RADIOLOGICAL EVALUATION OF CORPORA CAVERNOSA AFTER PRIMARY REPAIR OF PENILE FRACTURE

Objectives: Evaluation of the effects of penile fracture on corporal anatomy after primary repair using cavernosography 
and post-cavernosography CT-scanning to demonstrate healing of tunical tear and its effects on penile shape and penile 
venous system. 
Patients: Twenty-one men who underwent primary repair of penile fracture were included in this study. Patients selected had a normal penile anatomy before injury. 
Methods: Patients were clinically evaluated for erectile function before and after injury. Primary repair was done within 24 hours of injury through a circumferential sub-glandular incision and penile skin de-gloving. Primary repair of the tear was done using continuous 5/0 suture. After a mean period of nine months of follow up, cavernosography was done for eight patients followed by post-cavernosography CT scan of the penis. Post-cavernosography reconstructed CT imaging formates were obtained to demonstrate the corpora in coronal and sagittal views. 
Results: Two cases only had associated incomplete corpora cavernosal injury. Post-operative period was uneventful in all 
patients. Twenty patients regained normal erection after primary repair (95%). One patient only (5%) had erectile 
dysfunction in the form of failure to sustain erection. Twenty patients had no penile deformity during erection (95%). Penile curvature developed in one patient but has been insignificant. Cavernosography demonstrated tunica as black line at site of healing. Only one patient (4.8%) has venous leakage away from the healed tunical tear. 
Post-cavernosography CT imaging demonstrated slight irregular indentation at the site of healing in all patients. Postcavernosography reconstructed CT images in both sagittal and coronal views demonstrated distortion of the tunica 
albuginea at the healed tear as an irregular area and bulging to outside in the coronal views. 
Conclusion: Primary repair of the penile fracture is effective in restoration of penile anatomy and erection in almost all 
patients. Cavernosography and CT scan of penis demonstrated the healed tear. Post-cavernosography CT and reconstructed CT views are the best means to demonstrate the healed tear in the tunica albuginea.