Summary: The clinical utility of ultrasonography in the diagnosis of penile tumors and trauma has not yet been defined, and only a few cases have been reported worldwide. In benign cystic tumors, the sonographic features are those observed in other fluid cystic collections, whereas solid masses are characterized by an echotexture that can be hypoechoic or hyperechoic. Penile cancer, common in some geographical areas, appears as an inhomogeneous, ill-defined mass, usually limited to the glans penis or prepuce. Ultrasonography and magnetic resonance images arc particularly useful for staging the primary tumor, because they define the degree of involvement of the corpora cavernosa and determine the appropriate tumor-free level for amputation. Penile trauma commonly occurs during erection. The injury can occur anywhere along the shaft, but is more common at the base. It is associated with a tear of the tunica albuginea with extensive hematoma. On occasion, there may be rupture of the urethra and the corpus spongiosum. Blunt penile or perineal trauma can produce injury to the dorsal or cavemosal arteries with a cavemosal-sinusoidal space fistula leading to secondary high-flow priapism. These arteriovenous fistulas can be successfully treated with selective cmbolization. Dorsal penile vein thrombosis, and rupture of the dorsal vein, are the most frequent post-traumatic lesions observed in the venous system. Late complications of penile trauma include focal or diffuse fibrotic intracavemousal fibrosis. They can be easily identified with sonography as areas of hyperechogenicity that show reduced expansion during erection. They can cause impotence, especially in young, otherwise healthy men.
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