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| Penile vascular anomalies: A retrospective single center study and cumulative analysis of studies from China |
Chong Maa,b,Feng Gaob,Ran Anc,Yawei Guana,Jingfei Tenga,*( ),Xing Aia,*()
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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.
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Received: 10 August 2022
Available online: 20 October 2023
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Corresponding Authors:
*E-mail address: drjfteng@126.com (J. Teng), aixing0007@163.com (X. Ai).
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| 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 |
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Vascular anomalies involving the perineum and external genitalia.
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The venous malformation of the penis. (A) The lesion before surgery; (B) Injection of normal saline to facilitate isolation; (C) Complete resection of the lesion; (D) Venous malformation with hematoxylin-eosin staining on microscopy.
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Flow diagram of the study selection.
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| 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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Results of different treatments for penile vascular anomalies.
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