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Tuesday, September 8, 2015

Congenital penile sinus (a case from the 1960s)


A ventral mid-line sinus of the penis is an unusual congenital defect. The following case report was published in the Postgraduate Medical Journal in 1964.

"A 43-yr old circumcised man sought advice about two superficial sore lesions on the under surface of his penis and scrotum. These had been present for two weeks and had discharged a small quantity of pus. Seven years previously he had noticed a pore on his penis from which it was possible to express a chalky material. At this time his doctor had incised a superficial infective lesion close by this orifice. On examining the penis and scrotum there were two mid-line infected lesions, one being at the peno-scrotal junction and the other 5 cm posterior to it. In addition there were two sinuses, one, 2 cm in length, extended along the proximal third of the shaft of the penis from an orifice situated in the mid-line just proximal to the peno-scrotal junction. The other, 12 cm in length, extended from a similar pore in the central part of the scrotum to just in front of the anus. Probing revealed that both sinuses terminated blingly and had no communication with the urethra, each other, or the superficial infective lesions. 

Each sinus was palpable [...] as a firm, non-tender cord. On general clinical examination there was no evidence of other congenital anomalies. There was no history of veneral [sic] disease [...] Culture of pus from the infective lesions grew only Staphylococcus albus.

Under general anaesthetic the sinuses were laid open with scissors and their deep aspects were seen to consist of pink mucous membrane. The slit thus produced healed rapidly during the next seven days with no treatment other than dressings." (Wastell 1964)

The case report contains two black-and-white photos, shown below. The left-hand one shows the sinus at the peno-scrotal junction, while the right-hand one depicts the more posterior of the two sinuses with a probe passed along its entire length. The tip of the probe is just anterior to the anus. 


Source:

Wastell C. (1964) Congenital Penile Sinus. Postgrad Med J. 40(460): 95–97.

 





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