Fracture A still from a 3D medical animation showing tunica albuginea. Penile fractures are the result of rupture of the tunica albuginea. They are fairly rare and can co-occur with partial or complete urethral rupture, though this is rare. Urethral damage occurs in 10–38% of cases. Fractures are treated with emergency surgery, and can be diagnosed with ultrasound, especially in pediatric cases. Penile fractures are caused by trauma to the erect penis, typically by suddenly bending it laterally during penetrative intercourse with the receptive partner on top of the penetrating partner, or during masturbation. Characterized by a loud popping sound at the time of the<unk> , the result of the tunica albuginea rupturing. Other symptoms include severe pain, loss of erection, and swelling. Symptoms of urethral<unk>  include hematuria, blood at the meatus, and dysuria. If left untreated, complications result in 28–53% of cases; these include permanent curvature of the penis, fistula, urethral diverticulum, priapism, and erectile dysfunction. Degloving and avulsion 3D medical animation still showing skin grafting in case of<unk> . Degloving and avulsion<unk> es involve the removal of the penis skin, which is a serious medical emergency. Treatment of these<unk> es involves either closure of the torn skin, or a skin graft to replace the skin lost in the<unk> . Skin grafts are constructed to attempt to preserve erectile function and sensation. Soft-tissue<unk> es Strangulation (A) A case of penile strangulation by a cable tie at the root of the penis. Both veins and arteries were compressed. (B) Penile ulcer at the root of the penis one week after the removal of the encircled object. The strangulation caused the permanent loss of sensation of the penis. Strangulation<unk> es to the penis, also called incarceration<unk> es, caused by hair, rubber bands, or other objects are the second most common soft tissue<unk>  in children. Hair strangulation may be hard to diagnose due to the anatomy of the penis; the hair causing the strangulation may be hidden under the coronal sulcus if it is swollen. In adults, strangulation<unk> es that require medical treatment can be caused by a variety of objects typically used for the purpose of sexual gratification, extending the time of an erection, or enuresis, including metal rings, which must be removed by specialized cutting instruments. The object can also be removed by decompressing the penis. Because the vasculature of the penis is compressed, a variety of complications can result from strangulation<unk> es, depending on whether the veins, arteries, or both are compressed, including mild, reversible vascular obstruction; ischemic necrosis; gangrene and kidney damage; lymphedema; ulceration; urethrocutaneous fistula, loss of sensation; urethral<unk> ; sepsis; and autoamputation. Penile strangulation<unk> es that require medical attention are rare: since their first description in 1755, there have been approximately 60–120 reported cases. Though usually acute, cases of chronic strangulation and acute cases lasting up to one month have been reported. Various objects have been involved in cases of strangulation: * Wedding ring * Steel ring * Bottle * Chastity belt Entrapment The most common soft-tissue<unk>  is an entrapment<unk>  involving the penis caught in a zipper; these<unk> es are particularly common in young children who are uncircumcised and are always superficial. They are treated by removing the zipper with local anesthesia using a bone cutter, lubrication, or hacksaw, dismantling the zipper, or removing the affected tissue, and can be prevented in most situations by circumcision. If not treated promptly, the affected tissue can swell and become infected. In some cases, emergency circumcision is necessary. Other Other soft-tissue<unk> es to the penis can be caused by burns, animal bites, and human bites. Animal bites are common in children, and dogs are the most common animals involved. Though typically not severe, animal bites can cause amputation or infection. Treatment for animal bites and human bites involves antibiotic treatment and closure of the wounds by secondary intention because they are contaminated. Penis burns can be very severe and often require specialized care in a burn unit to prevent contractures, severe scarring, or other complications including lymphedema, hypospadias, or necrosis. This treatment can involve debridement, skin grafts, antibiotics, and the use of a suprapubic catheter. Because of its thin skin, the penis is susceptible to full-thickness, third-degree burns. Burns to the penis typically co-occur with other severe burns. Most thermal penis burns are first or second degree burns caused by flame; some are caused by grease or boiling water. Electrical burns are typically deeper than thermal burns and require more extensive tissue removal. Amputation Amputation of the penis can be either partial or complete. Often self-inflicted by people with psychiatric disorders, it may be occur with other trauma, such as in an assault or a mechanical accident. These<unk> es are treated by re-implantation if possible, with or without anastomosis of the vasculature to restore erectile function; skin necrosis and loss of sensation are common complications after treatment. Microsurgery on the vasculature decreases the risk of necrosis significantly. Klingsor syndrome is a psychiatric disorder that causes self-harm, which can involve the penis. Paranoid schizophrenia, eating disorders, and psychotic breaks can also be associated with<unk> . In some cases, transgender people who are not able to access genital surgery may self-amputate their penis. Favorable prognostic factors for replantation of amputated penises include short ischemic time and a clean incision (as opposed to a crush<unk>  or ragged incision). Replantation of an amputated penis can be done up to 24 hours after the<unk> , though fewer than 16 hours of cold ischemia or 6 hours of warm ischemia leads to the best outcomes. If replantation is not possible or desired, a penile stump can be closed and phalloplasty could be performed later. Penetration Penetrating<unk> es can be caused by accidents during sexual activities (typically, by foreign objects inserted into the urethra), by weapons (i.e. bullets) during wartime, or by stabbing. These<unk> es can have varying severity and be superficial, affect the corpora cavernosa, other soft tissue, and/or urethra. In 50% of cases, the urethra is<unk> d. Some foreign objects may be removed like any other penetrating object in soft tissue; using forceps and gentle traction. However, if the foreign object was inserted into the urethra or has damaged the urethra transversely, urethography is used to avoid further<unk>  to the urinary tract while removing the object. Penetrating<unk> es make up approximately 45% of civilian<unk> es.
Penile injury
Penile fracture
Bulbar urethral necrosis
Penile torsion
Ureterovaginal fistula
Urethral syndrome
Urethrovaginal fistula
Urogenital fistula