Bilateral partial thrombosis of the corpus cavernosum associated with the use of a stationary bike. Case report and literature review

Abstract

Partial and segmental thrombosis of the corpus cavernosum is a rare pathology not entirely understood, however, there are some triggers that have been associated in its appearance. We present a case of a 36-year-old patient with bilateral partial thrombosis of the corpus cavernosum, without priapism, after use of a stationary exercise bike. Ultrasound and magnetic resonance findings are shown, in which bilateral involvement stands out. The patient received conservative management with good response. This pathology is idiopathic and multiple factors have been associated to its origin, one of them being repetitive trauma due to sports activity.

Keywords: Bilateral thrombosis of the corpus cavernosum; Magnetic resonance imaging; Stationary bicycle; Ultrasound.

Fig. 1

Selected images of penile ultrasound in B mode and Doppler. The B-mode images in a and c show, in the transverse and longitudinal axis respectively, the increase in volume of the right corpus cavernosum with echogenic content inside (white arrow in a), compared to the contralateral one (black arrow in a) associated with mild posterior enhancement. In the color Doppler and low-flow Doppler images (b and d respectively), there is evidence of absence of vascularization. (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)

Fig. 2

Selected penile magnetic resonance images. Figures a, b and c present sagittal, coronal and axial T2 sequence slices where a hypointense signal is evident in the right corpus cavernosum (white arrow), which has a greater volume compared to the contralateral one and a hypointense linear image in a (black arrow) demonstrating a transverse septum. The left corpus cavernosum presents a hypointense area on T2 sequence suggestive of focal thrombotic involvement (black arrowhead). The image in d shows a sagittal cut of T1 sequence with fat saturation and contrast, showing absence of impregnation with intravenous contrast (white arrow) consistent with thrombotic origin.