Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
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Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
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Aug 2018

Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
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Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
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It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."

Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
On May 11,2011

Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."

Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
On April 2011

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.

Dr. Anuradha
On Jan 2020

Important Notice

Case report
Year : 2008 | Month : August | Volume : 2 | Issue : 4 | Page : 1017 - 1019 Full Version

Bilateral Corporal Fracture With Urethral Rupture Following Intercourse-Case Report With Review Of Literature

Published: August 1, 2008 | DOI:

Division of Urology, Department of Surgery University College of Medical Sciences (University of Delhi) & GTB Hospital,F-14 South Extension Part-2, New Delhi-110049. India

Correspondence Address :
Dr.(Prof.) Iqbal Singh*M.Ch(Urology)[AIIMS],D.N.B.(Urology), M.S.(Surg),D.N.B.(Surg),Professor & Senior Consultant Urologist Division of Urology, Department of Surgery University College of Medical Sciences(University of Delhi) & GTB Hospital,F-14 South Extension Part-2, New Delhi-110049. India Fax: 91-11-22590495, 26257693®, 9810499222(M)Email:


A 32-year-old man presented with complaints of pain and sudden detumescence of penis during intercourse. On examination his penis was flaccid but swollen and deviated to the left side with severe tenderness on the right side of shaft. On exploration a diagnosis of bilateral fracture penis with penile urethral rupture was confirmed. Repair of both the corpora and primary anastomotic urethroplasty was accomplished successfully. Foley’s catheter was removed after six weeks and immediate urethroscopy confirmed complete healing of urethra. At six months the erectile function and voiding was satisfactory. We present this case to highlight the rarity of bilateral corpora fracture complicated by urethral rupture and to review the current literature and it’s management.


Penile fracture, genitourinary trauma, urethral rupture, corpora-cavernosa tear

Fracture penis is an uncommon injury due to rupture of the corpora-cavernosal tunica albuginea that usually follows forceful injury on an erect penis during sexual intercourse(1). Co-existing corpora-spongiosal and urethral injury has been reported in (10%-38%)(2) of cases while bilateral corporal fracture with complete urethral disruption is even rarer and to the best of our knowledge only five similar published cases have been reported so far(3),(4),(5). We report an unusual and rare case of bilateral corporal cavernosal laceration with complete urethral rupture. Immediate surgical exploration and repair of both corpora (corporoplasty) with urethroplasty forms the mainstay of treatment in such cases that provides the best long-term results(7).

Case Report

A 32-year-old man presented in the surgical casualty with complaints of pain and sudden detumescence of penis following a sexual intercourse. Interrogation revealed that during intercourse he was on the top and while thrusting repeatedly he inadvertently thrust his penis on the pubic bone of his partner. On examination his penis was flaccid, swollen, deviated to the left, there was severe tenderness of the right shaft and a blood stained meatus.

Based on a clinical diagnosis of fracture penis and urethral injury he was explored under anaesthesia. A 2 cm tear in right mid corpora and a 0.5 cm tear in the left corpora with a virtual 3/4th circumferential tear in penile urethra at the same level was detected. Bilateral corporal repair with inverted sutures of prolene 2-0 was performed. After a limited mobilization of the penile urethra a spatulated end-to-end urethroplasty was carried over a 20 F silicone foley’s catheter. No suprapubic cystostomy was performed. Postoperatively patient was prescribed antibiotics, estrogens and catheter care. He was discharged on fifth postoperative day on a foley’s catheter. Four weeks later the catheter was removed and immediate urethroscopy with a 21 F cystoscope confirmed complete healing of urethra. At a current follow up of six months his erectile function and voiding evaluated by penile Doppler and uroflowmetry is satisfactory.


