RESUMO
BACKGROUND: Because it is a superficial structure, the penis is ideally suited to ultrasound imaging. A number of disease processes, including Peyronie's disease, penile fractures and tumors, are clearly visualized with ultrasound. Baseline and dynamic assessment of cavernosal arterial changes after pharmaco-stimulation with alprostadil allows standardized diagnosis of arterial and venogenic causes of erectile dysfunction (ED). OBJECTIVE: To illustrate how to correctly perform flaccid and dynamic penile duplex ultrasound (D-PDU) and in which patients to recommend it. MATERIALS/METHODS: An extensive search of the literature was carried out on Pubmed with the insertion of the following Medical Subjects Headings (MeSH) terms and keywords "penile color Doppler ultrasound" "peak systolic velocity" "end-diastolic velocity", "acceleration time", "resistance index". EVIDENCE: In our experience, arterial erectile dysfunction is identified after standardized intracavernous injection (ICI) of alprostadil (10 mcg) when values of peak systolic velocity (PSV) are <35 cm/s and, in the most severe forms, for values <25 cm/s. Arterial insufficiency can also be identified by increased acceleration time (AT) values (>110 ms) and/or by a lack of visualization of helicine arteries at power Doppler mode along with incomplete achievement of penile rigidity. The veno-occlusive incompetence is determined when end-diastolic velocity (EDV) values are >4.5-5 cm/s or in the case of resistance index (RI) values <0.75. The assessment of additional surrogate markers of endothelial dysfunction, that is, intima-media thickness, mean platelet volume (MPV), endothelial progenitor cells (EPC), endothelial cell specific molecule-1(endocan) are also useful in assessing the patient's cardiovascular risk but are still considered investigational in the interpretation of D-PDU results. CONCLUSION: D-PDU scan after ICI with vasoactive drugs is a safe procedure and represents the gold standard for the diagnostics of penile pathologies and should be performed in men with ED not responding to oral conventional therapies and/or in those requiring accurate stratification of cardiovascular risk.
Assuntos
Alprostadil/administração & dosagem , Doenças do Pênis/diagnóstico por imagem , Pênis/diagnóstico por imagem , Ultrassonografia Doppler Dupla/métodos , Vasodilatadores/administração & dosagem , Espessura Intima-Media Carotídea , Disfunção Erétil/diagnóstico por imagem , Humanos , Masculino , Induração Peniana/diagnóstico por imagem , Pênis/irrigação sanguínea , Ultrassonografia Doppler em Cores/métodosRESUMO
In this paper, we describe the pattern of an idiopathic corpus cavernosum (CC) abscess using contrast-enhanced ultrasound (CEUS) and compare this to the lesion characterization achieved using preliminary baseline ultrasound/color doppler (ECD). In a 43-year-old man, who arrived at our emergency department for a penile swelling and hematopyuria, ECD examination showed equivocal mucosal and subcutaneous tissue swelling, an inhomogeneous hypoechoic area in the left CC, and a suspected millimetric interruption of the albuginea. CEUS showed multiple avascular areas wrapped in a hyperperfused rim representing abscesses and a not-perfused balanopreputial-oriented fistula. A CEUS control documented clinical remission after surgery. CEUS is a noninvasive and bedside executable method that allows a more precise evaluation of the entity, localization, and possible complications of CC abscesses and, therefore, permits prescribing the most adequate therapy to the patient, as well as the evaluation of eventual postsurgical sequelae.
Assuntos
Abscesso , Doenças do Pênis , Abscesso/diagnóstico por imagem , Abscesso/cirurgia , Adulto , Meios de Contraste , Seguimentos , Humanos , Masculino , Doenças do Pênis/diagnóstico por imagem , Doenças do Pênis/cirurgia , Pênis/diagnóstico por imagem , Pênis/cirurgia , UltrassonografiaRESUMO
The purpose of this review is to discuss the role of magnetic resonance imaging (MRI) in the evaluation of penile pathology. Normal penile anatomy as well as the appearance of neoplastic and non-neoplastic entities on MRI will be reviewed. While ultrasound remains the first line imaging modality in evaluating most penile pathology, MR imaging has specific advantages owing to improved soft tissue resolution, ability to evaluate less accessible or complex anatomy (such as at the base of the penis), and the ability to detect subtle enhancement. Therefore, MRI is useful for when ultrasound and/or clinical findings are equivocal or incongruent. In addition, MR imaging is essential for preoperative surgical planning and is the imaging modality of choice in evaluating penile prostheses. The added value of MRI in these settings makes it an integral component to the management of many pathological entities affecting the penis.
