title: Idiopathic Partial Thrombosis (IPT) of the Corpus Cavernosum: A Hypothesis-Generating Case Series and Review of the Literature.
abstract: BACKGROUND
  Idiopathic partial thrombosis (IPT) of the corpus cavernosum is a rare condition. The etiology is not fully understood; however, the presence of an either or not congenital web in these patients may contribute to the development of IPT.
  
  
  OBJECTIVE
  The aim of this study was to describe 18 new IPT cases and compare these with 38 cases found in the literature.
  
  
  METHODS
  A multicenter retrospective analysis was performed. Descriptive statistics are given.
  
  
  METHODS
  The main outcome measures used were clinical presentation, clinical and radiographical diagnostics, treatment and resolution of symptoms.
  
  
  RESULTS
  Patients most frequently presented with perineal swelling (10/18; 56%) and pain (13/18; 72%), unilateral (12/18; 67%) or bilateral (4/18; 22%), and pain during erection (10/18; 72%). Penile curvature, dysuria or fever (each 1/18; 6%) were uncommon presenting symptoms. In our series, magnetic resonance imaging demonstrated a fibrous web in the corpus cavernosum in 100% of cases and was more bilaterally (11/18; 61%) than unilaterally (7/18; 39%) diagnosed. Cycling was found to be a provocative factor for IPT occurrence in patients at risk as 61% (11/18) of patients reported being a frequent cyclist with the episode of IPT occurring immediately after or during cycling activity in 8 out of 18 patients (8/18; 44%). In five centers, 15 patients were treated conservatively, the majority being treated with therapeutic doses of low molecular weight heparin and simultaneous anti-aggregant therapy. In one center, all three patients were treated with a surgical approach. Complete resolution of symptoms was noted in only 50% of cases.
  
  
  CONCLUSIONS
  IPT is a condition that presents typically with perineal pain and swelling. Cycling is often seen as a provocative factor, while the presence of a fibrous web at the level of the crurocavernosal junction is the underlying disorder allowing for entrapment of blood in the crura. Conservative treatment provides a reasonably good outcome in most cases. For therapy resistant cases, surgery can be considered.
authors.affiliation: Department of Urology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Weyne
authors.affiliation: Department of Urology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Schillebeeckx
authors.affiliation: Department of Urology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Caroline
authors.initials: C
authors.lastname: Jamaer
authors.affiliation: Department of Urology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Pieter
authors.initials: P
authors.lastname: D'Hulst
authors.affiliation: Department of Urology, Humanitas Mater Domini, Humanitas University, Castellanza, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bozzini
authors.affiliation: Division of Urology, Department of Surgery, University of Vermont College of Medicine, Burlington, VT, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Grunert
authors.affiliation: Department of Urology, Gent University Hospital, Ghent, Belgium.
authors.forename: Frederiek
authors.initials: F
authors.lastname: d'Hondt
authors.affiliation: Department of Urology, Gent University Hospital, Ghent, Belgium.
authors.forename: Piet
authors.initials: P
authors.lastname: Hoebeke
authors.affiliation: Clinic of Urology, Universitats Spital Zürich, Zürich, Zwitserland.
authors.forename: Alexander
authors.initials: A
authors.lastname: Müller
authors.affiliation: Clinic of Urology, Jessa Hospital Campus Salvator, Hasselt, Belgium.
authors.forename: Koenraad
authors.initials: K
authors.lastname: Van Renterghem
authors.affiliation: Department of Urology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Steven
authors.initials: S
authors.lastname: Joniau
authors.affiliation: Department of Urology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Maarten
authors.initials: M
authors.lastname: Albersen
mesh_terms: D000328:Adult; D000925:Anticoagulants; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017699:Pelvic Pain / Q000209:etiology* / Q000473:pathology; D010409:Penile Diseases / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D010413:Penis / Q000098:blood supply*; D012189:Retrospective Studies; D015912:Thrombolytic Therapy / Q000379:methods*; D013927:Thrombosis / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants
keywords: Corpus Cavernosum; Partial Priapism; Penis; Perineal Mass; Perineal Swelling; Priapism; Thrombus; Venous Outflow; Web