How inflammation develops
The corpora cavernosa is a spongy tissue with many cavities that fill with blood. Their rich blood supply makes them vulnerable to infection from outside or carried in blood. First, swelling occurs and the tissue becomes saturated with inflammatory fluid, then, if the process is not stopped, an abscess forms. After the inflammation subsides, the damaged areas are replaced by dense connective tissue, which does not stretch during erection. That is why even cured cavernitis can leave behind curvature and pain.
- Acute cavernitis - swelling and tissue infiltration
- Purulent cavernitis - abscess formation
- Chronic cavernitis - compaction and fibrosis
- Possible outcome in penile curvature
- Severe forms threaten the spread of infection
Causes and risk factors
The most common way is the spread of infection from the urethra with purulent urethritis, especially if it is advanced or self-treated. The second group of reasons is direct damage: fracture of the penis, bites, wounds, as well as the introduction of erection drugs into the cavernous bodies unsterilely or without a doctor’s prescription. A special role is played by prolonged priapism, in which stagnation of blood leads to inflammation and tissue death. The risk is higher in patients with diabetes and reduced immunity.
- Purulent urethritis and sexually transmitted infections
- Trauma to the penis and its fracture
- Intracavernous injections without medical supervision
- Priapism lasting more than a few hours
- Infection with blood from another purulent lesion
- Diabetes mellitus and immunodeficiency
Symptoms
The disease usually begins acutely. The penis becomes swollen, painful, the skin turns red, and a dense painful area is felt inside the tissue. The pain increases with spontaneous erections, which may become painful and incomplete. The temperature often rises, chills and weakness appear. Due to swelling of the urethra, difficulty urinating and even urinary retention are possible. In the chronic form, there are no acute phenomena, but the compaction remains, and the penis becomes curved during erection.
- Swelling and redness of the penis
- Dense painful lesion in the tissue
- Painful erections
- Fever and chills
- Difficulty urinating
- In the chronic form - curvature and compaction
Diagnostics
The diagnosis in most cases can be suspected upon examination, but it is confirmed by ultrasound examination of the penis: it shows swelling of the corpora cavernosa, areas of infiltration and cavities with pus. Doppler ultrasound helps assess blood flow and consequences for erectile function. Be sure to look for the source of infection: examine the urine, take a smear from the urethra, perform a culture to determine sensitivity to antibiotics. A blood test reflects the severity of inflammation, and glucose is checked to rule out diabetes.
- Examination by a urologist
- Ultrasound of the penis
- Dopplerography of penile vessels
- General blood and urine analysis
- Urethral smear and microflora culture
- Blood glucose
- MRI for unclear picture
Treatment and recovery
Acute cavernitis is treated in a hospital: broad-spectrum antibiotics are prescribed intravenously, anti-inflammatory drugs, local cooling and rest. If an abscess has formed, it is opened and drained, otherwise the inflammation will continue to destroy the tissue. After the acute phenomena have subsided, drugs and procedures that reduce scarring are added, and the doctor is responsible for their choice. Warming up, compresses with alcohol and attempts to “disperse” the compaction with massage are unacceptable. If the curvature is formed, surgical correction is discussed after a few months.
- Hospitalization and intravenous antibiotics
- Anti-inflammatory and analgesic therapy
- Opening and draining the abscess
- Sexual rest for the period of treatment
- Rehabilitation for the prevention of fibrosis as prescribed by a doctor
- Treatment of concomitant urethritis and diabetes
- Surgical correction of curvature if necessary
