Mondor Phlebitis (Mondor’s disease) of the Penis: A Review and Update of the Literature

Volume 2 - Issue 5

Anthony Venyo*

Received:February 25, 2020;   Published: March 12, 2020

DOI: 10.32474/OAJRSD.2020.02.000147

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Abstract

Mondor’s disease of the penis (MDP) is an uncommon disease which tends to affect sexually active males whose ages have tended to range between 18 years and 70 years, but it could manifest in younger and older males. MDP may present with a throbbing and aching painful dorsal induration that had involved the penis, a painful swelling of the penis which had ensued a laborious coital activity, The finding of a firm, sub-cutaneous cord-like structure or structures, that tend most often to be parallel to the coronal sulcus, The dorsal midline of the shaft of the penis as well as the foreskin could be affected by the disease which has produced firm cord-like structures, Tenderness and pain within the penis could occur in few cases especially during erection, painful lumps within the penis that may be present for a period of short time to few years in chronic cases. Isolated MDP may mimic Peyronies’s disease, laceration of corpus cavernosum and polyarteritis nodosa. Similar penile lesions of the penis could be on rare occasions be seen in associated with deep vein thrombosis, or a palpable cord-like lesion on the dorsum of the penis that has arisen within 24 hours to 48 hours of prolonged coital activity but the duration could be longer. Some of the possible aetiological factors of MDP include:

a) Trauma due to prolonged or vigorous coital activity, trauma to the penis, fracture of the penis, prolonged abstinence from coital activity, utilization of vacuum device for coitus.
(b) Infection due to syphilis, Candida infection of the penis, sexually transmitted infection, Behcet’s disease.
(c) Pursuant to surgical operation including repair of inguinal hernia, orchidopexy, varicocelectomy; oncological causes related to malignancy.
(d) Other causes including intracavernosal injection of drugs and tendency to thrombosis.

Diagnosis of MDP tends to be based upon the history and clinical examination findings and the diagnosis can be confirmed by utilization of ultrasound scan of the penis that shows upon Doppler scan no evidence of blood flow through the superficial dorsal vein and the ultrasound scan also shows thrombus within the superficial dorsal vein of penis. Treatment of MDP does involve expectant / non-surgical treatment with utilization of anti-inflammatory medicaments / topical heparin and majority cases do resolve within 4 to 8 weeks spontaneously. The medicaments would tend to ameliorate the symptoms, but they tend not to affect or influence the rate of resolution of MDP. Surgical intervention in the form of thrombectomy or resection of the thrombosed dorsal vein of penis does lead to be undertaken in cases of persistent symptoms and non-resolution after 6 weeks of conservative treatment as well as for cases of chronic disease and resolution of the MDP does ensue the surgical treatment. Clinicians need to carefully differentiate MDP from Peyronie’s disease, fracture of the penis and sclerosing lymphadenitis of the penis and thrombosis of the vein of the penis associated with generalized thrombosis including deep vein thrombosis, and malignancy. MDPs that are associated with treatable inflammatory conditions that may occur would also need to be treated additionally for the associated conditions.

Keywords: Mondor’s disease of penis; Superficial dorsal vein of penis; Thrombosis; Non-steroidal anti-inflammatory drugs; Topical heparin; Thrombectomy; Vein resection, Superficial thrombophlebitis of penis, Non-venereal sclerosing lymphangitis of penist

Abstract| Introduction| Aim| Method| Review and Update of the Literature| Case 1| Case 2| Case 3| Conclusion| Conflict of Interest| Acknowledgements| References|