Partielle einseitige Schwellkörperthrombose bei Homozysteinämie

Abstract

Partial unilateral penile thrombosis of the corpus cavernosum is a very rare disease and occurs mainly in young men. The leading symptoms are perineal swelling and pain, while erectile function is maintained. The exact pathogenesis of this condition remains unclear. This is the first report of partial penile thrombosis due to hyperhomocysteinemia. Magnetic resonance imaging is the procedure of choice in diagnostics of partial penile thrombosis. For the treatment of partial penile thrombosis, surgical procedures are increasingly being replaced by more conservative treatments with analgesics and heparinization. Both surgical and conservative treatment provides excellent outcomes. A table provided in this article lists all published cases and refers to pathogenesis, diagnostics, therapy, and follow-up.

Idiopathic partial thrombosis of the corpus cavernosum: Aetiology, diagnosis and treatment

“…However, IPT has most commonly been treated conservatively with anticoagulants, such as heparin and acetylsalicylic acid, and oral analgesics, and in all 12 previously reported cases, resolution of symptoms and preservation of erectile function were reported [1,4,6,7,12,14,15,[18][19][20]. In one article, the authors describe no treatment of two cases [17].…”

“…In the remaining 10 cases the issue was not addressed and the images of the condition were unclear with regard to a septum [1][2][3][11][12][13]21,22].…”

“…Various imaging modalities including cavernosogram, ultrasound, computed tomography (CT) and MRI have been used in the diagnosis of IPT [1][2][3][4][5][6][7][8][10][11][12][13][14][15][16][17][18][19][20][21][22]. In newer case studies a combination of ultrasound and MRI or CT has replaced the cavernosogram.…”

“…In addition to a painful mass in the perineum, which was how the condition presented in all cases, some of the patients experienced erectile dysfunction, and a few complained about dysuria or a decrease in the calibre of the urinary stream. IPT has been associated with haematological diseases such as homocysteinaemia [1], sickle cell disease [2] and congenital spherocytosis [3], cocaine [4] and marijuana abuse [2], a prior history of priapism [2,5], (vigorous or prolonged) sexual activity [2,[4][5][6][7][8][9][10], tamsulosin [11], bicycle riding [12][13][14][15] and aeroplane flight [12]. IPT is always located in the proximal part of the CC while the distal CC remains flaccid.…”

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

“…coitus or erection in 11 cases (26.8%), unremarkable causes in 11 cases (26.8%), cycling in 6 cases (14.6%), hematological disorders (i.e. spherocytosis [31], sickle cell anemia [21], hyperhomocysteinemia [6], protein C resistance [9], blood transfusion [15]) in 5 cases (12.2%), while alcohol or drugs abuse (marijuana, cocaine) may have been the cause in 3 cases (7.3%); in 2 cases (4.9%) the condition was associated with long distance flights and one case each (2.6%) was caused by Sildenafil [14] and Tamsulosin [18]. One or more of these elements may consider being the cause of PSTCC (Table 1) 10 cases were surgically treated (24.4%), 21 cases (51.2%) were managed conservatively, 3 cases were treated by surgical aspiration ± injection or irrigation (7.3%), while 2 cases (4.9%) were only followed without treatment.…”