DOI: 10.11648/j.ijcu.20261001.28 ISSN: 2640-1355

Late Diagnosis and Treatment of a Penile Fracture with Preservation of Erectile Function: A Case Report

Mah Diaby, Dadie Gnankou, Hamidou Kikalulu, Tibe Borgia, Kanate Goly, Babacar Sine
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A penile fracture is a rare urological emergency that requires immediate surgical repair to preserve erectile function. Most cases occur during sexual intercourse, while others result from different causes. The aim is to report a rare case of penile fracture that occurred during sleep following an erotic dream, and to highlight the diagnostic and therapeutic challenges despite a delay in treatment. We report the case of a 26-year-old male who presented 72 hours after the injury with penile swelling and an eggplant-shaped deformity. The patient reported that the deformity occurred while he was asleep following an erotic dream, with no history of trauma or sexual intercourse. Clinical examination revealed two distinct fractures of the corpora cavernosa and a urethropenile fistula at the level of the frenulum. Surgical exploration confirmed the injuries. Repair consisted of evacuating the hematoma, suturing the tears in the tunica albuginea with absorbable sutures, and closing the fistula using a urethral catheter. The postoperative course was uneventful. The patient was reviewed at 3-month and 24-month follow-up visits, the patient reported normal erections without curvature or pain. No recurrence of the fistula was observed. A penile fracture can occur during sleep without sexual intercourse or external trauma. A 72-hour delay in seeking treatment does not compromise functional outcomes if surgical repair is performed.

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