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Jamali M, Cherraqi A, Melang Mvomo A, Boukhlifi Y, Alami M, Ameur A. Thrombosis of the deep dorsal vein of the penis caused by vaccine-induced thrombotic thrombocytopenia: First reported case. Arab J Urol 2023; 21:36-39. [PMID: 36818370 PMCID: PMC9930863 DOI: 10.1080/2090598x.2022.2127236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
The first described case of deep dorsal vein thrombosis of the penis secondary to vaccine-induced thrombotic thrombocytopenia (VITT), a complication of COVID adenoviral vector vaccines. The patient reported pain in the penis one month after vaccination. On ultrasound, a deep dorsal vein thrombosis was found and a biological workup was ordered to confirm the VITT trail. Anticoagulant therapy was immediately initiated and the patient responds well while suffering from erectile dysfunction. VITT is a potentially serious event that can be life-threatening; every practitioner should know how to deal with it.
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Affiliation(s)
- Mounir Jamali
- Urology Department, Mohammed V Military Hospital, Rabat, Morocco,CONTACT Mounir Jamali Urology Department, Mohammed V Military Hospital, Hay Ryad 10100 - Rabat, Morocco
| | - Amine Cherraqi
- Radiology Department, Mohammed V Military Hospital, Rabat, Morocco
| | | | | | - Mohammed Alami
- Urology Department, Mohammed V Military Hospital, Rabat, Morocco
| | - Ahmed Ameur
- Urology Department, Mohammed V Military Hospital, Rabat, Morocco
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2
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Czesla D, van der Meirschen M, Woitalla-Bruning J. Oberflächliche Venenthrombose der V. dorsalis penis superficialis – der penile Morbus Mondor – ein Fallbericht. PHLEBOLOGIE 2023. [DOI: 10.1055/a-1979-6987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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3
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Durmus E, Ok F. Could Penile Mondor’s Disease Worsen Symptoms in Patients with Erectile Dysfunction? J INVEST SURG 2022; 35:1668-1672. [DOI: 10.1080/08941939.2022.2092664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Emrullah Durmus
- Department of Urology, Siirt Training and Research Hospital, Siirt, Turkey
| | - Fesih Ok
- Department of Urology, Siirt Training and Research Hospital, Siirt, Turkey
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Bagheri SM, Tabrizi Z. Deep dorsal penile vein thrombosis in a patient with COVID-19 infection: A rare complication and the first reported case. Clin Case Rep 2021; 9:e05117. [PMID: 34925832 PMCID: PMC8647807 DOI: 10.1002/ccr3.5117] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/05/2021] [Accepted: 11/06/2021] [Indexed: 01/19/2023] Open
Abstract
COVID-19 infection may have extrapulmunary manifestations such as blood hypercoagulability that may cause thrombosis in both arterial and venous system. Deep dorsal penile vein thrombosis is very rare, and the most common reason is coagulation disorders. The common observed symptom is penile pain especially during erection and it is diagnosed by ultrasound evaluation of the vein. It is necessary to distinguish deep dorsal penile vein thrombosis from superficial dorsal penile vein thrombosis as it needs anti-coagulant treatment. In present study, we describe a unique case of the deep dorsal penile vein thrombosis following COVID-19 infection.
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Affiliation(s)
- Seyed Morteza Bagheri
- Department of RadiologyHasheminejad Kidney Center (HKC)Iran University of Medical SciencesTehranIran
| | - Zhale Tabrizi
- Radiology DepartmentIran University of Medical ScienceTehranIran
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Acute Superficial Vein Thrombosis of the Upper Extremity: A Case Report. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e3322. [PMID: 33425625 PMCID: PMC7787343 DOI: 10.1097/gox.0000000000003322] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 10/21/2020] [Indexed: 11/26/2022]
Abstract
Superficial vein thrombosis has traditionally been considered a disease of the lower extremity. Less frequently it can affect the breast, chest wall, penis, or upper extremity. Cases involving upper extremities are usually associated with intravascular access, and the vast majority remain self-limiting. This case report presents a 63-year-old patient who had acute extensive thrombosis of cephalic and basilic venous systems following resection of a desmoid tumor from the flank. This was likely related to intraoperative positioning and resulted in severe symptoms mimicking deep vein thrombosis and carpal tunnel syndrome. Additionally, diagnostic tools available to the hand surgeon that allow prompt diagnosis, management, and prevention are discussed.