Assuntos
Imageamento por Ressonância Magnética/métodos , Doenças do Pênis/diagnóstico por imagem , Doenças do Pênis/patologia , Pênis/diagnóstico por imagem , Pênis/patologia , Humanos , Masculino , Pênis/anatomia & histologiaRESUMO
The utility of PET in septicemia for showing its source and possible metastatic infection has been demonstrated. We describe the diagnosis on PET/CT of a spontaneous corpus cavernosum abscess in a 64-year-old man presenting with Streptococcus constellatus septicemia, in whom the clinical diagnosis had been elusive for 10 days.
Assuntos
Abscesso/diagnóstico por imagem , Doenças do Pênis/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Infecções Estreptocócicas/diagnóstico por imagem , Fluordesoxiglucose F18 , Humanos , Masculino , Pessoa de Meia-Idade , Compostos RadiofarmacêuticosRESUMO
ABSTRACT We present the case of a 28 year old patient with an incomplete tear of the tunica albuginea occurred after having sexual intercourse in the female superior position. The diagnostic assessment was performed first clinically, then with CT, owing to its high resolution, allowed to exactly detect the tear location leading to precise preoperative planning. After adequate diagnosis through imaging and proper planning, the patient was performed a selective minimally invasive surgical approach to repair the lesion. The patient had good erection with no angular deformity or plaque formation after a 3-month follow-up.
Assuntos
Humanos , Masculino , Adulto , Doenças do Pênis/cirurgia , Pênis/lesões , Ruptura/cirurgia , Doenças do Pênis/diagnóstico por imagem , Pênis/cirurgia , Pênis/diagnóstico por imagem , Ruptura/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Procedimentos Cirúrgicos Minimamente InvasivosRESUMO
We present the case of a 28 year old patient with an incomplete tear of the tunica albuginea occurred after having sexual intercourse in the female superior position. The diagnostic assessment was performed first clinically, then with CT, owing to its high resolution, allowed to exactly detect the tear location leading to precise preoperative planning. After adequate diagnosis through imaging and proper planning, the patient was performed a selective minimally invasive surgical approach to repair the lesion. The patient had good erection with no angular deformity or plaque formation after a 3-month follow-up.
Assuntos
Doenças do Pênis/cirurgia , Pênis/lesões , Ruptura/cirurgia , Adulto , Humanos , Masculino , Procedimentos Cirúrgicos Minimamente Invasivos , Doenças do Pênis/diagnóstico por imagem , Pênis/diagnóstico por imagem , Pênis/cirurgia , Ruptura/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
Penile disease is one of the male urological diseases. Although the penis is a small organ, once the problem occurs, it often brings great trouble to the patient. Therefore, the accurate diagnosis of penile disease is particularly important. High-frequency ultrasonography, with its advantages of noninvasiveness, safety, low cost, easy operation and reproducibility, can clearly show the structure and blood flow of the penis and has a significant value in the diagnosis and follow-up of penile diseases such as vascular erectile dysfunction, priapism, penile injury, penile neoplastic and non neoplastic nodules. Meanwhile, the development of new technologies such as shear wave elastography (SWE) and contrast enhanced ultrasound (CEUS) has made up for the shortcomings of traditional ultrasound imaging, expanded the application of ultrasound in penile diseases, and improved the efficiency of ultrasound diagnosis of the diseases. This article focuses on the application value of ultrasound in erectile dysfunction, priapism, penile cavernous injury and penile tubercle, as well as the latest progress in such new technologies as SWE and CEUS applied to penile diseases.
