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Microbubble-enhanced ultrasound to demonstrate urethral transection in a case of penile fracture
  1. Oliver Czarnecki1,
  2. Conrad Brice von Stempel2,
  3. Pippa Sangster3,
  4. Miles Walkden2
  1. 1University College London Medical School, London, UK
  2. 2Department of Imaging, University College London Hospitals NHS Foundation Trust, London, UK
  3. 3Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK
  1. Correspondence to Dr Conrad Brice von Stempel, vonstempel{at}


A 47-year-old man attended the emergency department following trauma during sexual intercourse after which he developed penile swelling and haematuria several hours later. A penile fracture was suspected but given the slightly atypical history, ultrasound was performed to look for a fracture. Given the history of haematuria, both a standard Doppler ultrasound and a microbubble-enhanced retrograde ultrasound urethrogram were performed. The Doppler confirmed the suspected diagnosis of penile fracture, and microbubble urethrogram demonstrated a urethral injury. This facilitated prompt surgical treatment and helped guide the surgical approach. Retrograde microbubble enhanced ultrasound urethrogram is a novel technique that can be used in conjunction with standard ultrasound to confirm the presence of a concurrent urethral rupture in penile fracture.

  • radiology
  • urology
  • hematuria
  • urological surgery

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  • Contributors OC wrote the initial draft with MW and CBvS performed the imaging. PS wrote the section on surgical treatment. MW edited the draft manuscript and wrote the section on penile anatomy.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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