A Rare Presentation of Partial Segmental Thrombosis of the Corpus Cavernosum Secondary to Sickle Cell Anemia

Abstract

Background: Partial segmental thrombosis of the corpus cavernosum, known as partial priapism, is an uncommon urological condition which predominantly affects young men in which the proximal part of one corpus cavernosum is thrombosed. Many risk factors have been described in the literature, however, the exact etiology of penile thrombosis and its pathogenesis remains unclear. Several treatment options are available ranging from conservative medical treatment, surgical intervention, or simple follow-up observation without treatment. Aim: In this study, we describe a patient with sickle cell anemia who presented with pain and a perineal swelling that was eventually diagnosed as partial priapism utilizing MRI scan and was treated conservatively with a successful outcome. We then performed a literature search of similar cases highlighting incidence, risk factors and management of this rare presentation. Case Presentation: A 23-year-old male who is known with sickle cell anemia presented to casualty with a 1-day history of perineal pain of a sudden onset associated with perineal swelling and vomiting. Genitourinary exam findings confirmed the absence of classic priapism. Careful examination of his perineal area revealed the presence of a fixed, hard, and tender mass at the proximal part of the penis. It was not attached to the overlying skin and no enlarged pelvic lymph nodes were felt. Once stabilized, MRI of the pelvis was performed showing right intra-tunical corpus cavernosum features suggestive of hematoma in keeping with partial segmental thrombosis of the corpus cavernosum. Conservative treatment was initiated, and the patient was managed expectantly in which he improved gradually with eventual disappearance of the perineal mass. Conclusion: Partial segmental thrombosis of the corpus cavernosum is a rare urological condition. Pathogenesis and etiologies are poorly understood but risk factors have been advocated of which sickle cell anemia is one of them. MRI has a crucial role in the diagnosis under this condition. Conservative treatment appears to be a reliable initial therapeutic option.