Case Report Color Doppler Sonographic Findings in Penile Fracture Selim Kervancioglu, MD, Ayhan Ozkur, MD, M. Metin Bayram, MD Department of Radiology, Faculty of Medicine, Gaziantep University, Sarigulluk Mah. 15. Sok., No: 42/5 Fulya Apt., 27090, Sehitkamil, Gaziantep, Turkey Received 1 December 2003; accepted 11 August 2004 ABSTRACT: We performed color Doppler sonographic examination on 4 patients, 3 of whom had preliminary diagnoses of penile fracture and 1 of whom had under- gone an operation due to penile fracture a year previously. Color Doppler sonography helped evaluate the relationships between the hematoma and the vascular structures and aided in differential diagnosis of the vascular injuries that may accompany tunical rupture (or have similar clinical presentations) and Mondor’s disease; thus, this method has a crucial role in choosing the treatment approach. Color Doppler sonography may also assist in the follow-up of patients after surgical or conservative treatment. ª 2004 Wiley Periodicals, Inc. J Clin Ultrasound 33: 38–42, 2005; Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/jcu.20078 Keywords: penile fracture; ultrasonography; color Doppler ultrasonography; differential diagnosis P enile fracture is the rupture of tunica albu- ginea, typically resulting from blunt trauma, intercourse, or penile manipulation. It occurs only rarely. It can be easily diagnosed on the basis of its typical symptoms, which include a cracking noise, swelling, discoloration, and deformity, but hema- toma and swelling might hinder the identification of the rupture site. 1 Urethral ruptures and penile vascular injuries may accompany or mimic penile fractures. Many authors have advocated the use of cavernosography and urethrography in the diagno- sis of penile fractures. 2 Compared with cavernosog- raphy and urethrography, sonography is a non- invasive diagnostic technique. Color Doppler sono- graphy (CDUS) is also potentially useful in the diagnosis of penile fracture, but few reports of its use have been published. In this article, we aim to demonstrate the contributions of gray-scale sonography and CDUS to the diagnosis of penile fracture. CASE REPORTS We performed gray-scale sonography, CDUS, and power Doppler sonography in 4 cases; 3 of the patients had preliminary diagnoses of penile frac- ture, and the last 1 had undergone an operation due to penile fracture a year earlier. The exam- ination was performed with a Sonoline Elegra Advanced scanner (Siemens-Acuson, Mountain View, CA) equipped with a 7.5-MHz linear-array probe. Sonography was performed from the ven- tral or lateral side of the penile shaft while the penis was lying on the abdominal wall with the patient in the supine position. Corpora cavernosa, corpora spongiosa, and penile vascular structures were evaluated in all of the cases. Case 1 A 24-year-old patient was admitted complaining of pain and swelling following penile manipula- tion. Findings at presentation included penile swelling, ecchymosis, penile deviation, and a palp- able gap in the right distal penile shaft. Gray-scale sonography revealed a longitudinal tear of 8 mm in the tunica albuginea in the distal third of the right penile shaft; there was also a hematoma in the neighboring extratunical region. Power Dop- pler sonography did not show any color Doppler signals within the hematoma (Figure 1). The cor- pus spongiosum was intact, and arterial and venous structures were patent, with normal flow. Correspondence to: S. Kervancioglu Ó 2004 Wiley Periodicals, Inc. 38 JOURNAL OF CLINICAL ULTRASOUND