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Kho YY, Lee SHE, Chin K, Sidek NZ, Ma VC, Seng DH, Cai S, Tan LW, Teo SM, Gogna A, Patel A, Venkatanarasimha N. US of the Penis: Beyond Erectile Dysfunction. Radiographics 2024; 44:e230157. [PMID: 38814798 DOI: 10.1148/rg.230157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
High-frequency US, with a linear transducer and gray-scale, color, and spectral Doppler US techniques, is the primary imaging modality for evaluation of the penis. It can allow delineation of anatomy and assessment of dynamic blood flow; it is easily available and noninvasive or minimally invasive; it is cost effective; and it is well tolerated by patients. US assessment after pharmacologic induction of erection is an additional tool in assessing patients with suspected vasculogenic impotence, and also in selected patients with penile trauma and suspected Peyronie disease. Penile injuries, life-threatening infections, and vascular conditions such as priapism warrant rapid diagnosis to prevent long-term morbidities due to clinical misdiagnosis or delayed treatment. US can facilitate a timely diagnosis in these emergency conditions, even at the point of care such as the emergency department, which can facilitate timely treatment. In addition, color and spectral Doppler US are valuable applications in the follow-up of patients treated with endovascular revascularization procedures for vasculogenic erectile dysfunction. Image optimization and attention to meticulous techniques including Doppler US is vital to improve diagnostic accuracy. Radiologists should be familiar with the detailed US anatomy, pathophysiologic characteristics, scanning techniques, potential pitfalls, and US manifestations of a wide spectrum of vascular and nonvascular penile conditions to suggest an accurate diagnosis and direct further management. The authors review a range of common and uncommon abnormalities of the penis, highlight their key US features, discuss differential diagnosis considerations, and briefly review management. ©RSNA, 2024 Supplemental material is available for this article.
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Affiliation(s)
- Ying Ying Kho
- From the Allied Health Division (Y.Y.K., S.H.E.L., N.Z.S., V.C.M., D.H.S., S.C., L.W.T., S.M.T.) and Division of Radiological Sciences (K.C., A.G., A.P., N.V.), Singapore General Hospital, 31 Third Hospital Ave, Singapore 168753
| | - Sally Hsueh Er Lee
- From the Allied Health Division (Y.Y.K., S.H.E.L., N.Z.S., V.C.M., D.H.S., S.C., L.W.T., S.M.T.) and Division of Radiological Sciences (K.C., A.G., A.P., N.V.), Singapore General Hospital, 31 Third Hospital Ave, Singapore 168753
| | - Kenneth Chin
- From the Allied Health Division (Y.Y.K., S.H.E.L., N.Z.S., V.C.M., D.H.S., S.C., L.W.T., S.M.T.) and Division of Radiological Sciences (K.C., A.G., A.P., N.V.), Singapore General Hospital, 31 Third Hospital Ave, Singapore 168753
| | - Nur Zakiah Sidek
- From the Allied Health Division (Y.Y.K., S.H.E.L., N.Z.S., V.C.M., D.H.S., S.C., L.W.T., S.M.T.) and Division of Radiological Sciences (K.C., A.G., A.P., N.V.), Singapore General Hospital, 31 Third Hospital Ave, Singapore 168753
| | - Voon Chee Ma
- From the Allied Health Division (Y.Y.K., S.H.E.L., N.Z.S., V.C.M., D.H.S., S.C., L.W.T., S.M.T.) and Division of Radiological Sciences (K.C., A.G., A.P., N.V.), Singapore General Hospital, 31 Third Hospital Ave, Singapore 168753
| | - Dorothy Hkawn Seng
- From the Allied Health Division (Y.Y.K., S.H.E.L., N.Z.S., V.C.M., D.H.S., S.C., L.W.T., S.M.T.) and Division of Radiological Sciences (K.C., A.G., A.P., N.V.), Singapore General Hospital, 31 Third Hospital Ave, Singapore 168753
| | - Sihui Cai
- From the Allied Health Division (Y.Y.K., S.H.E.L., N.Z.S., V.C.M., D.H.S., S.C., L.W.T., S.M.T.) and Division of Radiological Sciences (K.C., A.G., A.P., N.V.), Singapore General Hospital, 31 Third Hospital Ave, Singapore 168753
| | - Lee Wei Tan
- From the Allied Health Division (Y.Y.K., S.H.E.L., N.Z.S., V.C.M., D.H.S., S.C., L.W.T., S.M.T.) and Division of Radiological Sciences (K.C., A.G., A.P., N.V.), Singapore General Hospital, 31 Third Hospital Ave, Singapore 168753
| | - Si Min Teo
- From the Allied Health Division (Y.Y.K., S.H.E.L., N.Z.S., V.C.M., D.H.S., S.C., L.W.T., S.M.T.) and Division of Radiological Sciences (K.C., A.G., A.P., N.V.), Singapore General Hospital, 31 Third Hospital Ave, Singapore 168753
| | - Apoorva Gogna
