Eruption of blood: Arteriovenous malformation of the penile urethra

Abstract

While arteriovenous malformations (AVMs) are a common congenital or post-traumatic abnormality, male genital AVMs are rare and have been described in the scrotum or penis in pediatric patients.1,2 We describe a 34-year-old male presenting with recurrent spontaneous penile urethral bleeding found to have an AVM of the penile urethra. While angiography has traditionally been helpful, magnetic resonance imaging (MRI) can aid in the diagnosis and characterization of these lesions.3 Each case of male genital AVM provides a unique challenge to manage depending on the presenting complaint, as there are no guidelines to direct treatment.4.

Fig. 1.

T2-weighted images demonstrating a serpiginous tangle of vessels present in the posterior aspect of the corpus spongiosum. Left and right corpus cavernosa are unremarkable.

Fig. 2.

Multiple small flow voids enhancing post-contrast, most in keeping with an arteriovenous malformation.

Fig. 3.

Urethrotomy exposing 3 cm arteriovenous malformation adjacent to penile urethra