Bilateral penile fracture associated with urethral rupture following intercourse is an uncommonly reported injury(3),(4),(5) (as shown in (Table/Fig 1). It is the extreme reduction (by about 75%) in the thinness of the corporal tunic (from 2 mm to 0.25mm) during erection and an intra-corporal pressure of at least 1500mmHg that predisposes it to trauma and fracture(5),(6). It is conceivable that only high-energy injuries can lead to penile fractures with urethral ruptures. At times rarely a flaccid penis may also sustain trauma (low energy injury) due to masturbation or deliberate manual kneading of the penis. Pre-existing histopathological abnormalities such as fibrosclerosis and perivascular lymphocytic infiltration (due to repetitive stress/trauma induced hematomas) are also known to predispose to a tear in the buck’s fascia leading to a penile fracture on bending(6). Diagnosis is generally straightforward, and is made in a majority on the basis of a proper history and clinical examination. History of sudden pain and detumescence of the penis during a sexual encounter associated with a snapping sound usually confirms the diagnosis(7). Clinically a swelling of the penile shaft extending up to the scrotum associated with contralateral deviation of the penile shaft due to the mass effect of the intrafascial hematoma and tear of the Buck’s fascia, that produces the commonly seen characteristic “butterfly sign” described by Soylu et al(3). The presence of blood stained external urinary meatus should suggest a concomitant urethral injury (as partial or complete urethral tears may co-exist in up to 10-38% of cases)(2). When in doubt a gentle retrograde urethrogram (RGU) is very helpful(8),(9). Mydlo et al (10) also evaluated the utility of pre-operative RGU and cavernosography(CG) in their study of a series of seven cases of penile fracture(comparison with intra-operative findings) and found that, in two cases the RGU and CG revealed lacerations that were not initially detected surgically and in another two of their cases, the RGU and CG were falsely negative. They concluded that preoperative CG and RGU might show additional sites of corporal/urethral tears because hematoma formation may mask some tears (RGU~false negative rate of 15%)(10). In certain atypical situations other imaging modalities such as colour doppler ultrasound (indicated only in the post-operative follow-up of such cases) (11) and pre-operative magnetic reasonance imaging (to determine the various sites of rupture) have only a limited role(12). However at present the routine use of all these investigations is not justified.

Management entails immediate surgical exploration (careful examination of all the three corpora and urethra via a subcoronal degloving incision), a thorough wound toilet and corporal repair with interrupted inverted non-absorbable sutures. In cases of associated urethral injury primary stented urethroplasty offers the best results. Urinary diversion should only be offered to complex cases where the urethral distraction defect is wide or in cases where a patient presents late with a strong element of sepsis negating a primary urethroplasty.

Conservative treatment should be strongly discouraged as this carries a high risk of penile deformity, plaques, poorly sustained, angulated and painful erections in the long term(5),(13). Hence immediate surgical exploration, repair and reconstruction should be strongly advocated as the procedure of choice in all such cases presenting to the emergency as it carries the best long-term result in terms of erectile and voiding functions with avoidance of complications.


Cortelini P, Ferretti S, Larosa M, Peracchia G, Arena F. Traumatic injury of the penis: surgical management. Scand J Urol Nephrol 1996; 30(6): 517-9.
Fergany AF, Angermeier KW, Montague DK. Review of Cleveland Clinic experience with penile fracture. Urology 1999; 54(2): 352-5.
Soylu A, Yilmaz U, Davarci M, Baydinc C. Bilateral disruption of corpus cavernosum with complete urethral rupture. Int J Urol 2004;11(9):811-2.
Hafiani M, Bennani S, Debbagh A, el Mrini M, Benjelloun S. Bilateral fracture of the corpus cavernosum with complete rupture of the urethra. J.Urol 1995;101(4):200-2.
Asgari MA, Hosseini SY, Safarinejad MR, Samadzadeh B, Bardideh AR. Penile fractures: evaluation, therapeutic approaches and long term results. J Urol 1996;155: 148–49.
De Rose AF, Giglio M, Carmignani G. Traumatic rupture of the corpora cavernosa. New physiopathologic acquisitions. Urology 2001; 57: 319–22.
De Giorgi G, Luciani LG, Valotto C, Moro U, Praturlon S, Zattoni F. Early surgical repair of penile fractures: our experience. Arch Ital Urol Androl 2005; 77(2): 103-5.
Nymark J, Kristensen JK. Fracture of the penis with urethral rupture. J Urol 1983; 129(1): 147-8.
Heng CT, Brooks AJ. Penile fracture with complete urethral rupture. Asian J Surg 2003; 26(2): 126-7.
Mydlo JH, Hayyeri M, Macchia RJ. Urethrography and cavernosography imaging in a small series of penile fractures: a comparison with surgical findings. Urology 1998; 51(4):616-9.
Gontero P, Sidhu PS, Muir GH. Penile fracture repair: assessment of early results and complications using color Doppler ultrasound. Int J Impot Res 2000;12:125-8.
Fedel M, Venz S, Andreessen R, Sudhoff F, Loening SA: The value of magnetic resonance imaging in the diagnosis of suspected penile fracture with atypical clinical findings. J Urol 1996;155: 1924–27.
Ozen HA, Erkan I, Alkibay T, Kendi S, Remzi D. Fracture of the penis and long-term results of surgical treatment. Br. J. Urol. 1986; 58: 551–2.

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