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What is Penile Thrombosis?

By Misty Wiser
Updated Mar 03, 2024
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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.

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Discussion Comments
By anon995332 — On Apr 20, 2016

I had this happen to me. It was painful at first, but in a couple of days, it got better. It added girth to my penis due to swelling, and I did have sex with my wife during that period, and she quite enjoyed it, though she said it was a little painful at first, as I am a little above average in size as is.

I was glad when the issue resolved. There was never any explanation as to why it happened, other than possibly through very vigorous oral sex which my wife is quite good at. The doctor said suction may have caused it. It cleared up in less than a week, but I miss the girth.

By anon974664 — On Oct 20, 2014

It's a result of blood clotting. Mostly, it's painless and has no effect on sexual activity. It gets enlarged at the time of an erect penis. This could lead to difficulty with intercourse, so it's better to abstain from sex. Medicine can bring down the size of the clot, but the duration of time could be longer. Surgery is recommended if it lasts more than 12 weeks.

By anon354290 — On Nov 07, 2013

I have irritation in my shaft of my penis. I have masturbated more in recent days and I found a blood clot while urinating. Is it thrombosis? Please help me.

By anon340718 — On Jul 05, 2013

I have recently experienced this, but I feel that due to masturbation, that a vein has tied a knot on itself. This vein gets extremely hard and very painful during a hard erection. I just want to pop the vein, because I feel that would release the pressure! I am running out of options. I will have to go to the doctor.

By nadercorner — On Oct 24, 2012

I have a complicated case of penile thrombosis. I have a number of clots all over my veins. I am not sure what was the exact cause. Sex was a factor and Levitra might have helped, but I am in a severe pain 24/7, the worst pain I have ever had in my life and I think, in the world.

My urologist is suggesting to leave it to time, but I can't. The pain is killing me and nothing is killing it. I am afraid also that I might have a deep vein thrombosis, but the urologist doesn't seem to be worried about it. What can I do about the pain? I am on aspirin, fish oil and Heparin ointment but nothing helps. It has been six months now since that has started. Please help.

By ysmina — On Jul 10, 2012

@turquoise-- Yes, superficial dorsal penile vein thrombosis is the same as penile thrombosis. Sometimes it's also called Mondor's disease. It's when a blood clot forms in the dorsal vein of the penis.

The symptoms you mentioned do match penile thrombosis symptoms. Not everyone has excessive pain with this condition, the degree of pain can vary. Plus, it happens often because of a lot of sexual activity in a short period of time. Ultimately though, you need an ultrasound for the diagnosis.

I'm not a doctor, so don't rely only on my advice. I guess if you're not in a lot of pain, you can wait 4-6 weeks and see if it goes away. If it's still there after six weeks, you probably need medication and definitely need to see a urologist.

By turquoise — On Jul 10, 2012

I'm also looking for more information about penile thrombosis. The article has been very helpful but I'm still confused as to whether I have a thrombosed vein or not.

I have a knot like thing on my penis, it looks like a cord and very hard to the touch. It appeared after intercourse, which also fits the description of thrombosis. I do have some pain, but it's very minor, more like an irritation. I'm not sure if a thrombosis would usually cause more pain than this. And there is also no color change or anything like that.

From what I've read about it, I can just leave it be and it should take care of itself. Is that right?

By the way, what is superficial dorsal penile vein thrombosis? Is this the same thing or a subcategory of penile thrombosis?

By stoneMason — On Jul 09, 2012

Has anyone experienced penile vein thrombosis after a varicocelectomy?

If you did, how long after the surgery did it happen? When did you start seeing symptoms and how long did your recovery take?

Sorry for asking so many questions but I had a varicocelectomy a little over a month ago. One week after the surgery, I noticed a bump on my penis and it was painful. I went back to my doctor who did an ultrasound and found the thrombosis. He gave me antibiotics to take and an ointment to use.

My course of antibiotics is over and my doctor said that I don't need to do anything now other than rest and wait for it to resolve itself. But the bump is still there and my penis is still very sore and painful. I'm not sure if the pain is entirely from the thrombosis or if I'm still having pain from the surgery. But I'm worried that the thrombosis hasn't been treated properly.

I would like to hear from others who have experienced thrombosis after a varicocelectomy. Do you think my experience is normal?

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