1
|
Nguyen V. A case of unprovoked segmental proximal partial thrombosis of the corpus cavernosum. Urol Case Rep 2023; 48:102426. [PMID: 37215060 PMCID: PMC10196997 DOI: 10.1016/j.eucr.2023.102426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/07/2023] [Accepted: 05/09/2023] [Indexed: 05/24/2023] Open
Abstract
Partial thrombosis of the corpus cavernosum is an extremely rare and likely underdiagnosed urologic condition. We discuss a case of a 25-year-old male who presented with severe perineal pain and was diagnosed with idiopathic proximal partial thrombosis of the corpus cavernosum via ultrasound and MRI. The patient experienced symptom resolution with evidence of disease regression on follow up MRI after treatment with direct oral anticoagulation. Further studies are needed to fully delineate the pathophysiology of this condition to facilitate development of standardized diagnostic and treatment algorithms.
Collapse
Affiliation(s)
- Vi Nguyen
- Department of Urology University of California, San Diego 9300 Campus Point Drive, La Jolla, CA, 92037, USA.
| |
Collapse
|
2
|
Scanlon L, Compton N, Croghan S, Daly P, Cullen IM. Partial priapism of the penis: A case report and review. JOURNAL OF CLINICAL UROLOGY 2021. [DOI: 10.1177/20514158211024085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Lorraine Scanlon
- Department of Urology and Andrology, University Hospital Waterford, Ireland
| | - Niall Compton
- Department of Urology and Andrology, University Hospital Waterford, Ireland
| | - Stefanie Croghan
- Department of Urology and Andrology, University Hospital Waterford, Ireland
| | - Padraig Daly
- Department of Urology and Andrology, University Hospital Waterford, Ireland
| | - Ivor M Cullen
- Department of Urology and Andrology, University Hospital Waterford, Ireland
| |
Collapse
|
3
|
Terkmane N, Van Glabeke E, Olicki JM, Andre MH, Benkhelifa AM, Mouheb M. [Partial thrombosis of the corpus cavernosum: A new case with good outcomes under non-steroidal anti-inflammatory drugs]. Prog Urol 2021; 31:503-505. [PMID: 33941456 DOI: 10.1016/j.purol.2021.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 02/23/2021] [Accepted: 03/08/2021] [Indexed: 11/26/2022]
Abstract
Partial priapism is a rare pathology with less than 60 cases published in the literature; the etiology remains unknown, although certain favorable factors are identified as having in relation a prolonged perineal compression or a thrombopathy. The symptomatology is characterized by the appearance of pain, perineal edema and an induration of the root of the penis, which do not concern the distal part of the penis or the glans. MRI is the best complementary examination. The first-line surgical treatment is abandoned. Medical treatment with non-steroidal anti-inflammatory drugs or low molecular weight heparins combined with platelet aggregation inhibitors give good results with complete resolution of symptoms in 82% of cases; first-line medical treatment should be favored. We report a case of idiopathic partial priapism, successfully treated with non-steroidal anti-inflammatory without recurrence after 10 years.
Collapse
Affiliation(s)
- N Terkmane
- Service d'urologie, Centre hospitalier intercommunal André-Grégoire, Montreuil, France; Fédération interhospitalière d'urologie de Seine Saint-Denis, Paris, France.