- From the Allied Health Division (Y.Y.K., S.H.E.L., N.Z.S., V.C.M., D.H.S., S.C., L.W.T., S.M.T.) and Division of Radiological Sciences (K.C., A.G., A.P., N.V.), Singapore General Hospital, 31 Third Hospital Ave, Singapore 168753
| | - Ankur Patel
- From the Allied Health Division (Y.Y.K., S.H.E.L., N.Z.S., V.C.M., D.H.S., S.C., L.W.T., S.M.T.) and Division of Radiological Sciences (K.C., A.G., A.P., N.V.), Singapore General Hospital, 31 Third Hospital Ave, Singapore 168753
| | - Nanda Venkatanarasimha
- From the Allied Health Division (Y.Y.K., S.H.E.L., N.Z.S., V.C.M., D.H.S., S.C., L.W.T., S.M.T.) and Division of Radiological Sciences (K.C., A.G., A.P., N.V.), Singapore General Hospital, 31 Third Hospital Ave, Singapore 168753
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Foschi N, Santoro PE, Borrelli I, Gavi F, Amantea C, Russo P, Moscato U. Urological Safety and COVID-19 Vaccinations. Vaccines (Basel) 2022; 10:1887. [PMID: 36366395 PMCID: PMC9694307 DOI: 10.3390/vaccines10111887] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/28/2022] [Accepted: 11/03/2022] [Indexed: 01/17/2024] Open
Abstract
OBJECTIVE To discuss the impact of COVID-19 vaccines on the urological field and to review the available data in the literature. MATERIAL AND METHODS All the related reports and original articles discussing COVID-19 vaccines and their impact on the urological field were searched in PubMed, Scopus, and Web of Science. RESULTS There are few published articles discussing the COVID-19 vaccine impact on urology. Vaccine safety was confirmed in this field as no major side effects were described. AKI (Acute Kidney Injury) was reported in selected populations. However, about 1% of the side effects was urological. Rare genital complications, low urinary tract symptoms, and occasional gross hematuria were reported. Fertility seems to be not impaired after vaccination. A potential misinterpretation of radiological findings in the oncological field has been reported. CONCLUSIONS In the literature, there are few studies regarding COVID-19 vaccines and their impact on the urological and andrological fields. We need more studies and extended follow-ups after repeated vaccinations in order to have more corroborating data particularly in selected populations, such as kidney transplant recipients and oncological patients.
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Affiliation(s)
- Nazario Foschi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Paolo Emilio Santoro
- Department of Health Science and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy
- Postgraduate School of Occupational Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Ivan Borrelli
- Department of Health Science and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Postgraduate School of Occupational Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Filippo Gavi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Carlotta Amantea
- Postgraduate School of Occupational Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Pierluigi Russo
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Umberto Moscato
- Department of Health Science and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy
- Postgraduate School of Occupational Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
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Connelly ZM, Whitaker D, Dullea A, Ramasamy R. SARS-CoV-2 Effects on the Male Genitourinary System. AMERICAN JOURNAL OF CLINICAL AND EXPERIMENTAL UROLOGY 2022; 10:199-209. [PMID: 36051611 PMCID: PMC9428573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 06/30/2022] [Indexed: 06/15/2023]
Abstract
SARS-CoV-2 infection arose in 2019 and has changed life as we know it. With our ever-advancing knowledge, therapies, and vaccines, more functions of the SARS-CoV-2 virus are being investigated outside of its pulmonary invasion. Here, we set out to review the current and pertinent literature on the impact of SARS-CoV-2 on the male genitourinary system including the bladder, lower urinary tract, prostate, testis, and penis. The biggest newsworthy stake was if SARS-CoV-2 could be transmitted through semen. Although initially thought to occur, more recent studies have opposed this hypothesis. Outside of the reproductive spread of SARS-CoV-2, multiple studies in this review highlight where the virus resides and what effect it may be having on this genitourinary system including increased voiding problems, viral persistence months after systemic clearance, and rare penile complications post-infection. Long-term outcomes are still needed to fully understand how SARS-CoV-2 infection can alter the genitourinary system.