Assuntos
Doenças do Pênis/diagnóstico por imagem , Ultrassonografia/métodos , Meios de Contraste , Técnicas de Imagem por Elasticidade , Disfunção Erétil/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Penianas/diagnóstico por imagem , Pênis/diagnóstico por imagem , Pênis/lesões , Priapismo/diagnóstico por imagem , Reprodutibilidade dos TestesRESUMO
Lymphedema is the result of an alteration of the lymphatic drainage, and its most common worldwide cause is filariasis. In our practice usually is associated to neoplasic, inflammatory and granulomatous processes, radiotherapy, hydroelectrolytic disbalances, and idiopathic. It can affect any part of the body, including the penis and scrotum. The genital lymphedema is a rare presentation, it corresponds to 0.6% of lymphedema. However, causes serious functional, social and emotional limitations for the patient. Too often have pain, recurrent infections, sexual dysfunction, cosmetic deformity, sometimes it limits mobility and ambulation. Although there are several treatment options, both medical and surgical, it has not been found ideal for this disease. We present a 43 years old patient with penoscrotal lymphedema due to hidradenitis suppurativa, it limits his normal activity. The patient was referred to our center after unsuccessful medical treatment (doxycycline and clindamycin cycles). Surgical treatment consisted of total excision of the skin and subcutaneous tissue to Buck's fascia. Split thickness skin grafts were used to cover the defect. The result was satisfactory both functionally and aesthetically.
El linfedema es producto de una alteración en el drenaje linfático, y su causa más frecuente en todo el mundo es la filariasis. En nuestro medio suele encontrarse asociada a procesos neoplásicos, inflamatorios, granulomatosos, secuelas por radioterapia, desequilibrios hidroelectrolíticos y procesos idiopáticos. Puede afectar a cualquier parte del cuerpo, incluyendo el pene y el escroto. El linfedema genital es una presentación infrecuente, que corresponde al 0.6% de los linfedemas. No obstante, causa graves limitaciones funcionales, sociales y emocionales para el paciente. Con mucha frecuencia se presentan dolor, infecciones recurrentes, disfunción sexual y deformidad estética, llegando incluso a limitar la movilidad y la deambulación. Aunque existen varias opciones de tratamiento, tanto médico como quirúrgico, no se ha encontrado el ideal para esta enfermedad. Presentamos el caso de un paciente de 43 años afecto de hidrosadenitis axilar e inguinal que padece linfedema penoescrotal grave que limita seriamente su actividad habitual. El paciente fue remitido a nuestro centro tras el fracaso del tratamiento con antibióticos (ciclos de doxiciclina y clindamicina). El tratamiento quirúrgico consistió en la resección de piel y tejido celular subcutáneo hasta fascia de Buck y cobertura con injertos de piel. El resultado final fue adecuado desde un punto de vista tanto funcional como estético.
Assuntos
Doenças dos Genitais Masculinos/etiologia , Hidradenite Supurativa/complicações , Linfedema/etiologia , Escroto , Adulto , Clindamicina/uso terapêutico , Fístula Cutânea/etiologia , Doxiciclina/uso terapêutico , Doenças dos Genitais Masculinos/diagnóstico por imagem , Doenças dos Genitais Masculinos/tratamento farmacológico , Doenças dos Genitais Masculinos/cirurgia , Hidradenite Supurativa/tratamento farmacológico , Hidradenite Supurativa/cirurgia , Humanos , Linfedema/cirurgia , Imageamento por Ressonância Magnética , Masculino , Doenças do Pênis/diagnóstico por imagem , Doenças do Pênis/tratamento farmacológico , Doenças do Pênis/etiologia , Doenças do Pênis/cirurgia , Escroto/cirurgia , Transplante de PeleRESUMO
Partial segmental thrombosis of the corpus cavernosum is an unusual clinical condition of unknown origin that mainly affects young males, whose characteristic presentation is the appearance of unexplained perineal pain associated with a palpable perineal mass. This entity consists of thrombosis in the perineal portion of the corpus cavernosum, usually unilateral and it is associated with underlying malignant pathologies and predisposing factors such as microtrauma. After the adequate adherence to conservative treatment, the appearance of complications such as erectile dysfunction is very uncommon.