| | - E Van Glabeke
- Service d'urologie, Centre hospitalier intercommunal André-Grégoire, Montreuil, France; Fédération interhospitalière d'urologie de Seine Saint-Denis, Paris, France
| | - J-M Olicki
- Service de radiologie, Centre hospitalier intercommunal André-Grégoire, Montreuil, France
| | - M-H Andre
- Service de médecine interne, Centre hospitalier intercommunal André-Grégoire, Montreuil, France
| | - A M Benkhelifa
- Fédération interhospitalière d'urologie de Seine Saint-Denis, Paris, France
| | - M Mouheb
- Service d'urologie, Centre hospitalier intercommunal André-Grégoire, Montreuil, France; Fédération interhospitalière d'urologie de Seine Saint-Denis, Paris, France
| |
Collapse
|
4
|
Gomez Gomez E, Campos Hernandez JP, Cazalilla M, Triviño F, Barbudo J, Prieto R, Requena Tapia MJ. Partial thrombosis of the corpus cavernosum: should we dig deeper into coagulopathy disorders? Andrologia 2016; 48:1313-1316. [DOI: 10.1111/and.12572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2016] [Indexed: 11/26/2022] Open
Affiliation(s)
- E. Gomez Gomez
- Department of Urology (IMIBIC); Reina Sofia University Hospital; University of Córdoba; Córdoba Spain
| | - J. P. Campos Hernandez
- Department of Urology (IMIBIC); Reina Sofia University Hospital; University of Córdoba; Córdoba Spain
| | - M. Cazalilla
- Department of Internal Medicine; Reina Sofia University Hospital; University of Córdoba; Córdoba Spain
| | - F. Triviño
- Department of Radiology; Reina Sofia University Hospital; University of Córdoba; Córdoba Spain
| | - J. Barbudo
- Department of Emergency; Reina Sofia University Hospital; University of Córdoba; Córdoba Spain
| | - R. Prieto
- Department of Urology (IMIBIC); Reina Sofia University Hospital; University of Córdoba; Córdoba Spain
| | - M. J. Requena Tapia
- Department of Urology (IMIBIC); Reina Sofia University Hospital; University of Córdoba; Córdoba Spain
| |
Collapse
|
5
|
Partial segmental thrombosis of the corpus cavernosum presenting to the ED. Am J Emerg Med 2016; 34:1182.e3-5. [DOI: 10.1016/j.ajem.2015.10.040] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 10/22/2015] [Indexed: 11/24/2022] Open
|
6
|
Weyne E, Schillebeeckx C, Jamaer C, D'Hulst P, Bozzini G, Grunert R, d'Hondt F, Hoebeke P, Müller A, Van Renterghem K, Joniau S, Albersen M. Idiopathic Partial Thrombosis (IPT) of the Corpus Cavernosum: A Hypothesis-Generating Case Series and Review of the Literature. J Sex Med 2015; 12:2118-25. [PMID: 26553854 DOI: 10.1111/jsm.13036] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Idiopathic partial thrombosis (IPT) of the corpus cavernosum is a rare condition. The etiology is not fully understood; however, the presence of an either or not congenital web in these patients may contribute to the development of IPT. AIM The aim of this study was to describe 18 new IPT cases and compare these with 38 cases found in the literature. METHODS A multicenter retrospective analysis was performed. Descriptive statistics are given. MAIN OUTCOME MEASURES The main outcome measures used were clinical presentation, clinical and radiographical diagnostics, treatment and resolution of symptoms. RESULTS Patients most frequently presented with perineal swelling (10/18; 56%) and pain (13/18; 72%), unilateral (12/18; 67%) or bilateral (4/18; 22%), and pain during erection (10/18; 72%). Penile curvature, dysuria or fever (each 1/18; 6%) were uncommon presenting symptoms. In our series, magnetic resonance imaging demonstrated a fibrous web in the corpus cavernosum in 100% of cases and was more bilaterally (11/18; 61%) than unilaterally (7/18; 39%) diagnosed. Cycling was found to be a provocative factor for IPT occurrence in patients at risk as 61% (11/18) of patients reported being a frequent cyclist with the episode of IPT occurring immediately after or during cycling activity in 8 out of 18 patients (8/18; 44%). In five centers, 15 patients were treated conservatively, the majority being treated with therapeutic doses of low molecular weight heparin and simultaneous anti-aggregant therapy. In one center, all three patients were treated with a surgical approach. Complete resolution of symptoms was noted in only 50% of cases. CONCLUSION IPT is a condition that presents typically with perineal pain and swelling. Cycling is often seen as a provocative factor, while the presence of a fibrous web at the level of the crurocavernosal junction is the underlying disorder allowing for entrapment of blood in the crura. Conservative treatment provides a reasonably good outcome in most cases. For therapy resistant cases, surgery can be considered.
