The role of ultrasound in the diagnosis of penile fracture

Abstract Although considered a relatively rare occurrence, penile fracture is nonetheless a urological emergency. The importance of correctly identifying this pathology is essential when the long‐term sequelae of a delayed or misdiagnosis are considered. Due to the stigma attached to this entity, it is assumed that its true incidence remains underreported, and as such, literature on the sonographic evaluation of penile fracture is rendered to be relatively scarce. The consequence of such an unusual referral means that there is a gap in knowledge when it comes to attaining an accurate ultrasound diagnosis. This article will review the anatomy of the penis, the pathophysiology contributing to penile fracture, and how an inherent understanding of both is vital to the accurate sonographic grading of different fracture types. Although penile fracture is still considered a clinical diagnosis, ultrasound provides critical information in atypical or equivocal cases whereby multiple differential diagnoses cannot be excluded. The possibility of an incorrect diagnosis based on inconclusive historical and clinical findings therefore highlights not only the important role of ultrasound in the facilitation of prompt surgical intervention but also its contribution to a favourable patient outcome by way of correct management.