|Year : 2004 | Volume
| Issue : 2 | Page : 66-67
Spontaneous bacterial abscess of corpus cavernosum
Santosh Kumar, SK Sharma, AK Goswami
Department of Urology, PGIMER, Chandigarh - 160012, India
A K Goswami
Department of Urology, PGIMER, Chandigarh - 160012
Source of Support: None, Conflict of Interest: None
Keywords: MRI, Spontaneous bacterial abscess, Corpus Cavernosum.
|How to cite this article:|
Kumar S, Sharma S K, Goswami A K. Spontaneous bacterial abscess of corpus cavernosum. Indian J Urol 2004;20:66-7
| Case Report|| |
A 22-year-old man presented to our Outpatient Clinic with painful swelling in the penile shaft and malaise for five days. Symptoms started after masturbation. He denied recent UTI, trauma, voiding symptoms, urethral discharge or instrumentation.
Physical examination revealed edema, induration and tenderness in the mid penile shaft. The testicle and epididymides were palpably normal. Rectal examination was unremarkable. White cell count was 10200/ul.
Random blood sugar was 127 mg% and urine analysis showed 4-6 pus cells per high power field. Urine and blood cultures were negative. HIV serology was negative. Ultrasound scan of the penis showed a well-defined anechoic lesion in the distal part of left corpus cavernosum [FIugre 1]. MRI scan of penis axial and coronal T2 W images of penis showed a well-defined hyperintense area in left corpus cavernosum with surrounding oedema suggestive of abscess [Figure - 2].
10 ml of pus was aspirated from the abscess. Staph. aureus sensitive to ofloxacillin was grown in culture. After 5 days of ofloxacillin the pain and swelling reduced markedly. At 9 months follow-up patient had good urinary stream, normal erectile function and no deformity.
| Comments|| |
A spontaneous abscess of corpus cavernosum is rare. Corporeal infection and abscess formation have been described in association with gonorrhea, trauma, penile prosthesis, cavernosography and intracorporeal paparverine injection  . Yachia and Fiedman  reported a case of tuberculous cold abscess of corpus cavernosum. Corpora cavernosa are resistant to hematogenous dissemination of infection. Hematogenous infection usually occurs in immuno compromised individual. Sater and Vandendris  reported a case of spontaneous bacterial abscess of the corpora; they believed that dental caries was responsible for abscess formation in the corpus cavernosum.
Our patient had no history of either diabetes, immunodeficiency, dental caries, skin infection or urinary tract infection. The present patient gives history of vigorous masturbation prior to onset of symptom. Culture of abscess yielded staphylococcus aureus which is a part of the skin microflora. Whether vigorous masturbation was of etiological significance is unclear.
Koksal et al  reported a case of spontaneous bacterial abscess of bilateral cavernosal bodies which was drained surgically by opening tunica and putting penrose drain. Patient developed left penile deviation later on.
Treatment of an abscess by means of aspiration and systemic antibiotic after localization by ultrasonography and MRI is a viable form of therapy. Avoidance of corporotomy will reduce troublesome secondary fibrosis, which can lead to penile curvature, venous leak and impotence.
| References|| |
|1.||Yachia D, Friedman M and Auslaender L. Tuberculous cold abscess of the corpus cavernosum. A case report. J. Urol, 1990, 144: 351. |
|2.||Sater AA, Vandendris M.Abscess of corpus cavernosum. J Urol,1989, 141:949. |
|3.||Koksal T, Kadioglu A, Tefelli A, et al. Spontaneous bacterial abscess of bilateral cavernosal bodies. BJU International, 1999, 84: 1107. |
[Figure - 1], [Figure - 2]