XXXX seems more likely during sex under stressful situations.

@entity1 @entity546 @entity548 @entity146
INTRODUCTION: The unusual event of @entity546 occurs when there is a disruption of the tunica albuginea surrounding engorged erectile tissue during aggressive @entity146 . There is often an audible crack and rapid detumescence with @entity548 that follows. AIMS: Medical literature has described the etiology and treatment of @entity546 . We report the remarkably unusual social situations of a series of @entity1 who sustained this unique injury. METHODS: We conducted a retrospective chart review of 16 @entity1 whose injury was severe enough to require surgical repair at the University of Maryland between 2007 and 2011. Particular attention was paid to the intake interview in the emergency department and the postoperative chart notes by the attending urologist to ascertain out-of-the-ordinary social situations in which the injury was sustained. MAIN OUTCOME MEASURES: The occurrence of @entity546 is sufficiently rare that the author was able to interact personally with most of the @entity1 . The @entity1 were remarkably forthcoming with the personal social dynamics of the sexual encounter. RESULTS: Half of these @entity546 @entity1 sustained the injury during an extramarital affair. Only three @entity1 sustained the injury in a bedroom; the remainder was in out-of-the-ordinary locations for sexual intercourse, e.g., cars, elevator, the workplace, and public restrooms. CONCLUSIONS: @entity546 @entity1 appear to be a unique population of @entity1 who are having sexual intercourse under stressful situations. Extramarital affairs and out-of-the-ordinary locations appear common in @entity1 sustaining this relatively rare injury.
