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Asian Journal of Urology, 2023, 10(4): 555-562    doi: 10.1016/j.ajur.2023.03.006
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Penile vascular anomalies: A retrospective single center study and cumulative analysis of studies from China
Chong Maab,Feng Gaob,Ran Anc,Yawei Guana,Jingfei Tenga*(),Xing Aia*()
aDepartment of Urology, The Third Medical Center of PLA General Hospital, Beijing, China
bDepartment of Urology, The Seventh Medical Center of PLA General Hospital, Beijing, China
cDepartment of Pathology, The Seventh Medical Center of PLA General Hospital, Beijing, China
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Abstract: 

Objective: Penile vascular anomalies (PVAs) or hemangioma can arouse patient concern about aesthetics and cause symptoms like bleeding and sexual dysfunction. However, its low incidence and the deficiency of large-volume studies hinder urologists from making informed decisions. This study aimed to investigate the clinical features and treatment experience of PVAs at the Seventh Medical Center of PLA General Hospital, Beijing, China. Furthermore, by systematically analysis of studies on PVAs in Chinese people, we aimed to provide novel insights on the management of this condition.

Methods: We retrospectively investigated clinical features and pathology of surgery-treated PVAs at our center. Moreover, by systemically reviewing the literature from PubMed and the three largest medical databases (China National Knowledge Infrastructure, Wan Fang, and Chinese Medical Journal Database) in China, we analyzed the clinical features and various therapies of PVAs in Chinese people.

Results: Between March 1, 2018 and March 1, 2023, a total of 356 cases with vascular anomalies were treated with surgery at out center. Only seven (2.0%) cases had lesions involving the perineum and external genitalia. All the seven cases were pathologically benign and demonstrated no recurrence over a follow-up period of 1-52 months (median 14 months). A total of 410 cases from 44 studies were selected in the cumulative analysis. Most patients (92.4%) diagnosed with PVAs were asymptomatic, and 68.8% of the patients were treated with sclerotherapy. As to the pathology, 57.1% were venous malformation.

Conclusion: The most common PVA is venous malformation and the majority of patients are asymptomatic. Sclerotherapy and laser have emerged as viable options for treating small lesions. Surgery still has its role in treating large lesions and obtaining pathology. Although PVAs often relapse or demand multiple treatments, the prognosis is favorable.

Key words:  Hemangioma    Laser irradiation    Penis    Surgery    Vascular anomaly
收稿日期:  2022-08-10      修回日期:  2023-01-03      接受日期:  2023-03-15      出版日期:  2023-10-20      发布日期:  2023-11-13      整期出版日期:  2023-10-20
引用本文:    
. [J]. Asian Journal of Urology, 2023, 10(4): 555-562.
Chong Ma, Feng Gao, Ran An, Yawei Guan, Jingfei Teng, Xing Ai. Penile vascular anomalies: A retrospective single center study and cumulative analysis of studies from China. Asian Journal of Urology, 2023, 10(4): 555-562.
链接本文:  
http://www.ajurology.com/CN/10.1016/j.ajur.2023.03.006  或          http://www.ajurology.com/CN/Y2023/V10/I4/555
Patient Sex Age, year Symptom Lesion location, size (cm×cm) Pathology Follow-up, month Outcome
1 Male 5 No - Scrotum, 1.8×1.4 - Venous malformation 6 - No recurrence
2 Female 13 Tenderness, bleeding - Perineum, 2.8×2.0 - Venous malformation 1 - Symptom relief, no recurrence
3 Male 19 No - Scrotum, 2.0×1.0 - Lymphatic malformation 2 - No recurrence
4 Male 22 No - Penis, 2.0×1.0 - Venous malformation 26 - No recurrence
5 Female 47 No - Vulva, 1.0×0.6 - Venous malformation 52 - No recurrence
6 Female 64 No - Perineum, 1.8×1.2 - Venous malformation 19 - No recurrence
7 Female 67 Bleeding - Perineum, 1.2×0.8
- Vulva, 0.4×0.4
- Capillary malformation
- Venous malformation
14 - Symptom relief, no recurrence
  
  
  
Treatment Pain or swelling Recurrence or had ≥2 operations Infection or delayed healing
Sclerotherapy 28/280 (10.0) 203/280 (72.5) 7/280 (2.5)
40% urea solution 2/154 (1.3) 133/154 (86.4) 0/154 (0)
Bleomycin 8/76 (10.5) 60/76 (78.9) 5/76 (6.6)
95% ethanal 1/19 (5.3) 3/19 (15.8) 1/19 (5.3)
Polidocanol 2/15 (13.3) 5/15 (33.3) 1/15 (6.7)
2% phenol glycerin 14/14 (100.0) 2/14 (14.3) 0/14 (0)
5% sodium morrhuate 0/1 (0) 0/1 (0) 0/1 (0)
Liquid nitrogen 1/1 (100.0) 0/1 (0) 0/1 (0)
Laser irradiation 13/71 (18.3) 25/71 (35.2) 1/71 (1.4)
Nd:YAG 13/41 (31.7) 25/41 (61.0) 1/41 (2.4)
Semiconductor 0/15 (0) 0/15 (0) 0/15 (0)
Copper vapor 0/13 (0) 0/13 (0) 0/13 (0)
CO2 laser 0/2 (0) 0/2 (0) 0/2 (0)
Copper wire insertion 2/15 (13.3) 15/15 (100) 0/15 (0)
Surgery 0/41 (0) 0/41 (0) 1/41 (2.4)
Total 43/407 (10.6) 243/407 (59.7) 9/407 (2.2)
  
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