Penile Mondor Disease Following Circumcision: Diagnostic Insights from Color Doppler Ultrasound

Dorsal vein thrombophlebitis, or penile Mondor disease, is a rare benign penile condition presenting with cord-like induration at the dorsum of the penis. This induration is caused by an isolated thrombosis of the dorsal superficial vein of the penis. As symptoms are not typical and many patients are asymptomatic, it is often underdiagnosed. Causes include trauma, infection, sexual activity, genital surgery, and cancer. Differential diagnosis includes Peyronie's disease and sclerosing lymphangitis, and diagnosis remains crucial as it facilitates the treatment plan and reassures the patient. Treatment consists of conservative measures, such as oral nonsteroidal anti-inflammatory medications (NSAIDs) and anticoagulation, and surgical management, with excision of the thrombosed vein. We present a case report of penile Mondor disease following circumcision, with the aim to provide educational ultrasound images of this rare entity. The patient, 32 years old, on the sixth postoperative day, developed a cord-like induration, along with pain, at the dorsum of the penis. Physical examination revealed a cord-like mass on the dorsal aspect of the penis. Penile triplex demonstrated a lack of endoluminal flow signals of the superficial dorsal veins, which were uncompressible. Triplex of the femoral and iliac veins showed no sign of thrombosis. Clinical presentation, along with imaging findings, facilitated the diagnosis of Mondor disease. The patient was treated conservatively with sexual abstinence and NSAIDs, and 6 weeks after the presentation, the patient was asymptomatic, without evidence of the disease in clinical examination.