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Ocampo Flórez GM, Obando AC, García-Perdomo HA. Association between partial thrombosis of the corpus cavernosum, partial priapism, and hard flaccid syndrome: A scoping review. Andrology 2022; 10:844-851. [PMID: 35460544 DOI: 10.1111/andr.13190] [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: 09/09/2021] [Revised: 04/10/2022] [Accepted: 04/18/2022] [Indexed: 11/29/2022]
Abstract
AIM To describe the association between partial thrombosis of the corpus cavernosum, partial priapism, and hard flaccid syndrome. METHODS An scoping review was performed according to the recommendations of the Joanna Briggs Institute. Moreover, we performed a search strategy using the MEDLINE, EMBASE, and CENTRAL databases. We included the available information, evaluating the conditions of partial thrombosis of the corpus cavernosum, partial priapism, and hard flaccid syndrome, and their molecular and physiological mechanisms and clinical presentation. RESULTS We identified 207 manuscripts and chose eight studies published between 2001 and 2021. The total number of patients was 34, and their mean age was 28.2 years. Moreover, in 84% of the studies, the pathophysiology of the events was related to microtrauma or prolonged perineal compression. Also, 94.2% of the patients had some degree of erectile dysfunction. In addition, out of all patients, 94% underwent magnetic resonance imaging (MRI). However, patients with hard flaccid syndrome did not show relevant findings in these studies. Conversely, MRIs showed asymmetry in the proximal corpora cavernosa, thrombosed corpus cavernosum segments, and mainly cavernous fibrous septum in patients with partial cavernous thrombosis and partial priapism. CONCLUSION Partial thrombosis of the corpus cavernosum, partial priapism, and hard flaccid syndrome occurred more frequently in young patients, possibly related to microtraumas that generate cavernous fibrosis and trigger alterations in the erection of the distal portion of the penis. Also, they cause proximal hardening pelvic, perineal pain, painful ejaculations, and cavernous asymmetry. Moreover, the imaging characteristics are similar in patients with partial priapism and partial cavernous thrombosis. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Ginna Marcela Ocampo Flórez
- UROGIV Research Group, School of Medicine, University of Valle, Cali, Colombia.,Department of Urology, CES University, Medellín, Colombia
| | | | - Herney Andrés García-Perdomo
- UROGIV Research Group, School of Medicine, University of Valle, Cali, Colombia.,Division of Urology/Uro-oncology, Department of Surgery, School of Medicine, University of Valle, Cali, Colombia
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Cakiroglu B, Kaya C, Aksoy SH. A case of a high-flow priapism treated with superselective transcatheter embolization. Urologia 2021:3915603211016116. [PMID: 33977803 DOI: 10.1177/03915603211016116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
High-flow priapism is a rare condition characterized by prolonged and painless erection. It is defined as contusion or thrombosis of the cavernous body of the penis usually secondary to blunt trauma. Due to the rarity of the disease, there is no well-defined consensus about treatment. Conservative treatment is often applied with non-steroidal anti-inflammatory drug. We present a case of 58-year-old man with proximal partial priapism that developed secondary to blunt trauma to the penis. The patient did not benefit from non-steroidal anti-inflammatory drug therapy and then was successfully treated with selective embolization.
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Affiliation(s)
- Basri Cakiroglu
- Department of Urology, Hisar Intercontinental Hospital, Istanbul, Turkey
| | - Cevdet Kaya
- Department of Urology, Hisar Intercontinental Hospital, Istanbul, Turkey
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Singh D, Larson T, Campbell K, Dennis M, Yeung L. Surgical Management of Idiopathic Partial Thrombosis of the Corpus Cavernosum. Sex Med 2021; 9:100273. [PMID: 33307340 PMCID: PMC7930853 DOI: 10.1016/j.esxm.2020.10.001] [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: 05/15/2020] [Revised: 09/12/2020] [Accepted: 10/01/2020] [Indexed: 11/26/2022] Open
Abstract
A 36-year-old African American man presented to the emergency department with 2 days of left-sided perineal pain after sexual activity. He was found to have induration in the left perineum overlying the proximal left corporal body. Clinical picture was suspicious for traumatic corporal rupture; however, advanced imaging showed a proximal segmental thrombosis of the left corpus cavernosum. The patient underwent perineal exploration with evacuation of an intracorporal penile hematoma. In spite of disrupting a fibrous membrane in the proximal corpora and drainage of the corpora, we observed repeat tumescence during the procedure because of an observed arterial high-flow state in the corpora cavernosum. This was resolved with administration of phenylephrine into the cavernosum. The patient had return of normal erectile function 2 days after the procedure with resolution of pain at the site. Singh D, Larson T, Campbell K, et al. Surgical Management of Idiopathic Partial Thrombosis of the Corpus Cavernosum. Sex Med 2021;9:100273.
