1
|
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.
Collapse
Affiliation(s)
- Basri Cakiroglu
- Department of Urology, Hisar Intercontinental Hospital, Istanbul, Turkey
| | - Cevdet Kaya
- Department of Urology, Hisar Intercontinental Hospital, Istanbul, Turkey
| | | |
Collapse
|
2
|
Trombosis parcial segmentaria de cuerpo cavernoso: reporte de un caso, imágenes y factores de riesgo. Rev Int Androl 2016. [DOI: 10.1016/j.androl.2015.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
3
|
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
|
4
|
Sauer S, Goltz JP, Gassenmaier T, Kunz AS, Bley TA, Klein D, Petritsch B. Partial segmental thrombosis of the corpus cavernosum (PSTCC) diagnosed by contrast-enhanced ultrasound: a case report. BMC Urol 2014; 14:100. [PMID: 25515840 PMCID: PMC4289566 DOI: 10.1186/1471-2490-14-100] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 12/11/2014] [Indexed: 11/23/2022] Open
Abstract
Background Partial segmental thrombosis of the corpus cavernosum (PSTCC) is a rare disease predominantly occurring in young men. Cardinal symptoms are pain and perineal swelling. Although several risk factors are described in the literature, the exact etiology of penile thrombosis remains unclear in most cases. MRI or ultrasound (US) is usually used for diagnosing this condition. Case presentation We report a case of penile thrombosis after left-sided varicocele ligature in a young patient. The diagnosis was established using contrast-enhanced ultrasound (CEUS) and was confirmed by contrast-enhanced magnetic resonance imaging (ceMRI). Successful conservative treatment consisted of systemic anticoagulation using low molecular weight heparin and acetylsalicylic acid. Conclusion PSTCC is a rare condition in young men and appears with massive pain and perineal swelling. In case of suspected PSTCC utilization of CEUS may be of diagnostic benefit.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Bernhard Petritsch
- University Hospital Würzburg, Institute of Diagnostic and Interventional Radiology, Oberdürrbacher Str, 6, 97080 Würzburg, Germany.
| |
Collapse
|
5
|
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]
|
6
|
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
|
7
|
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
|
8
|
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
|
9
|
Galvin SD, Letts JA, Sampangi NR. Magnetic Resonance Imaging of Partial Segmental Priapism (Segmental Thrombosis of Corpus Cavernosum). Urology 2009; 73:275-6. [DOI: 10.1016/j.urology.2008.06.040] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2007] [Revised: 06/08/2008] [Accepted: 06/19/2008] [Indexed: 10/21/2022]
|
10
|
Asbach P, Oelrich B, Haase O, Lenk SV, Loening SA. Acute partial segmental thrombosis of the corpus cavernosum: imaging findings on ultrasound, computed tomography, and magnetic resonance imaging. Clin Imaging 2008; 32:400-2. [DOI: 10.1016/j.clinimag.2008.02.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2008] [Accepted: 02/04/2008] [Indexed: 10/21/2022]
|
11
|
Blaut S, Schneider M, Zschuppe E, Günl U, Steinbach F. Partielle einseitige Schwellkörperthrombose bei Homozysteinämie. Urologe A 2008; 47:748-52. [DOI: 10.1007/s00120-008-1650-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
12
|
Horger DC, Wingo MS, Keane TE. Partial segmental thrombosis of corpus cavernosum: Case report and review of world literature. Urology 2005; 66:194. [PMID: 15921728 DOI: 10.1016/j.urology.2005.01.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2004] [Revised: 12/20/2004] [Accepted: 01/07/2005] [Indexed: 11/21/2022]
Abstract
Partial segmental priapism is an unusual clinical condition characterized by thrombosis within the proximal corpora cavernosa. Previous management strategies have included open exploration, surgical shunts, corporal injection, irrigation, and oral medication therapy. We report a case of a 37-year-old man treated conservatively with full restoration of erectile function.
Collapse
Affiliation(s)
- David C Horger
- Department of Urology, Medical University of South Carolina, Charleston, South Carolina, USA
| | | | | |
Collapse
|
13
|
Goeman L, Joniau S, Oyen R, Claes H, Van Poppel H. Idiopathic partial thrombosis of the corpus cavernosum: conservative management is effective and possible. Eur Urol 2003; 44:119-23. [PMID: 12814686 DOI: 10.1016/s0302-2838(03)00217-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Three cases of spontaneous, partial, unilateral thrombosis of the corpus cavernosum are described. The patients presented with a painful mass in the perineum without priapism. Diagnosis was made through ultrasound evaluation and magnetic resonance imaging, showing unilateral, partial thrombosis of the corpus cavernosum. Treatment consisted of systemic anticoagulation. In all three cases, the thrombosis resolved spontaneously over several months without complications. The aetiology of partial thrombosis of the corpus cavernosum remains unclear, but conservative management of this rare condition appears to be effective and safe.
Collapse
Affiliation(s)
- Lieven Goeman
- UZ Gasthuisberg Leuven, Department of Urology, Herestraat 49, 3000 Leuven, Belgium
| | | | | | | | | |
Collapse
|
14
|
Abstract
We report the cases of 2 patients with partial segmental priapism. The patients presented with pain, a perineal mass, and proximal segmental corporal thrombosis. Treatment consisted of a proximal corpus cavernosal-spongiosum shunt. Diagnostic considerations, literature review, and treatment options are discussed.
Collapse
Affiliation(s)
- J H Lewis
- Department of Urology, Henry Ford Hospital, Detroit, Michigan, USA
| | | | | | | |
Collapse
|