Objective: Penile superficial venous throm- bosis is a rare and little-known benign genital condition. The largest series of penile superficial venous thrombosis cases in literature include 25 and 30 patients.
Material and Methods: A retrospective eva- luation was made of the data of 23 patients who were treated and followed up for a diagnosis of PMD in the Urology Outpatient Clinic between January 2009 and January 2018. Anamnesis, su- perficial vein color Doppler ultrasonography and routine laboratory analysis (i.e. blood count, elect- rolytes and coagulation tests) were applied to the patients. A conservative approach was provided the use of NSAIDs, anti-coagulant agents and to- pical Arnica Montana, and avoidance of the sexual activity. Follow-up examinations were made after 1, 3, 5, and 8 weeks and 3 months of treatment. Clinical improvement was evaluated.
Results: The age of the patients in the study was mean 42.4 ±11.12 years and median 44 ye- ars (range, 22-66 years). The mean BMI of the patients was 28.5±2.48 (range, 22.91-34.31). The mean period between the onset of symptoms and presentation was 9.35±13.42 days, median 4 days, and range, 1-60 days. On presentation, all the pa- tients had painless palpable cord symptoms. In 20 patients, the thrombotic vein could not be deter- mined externally. The diameter of the thrombosis was mean 3.09±1.04mm and median 3mm (range, 1.8–5). The diameter of the obstructed veins ran- ged from 1.3 to 4.7 mm. No pathological findings were determined in the standard laboratory tests of all 23 patients. The lesions were found to be pa- rallel to the sulcus below the coronal sulcus in 8 patients , and 15 patients had a cord-like lesion on the dorsal penis. The venous color Doppler ultra- sound results were similar for all the patients. No color filling and flow spectrum was observed in the lumen of the superficial vein on color Doppler US. In the etiology, prolonged sexual activity was determined in 8 patients, prolonged masturbation in 5, the use of a vacuum erection device in 3, and 7 patients were idiopathic. Only 1 patient had a history of PMD deve- lopment. Conservative treatment was applied to 21 of the 23 cases. Thrombectomy was required in 2 cases. At follow-up examination, two recurrent episodes were observed.
Conclusions: Penile Mondor’s disease is rare, but causes notice- able anxiety in patients. The results of this study demonstrate the effect of trauma in the etiology. Patients generally recover with conservative treatment, and occasionally surgical treatment may be necessary.
Keywords: Mondor’s disease, penis, thrombophlebitis
Abstract
Objective: Penile superficial venous throm- bosis is a rare and little-known benign genital condition. The largest series of penile superficial venous thrombosis cases in literature include 25 and 30 patients.
Material and Methods: A retrospective eva- luation was made of the data of 23 patients who were treated and followed up for a diagnosis of PMD in the Urology Outpatient Clinic between January 2009 and January 2018. Anamnesis, su- perficial vein color Doppler ultrasonography and routine laboratory analysis (i.e. blood count, elect- rolytes and coagulation tests) were applied to the patients. A conservative approach was provided the use of NSAIDs, anti-coagulant agents and to- pical Arnica Montana, and avoidance of the sexual activity. Follow-up examinations were made after 1, 3, 5, and 8 weeks and 3 months of treatment. Clinical improvement was evaluated.
Results: The age of the patients in the study was mean 42.4 ±11.12 years and median 44 ye- ars (range, 22-66 years). The mean BMI of the patients was 28.5±2.48 (range, 22.91-34.31). The mean period between the onset of symptoms and presentation was 9.35±13.42 days, median 4 days, and range, 1-60 days. On presentation, all the pa- tients had painless palpable cord symptoms. In 20 patients, the thrombotic vein could not be deter- mined externally. The diameter of the thrombosis was mean 3.09±1.04mm and median 3mm (range, 1.8–5). The diameter of the obstructed veins ran- ged from 1.3 to 4.7 mm. No pathological findings were determined in the standard laboratory tests of all 23 patients. The lesions were found to be pa- rallel to the sulcus below the coronal sulcus in 8 patients , and 15 patients had a cord-like lesion on the dorsal penis. The venous color Doppler ultra- sound results were similar for all the patients. No color filling and flow spectrum was observed in the lumen of the superficial vein on color Doppler US. In the etiology, prolonged sexual activity was determined in 8 patients, prolonged masturbation in 5, the use of a vacuum erection device in 3, and 7 patients were idiopathic. Only 1 patient had a history of PMD deve- lopment. Conservative treatment was applied to 21 of the 23 cases. Thrombectomy was required in 2 cases. At follow-up examination, two recurrent episodes were observed.
Conclusions: Penile Mondor’s disease is rare, but causes notice- able anxiety in patients. The results of this study demonstrate the effect of trauma in the etiology. Patients generally recover with conservative treatment, and occasionally surgical treatment may be necessary.
Keywords: Mondor’s disease, penis, thrombophlebitis