Penile thrombosis is the formation of a painful blood clot inside one of the veins in the penis. It may occur as a complication of a fertility procedure called varicocelectomy, which is the removal of extremely dilated veins in the testicles. If the affected vein is the superior dorsal vein, the condition may be called penile Mondor’s disease. Penile thrombosis is usually treated with non-steroidal anti-inflammatory (NSAID) pain relievers and an ointment containing the anticoagulant heparin.
Pain is one of the first symptoms of penile thrombosis a man may notice. Men with this rare condition commonly report painful erections. A blood clot causes a hard knotty vein to extend from the base of the penis to mid-shaft. The affected vein becomes rigid and painful even when the penis is not erect. Small lumpy clots may be felt through the penile tissue.
Diagnosing a penile thrombosis is done after a scan of the penis. An ultrasound machine is used to visualize the occlusion in the penis. Before the procedure, a technician may have to do a physical exam of the penis to identify the specific technique to use during the ultrasound.
The causes of penile thrombosis are varied. It may occur as a result of an overfull bladder putting pressure on the vein supply of the penile tissue. Tumors may form in the penis that can cause a blood clot to form. Some men have reported penile thrombosis after energetic sexual activity, including the use of a sexual aid called a constrictor device. A traumatic injury to the penis may cause blood clots to form within the veins of the penis.
Penile thrombosis may also occur as a complication of a surgical procedure. It is the most common side effect of the subinguinal access method for a varicocelectomy, the operation to remove distended veins in the testicles. The painful condition has also been reported as a complication of long saphenous vein removal in the leg.
Medication is usually prescribed to treat penile thrombosis. An ointment containing heparin is applied daily to the affected area. Prescription or over-the-counter pain relievers may be recommended to reduce the pain and inflammation. A physician may recommend abstinence from sexual activity during the healing process.
The amount of time it takes for the thrombosis to heal varies. Some men have reported an absence of symptoms after four to five weeks. Other men may take as long as four months to heal. Most men do not have a repeat occurrence of the condition, and no erectile dysfunction has been reported after the thrombosis had resolved.