When the penis is rigid, buckling trauma can cause a mild or significant tear to the tunical albuginea within the penis. The Normal Anatomy section provides an illustration of this structure within the penis. When there is truly an acute and significant fracture of the penis, the patient often hears a “popping sound” and there can be an immediate loss of the erection associated with swelling of the penis due to blood exiting the tunica albuginea and accumulating under the skin. This is considered a Urologic emergency, and the treatment is surgery to identify and repair the tear. In some cases there can be an associated injury to the urethra.
Acute penile fracture. This patient underwent emergency surgery to repair the tear, and had an excellent outcome.
Some men experience very mild buckling trauma without associated penile swelling and do not seek treatment on an emergency basis, but later ask if any testing should be done to assess for injury or ask if they should be treated in some way to prevent problems with curvature or erectile dysfunction. In these cases, testing is generally not indicated and treatment is not beneficial.
The most important point is that a man who experiences an acute penile fracture should seek immediate medical attention.