It is possible to experience a rupture of blood vessels in the penis, ranging from minor bruising to a severe structural injury. Although the term “popped blood vessel” is common, the injury often involves tearing the main internal supportive structures rather than just a superficial vessel. A minor injury results in a localized subcutaneous hematoma, which is simple bruising under the skin. A major rupture, however, constitutes a urological emergency requiring immediate medical attention to prevent long-term complications affecting sexual and urinary function.
The Mechanics of Penile Vascular Injury
The penis consists of three main columns of spongy tissue: the corpus spongiosum and two corpora cavernosa. These columns fill with blood under high pressure during sexual arousal, causing an erection. Each of the two corpora cavernosa is encased in the tunica albuginea, a thick, fibrous sheath that provides the necessary rigidity.
When flaccid, the tunica albuginea is relatively thick, measuring approximately 2 millimeters. During an erection, the intense pressure of trapped blood causes this sheath to stretch and thin significantly, often measuring between 0.25 and 0.5 millimeters thick. This dramatic thinning makes the erect structure vulnerable to sudden, forceful bending or blunt trauma.
A severe injury, commonly known as a penile “fracture,” occurs when internal pressure exceeds the tensile strength of the thinned tunica albuginea. This results in a tear in the sheath, allowing blood to escape from the high-pressure corpus cavernosum into surrounding tissues. This rupture of connective tissue is often referred to as a “popped blood vessel” because it involves the violent release of blood from the main erectile chambers. The tear immediately compromises the vascular containment mechanism necessary to maintain an erection.
When rupture occurs, the escaping blood rapidly forms a large collection under the skin, known as a hematoma, causing characteristic swelling and discoloration. A true penile fracture involves the tear of the tunica albuginea and the underlying corpus cavernosum. A minor injury, conversely, involves only the rupture of smaller, superficial vessels beneath the skin, resulting in a simple, localized bruise without structural damage.
Common Causes of Penile Trauma
Penile trauma sufficient to cause vascular or structural injury almost always occurs when the penis is rigid and erect. The most frequent cause of this blunt trauma involves coital activity. This often happens when the penis accidentally slips out and is forcefully thrust against the partner’s pubic bone or perineal area.
Certain sexual positions, particularly those where the receiving partner is on top, carry a higher risk. This is because the partner controlling the thrusting motion may not be able to stop in time to prevent sudden, sharp bending. Injuries can also occur during vigorous masturbation, especially when aggressive manipulation or forceful bending of the erect shaft is involved.
Non-coital causes, though less common, can also exert the necessary force to cause a structural tear. This includes falling onto an erect penis, such as rolling out of bed or a sudden fall. In some cultures, the practice known as taqaandan—forcefully bending the erect penis downward to achieve rapid detumescence—is a documented cause of fracture. Any scenario involving a sudden, significant, and forceful bend to the rigid shaft can lead to this structural vascular injury.
Recognizing the Signs of Serious Injury
Distinguishing between a minor bruise and a severe structural injury is important for determining the need for immediate medical care. A severe rupture of the tunica albuginea presents with highly specific and dramatic symptoms. The first sign is often an audible “popping,” cracking, or snapping sound, which is the sound of the fibrous sheath tearing under pressure.
Following this sound, the individual experiences immediate and severe pain at the injury site. The high-pressure blood rapidly escaping the corpus cavernosum causes the erection to be lost almost instantaneously, a phenomenon called rapid detumescence. Within minutes, the penis swells dramatically and develops dark, purplish discoloration due to the large hematoma forming beneath the skin.
The combination of massive swelling and discoloration results in a distinct appearance known as the “eggplant deformity.” The shaft may also appear visibly bent or angulated away from the tear site. If the trauma injured the urethra, which occurs in a minority of cases, blood may be visible at the urethral opening. An audible sound, rapid loss of erection, and severe swelling necessitate emergency medical evaluation.
Immediate Action and Medical Management
For a minor injury involving only superficial bruising, rest, application of a cold compress, and monitoring for several days are appropriate steps. However, if severe symptoms are present—especially the popping sound, rapid detumescence, or the eggplant deformity—immediate travel to an emergency room is mandatory. A penile fracture is a time-sensitive urological emergency, and delaying treatment significantly increases the risk of long-term complications.
Upon arrival, a healthcare provider can diagnose the injury based on the patient’s history and physical examination. Imaging studies, such as a penile ultrasound or Magnetic Resonance Imaging (MRI), may be used to confirm the location and extent of the tear in the tunica albuginea. An associated urethral injury is confirmed using a retrograde urethrogram.
The definitive treatment for a confirmed tear in the tunica albuginea is prompt surgical repair. During the procedure, the surgeon evacuates the large hematoma and stitches the tear in the fibrous sheath to restore the integrity of the erectile chamber. Timely surgical intervention, ideally within 24 hours, is associated with the best outcomes for preserving long-term erectile function and preventing deformity. Failure to repair the tear can lead to complications such as permanent penile curvature and painful or difficult erections.