# Postcoital Urethral and Penile Trauma in a 28-Year-Old Male: A Case Report and Surgical Management

## TL;DR

A 28-year-old man experienced severe urethral bleeding after sex, requiring surgery to repair rare combined injuries to the penis and urethra.

## Contribution

This case report highlights a rare instance of combined cavernosal and urethral rupture after sexual activity requiring surgical repair.

## Key findings

- Combined rupture of the urethra and corpora cavernosa can occur after sexual intercourse.
- Surgical exploration and layered reconstruction led to good functional and cosmetic outcomes.
- Persistent bleeding and lack of external trauma signs delayed diagnosis but required urgent intervention.

## Abstract

Urethral bleeding following sexual activity is uncommon and typically benign. However, in rare cases, it may indicate significant trauma to the penile structures requiring surgical intervention.
A 28-year-old male was admitted to the Urology Department from the Emergency Department due to profuse urethral bleeding after sexual intercourse. Physical examination revealed blood at the external urethral meatus, but no penile deviation, hematoma, or swelling. This atypical presentation without external signs of trauma delayed definitive diagnosis. Due to persistent bleeding and suspected cavernosal and urethral injury, the patient was qualified for surgical exploration.
Intraoperatively, through a penoscrotal approach, complete denudation of the penis was performed. A tourniquet was placed at the penile base. Saline injection into the corpora cavernosa revealed a tear on the ventral aspect of both the corpus spongiosum and cavernosa. Buck’s fascia was dissected, and the urethral injury was repaired with 5-0 Monocryl absorbable sutures. The cavernosal rupture was closed with 2-0 Serapren. A saline leak test confirmed a watertight repair. Layered closure was performed, a Foley catheter was inserted, and a sterile dressing was applied.
Although rare, combined rupture of the urethra and corpora cavernosa following sexual intercourse can occur and requires prompt diagnosis and surgical repair. Penile exploration with layered reconstruction ensures good functional and cosmetic outcomes.