Tri-tubular penile fracture: A case of complete rupture of urethra and bilateral corpus cavernosa.

Introduction: Tri-tubular penile fracture is a very rare subset of penile fractures, typically due to high-energy trauma to the erect penis.

Case Presentation: A 26-year-old healthy man presents with a triad of audible crack, immediate detumescence, and hematoma formation, following blunt trauma sustained during vaginal sexual intercourse. A diagnosis of penile fracture is made, with intraoperative finding of a complete traumatic transection of the urethra with total bilateral corpus cavernosa disruption. Both corpora cavernosa were repaired using 2/0 polydioxanone sutures, with the dartos fascia placed in between. The urethra was repaired with interrupted 5/0 polyglactin braided absorbable suture. At 5 weeks, patient reported normal erections and sexual activity with no physical or psychological issues. The literature on management was reviewed.

Conclusion: Current evidence of surgical management of tri-tubular penile fractures remains predominantly expert opinion, due to difficulties of conducting prospective trials for a rare condition.