Efficacy of magnetic resonance imaging for diagnosis of penile fracture: A controlled study

PURPOSE: To evaluate the diagnostic value of magnetic resonance imaging (MRI) in patients with suspected penile fracture. MATERIALS AND METHODS: A total of 122 patients admitted to our inpatient clinic with a suspicion of penile fracture following a recent history of penile trauma and who underwent surgical exploration were included this study. A thorough physical examination, a detailed medical history, description of the trauma, and preoperative International Index of Erectile Function (IIEF) scores were obtained for each patient prior to surgery. Thirty-eight of these patients were evaluated with MRI before the surgical exploration. Intraoperative findings were also recorded. Physical findings and IIEF scores were also recorded at postoperative 6 months. RESULTS: The mean age of our patient group was 36.5±12.3 years. Penile fracture was detected in 105 of 122 patients in whom surgical exploration was performed owing to a suspected diagnosis. The mean time interval from penile trauma to hospital admittance was 9.9±15.1 hours. No cavernosal defect was detected in 9 of 84 patients (10.7%) who were not evaluated with MRI prior to surgery. Compared with surgical exploration, MRI findings showed 100% (30 of 30) sensitivity and 87.5% (7 of 8) specificity in the diagnosis of penile fracture. MRI had a high negative predictive value of 100% (7 of 7) and a positive predictive value of 96.7% (30 of 31) with just 1 misdiagnosed patient. CONCLUSIONS: MRI is a reliable diagnostic tool in the diagnosis of penile fractures. Compared to history and physical findings taken all together, the high sensitivity and specificity of this imaging technique can decrease the number of unnecessary surgical explorations.