Partial Segmental Thrombosis of the Corpus Cavernosum: A Case Report and a Review of the Literature

Ilicki, Jonathan; Krauß, W.; Andersson, Swen‐Olof

doi:10.1016/j.urology.2011.11.032

Cited by 28 publications

(47 citation statements)

References 23 publications

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“…However, as more patients with acute and chronic perineal and genital pain are investigated with MRI, there are likely to be more cases diagnosed 9 13 15 17 18 20 21 23 24 27 28 30 32–35…”

Section: Discussionmentioning

confidence: 99%

“…The underlying cause is still unclear, but in earlier case reports where surgical exploration was the preferred management for pain, a fibrous septum was found within the corpus cavernosum separating the proximal part of the thrombus from the uninvolved distal corpus cavernosum 1–3 11 23 27 33. 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.…”

Section: Discussionmentioning

confidence: 99%

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Partial segmental thrombosis of the corpus cavernosum presenting with perineal pain

et al. 2016

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We describe the case of a man aged 43 years who presented with a 2-week history of a palpable lump in the right proximal penile shaft. This was preceded by a 6-month history of perineal pain, accompanied by erectile dysfunction. An urgent MRI scan of his penis identified a thrombus within the right crus and corpus of the penis. His thrombophilia screen was normal. The patient was started on oral anticoagulation and a phosphodiesterase inhibitor (PDE-5i) to prevent thrombus progression and maintain erectile function. At 5 months, the patients' symptoms had resolved and an MRI showed a reduction in the thrombus size. MRI is a useful imaging modality to diagnose a thrombus within the corpus cavernosum in patients presenting with a history of penile and perineal pain together with a palpable lump. The non-enhancement of the lesion helps to differentiate this from alternative rare lesions within the penis and perineum.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Partial segmental thrombosis of the corpus cavernosum presenting with perineal pain

et al. 2016

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“…De twijfel wordt verder versterkt door de bevinding dat het septum altijd bilateraal aanwezig is, terwijl de trombus zich vaak aan één zijde bevindt [6]. Daarnaast treedt de aandoening vaak op bij jonge mannen [4][5][6]14]. Indien een septum daadwerkelijk zou zijn ontstaan door recidiverende microtraumata en een trombose geluxeerd zou worden door een groter trauma, zou je de aandoening vaker verwachten bij oudere mannen.…”

Section: Discussieunclassified

“…Uit de literatuur komt naar voren dat de typische klachten waarmee een patiënt zich presenteert, bestaan uit hevige perineale pijnklachten en erectiestoornissen [3,4,6,14]. Ook wordt in sommige gevallen dysurie en een zwakkere urinestraal omschreven [6].…”

Section: Discussieunclassified

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

Jongerius¹,

Selm

Beck

2017

Tijdschr Urol

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“…3 This proposes that predisposed individuals have a permeable membrane between the proximal and distal corpora, which forms congenitally or as a result of repeated microtrauma or vascular insults. In PSTCC, an acute insult may lead to blockage of this membrane, resulting in increased pressure in the proximal compartment and resultant partial priapism.…”

Section: Case Bmentioning

confidence: 99%

Quantitative functional outcomes of the conservative management of partial segmental thrombosis of the corpus cavernosum

Gresty

Tadtayev

Arumainayagam

et al. 2015

annals

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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. Partial segmental thrombosis of the corpus cavernosum (PSTCC) is a rare condition with no reported UK cases and only 35 described in the world literature to date.1 The optimal management strategy of PSTCC remains elusive; both surgical and non-surgical approaches have been reported. We describe two conservatively managed cases of PSTCC and detail their formal erectile function at follow-up review, measured using the validated five-item version of the International Index of Erectile Function (IIEF-5) questionnaire. 2 Case histories Case AA 19-year-old moped user presented with a 3-day history of a painful perineal mass and no lower urinary tract symptoms, prior erectile dysfunction or priapism. He had engaged in vigorous sexual activity the night before the appearance of the mass and admitted misuse of anabolic steroids.Examination revealed a tender swelling over the proximal left corpus cavernosum with a flaccid distal penis. Admission blood tests and urinalysis were unremarkable apart from elevation of C-reactive protein at 91mg/l. Further investigation revealed hypogonadotrophic hypogonadism (low testosterone, normal luteinising hormone and follicle stimulating hormone) secondary to anabolic steroid misuse. Subsequent magnetic resonance imaging (MRI) showed thrombosis of the perineal part of the corpus cavernosum (Figure 1).The patient was managed conservatively (analgesia, 1 month of daily low molecular weight heparin [LMWH] injections and 3 months of aspirin 75mg daily). Repeat MRI at six weeks (Figure 1) showed significantly reduced thrombus volume. He subsequently reported resolution of the tender mass. However, detailed assessment using the IIEF-5 questionnaire revealed mild erectile dysfunction at 17 weeks and mild/moderate erectile dysfunction at 30 weeks (Table 1). He reported no penile curvature as the result of PSTCC. Case BA 37-year-old without any prior erectile dysfunction presented with perineal pain and dysuria. He had had vigorous sexual intercourse the preceding day, having just returned home after a two-hour flight from a long cycling holiday. Examination revealed a tender mass in the perineum arising from the left corpus cavernosum with a distal flaccid penis. Blood tests were unremarkable. Urinalysis was negative. Pelvic radiography and Doppler ultrasonography of the scrotum, inguinal and perineal region detected no abnormality. He underwent MRI, which showed low signal intensity in the base of the left corpus cavernosum, in keeping with PSTCC (Figure 2).At the six-week follow-up review, the patient reported resoluti...

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Partial Segmental Thrombosis of the Corpus Cavernosum: A Case Report and a Review of the Literature

Cited by 28 publications

References 23 publications

Partial segmental thrombosis of the corpus cavernosum presenting with perineal pain

Partial segmental thrombosis of the corpus cavernosum presenting with perineal pain

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

Quantitative functional outcomes of the conservative management of partial segmental thrombosis of the corpus cavernosum

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