Erectile dysfunction can result from blunt or penetrating pelvic or perineal trauma. Rupture of the corpora cavernosa leading to loss of the veno-occlusive mechanism and penile artery occlusion have been found in these patients. We present a case of immediate loss of erectile function after penetrating perineal trauma resulting in corpus cavemosum rupture and traumatic occlusion of multiple arteries in the hypogastric-cavernous bed. Conservative management of the corpus injury resulted in post-traumatic aneurysmal dilation at the site of injury with venous leakage from aberrant veins. Penile arterial revascularization and aneurysm repair with deep penile venous ligation resulted in near-complete return of normal erectile function.
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