Hematoma or “Partial Priapism” in the Proximal Part of the Corpus Cavernosum

Abstract

Introduction “Partial priapism” is a rare disorder. Therapy is controversial in literature. Aim To show that conservative treatment leads to a full functional recovery of this condition. Methods This report describes a case of a hematoma or “partial priapism” in the proximal part of the right corpus cavernosum. Results Complete functional recovery after conservative treatment with nonsteroidal anti-inflammatory drugs. Conclusion “Partial priapism” probably represents a hematoma in the interstitium of the proximal part of the corpus cavernosum. Conservative treatment is advised.

Partial segmental thrombosis of the corpus cavernosum presenting with perineal pain

“…Ilicki et al 27 suggested a two-hit model in which a transverse membrane divides the corpus into a proximal and distal portion and a trigger event such as microtrauma during vigorous sexual activity or prolonged cycling resulting in the formation of the thrombus. 36 We suspect that the cause of the PSTCC in this case was a combination of microtrauma during cycling and the presence of a fibrous septum illustrated in figure 1 9 11 14 18 30 31 33 36. This theory has also been proposed in recent case series published by Weyne et al 33…”

“…Risk factors associated with PSTCC are: haematological abnormalities such as thrombophilia or sickle-cell disease; alcohol or drug abuse such as cocaine or marijuana and hypercoagulability associated with dehydration, surgery, malignancy and long-distance flights 8 16 18 27 31 34 35. Hyperhomocysteinaemia and a-blockers have also been associated with PSTCC 21 24…”

“…Kimball et al 9 in 1988 did not administer any medical treatment and resolution of the thrombus began within a month of its occurrence. Additionally, several cases have reported successful treatment of PSTCC with aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) alone 11 18 23 25 31. However, low molecular weight heparin (LMWH) has been used more frequently in practice for the treatment of PSTCC, although the benefit over NSAIDs is unclear 13 17 18 20 26 27 29 32 33…”

“…Owing to minimal long-term data on outcomes, we recommend a follow-up by a specialist for at least 1 year, especially in the presence of erectile dysfunction or cavernosal fibrosis. PSTCC recurrence and long-term complications following medical management are still unknown and patients should be warned about this prior to discharge from specialist follow-up 30 31 33Learning points

Segmental thrombosis of the corpus cavernosum is rare, but should be suspected when a patient presents with perineal or penile pain and a palpable lump.

MRI of the pelvis and penis (T2-weighted and T1-weighted precontrast and postcontrast images) will identify a thrombus within the corpus cavernosum.

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Case report. Het herkennen en behandelen van een idiopathische partiële trombose van het corpus cavernosum, een zeldzaam en wellicht onbekend fenomeen in de acute urologie

“…Toch lijkt het ontstaan meestal idiopathisch [1][2][3][4][5][6][7][8][9][10][11]. Wel verdient het aanbeveling om hematologische tests te verrichten of de patiënt voor dergelijke tests door te verwijzen naar de hematoloog.…”