Which pathologies of the penis can be diagnosed with computed tomography? A comprehensive approach to imaging findings

Yeliz Aktürk; Esra Soyer Güldoğan; Serra Özbal Güneş

doi:10.18621/eurj.1386294

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Which pathologies of the penis can be diagnosed with computed tomography? A comprehensive approach to imaging findings

Year 2024, Volume: 10 Issue: 3, 286 - 294, 04.05.2024

Yeliz Aktürk Esra Soyer Güldoğan Serra Özbal Güneş

https://doi.org/10.18621/eurj.1386294

Abstract

Objectives: Since there are various benign and malignant diseases of the penis, different imaging methods can be used for diagnosis. Abdominal computed tomography (CT) is not a frequently used imaging method in diagnosing penile pathologies. In an abdominal CT scan performed with the standard technique, the slices are obtained by scanning from the diaphragm's dome to the symphysis pubis's lower edge. Although the whole penis is not always captured, almost all abdomen scans include a portion of the penis. Penile pathologies can be detected with careful evaluation by CT.

Methods: In this study, we aim to investigate incidental penile pathologies detected in abdominal CT performed for other reasons and whether abdominal CT contributes to showing penile pathologies. Therefore, abdominal CTs of 3,698 male patients were re-evaluated for penile pathologies.

Results: The mean age was 52.2 years. Of the CT scans, 38% were obtained due to trauma, 16% were taken for oncological causes, 16% for abdominal pain and acute abdominal pathologies, 10% for urological reasons, 20% for other causes. Penile pathology was detected in 33 (0.83%) of 3968 patients. The patients were divided into four groups according to the pathologies observed in the penis: Traumatic, inflammatory, tumoral, and other findings.

Conclusion: Although CT is not routinely used to diagnose penile pathologies, it may be necessary if the whole penis is included in the examination.

Keywords

Penile imaging, penile pathologies, incidental findings, male health, penile trauma

References

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4. Pretorius ES, Siegelman ES, Ramchandani P, Banner MP. MR imaging of the penis. Radiographics. 2001;21 Spec No:S283-S298. doi: 10.1148/radiographics.21.suppl_1.g01oc24s283.
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6. Avery LL, Scheinfeld MH. Imaging of penile and scrotal emergencies. Radiographics. 2013;33(3):721-740. doi: 10.1148/rg.333125158.
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9. Bertolotto M, Pavlica P, Serafini G, Quaia E, Zappetti R. Painful penile induration: imaging findings and management. Radiographics. 2009;29(2):477-493. doi: 10.1148/rg.292085117.
10. El-Sakka AI, Hassoba HM, Pillarisetty RJ, Dahiya R, Lue TF. Peyronie's disease is associated with an increase in transforming growth factor-beta protein expression. J Urol. 1997;158(4):1391-1394.
11. Bertolotto M, Coss M, Neumaier C. US evaluation of patients with Peyronie’s disease. In: Bertolotto M, ed. Color Doppler US of the penis. Berlin, Germany: Springer-Verlag, 2008: pp. 61-69.
12. Vosshenrich R, Schroeder-Printzen I, Weidner W, Fischer U, Funke M, Ringert RH. Value of magnetic resonance imaging in patients with penile induration (Peyronie's disease). J Urol. 1995;153(4):1122-1225.
13. Al-Thakafi S, Al-Hathal N. Peyronie's disease: a literature review on epidemiology, genetics, pathophysiology, diagnosis and work-up. Transl Androl Urol. 2016;5(3):280-9. doi: 10.21037/tau.2016.04.05.
14. Suh CH, Baheti AD, Tirumani SH, et al. Multimodality imaging of penile cancer: what radiologists need to know. Abdom Imaging. 2015;40(2):424-435. doi: 10.1007/s00261-014-0218-6.
15. Clark PE, Spiess PE, Agarwal N, et al; National Comprehensive Cancer Network. Penile cancer: Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2013;11(5):594-615. doi: 10.6004/jnccn.2013.0075.
16. Chou HL, Mohsen NA, Garber BB, Feldstein DC. CT imaging of inflatable penile prosthesis complications: a pictorial essay. Abdom Radiol (NY). 2019;44(2):739-748. doi: 10.1007/s00261-018-1764-0.
17. Darouiche RO. Device-associated infections: a macroproblem that starts with microadherence. Clin Infect Dis. 2001;33(9):1567-1572. doi: 10.1086/323130.
18. Ali M, Safriel Y, Sclafani SJ, Schulze R. CT signs of urethral injury. Radiographics. 2003;23(4):951-963. doi: 10.1148/rg.234025097.
19. Dane B, Baxter AB, Bernstein MP. Imaging Genitourinary Trauma. Radiol Clin North Am. 2017;55(2):321-335. doi: 10.1016/j.rcl.2016.10.007.
20. Brandes S. Initial management of anterior and posterior urethral injuries. Urol Clin North Am. 2006;33(1):87-95, vii. doi: 10.1016/j.ucl.2005.10.001.
21. Rosenstein DI, Alsikafi NF. Diagnosis and classification of urethral injuries. Urol Clin North Am. 2006;33(1):73-85, vi-vii. doi: 10.1016/j.ucl.2005.11.004.
22. Mak CWH, Cho CL, Chan WKW, Chu RWH, Law IC. Per urethral insertion of foreign body for erotism: case reports. Hong Kong Med J. 2019;25(4):320-322. doi: 10.12809/hkmj177044.
23. Gunasekaran K, Murthi S. Unusual metallic penile foreign body. BMJ Case Rep. 2017;2017:bcr2017219377. doi: 10.1136/bcr-2017-219377.
24. Edwards SK, Bunker CB, Ziller F, van der Meijden WI. 2013 European guideline for the management of balanoposthitis. Int J STD AIDS. 2014;25(9):615-626. doi: 10.1177/0956462414533099.
25. Pearle MS, Wendel EF. Necrotizing cavernositis secondary to periodontal abscess. J Urol. 1993;149(5):1137-1138. doi: 10.1016/s0022-5347(17)36321-8.
26. Kickuth R, Adams S, Kirchner J, Pastor J, Simon S, Liermann D. Magnetic resonance imaging in the diagnosis of Fournier's gangrene. Eur Radiol. 2001;11(5):787-790. doi: 10.1007/s003300000599.
27. Singh A, Ahmed K, Aydin A, Khan MS, Dasgupta P. Fournier's gangrene. A clinical review. Arch Ital Urol Androl. 2016;88(3):157-164. doi: 10.4081/aiua.2016.3.157.
28. Ballard DH, Raptis CA, Guerra J, et al. Preoperative CT Findings and Interobserver Reliability of Fournier Gangrene. AJR Am J Roentgenol. 2018;211(5):1051-1057. doi: 10.2214/AJR.18.19683.