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Affiliation(s)
- Danish Singh
- University of Florida College of Medicine, Gainesville, FL, USA.
| | - Troy Larson
- Department of Urology, University of Florida College of Medicine Gainesville, FL, USA
| | - Kevin Campbell
- Department of Urology, University of Florida College of Medicine Gainesville, FL, USA
| | - Michael Dennis
- Department of Urology, University of Florida College of Medicine Gainesville, FL, USA
| | - Lawrence Yeung
- Department of Urology, University of Florida College of Medicine Gainesville, FL, USA
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Ozden S, Yildirim O, Ozbek E, Gulsen F. A case of proximal partial priapism successfully treated with autologous clot embolisation. Andrologia 2020; 52:e13510. [PMID: 31965580 DOI: 10.1111/and.13510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 07/30/2019] [Accepted: 08/22/2019] [Indexed: 12/17/2022] Open
Abstract
Partial priapism is a rare disorder in literature and generally described as a contusion or thrombosis of the cavernous body of the penis secondary to blunt trauma. Because of the rarity of disease, there is not much information about the treatment. Conservative management with nonsteroidal anti-inflammatory drug is often applied treatment. Here, we presented a proximal partial priapism treated successfully with autologous clot embolisation secondary to pelvic trauma.
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Affiliation(s)
- Sami Ozden
- Department of Urology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Omer Yildirim
- Department of Urology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Emin Ozbek
- Department of Urology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Fatih Gulsen
- Department of Interventional Radiology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Ranasinghe SV, Chen M, Roberts MJ, Westera J, Thangasamy I, Dunglison N. Idiopathic partial thrombosis of the corpus cavernosum: An unusual presentation to consider. JOURNAL OF CLINICAL UROLOGY 2018. [DOI: 10.1177/2051415817747476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Sachinka V Ranasinghe
- Department of Urology, Royal Brisbane and Women’s Hospital, Australia
- Faculty of Medicine, The University of Queensland, Australia
| | - Michael Chen
- Department of Urology, Royal Brisbane and Women’s Hospital, Australia
| | - Matthew J Roberts
- Department of Urology, Royal Brisbane and Women’s Hospital, Australia
- Faculty of Medicine, The University of Queensland, Australia
- Centre for Clinical Research, The University of Queensland, Australia
| | - Jurjen Westera
- Department of Urology, Royal Brisbane and Women’s Hospital, Australia
| | - Isaac Thangasamy
- Department of Urology, Royal Brisbane and Women’s Hospital, Australia
| | - Nigel Dunglison
- Department of Urology, Royal Brisbane and Women’s Hospital, Australia
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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.
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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
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Cooper MA, Carrion RE, Yang C. Partial Priapism Treated with Pentoxifylline. Int Braz J Urol 2015; 41:804-7. [PMID: 26401875 PMCID: PMC4757011 DOI: 10.1590/s1677-5538.ibju.2014.0363] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 09/18/2014] [Indexed: 11/22/2022] Open
Abstract
MAIN FINDINGS A 26-year-old man suffering from partial priapism was successfully treated with a regimen including pentoxifylline, a nonspecific phosphodiesterase inhibitor that is often used to conservatively treat Peyronie's disease. CASE HYPOTHESIS: Partial priapism is an extremely rare urological condition that is characterized by thrombosis within the proximal segment of a single corpus cavernosum. There have only been 36 reported cases to date. Although several factors have been associated with this unusual disorder, such as trauma or bicycle riding, the etiology is still not completely understood. Treatment is usually conservative and consists of a non-steroidal anti-inflammatory and anti-thrombotic. Promising future implications: This case report supports the utilization of pentoxifylline in patients with partial priapism due to its anti-fibrogenic and anti-thrombotic properties.
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Affiliation(s)
- Meghan A. Cooper
- Lake Erie College of Osteopathic Medicine, Bradenton, Florida, USA
| | - Rafael E. Carrion
- Department of Urology, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
| | - Christopher Yang
- Department of Urology, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
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