Clinical management of high-flow priapism and penile Mondor's disease following transrectal prostate biopsy

Transrectal ultrasound-guided biopsy is considered a safe procedure that can be performed in an outpatient setting. However, occasional major complications can occur. The present 53-year-old patient had a transrectal prostate biopsy because of persistently high prostate-specific antigen levels. The histologic examination reported the absence of cancer. Two weeks later, he presented with high-flow priapism and penile Mondor's disease that was characterized by penile superficial dorsal vein thrombosis. There was a palpable rope-like induration on the dorsal surface of the penile shaft. Diagnosis of the 2 concurrent disorders required complex radiological investigation that included magnetic resonance angiography, which is presented in detail in a companion paper. The present report contains a description of the conservative treatment simultaneously adopted for the posttraumatic priapism and the penile vein thrombosis. There was a progressive decrease in the induration, with a final complete resolution and preservation of full erections at 3 months. © 2010.