Table of ContentsView AllTable of ContentsWhat Is PMD?SymptomsCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
What Is PMD?
Symptoms
Causes
Diagnosis
Treatment
vchal / Getty Images
The diagnosis of PMD can be made with a physical exam andultrasound. The treatment of this otherwise benign (not harmful) and self-limiting condition is typically supportive to relieve pain and inflammation.
This article discusses penile Mondor’s disease and its symptoms and causes. It also looks at how the condition is diagnosed and treated.
What Is Penile Mondor’s Disease?
The first case of Mondor’s disease isolated to the penis was described in 1958 and was subsequently dubbed PMD.
With PMD,superficial thrombophlebitistypically occurs in the superficial dorsal vein situated on the top of the penis that runs the length of the penis. The smaller tributary veins that branch off the dorsal vein can also be affected.
Mondor’s disease is considered rare with fewer than 400 cases reported in medical literature worldwide.
Despite their absence in medical literature, many cases of PMD are likely to go undiagnosed because people may be too embarrassed to see their healthcare provider. And, when they do, the symptoms may already have begun to resolve or have disappeared completely.
Urological Health
Penile Mondor’s Disease Symptoms
PMD tends to occur after a precipitating event, such as prolonged and vigorous sex. The first sign is usually the palpable hardening of part of the dorsal vein on top of the penis, usually within 24 to 48 hours of the event. This will create a rope-like mass just beneath the skin running anywhere from 1 to 4 inches in length.
In addition to the formation of a hardened lesion, symptoms of PMD may include:
Some cases may only involve the formation of a hardened vein on top of the penis with no other symptoms. Other cases may occur in tandem with the formation of similar thrombotic lesions on the breast, chest, or arm.
PMD is typically self-limiting, meaning that it will resolve on its own as natural anticoagulants (blood thinners) in the body begin to break down the clot. Most cases will return to normal within four to six weeks.
When Is a Painful Erection a Medical Emergency?
Causes of Penile Mondor’s Disease
Because PMD is so rarely diagnosed, the exact cause of the condition is poorly understood. Based on the current body of case reports, PMD usually arises as a result of mechanical trauma to the penis.
At the same time, there is evidence that PMD may be secondary to disease, infections, or surgeries that directly or indirectly affect the penis.
The list of possible causes is extensive and may include:
Other predisposing factors for PMD include thrombophilia (an imbalance inblood clotting factors), the abuse of intravenous drugs, and a history ofsexually transmitted infections (STIs).
Is It Possible To Fracture a Penis?
Genetics
Clearly, not anyone with the risk factors listed above will develop PMD. Because of this, many scientists believe that certain people have a genetic predisposition for PMD.
There are several gene mutations linked to PMD that can place a person in a hypercoagulative state (meaning prone to excessive blood clotting). This includes the aforementioned antithrombin III deficiency as well as protein S deficiency, protein C deficiency, factor V Leiden mutation, and PT 20210 mutation.
What all these disorders share is anautosomal dominantpattern of inheritance, meaning that only onegenemutation from one parent is needed for the child to develop the disease (in this case, hypercoagulation). Moreover, the parent with the gene mutation will also have the disorder.
Despite the association, not everyone with PMD will have these or any other gene mutation linked to hypercoagulation. As such, it is still unclear how much genetics influence the likelihood of PMD in relationship to other known risk factors.
Platelet Disorders That Affect Blood Clotting
Express your concerns to aprimary care physicianor make an appointment with a specialist called aurologistwho specializes in diseases of the urinary tract and male reproductive system.
PMD can often be diagnosed with a physical exam and a review of the person’s medical history. An ultrasound and other tests may be used to confirm the diagnosis.
Physical Exam
The physical examination will usually reveal classic signs of PMD, most predominately the hardened, rope-like vein along the top of the penis.It is not uncommon for the lesion to extend above the pubic bone.
PMD has certain telltale signs. Among them, the skin overlying the lesion will not be loose; rather, it will adhere to the lesion and be immovable.
In reviewing the person’s medical history, your healthcare provider will assess whether there are any risk factors linked to PMD (such as a history of STIs or the use of intracavernous drugs).
In many cases, the appearance of the lesion will have occurred 24 to 48 hours after prolonged or vigorous sex. Other cases may be idiopathic (of unknown origin), possibly due to penile injury a long time ago.
