Mathews Journal of Urology and Nephrology


Previous Issues Volume 2, Issue 1 - 2018

Case Report PDF  

Severe and Deep Perineal Trauma with a Commando Knife Causing Long Term Erectile Dysfunction

Selcuk Sarikaya1,Murat Yildirim2,Cagri Senocak3,Omer Faruk Bozkurt3

Corresponding Author:Selcuk Sarikaya, Gulhane Egitim ve Arastirma Hastanesi, General Tevfik Saglam Caddesi Etlik / Ankara, Turkey, Tel: +905316274819; Email: [email protected]

Received Date: 08 Aug 2018    Accepted Date: 14 Sep 2018   Published Date: 17 Sep 2018

Copyright © 2018 Sarikaya S

Citation: Sarikaya S, Yildirim M, Senocak C and Bozkurt OF. (2018). Severe and Deep Perineal Trauma with a Commando Knife Causing Long Term Erectile Dysfunction.Mathews J Urol Nephrol 2(1): 008.


Perineal; Trauma; Commando; Knife; Erectile Dysfunction.


Perineal traumas in males are rare pathologic entities and it would be both blunt or penetrating [1]. Both of these trauma types would cause severe health and erectile problems. As a result, quality of life is affected. These traumas would cause severe injuries of urethra and corpus cavernosum [1]. These damages would also occur due to the endothelial dysfunction in penile, pudendal and cavernosal arteries [2]. According to the severity of traumas, several consecutive clinical signs and symptoms would occur. Erectile dysfunction is one of the most important consequences of perineal traumas. In this study we aimed to present a 34 year-old male patient that had a severe penetrating perineal trauma due to knife injury and erectile dysfunction that occurred as a consequence.


A 34 year old male patient admitted to emergency clinic with a severe penetrating perineal trauma with a commando knife. (Figure1) Patient was consulted to urology clinic. According to the physical examination, there was 3-4cm diameter penetrating trauma and the knife was seen. X-ray showed the deep penetrance of knife (Figure 2) and the patient was performed surgical intervention for repairing the genital and perineal structures and for getting the knife out. (Figure 3) It was observed that both cavernosal structures were affected from the severe penetration.

Figure 1: Severe perineal trauma; physical examination.  

Figure 2: X-ray; penetrating trauma with commando knife.  

Figure 3: Knife removed from perineal wound.


Perineal traumas are usually causes severe consecutive health problems that affect quality of life. These patients would present with severe pain, dysuria, hematuria, hematoma in perineal region and open wounds due to penetrating traumas [3]. Physical examination is very important for diagnosis and also several radiologic interventions would be used. Conservative or surgical approaches would be preferred in the treatment of genital traumas. Surgical intervention would be considered according to the severity of traumas especially for penetrating traumas. The technique of surgical intervention depends on the severity of traumas [4]. Various problems would be seen after these traumas. Some of them would recover with medical treatment options and observation but for some cases additional surgical interventions would be necessary. Conservative approaches may sometimes result in unwanted postoperative conditions such as erectile dysfunction and some cosmetic problems [5]. Revascularization surgeries would be performed in for the treatment of erectile dysfunction and in some studies improvements were observed with validated questionnaires while comparing preoperative and postoperative conditions [5, 6].


Perineal traumas are rarely seen and severe pathologic entities that would affect the entire life of the patient. Both conservative or surgical approaches would be considered and also additional approaches especially revascularization surgeries would be necessary according to clinical conditions of patients.


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  2. Goldstein I, Lurie AL and Lubisich JP. (2007). Bicycle riding, perineal trauma, and erectile dysfunction: data and solutions. Curr Urol Rep. 8(6): 491-497.
  3. Puchkov KV, Filimonov VB, Katrovskii AV and Vasin RV. (2007). [Pelvic hematoma as a late consequence of perineal trauma in a young male]. Urologiia. (6): 76-78.
  4. Zuccon W, Paternollo R, Del Re L, Cordovana A, et al. (2013). Emergency treatment of violent trauma: clinical cases and surgical treatment of penetrating thoracoabdominal, perineal and anorectal trauma. Ann Ital Chir. 84(1): 11-18.
  5. Licht MR, Lewis RW and Sershon PD. (1995). Immediate impotence after penetrating perineal trauma: restoration of erections with penile artery revascularization, corpus cavernosum aneurysm repair, and deep penile venous ligation. Urology. 46(4): 577-80.
  6. Munarriz RM, LaSalle MD and Goldstein I. (2003). Penile revascularization for treatment of erectile dysfunction secondary to blunt perineal trauma. Urology. 61(1): 222- 223.

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