A 35-year-old man presented with complaints of acute-onset penile pain and swelling that started while in the act of sexual intercourse with his female partner 36 hours before presentation . During intercourse, he missed the vaginal introitus and hit the perineum with some force on struggling to re-enter the vagina with the penis while performing thrusting movements . His partner recalls hearing a cracking sound. He experienced instant penile pain, immediate loss of erection, and the almost sudden swelling of the penis.
About half an hour later, he observed blood at the urethral meatus . He presented to the ED 36 hours after the injury, by which time his entire penis was injured, with progressive swelling. He has been unable to urinate since the injury; every time he has tried, blood oozes from his urethral meatus . As a result, he was also experiencing great discomfort from urinary…
