Abscess of the corpus cavernosum

Ultrasound-guided puncture and drainage for penile abscess: Case report and review of the literature

A subcutaneous abscess of the penis is a rare condition. It can be idiopathic or have an underlying cause, such as intracavernous injection therapy, foreign body, dilated perineal abscess, abnormal erection, or trauma. Clinical signs are mainly swelling in the penis, penile pain, and swelling. Conventional treatment is primarily surgical incision and drainage, followed by systemic antibiotic therapy. In recent years, with the development of medical technology, minimally invasive interventions and less invasive techniques, such as ultrasound-guided aspiration, are being developed. This article aims to report a case of ultrasound-guided successful diagnosis and treatment of an aseptic idiopathic subcutaneous abscess at the root of the penis and to review the literature on penile abscesses. The patient, a 61-year-old male, underwent ultrasound-guided puncture and drainage using a coaxial aspiration/flushing technique in combination with antibiotics to treat this rare urinary tract condition. The patient recovered well postoperatively and was discharged 3 days later. At a 2-week postoperative follow-up, an ultrasound showed a marked reduction in the penile abscess mass.

Corpus cavernosum abscess complicating distal shunt procedures for priapism

Abscess of the corpus cavernosum is a rare condition. We describe the case of a 36-year-old male presenting with bilateral corpus cavernousm abscesses, on a background of distal shunt procedures for recurrent priapism, that was managed with a bilateral corporotomy and systemic antibiotic therapy.

Level of Evidence: Level 4

Lactobacillus paragasseri as a novel causative pathogen of cavernosal abscess

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L. paragasseri causes oligosymptomatic febrile spontaneous cavernosal abscesses.

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Molecular identification methods alone can misidentify L. paragasseri as L. gasseri.

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Molecular and microbial biochemistry methods can identify L. paragasseri.

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Penicillins are optimal antimicrobials for treatment of L. paragasseri infections.

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L. paragasseri cavernosal abscesses need drainage with appropriate antimicrobials.

Most cases of cavernosal abscesses result from the progression of sexually transmitted diseases (STDs) commonly caused by Neisseria gonorrhoeae; however, cavernosal abscesses without STDs are rare events. Herein, we describe the first case report of a Lactobacillus paragasseri cavernosal abscess. A 63-year-old man with diabetes and a history of foreign object insertion into the urethra one year prior presented with high-grade fever and slight local pain. The patient was diagnosed with L. paragasseri cavernosal abscess based on computed tomography and microbial biochemical examinations in addition to matrix-assisted laser desorption ionization (MALDI) and 16S rRNA sequencing from blood and pus cultures. The patient was successfully treated with a surgical procedure and appropriate antimicrobials. Hence, L. paragasseri, a commensal bacterium of the gastrointestinal or genitourinary tract, can cause cavernosal abscesses. Notably, L. paragasseri is difficult to distinguish from L. gasseri using MALDI or 16S rRNA sequencing without microbial biochemical examinations owing to morphological similarities. Therefore, special attention should be paid, clinically and microbiologically, to the potential of L. paragasseri cavernosal abscess in clinical settings.

Penile aseptic abscess in the cavernous body at the base of the penis: a case report

We report a case of aseptic abscess in the cavernous body at the base of the penis. In our clinical observation, the patient underwent puncture and drainage of the corpus cavernosum abscess, followed by surgical resection of the abscess wall, with the incisions closed layer by layer with primary suture. In addition, we paid attention to strengthening the postoperative management by using elastic bandages to wrap the penis intermittently to prevent edema; the incision would not be covered with dressings from the third day after the operation, so as to keep the incision site dry in an open way. During the period of indwelling of the catheter after the operation, we noticed the care of the external orifice of the urethra to reduce the occurrence of catheter-related infections. Finally, the patient was diagnosed with a penile aseptic abscess in the cavernous body at the base of the penis. The patient recovered well after surgery and was discharged 1 week later. At 1.5 years after the operation, the shape of the penis returned to normal, and the erectile function was normal. It was seen that good nursing concept is of great help for prognosis, which could avoid infection and edema, and is conducive to wound healing.