Collapse
Affiliation(s)
- Emmanuel Weyne
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | | | - Caroline Jamaer
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Pieter D'Hulst
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Giorgio Bozzini
- Department of Urology, Humanitas Mater Domini, Humanitas University, Castellanza, Italy
| | - Richard Grunert
- Division of Urology, Department of Surgery, University of Vermont College of Medicine, Burlington, VT, USA
| | | | - Piet Hoebeke
- Department of Urology, Gent University Hospital, Ghent, Belgium
| | - Alexander Müller
- Clinic of Urology, Universitats Spital Zürich, Zürich, Zwitserland
| | | | - Steven Joniau
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Maarten Albersen
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| |
Collapse
|
7
|
Kropman RF, Schipper J. Hematoma or “Partial Priapism” in the Proximal Part of the Corpus Cavernosum. J Sex Med 2014; 11:2618-22. [DOI: 10.1111/jsm.12388] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
8
|
Pediatric penile pain secondary to idiopathic arterial thrombosis. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2013. [DOI: 10.1016/j.epsc.2013.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
9
|
Abstract
With only 34 prior cases in world literature, partial priapism (PP), also called partial segmental thrombosis of the corpus cavernosum, is a rare urological condition. The aetiology and treatment of PP is still unclear, but bicycle riding, trauma, drug usage, sexual intercourse, haematological diseases and α-blockers have been associated with PP. In this case report and world literature review, we describe the case of a 50-year-old man suffering from PP after ingesting 100 mg of sildenafil. The patient was treated with a surgical incision for corpus cavernosum and clot evacuation, as a conservative treatment of PP was not feasible due to severe pain and unresponsiveness to analgesics.
Collapse
Affiliation(s)
- Peter Hoyerup
- Department of Urology, Roskilde Hospital, Roskilde, Denmark
| | | |
Collapse
|
10
|
Hulth M, Albersen M, Fode M, Peeters K, Ramskov KL, Joniau S, Bisbjerg R, Sønksen J. Idiopathic partial thrombosis of the corpus cavernosum: aetiology, diagnosis and treatment. Scand J Urol 2012; 47:163-8. [PMID: 22762201 DOI: 10.3109/00365599.2012.698305] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Idiopathic partial thrombosis of the corpus cavernosum (IPT) is a rare cause of perineal pain involving thrombosis within the proximal corpora cavernosa. This article clarifies the aetiology and makes recommendations on diagnosis and treatment. Three cases are described and a systematic review of the literature is presented. Magnetic resonance imaging (MRI) scans of the penis conducted for reasons other than IPT were also reviewed, to compare the normal anatomy of the corpora cavernosa with that of IPT patients.Twenty-nine IPT cases were identified, including the three described here. All patients presented with perineal pain and in all cases the thrombus was located in the proximal part of the corpora cavernosa.IPT has been associated with haematological diseases, drugs, prior priapism, sexual activity, bicycle riding and aeroplane flights. A fibrous septum within the corporeal tissue has been identified with advanced imaging modalities. Ultrasound, computed tomography and MRI have proven useful in the diagnosis. Both surgical and medical treatments have been attempted and the results have usually been good. However, two cases of surgical treatment have resulted in erectile dysfunction. It is suggested that ITP is based on the development of penile thrombosis and/or priapism in the presence of a pre-existing fibrous septum in the corpora cavernosa. MRI should be used to confirm the presence of a thrombus and a septum. First choice of treatment is pain medication and systemic anticoagulation; more invasive treatments should only be attempted only if this approach fails.
Collapse
|
11
|
|
12
|
Ilicki J, Krauss W, Andersson SO. Partial segmental thrombosis of the corpus cavernosum: a case report and a review of the literature. Urology 2012; 79:708-12. [PMID: 22386425 DOI: 10.1016/j.urology.2011.11.032] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2011] [Revised: 11/15/2011] [Accepted: 11/19/2011] [Indexed: 10/28/2022]
Abstract
Partial segmental thrombosis of the corpus cavernosum (PSTCC) is a rare urological condition characterized by a painful, firm mass in the proximal part of the corpus cavernosum. The underlying pathophysiology of this condition is not fully understood. We present a case diagnosed by magnetic resonance imaging with complete clinical recovery after conservative treatment and novel associated findings, such as excessive alcohol intake. We also review the previous cases of PSTCC and propose a two hit model explaining PSTCC's etiology.
Collapse
Affiliation(s)
- Jonathan Ilicki
- Department of Urology, Örebro University Hospital and Örebro University, Örebro, Sweden.
| | | | | |
Collapse
|
13
|
Ralph DJ, Borley NC, Allen C, Kirkham A, Freeman A, Minhas S, Muneer A. The use of high-resolution magnetic resonance imaging in the management of patients presenting with priapism. BJU Int 2010; 106:1714-8. [DOI: 10.1111/j.1464-410x.2010.09368.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|