Year 2024, Volume: 10 Issue: 3, 286 - 294, 04.05.2024

Yeliz Aktürk Esra Soyer Güldoğan Serra Özbal Güneş

https://doi.org/10.18621/eurj.1386294

Abstract

References

1. Shenoy-Bhangle A, Perez-Johnston R, Singh A. Penile imaging. Radiol Clin North Am. 2012;50(6):1167-1181. doi: 10.1016/j.rcl.2012.08.009.
2. Kirkham A. MRI of the penis. Br J Radiol. 2012;85 Spec No 1(Spec Iss 1):S86-93. doi: 10.1259/bjr/63301362.
3. Parker RA 3rd, Menias CO, Quazi R, et al. MR Imaging of the Penis and Scrotum. Radiographics. 2015;35(4):1033-1050. doi: 10.1148/rg.2015140161.
4. Pretorius ES, Siegelman ES, Ramchandani P, Banner MP. MR imaging of the penis. Radiographics. 2001;21 Spec No:S283-S298. doi: 10.1148/radiographics.21.suppl_1.g01oc24s283.
5. Tu LH, Spektor M, Ferrante M, Mathur M. MRI of the Penis: Indications, Anatomy, and Pathology. Curr Probl Diagn Radiol. 2020;49(1):54-63. doi: 10.1067/j.cpradiol.2018.12.004.
6. Avery LL, Scheinfeld MH. Imaging of penile and scrotal emergencies. Radiographics. 2013;33(3):721-740. doi: 10.1148/rg.333125158.
7. Wallner KE, Merrick GS, Benson ML, Butler WM, Maki J, Tollenaar BG. Penile bulb imaging. Int J Radiat Oncol Biol Phys. 2002;53(4):928-933. doi: 10.1016/s0360-3016(02)02805-5.
8. Hodler J, Kubik-Huch RA, von Schulthess GK, editors. Diseases of the Abdomen and Pelvis 2018-2021: Diagnostic Imaging - IDKD Book [Internet]. Cham (CH): Springer; 2018.
9. Bertolotto M, Pavlica P, Serafini G, Quaia E, Zappetti R. Painful penile induration: imaging findings and management. Radiographics. 2009;29(2):477-493. doi: 10.1148/rg.292085117.
10. El-Sakka AI, Hassoba HM, Pillarisetty RJ, Dahiya R, Lue TF. Peyronie's disease is associated with an increase in transforming growth factor-beta protein expression. J Urol. 1997;158(4):1391-1394.
11. Bertolotto M, Coss M, Neumaier C. US evaluation of patients with Peyronie’s disease. In: Bertolotto M, ed. Color Doppler US of the penis. Berlin, Germany: Springer-Verlag, 2008: pp. 61-69.
12. Vosshenrich R, Schroeder-Printzen I, Weidner W, Fischer U, Funke M, Ringert RH. Value of magnetic resonance imaging in patients with penile induration (Peyronie's disease). J Urol. 1995;153(4):1122-1225.
13. Al-Thakafi S, Al-Hathal N. Peyronie's disease: a literature review on epidemiology, genetics, pathophysiology, diagnosis and work-up. Transl Androl Urol. 2016;5(3):280-9. doi: 10.21037/tau.2016.04.05.
14. Suh CH, Baheti AD, Tirumani SH, et al. Multimodality imaging of penile cancer: what radiologists need to know. Abdom Imaging. 2015;40(2):424-435. doi: 10.1007/s00261-014-0218-6.
15. Clark PE, Spiess PE, Agarwal N, et al; National Comprehensive Cancer Network. Penile cancer: Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2013;11(5):594-615. doi: 10.6004/jnccn.2013.0075.