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Dobran M, Benigni R, Nasi D, Cantoro D. Penile Mondor's disease after anterolateral retroperitoneal approach for lumbar fracture. BMJ Case Rep 2017; 2017:bcr-2017-220790. [PMID: 29092965 PMCID: PMC5695466 DOI: 10.1136/bcr-2017-220790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
This is a rare case of thrombosis of the dorsal vein of the penis (Mondor’s disease) occurred after an anterior-lateral retroperitoneal approach for a vertebral stabilisation in thoracolumbar vertebral fracture. Potential causes are traumatism, neoplasms, excessive sexual activity or abstinence. Although penile Mondor’s disease is a clinical diagnosis, ultrasound imaging is the gold standard to confirm it. In the reported case, 1 week after neurosurgical retroperitoneal procedure of vertebral stabilisation, the patient complained of a painful cord-like mass midshaft of penis. The diagnosis was made by clinical evaluation and ultrasound images. After 2 weeks of therapy with enoxaparin sodium, the patient recovered. The authors report this case evaluating the possible correlation between the anterior-lateral retroperitoneal approach and the development of the rare Mondor’s disease.
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Affiliation(s)
- Mauro Dobran
- Neurosurgery, Neurosurgery, Ancona, Italy, Italy
| | | | - Davide Nasi
- Neurosurgery, Neurosurgery, Ancona, Italy, Italy
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Pittaka M, Fotiou E, Dionysiou M, Polyviou P, Eracleous E, Andreopoulos D, Vassiliou VP. Penile Mondor's disease in a patient treated with radical chemoradiation for anal cancer. Oxf Med Case Reports 2017; 2017:omx036. [PMID: 29383260 PMCID: PMC5786214 DOI: 10.1093/omcr/omx036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 04/25/2017] [Indexed: 11/13/2022] Open
Abstract
Penile Mondor's disease is a rare condition characterized by sclerosing thrombophlebitis of the superficial dorsal penile vein. Usually its causes are benign, but it is also evident in cancer patients. We report the case of a 62-year-old man with a cT4 anal cancer (infiltration of corpora spongiosa and penile bulb), associated with extensive loco-regional lymphadenopathy, who developed painful lumps in the midline of the anterior penile surface while receiving radical chemoradiotherapy. Physical examination revealed two palpable cord-like swellings located 2 cm from the pubic symphysis. Color Doppler ultrasound established the diagnosis of Mondor's disease. The patient was successfully managed with non-steroidal anti-inflammatory drugs. The causative factors were pelvic malignancy and radiotherapy. The diagnosis was challenging since Mondor's disease is a rare condition and the differential diagnosis included malignancy progression. This is the first case report describing penile Mondor's disease in a patient with anal cancer under chemoradiotherapy.
