A case of unprovoked segmental proximal partial thrombosis of the corpus cavernosum

Abstract

Partial thrombosis of the corpus cavernosum is an extremely rare and likely underdiagnosed urologic condition. We discuss a case of a 25-year-old male who presented with severe perineal pain and was diagnosed with idiopathic proximal partial thrombosis of the corpus cavernosum via ultrasound and MRI. The patient experienced symptom resolution with evidence of disease regression on follow up MRI after treatment with direct oral anticoagulation. Further studies are needed to fully delineate the pathophysiology of this condition to facilitate development of standardized diagnostic and treatment algorithms.

Keywords: Corpus cavernosum; Direct oral anticoagulant; Idiopathic partial thrombosis.

Fig. 1

(a) Hypoechoic area corresponding to the abnormality seen in the left corpus cavernosum with no internal vascularity and absent flow on the spectral Doppler images. (b) Arterial flow is demonstrated in the distal portion of the left corpus cavernosum.

Fig. 2

(a) Initial MRI at presentation with 11.5cm segment from the base to the midportion of left corpora cavernosum with restricted diffusion. b) Repeat MRI at 4-month interval with 2.1cm area of T2 hypointensity in the left corpus cavernosum at the midportion of the penis decreased from prior. c) Repeat MRI at 8-month interval with stable 2.1cm area of T2 hypointensity with loss of peripheral enhancement consistent with scar formation.