Alzahrani Abdullah, Al-Sharydah Abdulaziz, Alkhamis Abdulmalik, Alarifi Mishal, AlMomen Mohammed, Alwarthan Abdulaziz, Aldamanhori Reem
Department of Urology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Diagnostic and Interventional Radiology Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
J Med Life. 2023 Oct;16(10):1566-1570. doi: 10.25122/jml-2023-0113.
Penile torsion is the abnormal three-dimensional twisting of penile corporal bodies. It can be classified as mild, moderate, or severe, depending on the degree of torsion. Severe penile torsion (>90°) is a very rare condition, with an estimated incidence of 0.4%-1% among all penile torsion cases. Our patient was a 37-year-old man complaining of a 2-year history of lower urinary tract symptoms. These symptoms appeared after the patient sustained an iatrogenic injury during Foley catheter insertion. Physical examination incidentally revealed an obvious counterclockwise penile rotation of 180°. Several theories have been proposed to explain the etiology of penile torsion, including theories based on genetic factors, abnormal urethral development, and abnormal attachment of the dartos fascia to the skin. Penile torsion may be associated with other penile anomalies, including chordee, hypospadias, and epispadias; however, it is often detected as an isolated finding. Clinical examination is sufficient to confirm its diagnosis without the need for further imaging. While no standardized procedure has been indicated for all penile torsion cases, the severity of torsion and the presence of other anomalies determine the most suitable procedure. No reports on the imaging features of penile torsion (irrespective of the degree of torsion) are available. We present the first such report on the imaging features, including advanced magnetic resonance imaging findings, of a 180° penile torsion in an adult patient.
阴茎扭转是阴茎海绵体的异常三维扭转。根据扭转程度，可分为轻度、中度或重度。重度阴茎扭转（>90°）是一种非常罕见的情况，在所有阴茎扭转病例中，估计发病率为0.4%-1%。我们的患者是一名37岁男性，主诉有2年的下尿路症状病史。这些症状在患者插入Foley导尿管时遭受医源性损伤后出现。体格检查偶然发现阴茎明显逆时针旋转180°。已经提出了几种理论来解释阴茎扭转的病因，包括基于遗传因素、尿道发育异常以及肉膜筋膜与皮肤异常附着的理论。阴茎扭转可能与其他阴茎异常有关，包括阴茎下弯、尿道下裂和尿道上裂；然而，它通常作为一个孤立的发现被检测到。临床检查足以确诊，无需进一步影像学检查。虽然尚未针对所有阴茎扭转病例指明标准化程序，但扭转的严重程度和其他异常的存在决定了最合适的程序。目前尚无关于阴茎扭转（无论扭转程度如何）影像学特征的报道。我们首次报道了一名成年患者180°阴茎扭转的影像学特征，包括先进的磁共振成像结果。