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Affiliation(s)
- Zachary M Connelly
- Department of Surgery, Louisiana State University Health ShreveportShreveport, LA, USA
| | - Dustin Whitaker
- Department of Urology, University of Tennessee KnoxvilleKnoxville, TN, USA
| | | | - Ranjith Ramasamy
- Department of Urology, University of Miami Miller School of MedicineMiami, FL, USA
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Balawender K, Pliszka A, Surowiec A, Rajda S. COVID-19 infection as a new risk factor for penile Mondor disease. BMC Urol 2022; 22:57. [PMID: 35413893 PMCID: PMC9005161 DOI: 10.1186/s12894-022-01002-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 03/24/2022] [Indexed: 12/03/2022] Open
Abstract
Background Penile Mondor disease is a superficial dorsal vein thrombophlebitis of the penis, which mainly affects young and middle-aged men. It generally manifests as a visible painful cord located along the dorsal surface of the penis with signs of skin inflammation. The condition is usually self-limiting, but in severe cases a surgical procedure may be necessary in addition to pharmacological treatment. Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 is associated with a frequent incidence of thrombophilia; therefore, such a prothrombotic state during infection may be a significant risk factor for penile Mondor disease. Case presentation The 34-year-old patient reported moderate pain felt on the surface of the penis. During the medical interview, the patient did not admit significant risk factors for Mondor Disease, apart from the previous, a month earlier COVID-19 disease. Examination revealed swelling erythema and a thick indurated cord on the surface of the penis. Color Doppler ultrasound was performed to confirm assumptions and exclude thrombosis of other penile vessels. Based on visible clots in the course of the superficial penile vein and after exclusion of vasculitis due to autoimmune disease the diagnosis of penile Mondor disease was made. Pharmacological therapy was implemented to further break down the clot and prevent rethrombosis in the penile vessels. The patient did not report any treatment complications and returned for a control visit, which revealed complete clot dissolution on ultrasound; therefore, complete recovery was stated. Conclusions This case report presents the correlation between SARS-Cov-2 infection and penile Mondor disease, based on the confirmed influence of COVID-19 on the pathophysiology of thrombosis. It can be concluded that COVID- 19 is a risk factor for Mondor disease, as in the presented case the virus was the only prothrombotic risk factor for the patient. Consequently, the possibility of developing thrombosis in the form of penile Mondor disease should be taken into account among patients with post-COVID-19 and active SARS-Cov-2 infection.
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Affiliation(s)
- Krzysztof Balawender
- Clinical Department of Urology and Urological Oncology, Municipal Hospital in Rzeszow, Rycerska 4, 35-241, Rzeszow, Poland. .,Morphological Sciences Department, Institute of Medical Sciences, Medical College of Rzeszow University, Leszka Czarnego 4, 35-301, Rzeszow, Poland.
| | - Anna Pliszka
- Morphological Sciences Department, Institute of Medical Sciences, Medical College of Rzeszow University, Leszka Czarnego 4, 35-301, Rzeszow, Poland
| | - Agata Surowiec
- Morphological Sciences Department, Institute of Medical Sciences, Medical College of Rzeszow University, Leszka Czarnego 4, 35-301, Rzeszow, Poland
| | - Sebastian Rajda
- Morphological Sciences Department, Institute of Medical Sciences, Medical College of Rzeszow University, Leszka Czarnego 4, 35-301, Rzeszow, Poland
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