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Affiliation(s)
- Maria Pittaka
- Department of Radiation Oncology, Bank of Cyprus Oncology Center 2006, Strovolos 2012, Nicosia, Cyprus
| | - Eleni Fotiou
- Department of Radiation Oncology, Bank of Cyprus Oncology Center 2006, Strovolos 2012, Nicosia, Cyprus
| | - Margarita Dionysiou
- Department of Radiation Oncology, Bank of Cyprus Oncology Center 2006, Strovolos 2012, Nicosia, Cyprus
| | - Petros Polyviou
- Diagnostic Radiology, Bank of Cyprus Oncology Center 2006, Strovolos 2012, Nicosia, Cyprus
| | - Eleni Eracleous
- Medical Diagnostic Center Ayios Therissos, 92 Spyrou Kyprianou Ave, 2033, Strovolos, Nicosia, Cyprus
| | - Demetris Andreopoulos
- Department of Radiation Oncology, Bank of Cyprus Oncology Center 2006, Strovolos 2012, Nicosia, Cyprus
| | - Vassilios P Vassiliou
- Department of Radiation Oncology, Bank of Cyprus Oncology Center 2006, Strovolos 2012, Nicosia, Cyprus
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Manimala NJ, Parker J. Evaluation and Treatment of Penile Thrombophlebitis (Mondor's Disease). Curr Urol Rep 2015; 16:39. [PMID: 25962547 DOI: 10.1007/s11934-015-0512-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Superficial penile thrombophlebitis or penile Mondor's disease (PMD) is an underreported condition that causes anxiety and embarrassment in affected men. Patients usually present with a smooth, cord-like induration on the dorsal penile shaft 1-7 days after prolonged or intensive sexual intercourse, but other presentations of disease and triggers for endothelial damage are possible. The condition is typically self-limited with expected spontaneous resolution within 4-8 weeks of initial presentation, and absolute diagnosis is usually not necessary with management including supportive care and pain control. However, when disease course is prolonged or there are concerning risk factors, it may be important to differentiate PMD from other conditions such as Peyronie's disease, hypercoagulability, blood stasis, genitourinary infection, and malignancy. History and physical are often sufficient to distinguish these conditions from PMD, but providers may employ ultrasound to assist with the diagnosis. If PMD does not spontaneously resolve, patients may be considered for thrombectomy, at which point histological analysis can confirm the diagnosis.
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Affiliation(s)
- Neil J Manimala
- Department of Urology, Morsani College of Medicine, University of South Florida, 2 Tampa General Cir, STC6, Tampa, FL, 33606, USA,
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Abstract
Mondor’s disease is a rare, self-limiting, benign process with acute presentation characterized by subcutaneous bands in several parts of the body. Penile Mondor’s disease (PMD) is thrombophlebitis of the superficial dorsal vein of the penis. It is usually considered as thrombophlebitis or phlebitis of subcutaneous vessels. Some findings suggest that it might be of lymphatic origin. The chest, abdominal wall, penis, upper arm, and other parts of the body may also be involved by the disease. Although its physiopathology is not exactly known, transection of the vessel during surgery or any type of trauma such as external compression may trigger its possible development. This disease almost always limits itself. It may be associated with psychological distress and sexual incompatibility. The patients usually feel the superficial vein of the penis like a hard rope and present with complaint of pain around this hardness. Diagnosis is usually easy with physical examination but color Doppler ultrasound examination is important for differential diagnosis. Thus, a close collaboration is required between radiologist and urologist in order to determine the correct diagnosis and appropriate therapies.
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Affiliation(s)
- Hakan Öztürk
- Department of Urology, School of Medicine, Sifa University, Fevzipasa Boulevard No:172/2 Basmane, Konak, 35240 Izmir, Turkey
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Nazir SS, Khan M. Thrombosis of the dorsal vein of the penis (Mondor's Disease): A case report and review of the literature. Indian J Urol 2011; 26:431-3. [PMID: 21116369 PMCID: PMC2978449 DOI: 10.4103/0970-1591.70588] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Superficial thrombophlebitis of the dorsal vein of the penis (penile Mondor's Disease) is an important clinical diagnosis that every family practitioner should be able to recognize. Dorsal vein thrombosis is a rare disease with pain and induration of the dorsal part of the penis. The possible causes comprise traumatism, neoplasms, excessive sexual activity, or abstinence. The differential diagnosis must be established with Sclerotizing lymphangitis and peyronies disease and doppler ultrasound is the imaging diagnostic technique of choice. Proper diagnosis and consequent reassurance can help to dissipate the anxiety typically experienced by the patients with this disease. We describe the symptoms, diagnosis, and treatment of the superficial thrombophlebitis of the dorsal vein of the penis.