Assuntos
Doenças do Pênis/diagnóstico por imagem , Pênis/irrigação sanguínea , Pênis/diagnóstico por imagem , Trombose/diagnóstico por imagem , Adulto , Humanos , Imageamento por Ressonância Magnética , Masculino , Doenças do Pênis/patologia , Trombose/patologia , UltrassonografiaRESUMO
The intravascular papillary endothelial hyperplasia (IPEH) or Masson's tumor is an unusual and rare benign disease.It is histologically characterized by papillary and anastomosing channel-like structures lined by proliferating e n dothelium. Radiologically, it is usually presented as a heterogenic solid mass with contrast enhancement, withareas resembling necrosis and thrombosis. These signs can easily be attributed to malignancy. The urogenital tractis extremely rarely affected with only 8 cases described in the kidneys and one of the penis. We present a rarecase of IPEH at the base of the penis, visible only on MRI, causing chronic pelvic pain and erectile dysfunction.According to available English literature our case is the first in this pelvic location and only the second to affect thepenis. Radical excision of the formation cured the condition.
Assuntos
Endotélio Vascular/patologia , Doenças do Pênis/diagnóstico por imagem , Dor Crônica/etiologia , Humanos , Hiperplasia/complicações , Hiperplasia/diagnóstico por imagem , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Dor Pélvica/etiologia , Doenças do Pênis/complicações , Doenças do Pênis/cirurgia , SíndromeRESUMO
A 66-year-old man presented with a chief complaint of glans penis pain, induration, and discharge of pus. He was prescribed a course of antibiotics, but the condition persisted despite treatment. Thus, we differrentially diagnosed the patient with penile tuberculosis and pyoderma gangrenosum, and performed a biopsy of the penis. The biopsy result was thickening of the horny layer epidermis with only a foreign body granuloma composed of inflammatory cells, and did not lead to a definitive diagnosis. Thoraca-abdominal computed tomography revealed axillary lymphadenopathy with necrosis. Suspecting tuberculosis lymphadenitis, we performed T-spot and QuantiFERONtests. The result was T-spot negative and QuantiFERONpositive, so we diagnosed the patient with penile tuberculosis, and started antituberculosis medication. In about half a year after the start of treatment the symptoms subsided, and lymphadenopathy showed reduction.
Assuntos
Doenças do Pênis/diagnóstico por imagem , Tuberculose/diagnóstico por imagem , Idoso , Biópsia , Diagnóstico Diferencial , Combinação de Medicamentos , Humanos , Masculino , Imagem Multimodal , Doenças do Pênis/tratamento farmacológico , Doenças do Pênis/patologia , Tuberculose/tratamento farmacológico , Tuberculose/patologiaRESUMO
CONTEXT:: Lymphedema consists of extracellular fluid retention caused by lymphatic obstruction. In chronic forms, fat and fibrous tissue accumulation is observed. Genital lymphedema is a rare condition in developed countries and may have primary or acquired etiology. It generally leads to urinary, sexual and social impairment. Clinical treatment usually has low effectiveness, and surgical resection is frequently indicated. CASE REPORT:: We report a case of a male-to-female transgender patient who was referred for treatment of chronic genital lymphedema. She had a history of pelvic radiotherapy to treat anal cancer and of liquid silicone injections to the buttock and thigh regions for esthetic purposes. Radiological examinations showed signs both of tissue infiltration by liquid silicone and of granulomas, lymphadenopathy and lymphedema. Surgical treatment was performed on the area affected, in which lymphedematous tissue was excised from the scrotum while preserving the penis and testicles, with satisfactory results. Histopathological examination showed alterations compatible with tissue infiltration by exogenous material, along with chronic lymphedema. CONCLUSION:: Genital lymphedema may be caused by an association of lesions due to liquid silicone injections and radiotherapy in the pelvic region. Cancer treatment decisions for patients who previously underwent liquid silicone injection should take this information into account, since it may represent a risk factor for radiotherapy complications.
Assuntos
Linfedema/etiologia , Doenças do Pênis/etiologia , Silicones/efeitos adversos , Pessoas Transgênero , Feminino , Humanos , Linfedema/diagnóstico por imagem , Linfedema/cirurgia , Espectroscopia de Ressonância Magnética , Masculino , Doenças do Pênis/diagnóstico por imagem , Doenças do Pênis/cirurgia , Retalhos CirúrgicosRESUMO
INTRODUCTION: Penile fracture is a relatively common phenomenon. The main problem associated with this condition is the lack of patients' awareness on the urgency of the situation. This study reports the different modes of presentations and treatment results. MATERIALS AND METHODS: We reviewed 21 cases of penile fracture over 5 years. Parameters were mode of injury, age group, time interval before presentation, management, site of injury, urethral involvement, results, complications and erectile function at follow-up. RESULTS: The mean age of patients was 34 years, the mean time interval until presentation was 26 h. Cases involving the right corpus cavernosum comprised 57.14% and 42.85% were cases involving the left corpus cavernosum. Two patients had full circumferential urethral tear. Two patients developed wound infections and 2 patients developed mild penile curvature (<30°). These 4 patients had all presented late for treatment (>40 h). CONCLUSION: Urologists need to consider penile fracture a urological emergency and atypical presentations need to be considered when deciding on management.
