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CASE 2: This case was presented electronically. Candidates were given a collage of 4 still images selected from a fluoroscopic study.
See images below. Click to enlarge.
Os penis fracture with concurrent urethral laceration forming a urethral-cavernous fistula.
This is a diagnostic study with no further imaging needed. Surgical treatment would be the next step in management.
The patient was treated by penile amputation, scrotal urethrostomy and castration.
Candidates varied greatly in their assessment of this case. Those that did poorly failed to identify that a urethral-vascular communication had developed. Misdiagnoses of abnormal ureteral connections, prostatic contrast extravasation, and bizarre congenital urethral anomalies were made.
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