Unilateral Corporal Cavernosum Partial Thrombosis: A Challenging Presentation and Management

Koller, Christopher; Fustok, Judy; Hua, Jack; Triche, Benjamin L; Khera, Mohit; Raheem, Omer

doi:10.1016/j.urology.2021.02.009

Cited by 3 publications

(3 citation statements)

References 6 publications

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“…[2][3][4][8][9][10]12,14 Interestingly, a routine hematological study in these three conditions has not been established due to its typical results. 19 In 2015,…”

Section: Discussionmentioning

confidence: 99%

“…were variable because the etiology and clinical presentation of these three conditions remain controversial due to the paucity of reports. Nevertheless, conservative treatment with anti-inflammatory drugs and systemic anticoagulation was the first line of management19 to maintain erectile function, considering the presentation at a young age. Moreover, surgery was reserved for patients in whom conservative management failed,11,15 and pelvic Management algorithm muscle exercises, PDE5 inhibitors, and low-intensity shock wave therapy were offered as conservative management to patients affected by the hard flaccid syndrome 4.…”

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confidence: 99%

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Association between partial thrombosis of the corpus cavernosum, partial priapism, and hard flaccid syndrome: A scoping review

2022

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Aim:To describe the association between partial thrombosis of the corpus cavernosum, partial priapism, and hard flaccid syndrome.Methods: A scoping review was performed according to the recommendations of the Joanna Briggs Institute. Moreover, we performed a search strategy using the MED-LINE, 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 articles 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. Additionally, 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, MRI 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. Additionally, they cause proximal hardening of the pelvis, perineal pain, painful ejaculations, and cavernous asymmetry. Moreover, the imaging characteristics are similar in patients with partial priapism and partial cavernous thrombosis.

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“…[2][3][4][8][9][10]12,14 Interestingly, a routine hematological study in these three conditions has not been established due to its typical results. 19 In 2015,…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Association between partial thrombosis of the corpus cavernosum, partial priapism, and hard flaccid syndrome: A scoping review

2022

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“…MRI of the penis is commonly performed in the management of priapism with a combination of small field of view T2 weighted sequences in three orthogonal planes, larger field of view pelvic sequences, and dynamic post-gadolinium sequences. The small field of view anatomical T2 weighted sequences can demonstrate the extent of necrosis and fibrosis in ischemic priapism [14] and can identify lesions that may mimic true priapism such as metastatic infiltration [15] and segmental thrombosis [16,17].…”

Section: Imaging Techniquesmentioning

confidence: 99%

Review of the role of imaging in the diagnosis of priapism

von Stempel,

Walkden,

Kirkham

2024

Int J Impot Res

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Imaging has a specific role in the diagnosis and management of priapism. The primary imaging modality is ultrasound with colour Doppler (CDUS) which can accurately assess the hemodynamics of the cavernosal arteries. This is particularly useful in equivocal cases and can help differentiate ischemic from non-ischemic priapism as well as confirm the presence and location of arterio-venous fistulae post penile trauma. Furthermore, CDUS is invaluable in the post treatment follow up of non-ischemic priapism. Contrast enhanced magnetic resonance imaging (MRI) can demonstrate the extent of cavernosal necrosis in ischemic priapism and in conjunction with computer tomography (CT) has an important role in excluding underlying malignancy. MRI and CT angiography are used to evaluate pudendal arterial anatomy, which can be extremely variable and aids in the management of non-ischemic priapism. In selected cases of non-ischemic priapism, catheter angiography and transcatheter embolization of arteriovenous fistulae is an effective treatment. This review will examine the specific roles of different imaging modalities in the subtypes of priapism as well as highlight some of the pitfalls encountered in imaging.

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The International Penile Prosthesis Implant Consensus Forum: clinical recommendations and surgical principles on the inflatable 3-piece penile prosthesis implant

Chung

Bettocchi

Egydio³

et al. 2022

Nat Rev Urol

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Unilateral Corporal Cavernosum Partial Thrombosis: A Challenging Presentation and Management

Cited by 3 publications

References 6 publications

Association between partial thrombosis of the corpus cavernosum, partial priapism, and hard flaccid syndrome: A scoping review

Association between partial thrombosis of the corpus cavernosum, partial priapism, and hard flaccid syndrome: A scoping review

Review of the role of imaging in the diagnosis of priapism

The International Penile Prosthesis Implant Consensus Forum: clinical recommendations and surgical principles on the inflatable 3-piece penile prosthesis implant

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