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Penile contusion and dislocation.
Last reviewed: 04.07.2025
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The mildest closed injury to the penis is a contusion of the penis.
Causes penile contusion and dislocation
The causes of a contusion of the penis are very different: most often it develops from blows during exercises on sports equipment (on the crossbar during sports games), from a fall, a kick during wrestling or in a fight, a kick from a horse's hoof, a dog bite, etc. When the penis is contused, the integrity of the outer coverings is not damaged, there is no rupture of the protein membrane of the cavernous bodies, the cavernous bodies are not damaged, but damage to the urethra is possible.
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Symptoms penile contusion and dislocation
When the penis is bruised, damage occurs to the loose subcutaneous fatty tissue, which is richly supplied with blood.
This is why a contusion of the penis is usually accompanied by severe pain in the groin, extensive hemorrhage, often spreading to the scrotum and/or subcutaneous fat. In this case, the penis enlarges, swells, walking becomes difficult, and extensive blue-purple hematomas form under the skin, which can spread to the pubis, scrotum and perineum. Hematomas can compress the urethra and cause difficulty urinating and even urinary retention.
More severe injuries of the closed (blunt) type are typical for the penis in the erect state, in which the thickness of the corpus cavernosum protein layer decreases to 0.25-0.5 mm, instead of 2.4 mm in the detumescence state. In the non-erect state, a blunt blow does not lead to a rupture of the penis, and only a subcutaneous hematoma develops.
Dislocation of the penis
Dislocation of the penis is one of the rare injuries that develops for the same reasons as its fracture. In this case, the ligaments that fix the penis to the pelvic bones are torn. The cavernous bodies of the penis are displaced under the skin of the perineum, thigh, pubic bone area and scrotum (the penis is palpated as an empty sac).
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Penile constriction
Penile strangulation occurs when it is pulled too tightly or when ring-shaped objects (various rings, nuts, ropes, rubber, wire, etc.) are put on it. The damage is caused by the victims themselves or by sexual partners to achieve an erection or prevent nocturnal enuresis. Such damage is observed in mentally ill people, and it can also be the result of children's pranks or masturbation. When the penis is strangulated, pain occurs, its blood circulation and lymph flow are disrupted, and as a result, tissue edema develops, which subsequently leads to trophic disorders up to skin necrosis and gangrene of the penis. Compression of the urethra from the outside leads, in turn, to acute urinary retention.
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Diagnostics penile contusion and dislocation
When collecting anamnesis, it is necessary to collect complete information about the characteristics of the factor leading to damage to the penis and the circumstances of the injury. In addition to the general principles of treating injuries, it is necessary to remember that in case of injuries to the external genitalia, it is often necessary to pay attention to the intimate side of the issue.
Diagnosis of a contusion of the penis is not difficult. When establishing a diagnosis, it is mainly necessary to differentiate damage to the protein membrane and the urethra.
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Treatment penile contusion and dislocation
Treatment of a contusion of the penis includes rest, cold in the first 3 days, non-steroidal analgesics and then heat. In the development of an extensive hematoma, surgical treatment is indicated: removal of blood clots, stopping bleeding, suturing the protein membrane. In case of damage to the urethra, it is necessary to restore its patency and adequate drainage of urine. Treatment of a contusion of the penis includes the prescription of cold, rest, means to prevent erection, prophylactic antibacterial treatment.
Dislocation of the penis should be treated only by surgery, and this treatment consists of exposing the root of the penis, draining the hematoma, performing hemostasis and repositioning the penis, after which sutures are applied to the torn ligaments, again fixing the cavernous bodies to the pelvic bones.
Penile strangulation should be treated immediately after the injury. Treatment consists of removing the constricting objects as soon as possible and freeing the organ. If urination is not restored after the strangulation is removed, the urine is diverted by trocar cystostomy. If penile necrosis develops distally to the strangulation, the necrotic part is removed and plastic surgery is performed. Skin necrosis may be an indication for autotransplantation of a split skin flap.