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Urology/Bruised Penis

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Question
"My boyfriend and I had intercourse yesterday and on thrusting hit me on an awkward angle. As soon as he pulled out, it had started to swell at the bottom but was still partly erect. We iced it and went to emergency. Bruising did not occur till 3-4 hours later. Saw a doctor, who said he was bruising. And the urologist who said it looked like bruising and a minor tear but was happy for him to go home. By then the swelling had reduced but there was bruising slightly around the base and on the underside. This was last night. This morning I had woken up to check on the bruising. And it had spread all along the shaft, just on the underside but also now around the tip and is a dark colour. Went back and saw the urologist who gave two options of healing itself or surgery. We were told if he was able to get an erection then we had less to worry about. So when he achieved an erection we could go home.

Is it normal for the bruising to spread and swell only very very slightly, the way a normal bruise would eg black eye. Or should we go back to emergency?

Right now. Swelling for the shaft has gone down. Still slight swelling but nothing bigger than 2.5cm diameter just where the new bruising is occuring. The bruising colour has spread and looks quite purple and blue. There is no pain and urination is completely normal."

Answer
Ellie, it sound like your friend may have suffered a mild penile fracture.   These fracture are usually obvious.  They generally occur when while having vigorous intercourse, on thrusting inward, the penis misses  the vaginal opening and forcefully strikes your partner's pelvis.  This is typically accompanied by a cracking sound, similar to snapping a twig.  The penis immediately becomes limp, swollen and bruised.  The fracture is actually a tear in the membrane around the corpora cavernosa (erectile body).  Minor tears may heal without treatment but larger ones are best repaired surgically.  If left alone, the scarring that occurs during the healing process, may cause some future curvature of the penis with erection.  However, with minor tears this is not generally a problem that in any way interferes with normal sexual activity.

As in your boyfriends case, it is usual for the bruising and swelling to spread during the first 48-72 hours, after which it gradually recedes.  If he did suffer a minor tear, it is reasonable to treat him conservatively without surgery as long as the process gradually improves.  In the interim, it is important that he substation no further injury to the penis.  In other words, no sexual intercourse or masturbation for at least 2-3 weeks so as not to compound the problem.  Good luck.

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Arthur Goldstein, M.D.

Expertise

Problems or questions related to the field of urology; ie urinary stone disease, urinary cancers (kidney, bladder, prostate, testis, etc.), urinary infections, etc. I no longer answer questions related to erection problems or male sexual dysfunction.

Experience

I am retired from the active practice of urology. My 34 years was totally in the clinical field and involved the entire gamut of genitourinary problems, with special interest in endourology.

Organizations
American Medical Association, American Urological Association, American College of Surgeons

Education/Credentials
College degree - BS Medical degree - MD Master of Science - MS

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