Cavernosal abscess after routine urological surgery

Penile abscesses have been reported to occur because of a wide range of causes, including blunt trauma, infection (eg, gonorrhea), and intracorporeal injections (eg, for erectile dysfunction).[1] The reported incidences are low, and published images of this pathology are rare.[2] We share such images in the case of a 47-year-old man who was previously fit and well but presented with complications after circumcision and meatal dilation at another healthcare provider. The symptoms included penile swelling, localized pain, and chills. Computed tomography revealed a penile abscess originating from the corpus cavernosum (Fig. 1). Cystoscopy confirmed concomitant urethrocavernosal fistula. Abscess drainage was assessed using interventional radiology. However, this did not fully resolve the abscess; therefore, the patient underwent open incision and drainage. Intraoperative examination revealed necrosis of the cavernosal tissue (Fig. 2). In addition to culture-guided antibiotic therapy, the patient underwent prolonged catheterization to manage the fistula. This resolved accordingly, as confirmed by using urethrography. At 6-month follow-up, the patient recovered fully and was referred to another center for consideration of a penile implant because of impaired erectile function.Figure 1: Sagittal view on computed tomography of abscess originating in the corpus cavernosum.Figure 2: Intraoperative image of necrotic cavernosal tissue.In addition to being educational, these images and cases serve as reminders that serious complications can occur even after routine and minor urological surgeries.