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Affiliation(s)
- Syed Sajjad Nazir
- Department of Surgery and Urological Division Government Medical College, Srinagar, India
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Shen HL, Liu SP, Wang SM, Tsay W, Hsieh JT. Elevated plasma factor VIII coagulant activity presenting with thrombophlebitis of the deep dorsal vein of the penis. Int J Urol 2007; 14:663-4. [PMID: 17645617 DOI: 10.1111/j.1442-2042.2007.01789.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A 55-year-old man started to suffer from severe penile pain 2 days after engaging in sexual intercourse in the woman-on-top position. A fixed, 2-cm long, cord-like lesion was found on the dorsal midline of his penis which was in a partially tumescent state. Ultrasonography showed part of the deep dorsal vein was obstructed by a hyperechoic mass. Laboratory tests revealed elevated plasma factor VIII coagulant activity. The patient received thrombophlebectomy of the deep dorsal penile vein. Pathology reported venous thrombosis with eosinophilic and lymphocytic infiltration of the venous wall. At the outpatient follow up, painful thrombophlebitic veins at the previous i.v. accesses were noted on his left arm. He has received long-term warfarin control as suggested by hematologists. This patient represents the first reported case of deep dorsal penile thrombophlebitis associated with elevated plasma factor VIII coagulant activity, which is an independent risk factor of recurrent venous thromboembolism and superficial thrombophlebitis.
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Affiliation(s)
- Heng-Li Shen
- Department of Urology, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, Taiwan 100
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Arce Gil J, Rodríguez-Ledesma JM, Mavrich HV. [Rupture of the superficial dorsal vein of the penis]. Actas Urol Esp 2006; 30:215-7. [PMID: 16703678 DOI: 10.1016/s0210-4806(06)73425-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Rupture of the superficial dorsal vein of the penis during intercourse is an unfrequented entity that makes the differential diagnosis with other acute penile injuries that may require surgical exploration necessary. We report the case of a 58-year-old male patient with 24-hours evolution painless haematoma after intercourse; its evolution and characteristic physical exploration enable us to adopt a conservative approach that resulted in complete recovery without sequels.
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Affiliation(s)
- J Arce Gil
- Servicio de Urología, Fundació Puigvert, Barcelona.
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Abstract
Injuries to the GU system commonly occur in patients with high-energy lower abdominal or pelvic trauma. The emergency physician should be well versed in the diagnosis and management of GU trauma, although these injuries are not usually life threatening because of the potential for loss of urinary or sexual function. In the setting of hemodynamic instability, diagnosis and treatment of GU injuries is often accomplished in the operative setting. In the stable patient, diagnostic testing is directed by the type of suspected injury and must proceed in a reverse manner, i.e., external injury then urethral injury then bladder, and finally urethral and renal damage. Treatment focuses on a team approach between the emergency physician, general, orthopedic, and urologic surgeon. The decision for operative repair is often dictated more by other associated injuries than urologic injuries, and the urologic surgeon often provides temporizing measures with definitive repair at a later time. Prompt diagnosis and treatment of injuries to the external genitals results in excellent long-term outcome, minimizing the devastating consequences of impotence, urinary incontinence, and sexual disfiguration.
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Affiliation(s)
- D A Dreitlein
- Department of Emergency Medicine, Rhode Island Hospital, Brown University School of Medicine, Providence, Rhode Island, USA
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Lee J, Singh B, Kravets FG, Trocchia A, Waltzer WC, Khan SA. Sexually acquired vascular injuries of the penis: a review. THE JOURNAL OF TRAUMA 2000; 49:351-8. [PMID: 10963554 DOI: 10.1097/00005373-200008000-00029] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- J Lee
- Department of Urology, SUNY at Stony Brook, New York 11794-8093, USA
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