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Fast Five Quiz: Sexual

Intercourse Injuries
Richard H. Sinert, DO
DISCLOSURES | June 10, 2022

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ANSWER 1/5

Which is most accurate

regarding the presentation of
penile fracture?
YOUR PEERS CHOSE:

The detumescence associated with

penile fracture is often delayed by
as long as 20 minutes
26%

Successful voiding excludes

urethral injury in patients with penile
fractures
21%

If the Buck fascia is intact in a

patient with penile fracture,
ecchymosis is confined to the shaft
30%

Ecchymosis of the penis indicates

penile fracture and excludes rupture
of the deep dorsal vein of the penis
23%

The clinical presentation of a penile fracture is

often fairly straightforward. Diagnosis is based
on history and physical examination findings.
The fractured penis is often quite tender to the
touch. Because of the severity of pain, a
comprehensive penile examination may not be
possible.

If the Buck fascia is intact, penile ecchymosis is

confined to the penile shaft. If the Buck fascia
has been violated, the swelling and ecchymosis
are contained within the Colles fascia. In this
instance, a "butterfly-pattern" ecchymosis may
be observed over the perineum, scrotum, and
lower abdominal wall.

Patients often describe a popping, cracking, or

snapping sound with immediate detumescence.
Less severe penile injuries can be distinguished
from penile fracture because they are not
usually associated with detumescence.
Successful voiding does not exclude urethral
injury; therefore, retrograde urethrography is
required whenever urethral injury is suspected.

Patients with a rupture of the deep dorsal vein

of the penis can present with findings similar to
those of a penile fracture. Associated swelling
and ecchymosis of the penis ("eggplant" sign) is
present. Injury commonly occurs during sexual
intercourse. However, the patient does not
typically hear a crack or popping sound. In
addition, detumescence does not immediately
occur. However, because of similar physical
examination findings, a deep dorsal vein rupture
should be surgical explored because it is often
difficult to differentiate from penile fracture.

Learn more about the presentation of penile

fracture.

QUESTION 2/5

Anal sexual intercourse can

result in anal fissures. Which is
the most common location for
anal fissures to develop?

Right lateral

Left lateral

Anterior midline

Posterior midline

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Any views expressed above are the author's own and do not
necessarily reflect the views of WebMD or Medscape.

Cite this: Richard H. Sinert. Fast Five Quiz: Sexual Intercourse

Injuries - Medscape - Jun 10, 2022.

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