Subcutaneous penile vein thrombosis (Penile Mondor's Disease): pathogenesis, diagnosis, and therapy.

OBJECTIVES: In international studies, only a few data are available on subcutaneous penile vein thrombosis. The pathogenesis is unknown, and no general recommendation exists regarding therapy.

METHODS: A total of 25 patients with the clinical picture of a "superficial penile vein thrombosis" were treated at our policlinic. All patients had noted sudden and almost painless indurations on the penile dorsal surface. The extent of the thrombosis varied. Detailed anamnesis, ultrasonography, and routine laboratory tests were performed for all patients, knowing that primary therapy was conservative.

RESULTS: No patient indicated any pain. Some reported a feeling of tension in the area of the thrombosis. In all patients, the thrombosis occurred in the dorsal penis shaft. It was close to the sulcus coronarius in 21 patients, near the penis root in 3, and in the entire penis shaft in 1 patient. The length of the thrombotic vein was between 2 and 4 cm. The ultrasound results were similar for all patients. The primary treatment was conservative for all patients. Recovery was achieved in more than 92% of cases (23 of 25 patients) using conservative therapy, which consisted of local dressing with heparin ointment (10,000 IU) and oral application of an antiphlogistic for 14 days. In 2 cases, thrombectomy was necessary.

CONCLUSIONS: Extended imaging diagnosis does not improve the evaluation of the extent of a superficial penile vein thrombosis. Conservative primary therapy consisting of heparin ointment and oral application of antiphlogistics is sufficient. If the thrombosis persists after conservative therapy, surgery is indicated.