accumulation or a hematoma, or an infection of the hematoma can occur. These men with penile fractures are typically young, sexually active, and highly motivated to resume sexual activity as soon as the healing process is complete so surgery is often the best treatment.