**Question:** In fracture of penis involving rupture of tunica albuginea with intact Buck's fascia following would be noted clinically -

A. Purulent discharge
B. Hematuria
C. Pain and swelling
D. Inability to achieve erection

**Core Concept:**

The penis is a complex organ composed of various layers and structures essential for its function and integrity. The tunica albuginea is a thin, fibrous layer surrounding the corpora cavernosa, while Buck's fascia is a thin, fibrous layer between the corpora cavernosa and corpus spongiosum. In a fracture of the penis, these layers may be compromised, leading to specific clinical findings.

**Why the Correct Answer is Right:**

When there is a fracture of the penis involving rupture of the tunica albuginea, the intraluminal pressure remains unchanged, leading to no change in the erectile function (Option D). However, the rupture of the tunica albuginea results in disruption of the fibrous sheath surrounding the corpora cavernosa. This disruption compromises the integrity of the corpora cavernosa, leading to pain and swelling (Option C).

**Why Each Wrong Option is Incorrect:**

Option A, purulent discharge, is not a typical finding in a fracture of the penis with rupture of tunica albuginea. Purulent discharge would more likely be seen in an infection (cellulitis) or a skin injury.

Option B, hematuria, is less likely as the tunica albuginea rupture primarily affects the corpora cavernosa, not the urethra or renal system. Hematuria is more commonly seen in renal or urethral injuries.

Option D, inability to achieve erection, is not directly related to the fracture of the penis with tunica albuginea rupture. Erectile function is primarily determined by the integrity of the cavernosal nerves, which are located in the penile skin and corpus cavernosum, not the tunica albuginea.

**Clinical Pearl:**

Fracture of the penis with rupture of tunica albuginea is a rare but potentially severe injury. When assessing a patient with suspected penile fracture, focus on signs of pain, swelling, and integrity of the corpora cavernosa, rather than erectile function. Prompt assessment and management are essential to prevent complications like erectile dysfunction and priapism.