16. Chou HL, Mohsen NA, Garber BB, Feldstein DC. CT imaging of inflatable penile prosthesis complications: a pictorial essay. Abdom Radiol (NY). 2019;44(2):739-748. doi: 10.1007/s00261-018-1764-0.
17. Darouiche RO. Device-associated infections: a macroproblem that starts with microadherence. Clin Infect Dis. 2001;33(9):1567-1572. doi: 10.1086/323130.
18. Ali M, Safriel Y, Sclafani SJ, Schulze R. CT signs of urethral injury. Radiographics. 2003;23(4):951-963. doi: 10.1148/rg.234025097.
19. Dane B, Baxter AB, Bernstein MP. Imaging Genitourinary Trauma. Radiol Clin North Am. 2017;55(2):321-335. doi: 10.1016/j.rcl.2016.10.007.
20. Brandes S. Initial management of anterior and posterior urethral injuries. Urol Clin North Am. 2006;33(1):87-95, vii. doi: 10.1016/j.ucl.2005.10.001.
21. Rosenstein DI, Alsikafi NF. Diagnosis and classification of urethral injuries. Urol Clin North Am. 2006;33(1):73-85, vi-vii. doi: 10.1016/j.ucl.2005.11.004.
22. Mak CWH, Cho CL, Chan WKW, Chu RWH, Law IC. Per urethral insertion of foreign body for erotism: case reports. Hong Kong Med J. 2019;25(4):320-322. doi: 10.12809/hkmj177044.
23. Gunasekaran K, Murthi S. Unusual metallic penile foreign body. BMJ Case Rep. 2017;2017:bcr2017219377. doi: 10.1136/bcr-2017-219377.
24. Edwards SK, Bunker CB, Ziller F, van der Meijden WI. 2013 European guideline for the management of balanoposthitis. Int J STD AIDS. 2014;25(9):615-626. doi: 10.1177/0956462414533099.
25. Pearle MS, Wendel EF. Necrotizing cavernositis secondary to periodontal abscess. J Urol. 1993;149(5):1137-1138. doi: 10.1016/s0022-5347(17)36321-8.
26. Kickuth R, Adams S, Kirchner J, Pastor J, Simon S, Liermann D. Magnetic resonance imaging in the diagnosis of Fournier's gangrene. Eur Radiol. 2001;11(5):787-790. doi: 10.1007/s003300000599.
27. Singh A, Ahmed K, Aydin A, Khan MS, Dasgupta P. Fournier's gangrene. A clinical review. Arch Ital Urol Androl. 2016;88(3):157-164. doi: 10.4081/aiua.2016.3.157.
28. Ballard DH, Raptis CA, Guerra J, et al. Preoperative CT Findings and Interobserver Reliability of Fournier Gangrene. AJR Am J Roentgenol. 2018;211(5):1051-1057. doi: 10.2214/AJR.18.19683.

There are 28 citations in total.

Details

Primary Language	English
Subjects	Radiology and Organ Imaging
Journal Section	Original Articles
Authors	Yeliz Aktürk 0000-0002-0244-0478 Esra Soyer Güldoğan 0000-0002-9251-5241 Serra Özbal Güneş 0000-0003-1019-9925
Early Pub Date	January 22, 2024
Publication Date	May 4, 2024
Submission Date	November 5, 2023
Acceptance Date	January 2, 2024
Published in Issue	Year 2024 Volume: 10 Issue: 3

Cite

AMA	Aktürk Y, Soyer Güldoğan E, Özbal Güneş S. Which pathologies of the penis can be diagnosed with computed tomography? A comprehensive approach to imaging findings. Eur Res J. May 2024;10(3):286-294. doi:10.18621/eurj.1386294

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