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Contusion and dislocation of the penis

 
, medical expert
Last reviewed: 17.10.2021
 
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The easiest closed damage to the penis is the contusion of the penis.

trusted-source[1], [2], [3], [4]

Epidemiology

In peacetime, the most common damage to the penis during sexual intercourse. As a rule, such damage is rare.

trusted-source[5], [6], [7], [8], [9], [10], [11], [12]

Causes of the contusion and dislocation of the penis

The reasons for contusion of the penis are very different: most often it develops during strokes during exercises on sports equipment (on the crossbar during sports games), when falling, kicking during a fight or in a fight, horse hoof, dog bite, etc. Contusion of the penis, the integrity of the outer covers is not disturbed, the rupture of the gallbladder shell of the cavernous bodies does not occur, the cavernous bodies are not damaged, however, damage to the urethra can occur. 

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Symptoms of the contusion and dislocation of the penis

During the contusion of the penis, damage occurs to loose subcutaneous fat, which is abundantly blooded.

That is why the contusion of the penis is usually accompanied by severe  pain in the groin, a vast hemorrhage, often extending to the scrotum and / or subcutaneous fatty tissue. This causes an increase in the penis, its swelling, walking is difficult, extensive hematomas of blue-purple color are formed under the skin, which can spread to the pubic area, the scrotum and the perineum. Hematomas can squeeze the urethra and cause difficulty urinating and even delay urination.

Heavier lesions of the closed (blunt) type are characteristic of the penis in a state of erection, in which the thickness of the alveolar cover of the cavernous body decreases to 0.25-0.5 mm, instead of 2.4 mm in the state of detumescence. In the unreduced state, a blunt impact does not lead to a rupture of the penis, and only subcutaneous hematoma develops.

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Dislocation of the penis

Dislocation of the penis is one of the rare lesions that develops for the same reasons as its fracture. In this case, there is a rupture of ligaments that fix the penis to the pelvic bones. The cavernous bodies of the penis are displaced under the skin of the perineum, thigh, area of the pubic bone and scrotum (the penis is probed as an empty sac).

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Infringement of the penis

Infringement of the penis occurs when it is pulled or placed on it objects of ring-shaped shape (various rings, nuts, ropes, rubber, wire, etc.). Damage is caused by the injured or sexual partners themselves to achieve an erection or a night urinary incontinence warning. Such injuries are observed in the mentally ill, and also they can be the result of the pranks of children, masturbation. When the penis is infringed, there is pain, blood circulation and lymph drainage are disturbed, and as a result, edema of the tissues develops, which subsequently leads to trophic disorders up to  necrosis of the skin  and gangrene of the penis. The compression of the urethra from the outside leads, in turn, to an acute delay in urination.

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Diagnostics of the contusion and dislocation of the penis

Collecting anamnesis, you should collect complete information on the characteristics of the factor leading to damage to the penis, and the circumstances of injury. In addition to the general principles of the treatment of injuries, it must be remembered that with traumas of external genitalia, it is often necessary to pay attention also to the intimate side of the question.

Diagnosis of the contusion of the penis is simple. When establishing the diagnosis, it is mainly necessary to differentiate the damage of the gall bladder and urethra.

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Treatment of the contusion and dislocation of the penis

Treatment of the contusion of the penis includes rest, in the first 3 days of cold, non-steroidal analgesics and further warmth. With the development of extensive hematoma, surgical treatment is shown: removal of blood clots, stopping of bleeding, suturing the belly coat. In case of damage to the urethra, it is necessary to restore adequate patency of the urinary tract. Treatment of the contusion of the penis includes the appointment of cold, rest, means to prevent erection, preventive antibacterial treatment.

Treatment of the dislocation of the penis should be performed only in the operative way and this treatment is performed in exposing the root of the penis, draining the hematoma, performing hemostasis and correcting the penis, then applying seams to the ruptured ligaments, again fixing the cavernous bodies to the bones of the pelvis.

To be treated, infringement of the penis should immediately after the injury. Treatment consists in the earliest possible removal of the compressive objects and the release of the organ. If, after removal of the infringement, urination is not restored, urine is removed by trocar cystostomy. With the development of necrosis of the penis distal to infringement, the necrotic part of it is removed and subsequently plastic surgery is performed. Necrosis of the skin can be an indication for autotransplantation of a split skin flap.

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