Adolescent with penile fracture and complete urethral transection

We report the first pediatric case of penile fracture with complete urethral transection caused by accidental fall. The patient presented atypically with the majority of swelling and ecchymosis occurring in the scrotal area rather than the penile shaft. The urethral injury occurred at the junction of the penile and bulbar urethra with significant urinary extravasation into the scrotum. The injury was repaired with plastic reanastomosis of the corpora cavernosa and urethra using a scrotal approach, rather than the commonly described degloving incision. The diagnosis and management of this unusual injury and the implications with respect to the pathophysiology of penile fracture are discussed.