Fracture of the penis with urethral rupture.

We report a rare case of penile fracture with incomplete urethral rupture in a 25 years old male who sustained the injury during sexual intercourse. He presented with a tense haematoma on the ventral aspect of the penile shaft, associated with urethral bleeding. Per urethral catheterization was possible though it was painful. Exploration and repair of the penile fracture and urethra were performed within 16 hrs. The patient made an uneventful recovery with good erectile and voiding function. This case illustrates the value of early surgical repair of the fracture in order to prevent complications. The true incidence of penile fracture is not known even in the Western countries because it is under reported or hidden for social embracement and even it is reported to physicians it remains undiagnosed or mismanaged. Very rarely it is associated with urethral rupture.

Leiomyoma of the urinary bladder.

Benign mesenchymal tumors of the bladder are rare and comprise less than 1% of the all bladder neoplasms. Leiomyoma is the most common type and comprises 35% of these tumors. These tumors may develop in submucosal (63%), intramural (7%) or subserosal (30%) layer, at any region of the bladder. The clinical presentation is varied and may include obstructive symptoms(50%), irritative symptoms (38%) and hematuria (11%). There are asymptomatic cases (19%), which make the diagnosis more difficult. Occurs more frequently in women than in men (3:1). The most common diagnostic investigations are ultrasonography, intravenous urography, computerized tomography scan and the magnetic resonance imaging. A 66 year old man presented with long standing voiding obstructive symptoms. Various examinations were performed in the last 2 years and was diagnosed either prostatic enlargement or bladder tumor. Cystoscopy was not available for confirming the diagnosis. The surgical exploration revealed a well-circumscribed mass at the bladder neck with moderate enlargement of the prostate. The pathological examination revealed a leiomyoma of the bladder. The post operative period was uneventful and the patient is doing well, without recurrence of the symptoms.