![]() ![]() Penile ultrasound should include longitudinal and transverse greyscale and Doppler color-flow images of the entire length of the penis, and if good visualization of the base of the penis cannot be obtained, a transperineal approach with the elevation of the testes should be considered, they continued. Ultrasound is conducted using a linear transducer of 7 and 15 MHz." "In a degloving injury, a careful ultrasound investigation using sterile gel and transducer covers is essential. A supporting towel between the patient's thighs will help elevate the scrotum," they noted. "Ultrasound examination should be performed ideally with the patient supine while holding his penis' tip onto his abdomen. Imaging allows a useful assessment of injuries for an easier decision on either surgical or conservative management, the authors explained. Paul Sidhu.Īlso, CEUS can increase the operators' confidence in confirming vessel patency and demonstrating active bleeding and pseudoaneurysms, and it can help to locate a dislocated penis and assess its viability. All images courtesy of Dr. Miguel Ángel Gómez-Bermejo, Dr. Dean Huang, and Prof. Five months later (f), the cavernosal hematoma and arteriovenous fistula had disappeared. It demonstrates persistence of the fistula, but with a decrease in the size of the hematoma (asterisk) and a reduction in the calibre and peak systolic velocity of the right cavernous artery (thin arrow). A follow-up ultrasound was performed two weeks later (e). The arteriovenous fistula was embolized with Gelfoam (not shown). Two weeks later, an MRI scan without contrast was performed, showing an area of hypointensity both on T2-weighted imaging (c) and T1-weighted imaging (d) compatible with a late subacute-chronic hematoma. There is an associated cavernosal hematoma (asterisk). On ultrasound in a sagittal plane of the right cavernosal body at the base of the penis (a-b), there is an abnormal communication between the right cavernosal artery (thin arrows) and a prominent draining vein (arrowheads) consisting of an arteriovenous fistula. "CEUS improves the localization of tears of the tunica albuginea and could help to differentiate cavernosal tissue herniation from hematoma, as the former enhances."Ī 37-year-old man presented after a crush injury to the perineum with swelling and high-flow priapism. "CEUS may help to delineate both cavernosal and extratunical hematomas, as they do not enhance after microbubble injection," explained Gómez-Bermejo and colleagues in an e-poster that received a cum laude award at ECR 2023. Penile trauma is a urological emergency that is often underdiagnosed, and it can have severe consequences, such as infarction or infection, according to Dr. Miguel Ángel Gómez-Bermejo, who is based at Hospital Universitario Ramón y Cajal in Madrid and was a European School of Radiology (ESOR) fellow at the King's College Hospital NHS Foundation Trust in London between September and December 2022. Ma- Multiparametric ultrasound, including contrast-enhanced ultrasound (CEUS), is an ideal diagnostic tool for penile traumatic injuries because it has a high resolution and is portable, safe, and widely available, prize-winning researchers reported at ECR 2023. Imaging sheds light on complex cases of penile trauma By Philip Ward, staff writer ![]()
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