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Danchi HG, Kay C, Hole SR, Baraki A. Partial Segmental Thrombosis of the Corpus Cavernosum Associated With Inappropriate Sildenafil Use. Cureus 2024; 16:e53462. [PMID: 38435230 PMCID: PMC10909401 DOI: 10.7759/cureus.53462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2024] [Indexed: 03/05/2024] Open
Abstract
The case presented is of a 39-year-old male with severe right groin pain and perineal pain the morning after sexual intercourse with the use of sildenafil without a diagnosis of erectile dysfunction. Partial segmental thrombosis of the corpus cavernosum (PSTCC) was diagnosed using magnetic resonance imaging and treated with direct oral anticoagulation without complications. Sildenafil use has been noted as an inciting factor for PSTCC in only two other cases of less than 60 cases reported in the literature and has even been used successfully as a component of therapeutic management of PSTCC in another previous case.
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Affiliation(s)
- Henry G Danchi
- Internal Medicine, Brooke Army Medical Center, San Antonio, USA
| | - Carl Kay
- Gastroenterology, Brooke Army Medical Center, San Antonio, USA
| | - Steven R Hole
- Radiology, Brooke Army Medical Center, San Antonio, USA
| | - Austin Baraki
- Internal Medicine, William Beaumont Army Medical Center, El Paso, USA
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2
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Schneider J, Schöttle T, Randecker D, Schwaibold H. [Idiopathic partial thrombosis of the corpus cavernosum (IPTCC) : A rare urological emergency]. UROLOGIE (HEIDELBERG, GERMANY) 2023; 62:929-935. [PMID: 37142812 DOI: 10.1007/s00120-023-02082-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/08/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Idiopathic partial thrombosis of the corpus cavernosum (IPTCC) is a rare, semi-acute disease in young, healthy men. In addition to an anatomical predisposition, perineal microtrauma is stated as the main risk factor. MATERIALS AND METHODS A case report and the results of a literature search with descriptive-statistical processing of 57 peer-reviewed publications are presented. A therapy concept was drawn up for clinical practice. RESULTS Our patient was treated conservatively and was consistent with the 87 cases which have been published since 1976. IPTCC is a disease of young men (33.2 years, range 18-70), which is associated with pain and perineal swelling in 88%. Sonography and contrast-enhanced magnetic resonance imaging (MRI) proved to be the diagnostic modality of choice, demonstrating the thrombus and in 89% a connective tissue membrane inside the corpus cavernosum. Treatment included antithrombotic and analgesic (n = 54, 62.1%), surgical (n = 20, 23%), analgesic (n = 8, 9.2%), via injection (n = 2, 2.3%), as well as radiological interventional (n = 1, 1.1%) options. In 12 cases, erectile dysfunction, mostly temporary, which required phosphodiesterase (PDE)-5 therapy developed. Recurrence and prolonged courses were rare. CONCLUSION IPTCC is a rare disease in young men. Conservative therapy with antithrombotic and analgesic treatment has shown good chances of full recovery. If relapse occurs or the patient refuses antithrombotic treatment, operative/alternative therapy management should be considered.
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Affiliation(s)
- J Schneider
- Klinikum am Steinenberg Reutlingen, Steinenbergstr. 31, 72764, Reutlingen, Deutschland.
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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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Baraças CA, Pinto J, Tavares MC. Partial thrombosis of the corpus cavernosum – a malignancy mimicker. BJR Case Rep 2022; 8:20210085. [PMID: 35136638 PMCID: PMC8803217 DOI: 10.1259/bjrcr.20210085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/26/2021] [Accepted: 08/30/2021] [Indexed: 11/23/2022] Open
Abstract
Partial thrombosis of the corpus cavernosum is a rare condition, typically seen in young patients. Etiology, physiopathology and treatment are still not entirely understood. The authors report a case of a 49-year-old male with gastric cancer, who successfully treated a thrombosis of the corpus cavernosum conservatively. Diagnostic considerations and treatment options are discussed.
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Affiliation(s)
| | - Jorge Pinto
- Hospital Pedro Hispano, ULS, Matosinhos, Portugal
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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
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6
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Militello FC, Aredez A, Yarade E, Pérez M. Segmental partial thrombosis of the corpora cavernosa: Case report and diagnostic/therapeutic algorithm. Rev Int Androl 2021; 20:68-72. [PMID: 33632657 DOI: 10.1016/j.androl.2020.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 05/22/2020] [Indexed: 11/18/2022]
Abstract
Cavernous body thrombosis is a rare condition. The etiology and pathophysiology of this entity is still poorly understood and there is no clear diagnostic and treatment algorithm. The objective of this article is to publish a clinical case of a partial segmental thrombosis of the corpus cavernosum and present a flow chart for diagnosis and treatment based on the review of the published literature on this disease.
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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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8
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Vieira-Leite C, Baleato-González S, Huelga-Zapico E, García-Figueiras R. Corpus cavernosum thrombosis: The membrane may play its role. Rev Int Androl 2018; 18:35-38. [PMID: 30501935 DOI: 10.1016/j.androl.2018.10.001] [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: 08/27/2018] [Revised: 10/05/2018] [Accepted: 10/15/2018] [Indexed: 10/27/2022]
Abstract
Partial thrombosis of corpus cavernosum is an uncommon condition that needs a high level of suspicious to be diagnosed. Imaging techniques may be very useful, and MR is the state-of-the-art technique. We present a case of a young male who presented to the emergency department with perineal and painful mass. MR imaging clearly depicted a thrombosed corpus cavernosum and a bilateral membrane that is possibly the underlying predisposing condition. With only conservative treatment the patient had an excellent outcome.
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Affiliation(s)
- Cecília Vieira-Leite
- Radiology Department, Hospital Clínico Universitario de Santiago de Compostela, Spain.
| | | | - Emilio Huelga-Zapico
- Radiology Department, Hospital Clínico Universitario de Santiago de Compostela, Spain
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Affiliation(s)
| | | | - Fabio Noro
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | | | - Márcio Miguez
- Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
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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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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
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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
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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]
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14
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Gresty H, Tadtayev S, Arumainayagam N, Patel S, King C, Boustead G, Banks F. Quantitative functional outcomes of the conservative management of partial segmental thrombosis of the corpus cavernosum. Ann R Coll Surg Engl 2015; 97:e108-11. [PMID: 26414373 DOI: 10.1308/rcsann.2015.0026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The low incidence of partial segmental thrombosis of the corpus cavernosum (PSTCC) means its management is guided by isolated case reports. Erectile function is an important outcome that has not been described quantitatively in the literature. We present two cases of PSTCC managed conservatively. Although both patients reported resolution of local symptoms, formal analysis of sexual function at follow-up review has revealed that only one achieved complete recovery.
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Affiliation(s)
- H Gresty
- Imperial College Healthcare NHS Trust , UK
| | - S Tadtayev
- East and North Hertfordshire NHS Trust , UK
| | | | - S Patel
- West Hertfordshire Hospitals NHS Trust , UK
| | - C King
- East and North Hertfordshire NHS Trust , UK
| | - G Boustead
- East and North Hertfordshire NHS Trust , UK
| | - F Banks
- West Hertfordshire Hospitals NHS Trust , UK
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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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Baran C, Mitchell GC, Hellstrom WJ. Cycling‐Related Sexual Dysfunction in Men and Women: A Review. Sex Med Rev 2014; 2:93-101. [DOI: 10.1002/smrj.32] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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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]
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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.
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Affiliation(s)
- Peter Hoyerup
- Department of Urology, Roskilde Hospital, Roskilde, Denmark
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