Diagnosing Penile Bumps or Rashes
Ultrasound
A color Doppler ultrasound is an imaging test that uses sound waves to show blood moving through blood vessels. It shows the flow in the arteries into and the veins out of the penis. (A traditional ultrasound also uses sound waves to create images, but it can’t show blood flow.) Changes in color correspond to the speed and direction of the blood flow.
On a color Doppler ultrasound, the blood flow in the dorsal vein will be slowed in someone with PMD but not in someone with NVSL.
A color Doppler ultrasound is also useful for differentiating PMD fromPeyronie’s disease, a far more common condition that causes the abnormal curvature of the penis.
How Peyronie’s Disease Is Diagnosed
Other Tests
Other tests may be ordered if PMD is believed to be secondary to an underlying disease. This may include an STI screen if syphilis is suspected.Enlarged lymph nodesin the groin may warrant a preliminaryinvestigation of cancer, including the use of theprostate-specific antigen (PSA) testto help detectprostate cancer.
On rare occasions,genetic testsmay be ordered to screen for hypocoagulative disorders. Even so, they are not commonly used, as a positive result would do little if anything to alter the treatment plan.
When To See a Doctor About Urethral Pain
Penile Mondor’s Disease Treatment Options
PMD is typically a self-limiting, benign condition that will resolve on its own without treatment. The treatment of PMD is generally supportive to relieve pain and inflammation.
If diagnosed with PMD, you should abstain from sex (including masturbation) until the symptoms resolve. Even if there is no pain, sex could worsen the lesion and slow the healing process.
Topical and Oral Therapies
Topical preparations containingnonsteroidal anti-inflammatory drugs (NSAIDs)like Voltaren (diclofenac) are sometimes used to reduce inflammation in people with PMD. Topical creams containing the anticoagulantheparinmay also be prescribed to help break down the blood clot. Neither preparation is known to be consistently beneficial.
More controversial is the use of oral heparin to treat refractory (treatment-resistant) PMD. Although it may be considered if the condition is severe and doesn’t resolve after six weeks, the side effects of oral heparin (including easy bleeding and liver toxicity) tend to outweigh the possible benefits.
Surgery
Penile thrombectomy with resection can usually be performed on an outpatient basis. The healing and recovery time takes around eight weeks.
What to Know About Telehealth With a Urologist
Summary
Penile Mondor’s disease is a rare, benign condition that causes a painful, rope-like vein on the top of the penis.
Penile Mondor’s disease is usually diagnosed based on appearance and/or with ultrasound. The condition usually resolves on its own within a few weeks, and treatment typically involves pain relief.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Öztürk H.Penile Mondor’s disease.Basic Clin Androl.2014;24:5. doi:10.1186/2051-4190-24-5Amano M, Shimizu T.Mondor’s disease: a review of the literature.Intern Med. 2018;57(18):2607-12. doi:10.2169/internalmedicine.0495-17Amano M, Shimizu T.Mondor’s disease: A review of the literature.Intern Med. 2018;57(18):2607-2612. doi:10.2169/internalmedicine.0495-17Wild J, Wilson L, Bajaj M.Penile Mondor’s disease- an understated entity.Urol Case Rep. 2020;31:101176. doi:10.1016/j.eucr.2020.101176Evans NS, Ratchford EV.Superficial vein thrombosis.Vasc Med. 2018;23(2):187-189. doi:10.1177/1358863X18755928Genetics and Rare Diseases Information Center.Hereditary antithrombin deficiency.Warner M, Durrani M, Yerram V, Coppa A, Barra A.Diagnosis of mondor’s disease in the setting of right-sided anterior chest wall pain.Cureus. 