Assuntos
Doenças do Pênis/etiologia , Pênis/lesões , Adulto , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Doenças do Pênis/diagnóstico por imagem , Doenças do Pênis/cirurgia , Ereção Peniana , Pênis/diagnóstico por imagem , Pênis/fisiopatologia , Pênis/cirurgia , Recuperação de Função Fisiológica , Estudos Retrospectivos , Ruptura , Infecção da Ferida Cirúrgica/etiologia , Fatores de Tempo , Tempo para o Tratamento , Resultado do Tratamento , Procedimentos Cirúrgicos Urológicos Masculinos/efeitos adversos , Adulto JovemRESUMO
ABSTRACT CONTEXT: Lymphedema consists of extracellular fluid retention caused by lymphatic obstruction. In chronic forms, fat and fibrous tissue accumulation is observed. Genital lymphedema is a rare condition in developed countries and may have primary or acquired etiology. It generally leads to urinary, sexual and social impairment. Clinical treatment usually has low effectiveness, and surgical resection is frequently indicated. CASE REPORT: We report a case of a male-to-female transgender patient who was referred for treatment of chronic genital lymphedema. She had a history of pelvic radiotherapy to treat anal cancer and of liquid silicone injections to the buttock and thigh regions for esthetic purposes. Radiological examinations showed signs both of tissue infiltration by liquid silicone and of granulomas, lymphadenopathy and lymphedema. Surgical treatment was performed on the area affected, in which lymphedematous tissue was excised from the scrotum while preserving the penis and testicles, with satisfactory results. Histopathological examination showed alterations compatible with tissue infiltration by exogenous material, along with chronic lymphedema. CONCLUSION: Genital lymphedema may be caused by an association of lesions due to liquid silicone injections and radiotherapy in the pelvic region. Cancer treatment decisions for patients who previously underwent liquid silicone injection should take this information into account, since it may represent a risk factor for radiotherapy complications.
RESUMO CONTEXTO: O linfedema consiste de retenção de fluido extracelular causada por obstrução linfática. Nas formas crônicas, observa-se acúmulo de tecido adiposo e fibrose. O linfedema genital é uma doença rara em países desenvolvidos e pode ter etiologia primária ou adquirida, em geral cursando com disfunções urinária e sexual, bem como com prejuízo do convívio social. O tratamento clínico é, em geral, pouco efetivo, indicando-se com frequência a abordagem cirúrgica, com excisão da área afetada. RELATO DE CASO: Relata-se o caso de paciente feminina transgênero, encaminhada para tratamento de linfedema genital crônico. Havia antecedente pessoal de tratamento de câncer de canal anal com radioterapia pélvica e de injeções de silicone líquido em glúteos e coxas com finalidade estética. Exames radiológicos mostraram tanto sinais de infiltração tecidual por silicone líquido como granulomas e linfadenopatia como de linfedema. Foi realizado o tratamento cirúrgico da área afetada, com excisão do tecido linfadenomatoso do escroto, preservando o pênis e testículos, com resultado satisfatório. A análise histopatológica mostrou achados compatíveis com infiltração tecidual por material exógeno, bem como com linfedema crônico. CONCLUSÃO: O linfedema genital pode ser causado pela associação de lesão por injeção de silicone líquido e radioterapia na região pélvica. As decisões no tratamento de neoplasias em pacientes previamente submetidos a injeção de silicone líquido devem levar em conta esse fato, já que pode representar fator de risco para complicações de tratamento radioterápico.
