Trombosis venosa yuxtafrenular: a propósito de un caso y revisión de la bibliografía

Abstract

In routine health care activities, we are confronted with unusual situations, where we doubt our diagnostic abilities, due to lack of available data which give us, and our patients, confidence. And we do not have these data available, probably because we only present and publish a small proportion of these rare diseases. And this is more so when these unusual diseases affect the genitals, more specifically the male ones and more precisely, the penis. Such is the clinical case that is presented here, a venous thrombosis of the juxtafrenular penile veins, as we can demonstrate in the limited eight literature references found using the appropriate literature search.A clinical case is presented of a 24-year old male, with no personal history of interest, who consulted due to having discomfort in the frenulum area, which on examination, had a cord-like, fibrosclerotic structure a few millimetres thick, and situated in the juxtafrenulum, painful to palpation. Due to the lack of response to conservative treatment with anti-inflammatories and antibiotics, it was decided to perform an excisional biopsy on it, under local anaesthesia, performing a frenulectomy and a resection of the suspected thrombosed juxtafrenular vessel, with a final histopathological diagnosis of a venous thrombosis in organisational phase.After reviewing and consulting the very sparse literature available on unusual thrombosis in the genitals and more precisely, penile frenulum thrombosis, to our understanding, the aetiology can be idiopathic, traumatic or neoplastic. Also to our understanding, conservative treatment must be chosen initially, using local and/or general anti-inflammatories which may or may not be combined with antibiotics. However, when the patient does not respond per se or because it is in the advanced stages, surgical extirpation of the thrombosed area is more often required, as in our clinical case.Finally, we conclude that venous thrombosis of the juxtafrenular penile vessels is an extremely rare condition, but which can be clinically important in the specialised andrology clinic. The data gathered from the literature are scarce and none referred to venous thrombosis of the penile frenulum. Precisely, the rarity of the clinical case described here is a clear indication for its presentation and publication, with the aim of providing information for specialists, and as a result, to improve the health care of our patients..