Cavernitis

CAVERNITIS (cavernitis), inflammation of the corpora cavernosa of the penis, may be localized or diffuse. The former form is most often localized in the cavernous bodies of the urethra, the latter in the cavernous bodies of the penis proper. The process may proceed acutely with violent manifestations (cavernitis acuta) or sluggishly, chronically (cavernitis chronica). The etiological factor of the localized form is most often inflammation of the urethra of a gonorrheal nature (cavernitis gonorrhoica), or it develops as a gummatous-syphilitic process (cavernitis luetica). The acute diffuse form of cavernitis can appear primarily as a complication of a general infectious disease (sepsis, typhus, etc.), and also as a result of the spread of infection (most often gonorrheal) from the urethra. Less often, cavernitis is a consequence of trauma. Clinical symptoms in acute diffuse cavernitis depend on the size of the inflammatory focus. With insignificant involvement of the cavernous tissue in the process, which is pathologically and anatomically expressed only in edema and infiltration of the interstitial tissue, symptoms may be unclear and expressed in the form of mild painful sensations in the penis during erection. With extensive involvement, continuous infiltration of the connective tissue trabeculae is observed, and often thrombosis in some of the cavernous cavities; this leads to a disturbance of the patient's general condition with an increase in temperature and severe painful sensations. The external integuments are inflamed, and the penis is in a semi-erect state (chorda venerea). Urination is difficult and painful, and the stream of urine is thin. In acute cavernitis, the process can end either with resorption and restitutio ad integrum or with suppuration and the opening of the abscess outward or into the urethra. In the latter case, urinary extravasation and urethral fistulas may form. More often, however, cavernitis takes a prolonged course and passes from acute to chronic; sometimes it has a sluggish course from the very beginning. In these cases, indurations ranging in size from a pea to a plum, which are slightly or completely painless upon palpation, can be felt in the thickness of the cavernous bodies. The process ends with the development of fibrous foci, which lead to persistent disturbances of erections (partial erections, curvature of the penis during erections). Sometimes, the formation of bone occurs in the fibrous tissue. Gummatous cavernitis resolves rapidly under the influence of specific treatment, while this treatment has almost no effect on cavernitis caused by other factors. Recommended internal treatments include iodine preparations, injections of fibrolysin, and locally, mud therapy, diathermy, and iontophoresis.