A rare case of a spontaneous abscess of the corpus cavernosum: the role of contrast-enhanced ultrasound in diagnosis and post-therapeutic follow-up

In this paper, we describe the pattern of an idiopathic corpus cavernosum (CC) abscess using contrast-enhanced ultrasound (CEUS) and compare this to the lesion characterization achieved using preliminary baseline ultrasound/color doppler (ECD). In a 43-year-old man, who arrived at our emergency department for a penile swelling and hematopyuria, ECD examination showed equivocal mucosal and subcutaneous tissue swelling, an inhomogeneous hypoechoic area in the left CC, and a suspected millimetric interruption of the albuginea. CEUS showed multiple avascular areas wrapped in a hyperperfused rim representing abscesses and a not-perfused balanopreputial-oriented fistula. A CEUS control documented clinical remission after surgery. CEUS is a noninvasive and bedside executable method that allows a more precise evaluation of the entity, localization, and possible complications of CC abscesses and, therefore, permits prescribing the most adequate therapy to the patient, as well as the evaluation of eventual postsurgical sequelae.

A case of cavernosal abscess after neglected penile fracture and bacteremia

Penile abscess is a urological entity rarely described in the literature. It has been associated with injection therapy for erectile dysfunction, penile instrumentation, trauma and priapism. Identified risk factors include immunosuppresion and pre-existing local or distant infection. Common causal microorganisms include Staphylococcus aureus, Streptococci and Bacteroides. We herein report on a case of penile abscess in a 37-year-old patient occurring after sexual trauma and presenting with bacteremia.

Spontaneous cavernosal abscess: a case report and review of literature

A cavernosal abscess is a rare condition. It can be idiopathic or with an underlying cause such as intracavernosal injection therapy, foreign bodies, perineal abscesses extension, priapism or trauma. The most common presenting symptoms were penile pain and swelling. Standard treatment consists of drainage via an incision, followed by broad-spectrum antibiotics where some authors describe less invasive techniques such as image-guided aspiration. We present a case of spontaneous left cavernosal abscess diagnosed on MRI in a 60-year-old patient with uncontrolled diabetes mellitus that was treated by percutaneous ultrasound-guided aspiration drainage and systemic antibiotic therapy without any long-term sequela.

Spontaneous corpus cavernosum abscess in a healthy man using long-term androgenic anabolic steroids

Abscess formation of the corpus cavernosum is very rare. Here, we report a case of long-term anabolic androgenic steroid (AAS) abuse that is suspected to have facilitated the development of a corpus cavernosum abscess in a healthy bodybuilder. Cultures obtained from the abscess contained Staphylococcus epidermidis, a microorganism that almost exclusively affects immunocompromised patients. Therefore, prompt drainage of pus from cavernosal bodies should be the primary aim of the treatment. This case illustrates the potential danger of AAS suppressing the immune system and causing a serious infection.

Corpus cavernosum abscess after Winter procedure performance

A 23-year-old male patient with sickle-cell disease reported his third episode of priapism complicated by the presence of a corpus cavernosum abscess after the performance of a Winter procedure 20 days prior to his presentation. While in hospital for 11 days, two penile needle aspirations and three surgical drainages were performed with associated antibiotic therapy. He evolved with erectile dysfunction refractory to drug therapy and his infectious condition improved. An early penile prosthesis implantation followed after the use of a vacuum pump in an attempt to decrease the fibrotic process of the corpora cavernosa. Final results were positive.

Corpus cavernosum abscess from a blind-ending urethra after urinary diversion surgery

Corpus cavernosum abscesses are rarely seen in the clinical setting. We report the case of an early diagnosis of corpus cavernosum abscess due to a blind-ending urethra in a 60-year-old man without known risk factors and who was successfully treated by antibiotic therapy alone. In this case, the blind-ending urethra after urinary diversion surgery was considered a risk factor of the abscess formation. If the physician notes that the patient has fever of uncertain cause after urinary diversion surgery, he/she should examine the penis and perineum in consideration of the possibility of corpus cavernosum abscess.

Penile abscess secondary to neglected penile fracture after intracavernosal vasoactive drug injection

Penile abscesses are rare, but can develop after trauma, injection therapy, or surgery of the penis, or as an unusual presentation of sexually transmitted diseases. We report a case of penile abscess in a 51-year-old diabetic man, presented 9 days after neglected penile fracture following intracavernosal injection therapy and sexual intercourse. Penile ultrasonography and surgical exploration confirmed the physical examination findings of involvement of the corpus cavernosum. The pus culture from the abscess revealed Enterococcous faecalis. The patient was successfully treated by surgical drainage of the abscess and primary closure of the ruptured tunica albuginea.