Deep venous thrombosis of the penis revealed by penile swelling, report on seven cases and literature review

Purpose. - Deep dorsal vein thrombosis of the penis is spontaneously remitting benign throm-bophlebitis. We propose to describe clinical assessment, diagnosis and differential diagnosis of deep dorsal vein thrombosis of the penis and to observe its natural course over time. Patients and methods. - Seven patients between ages of 13 and 50 years who self-presented for swelling penile, had diagnosis of deep dorsal vein thrombosis of the penis. Initial history, examination and Doppler ultrasound were undertaken. This was supplemented by blood screening for coagulation defects. Results. -All patients consulted for a painful penis. Priapism were noted in three patients. Doppler ultrasound which realized in all cases, revealed thrombosis of the deep dorsal vein of the penis. The first aetiology of the venous thrombosis was hemopathy (three cases). Early anticoagulants with low molecular weight heparin were instaured. Patients with priapism were treated with aspiration and irrigation of the corpa cavemosa and had good evolution. Specific treatment (chemotherapy, corticosteroid) was used in two patients. However, definitive erectile dysfunction persists in two patients. One among these patients had clinical history of priapism. Conclusion. - Dorsal vein thrombosis of the penis should be considered as a urologic urgency. Its natural course tends to be one of spontaneous resolution. Usually a benign condition, careful etiological search with risk factors is needed to avoid missing exceptional causes. But, followup is of utmost importance because risk of erectile dysfunction, which need early diagnosis, effective treatment and psychological support. (C) 2014 Elsevier Masson SAS. All rights reserved.