Rupture des corps caverneux : aspects techniques de la prise en charge

Abstract

Rupture of corpora cavernosa is a rare disease in young adults. In western countries, the most frequent cause is the so-called “faux pas du coït”. In the Middle East, masturbation and penis manipulations aimed at stopping morning erection are the most frequent causes. The fracture which is audible by the patient is accompanied by a rapid detumescence with progressive onset of a haematoma. Diagnosis is based on clinical findings but radiological investigations such as MRI, ultrasonography or cavernography may help localizing the exact fracture site. The treatment of albugineal ruptures is surgery, in an elective manner whenever possible; it consists in the eviction of the subcutaneous haematoma, the suture of the albuginea and treatment of a potentially associated urethral rupture. Conservative treatment is exceptional and limited to patients who reject surgery, since it generates more complications: painful erections, persistent haematoma with a risk of infection, arteriovenous fistula, impotence, and unrecognized urethral rupture. Patients must be clearly informed on all these complications.