External Genitourinary Trauma
PENILEFRACTURE
Results from traumatic rupture of corpus cavernosum. Most commonly
caused by blunt trauma to erect penis, usually during sexual intercourse with
penis striking perineum, pubic symphysis, desk, etc. May also result from ma-
nipulation to achieve detumescence.
SYMPTOMS/EXAM
Patients report cracking sound, pain, detumescence, and hematoma.
TREATMENT
■ Treated surgically with immediate hematoma evacuation and repair of
tunica albuginea.
■ Amputations must be reattached within 8–12 hours.
■ Skin lacerations can be repaired with 4–0 absorbable suture. Skin avul-
sions usually require grafting.
■ 10% will be permanently deformed.
TESTICULARTRAUMA
Trauma to the testicles may result in hematoma, contusion, laceration, frac-
ture, or dislocation.
DIAGNOSIS
Color Doppler ultrasound of testis will help determine severity of injury, by
assessing blood flow and hematoma formation.
TREATMENT
■ Laceration, disruption, and dislocation of testis mandate operative repair.
■ All other injuries can be managed with ice, rest, and pain control.
A stable patient has sustained a stab wound to the neck. What should be
your first consideration in determining extent of injury? Visual inspection
to determine if the platysma has been violated.NECK TRAUMALaryngotracheal Injuries
MECHANISMS
■ Neck hyperextension/hyperflexion or rotation
■ Direct impact (handle bars, clothes lines, seat belts, assault)
SYMPTOMS
■ Hoarseness
■ Shortness of breath
■ Hemoptysis
TRAUMA