2022;14(11):e31894. doi:10.7759/cureus.31894Singh D, Natarajan A, Nand S, Mai HP.Genetics of hypercoagulable and hypocoagulable states.Neurosurg Clin N Am.2018;29(4):493-501. doi:10.1016/j.nec.2018.06.002Al-Amiri A, Al-Terki A, Al-Shaiji T.Mondor’s disease of the penis.Research. 2015;2:1454. doi:10.13070/rs.en.2.1454Dell’Atti L.Role of ultrasonography with color-Doppler in diagnosis of penile Mondor’s disease.J Ultrasound. 2014;17(3):239-41. doi:10.1007/s40477-013-0035-8Gómez-Zubiaur A, Guirado-Koch C, Beà-Ardébol S, Trasobares-Marugán L.Nonvenereal sclerosing lymphangitis of the penis: importance of the clinical diagnosis.Images Dermatol.2018;109(6):551. doi:10.1016/j.adengl.2018.05.019MedlinePlus.Doppler ultrasound.Serrao A, Lucani B, Baldacci E, Fiori L, Chistolini A.Direct oral anticoagulants for the treatment of Mondor’s disease not responding to low-molecular weight heparin.Phlebology.2020;35(9):734-5. doi:10.1177/0268355520925022Sheikh M, Jeelani H, Farooqi A, et al.Penile Mondor’s disease: rare association with excessive masturbation.Cureus.2020;12(5):e8317. doi:10.7759/cureus.8317
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Öztürk H.Penile Mondor’s disease.Basic Clin Androl.2014;24:5. doi:10.1186/2051-4190-24-5Amano M, Shimizu T.Mondor’s disease: a review of the literature.Intern Med. 2018;57(18):2607-12. doi:10.2169/internalmedicine.0495-17Amano M, Shimizu T.Mondor’s disease: A review of the literature.Intern Med. 2018;57(18):2607-2612. doi:10.2169/internalmedicine.0495-17Wild J, Wilson L, Bajaj M.Penile Mondor’s disease- an understated entity.Urol Case Rep. 2020;31:101176. doi:10.1016/j.eucr.2020.101176Evans NS, Ratchford EV.Superficial vein thrombosis.Vasc Med. 2018;23(2):187-189. doi:10.1177/1358863X18755928Genetics and Rare Diseases Information Center.Hereditary antithrombin deficiency.Warner M, Durrani M, Yerram V, Coppa A, Barra A.Diagnosis of mondor’s disease in the setting of right-sided anterior chest wall pain.Cureus. 2022;14(11):e31894. doi:10.7759/cureus.31894Singh D, Natarajan A, Nand S, Mai HP.Genetics of hypercoagulable and hypocoagulable states.Neurosurg Clin N Am.2018;29(4):493-501. doi:10.1016/j.nec.2018.06.002Al-Amiri A, Al-Terki A, Al-Shaiji T.Mondor’s disease of the penis.Research. 2015;2:1454. doi:10.13070/rs.en.2.1454Dell’Atti L.Role of ultrasonography with color-Doppler in diagnosis of penile Mondor’s disease.J Ultrasound. 2014;17(3):239-41. doi:10.1007/s40477-013-0035-8Gómez-Zubiaur A, Guirado-Koch C, Beà-Ardébol S, Trasobares-Marugán L.Nonvenereal sclerosing lymphangitis of the penis: importance of the clinical diagnosis.Images Dermatol.2018;109(6):551. doi:10.1016/j.adengl.2018.05.019MedlinePlus.Doppler ultrasound.Serrao A, Lucani B, Baldacci E, Fiori L, Chistolini A.Direct oral anticoagulants for the treatment of Mondor’s disease not responding to low-molecular weight heparin.Phlebology.2020;35(9):734-5. doi:10.1177/0268355520925022Sheikh M, Jeelani H, Farooqi A, et al.Penile Mondor’s disease: rare association with excessive masturbation.Cureus.2020;12(5):e8317. doi:10.7759/cureus.8317