Assuntos
Humanos , Masculino , Feminino , Doenças do Pênis/etiologia , Silicones/efeitos adversos , Pessoas Transgênero , Linfedema/etiologia , Doenças do Pênis/cirurgia , Doenças do Pênis/diagnóstico por imagem , Retalhos Cirúrgicos , Espectroscopia de Ressonância Magnética , Linfedema/cirurgia , Linfedema/diagnóstico por imagemAssuntos
Óleo Mineral/efeitos adversos , Doenças do Pênis/induzido quimicamente , Adulto , Técnicas Cosméticas , Células Gigantes/patologia , Humanos , Injeções Subcutâneas , Masculino , Doenças do Pênis/diagnóstico por imagem , Doenças do Pênis/patologia , Doenças do Pênis/cirurgia , Procedimentos de Cirurgia Plástica , Úlcera Cutânea/etiologia , UltrassonografiaAssuntos
Artérias , Embolização Terapêutica/efeitos adversos , Isquemia/etiologia , Doenças do Pênis/etiologia , Pênis/irrigação sanguínea , Próstata/irrigação sanguínea , Hiperplasia Prostática/terapia , Angiografia Digital , Artérias/diagnóstico por imagem , Humanos , Isquemia/diagnóstico por imagem , Isquemia/terapia , Sintomas do Trato Urinário Inferior/etiologia , Masculino , Pessoa de Meia-Idade , Doenças do Pênis/diagnóstico por imagem , Doenças do Pênis/terapia , Hiperplasia Prostática/complicações , Hiperplasia Prostática/diagnóstico , Resultado do TratamentoRESUMO
Penile augmentation has been reported in the literature by injecting various materials. This study reports our experience in management of penile augmentation complications associated with selfpenile injection of silicone liquid. After a careful ultrasound study, the penile skin was excised through a circumferential sub-coronal incision and dissected with the silicon mass. Histology was well-compatible with silicone granulomas. The patient was discharged after 24 hours. Ultrasonography has permitted preoperatively to determine if the plane between the indurated inflammatory tissue and the Buck's fascia was preserved for the complete surgical excision of affected tissue.
Assuntos
Técnicas Cosméticas/efeitos adversos , Granuloma/etiologia , Doenças do Pênis/etiologia , Silicones/efeitos adversos , Adulto , Granuloma/diagnóstico por imagem , Granuloma/patologia , Humanos , Masculino , Doenças do Pênis/diagnóstico por imagem , Doenças do Pênis/patologia , Autoadministração , Silicones/administração & dosagemRESUMO
We report two cases of penile fracture. Case 1 was in a 22-year-old male. He heard a cracking sound during urination and experienced acute penile pain and detumescence. He was admitted to our hospital on that day. Case 2 was in a 52-year-old male. He heard a cracking sound during sexual intercourse and experienced detumescence. He was admitted to our hospital on the next day. In both cases, magnetic resonance imaging (MRI) showed disruption of the tunica albuginea. We performed immediate surgical repair through localized incision. They had no perioperative complications. Several months after surgery, they reported subjectively good erection without penile curvature or pain. We found that MRI is a useful tool for the assessment of location of the tunica rupture and minimization of the surgical incision.
Assuntos
Doenças do Pênis/diagnóstico por imagem , Coito , Hematoma/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Doenças do Pênis/cirurgia , Ereção Peniana , Resultado do Tratamento , Adulto JovemRESUMO
We report a rare case of a traumatic dislocation of the penis. The patient was a 39-year-old man who was ambulanced to our hospital because of a motorbike accident. He was diagnosed to have a pelvic fracture. He was admitted to our department because of his urinary retention and lower abdominal pain. Only the penile skin was left as the genital organ, and neither the penis nor the glans penis was palpable. As the computed tomography scan of the abdomen revealed the dislocation of the penis under the skin in the foreside of the pubic bone, urinary retention due to the traumatic dislocation of the penis was diagnosed, and a percutaneous cystostomy was performed. After improvement of his general condition, the patient was transferred to our department for the evaluation of the perineal region, including the lower urinary tract, and for the treatment of the traumatic dislocation of the penis. First, as hematoma and abscess in the left spermatic cord were suspected by magnetic resonance imaging of the pelvic region, removal of the hematoma and abscess in the left spermatic cord as well as an anterograde cystoscopy were performed under lumbar anesthesia, and the absence of urethral injury was confirmed. After infection control, repositioning of the penis was jointly performed with the Department of Plastic Surgery of our hospital under general anesthesia. After the operation, spontaneous urination was observed and erectile function was observed to be normal.