U J - Spring 2012.pdf 525Vol. 9 | No. 2 | Spring 2012 |U R O LO G Y J O U R N A L Penile Mondor’s Disease Long-Term Functional Follow-Up Rafael Boscolo-Berto,1 Daniela I. Raduazzo2 Keywords: penile diseases, orchiopexy, erectile dysfunction, thrombosis INTRODUCTION Penile Mondor’s disease is a rare and underdiagnosed entity involving the Mondor’s disease complicating a bilateral orchidopexy for funiculus sub- torsions episodes, with the longest andrological follow-up reported in literature. As this is a very common and worldwide spread surgical operation, urologists must be aware of this clinical condition. CASE REPORT A 19-year-old Caucasian man presented with a rope-like induration on the dorsal surface of the penis. He had an unremarkable previous medical and surgical his- tory with exception for a prior bilateral orchidopexy performed few days earlier on the basis of repeated funiculus sub-torsions episodes. He never experienced a sexually transmitted disease. The patient complained of a local discomfort wors- ening during erections. He negated sexual intercourse and other sexual activity during the preceding months. Physical examination revealed a palpable and visible cord-like induration on the dorsal surface of the penile shaft, without evidence of infection, masses comprising - coagulative screening was normal. A penile pulsed color Doppler ultrasonography signals. We advised the patient to abstain from sexual intercourse until a complete regres- 50 mg twice/day, for two weeks. Corresponding Author: Rafael Boscolo-Berto, MD Department of Oncologi- cal and Surgical Sciences, Urology Clinic, University of Padova, Via Giustiniani, 2–35100, Padova, Italy Tel: +39 339 113 1099 Fax: +39 049 821 2721 E-mail: boscolorafael@ tiscali.it Received January 2010 Accepted February 2010 1Department of Oncologi- cal and Surgical Sciences, Urology Clinic, University of Padua, Italy 2Department of Clinical and Experimental Medi- cine, University of Padua, Italy Case Report 526 | Case Report The clinical picture self-resolved in about a month evaluation, the patient came back to our depart- ment for an episodic urinary infection, successfully treated with antibiotics. During the revaluation, the physical examination was completely normal. Fur- thermore, the patient reported the absence of any clinical relapse and a full preservation of erections DISCUSSION The penile Mondor’s disease is an infrequent vein, a self-limiting pathology presenting as con- sequence of vigorous sexual intercourse, use of sexual vacuum-devices, local injection of illegal substances, pelvic neoplasms, distended bladder, local or remote infections, penile trauma, thrombo- philia, or inguinal hernia repair. In this report, we describe the onset of a penile Mondor’s disease after bilateral orchidopexy. The penile Mondor’s disease generally self-resolves vein recanalization is described within 9 weeks. In literature, other conservative approaches are suggested, including a local dressing with a heparin ointment, while use of antibiotics and anticoagulant drugs is not recommended as treat- ment. Only in case of unimproved conditions and persistent discomfort, a thrombectomy or a vein is performed. In our patient, a supportive care was instituted, consisting of temporary abstinence from sexual intercourse and the short-term administration of - ment was fully effective and no anatomical or year follow-up. - ported case of penile Mondor’s disease compli- cating a bilateral orchidopexy. Indeed, a previous paper reported the onset of such a condition as consequence of an inguinal hernia repair, which occurred after a week from the intervention. In our patient, the time-to-onset and recovery was the same, but the previous surgical intervention implied a lowinguinal incision without an ingui- nal channel violation. Therefore, we hypothesize a possible role of inguinal incision that can be ex- in the subcutaneous district, on an external plane with respect to the Scarpa’s fascia, and converge into the right and left external pudendal veins at - nous vein at the groin. Hence, the local venous surgical incision at that level, leading to a conse- quent thrombotic event. Leaving out the uncertain pathogenesis not yet clar- our longest follow-up existing in literature. CONFLICT OF INTEREST None declared. REFERENCES 1. Helm JD, Jr., Hodge IG. Thrombophlebitis of a dorsal vein of - 2. Kumar B, Narang T, Radotra BD, Gupta S. Mondor's disease of 3. Han HY, Chung DJ, Kim KW, Hwang CM. Pulsed and color Doppler sonographic findings of penile Mondor's disease. 4. Boscolo-Berto R, Iafrate M, Casarrubea G, Ficarra V. Magnetic resonance angiography findings of penile Mondor's dis- 5. Al-Mwalad M, Loertzer H, Wicht A, Fornara P. Subcutaneous penile vein thrombosis (Penile Mondor's Disease): patho- 6. Kutlay J, Genc V, Ensari C. Penile Mondor's disease. Hernia. 7. Ganem JP, Kennelly MJ. Ruptured Mondor's disease of the