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Öztürk H.Penile Mondor’s disease.Basic Clin Androl.2014;24:5. doi:10.1186/2051-4190-24-5Amano M, Shimizu T.Mondor’s disease: a review of the literature.Intern Med. 2018;57(18):2607-12. doi:10.2169/internalmedicine.0495-17Amano M, Shimizu T.Mondor’s disease: A review of the literature.Intern Med. 2018;57(18):2607-2612. doi:10.2169/internalmedicine.0495-17Wild J, Wilson L, Bajaj M.Penile Mondor’s disease- an understated entity.Urol Case Rep. 2020;31:101176. doi:10.1016/j.eucr.2020.101176Evans NS, Ratchford EV.Superficial vein thrombosis.Vasc Med. 2018;23(2):187-189. doi:10.1177/1358863X18755928Genetics and Rare Diseases Information Center.Hereditary antithrombin deficiency.Warner M, Durrani M, Yerram V, Coppa A, Barra A.Diagnosis of mondor’s disease in the setting of right-sided anterior chest wall pain.Cureus. 2022;14(11):e31894. doi:10.7759/cureus.31894Singh D, Natarajan A, Nand S, Mai HP.Genetics of hypercoagulable and hypocoagulable states.Neurosurg Clin N Am.2018;29(4):493-501. doi:10.1016/j.nec.2018.06.002Al-Amiri A, Al-Terki A, Al-Shaiji T.Mondor’s disease of the penis.Research. 2015;2:1454. doi:10.13070/rs.en.2.1454Dell’Atti L.Role of ultrasonography with color-Doppler in diagnosis of penile Mondor’s disease.J Ultrasound. 2014;17(3):239-41. doi:10.1007/s40477-013-0035-8Gómez-Zubiaur A, Guirado-Koch C, Beà-Ardébol S, Trasobares-Marugán L.Nonvenereal sclerosing lymphangitis of the penis: importance of the clinical diagnosis.Images Dermatol.2018;109(6):551. doi:10.1016/j.adengl.2018.05.019MedlinePlus.Doppler ultrasound.Serrao A, Lucani B, Baldacci E, Fiori L, Chistolini A.Direct oral anticoagulants for the treatment of Mondor’s disease not responding to low-molecular weight heparin.Phlebology.2020;35(9):734-5. doi:10.1177/0268355520925022Sheikh M, Jeelani H, Farooqi A, et al.Penile Mondor’s disease: rare association with excessive masturbation.Cureus.2020;12(5):e8317. doi:10.7759/cureus.8317
Öztürk H.Penile Mondor’s disease.Basic Clin Androl.2014;24:5. doi:10.1186/2051-4190-24-5
Amano M, Shimizu T.Mondor’s disease: a review of the literature.Intern Med. 2018;57(18):2607-12. doi:10.2169/internalmedicine.0495-17
Amano M, Shimizu T.Mondor’s disease: A review of the literature.Intern Med. 2018;57(18):2607-2612. doi:10.2169/internalmedicine.0495-17
Wild J, Wilson L, Bajaj M.Penile Mondor’s disease- an understated entity.Urol Case Rep. 2020;31:101176. doi:10.1016/j.eucr.2020.101176
Evans NS, Ratchford EV.Superficial vein thrombosis.Vasc Med. 2018;23(2):187-189. doi:10.1177/1358863X18755928
Genetics and Rare Diseases Information Center.Hereditary antithrombin deficiency.
Warner M, Durrani M, Yerram V, Coppa A, Barra A.Diagnosis of mondor’s disease in the setting of right-sided anterior chest wall pain.Cureus. 2022;14(11):e31894. doi:10.7759/cureus.31894
Singh D, Natarajan A, Nand S, Mai HP.Genetics of hypercoagulable and hypocoagulable states.Neurosurg Clin N Am.2018;29(4):493-501. doi:10.1016/j.nec.2018.06.002
Al-Amiri A, Al-Terki A, Al-Shaiji T.Mondor’s disease of the penis.Research. 2015;2:1454. doi:10.13070/rs.en.2.1454
Dell’Atti L.Role of ultrasonography with color-Doppler in diagnosis of penile Mondor’s disease.J Ultrasound. 2014;17(3):239-41. doi:10.1007/s40477-013-0035-8
Gómez-Zubiaur A, Guirado-Koch C, Beà-Ardébol S, Trasobares-Marugán L.Nonvenereal sclerosing lymphangitis of the penis: importance of the clinical diagnosis.Images Dermatol.2018;109(6):551. doi:10.1016/j.adengl.2018.05.019
MedlinePlus.Doppler ultrasound.
Serrao A, Lucani B, Baldacci E, Fiori L, Chistolini A.Direct oral anticoagulants for the treatment of Mondor’s disease not responding to low-molecular weight heparin.Phlebology.2020;35(9):734-5. doi:10.1177/0268355520925022
Sheikh M, Jeelani H, Farooqi A, et al.Penile Mondor’s disease: rare association with excessive masturbation.Cureus.2020;12(5):e8317. doi:10.7759/cureus.8317
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
