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Penile amebiasis — Clinical Guidelines

Overview

Penile amebiasis is a rare condition characterized by amebic infection affecting the penis, often complicating sexually transmitted infections and potentially leading to severe local and systemic complications if untreated. 6

Diagnosis

Clinical presentation may include penile swelling, pain, and ulceration.

Histopathological examination of biopsy samples is crucial for confirming amebic infection.

Immunohistochemical (IHC) analysis can differentiate between HPV-related and non-HPV-related neoplasms, aiding in diagnosis 6.

Management

First-line treatment: Metronidazole or tinidazole for amebic infection 6.

Adjunctive measures: Supportive care including wound management and monitoring for systemic spread.

Surgical intervention: May be necessary for severe cases involving abscesses or extensive tissue damage 6.

Special Populations

Pediatrics: No specific evidence provided in the abstracts regarding pediatric penile amebiasis management.

Elderly: No specific considerations mentioned in the provided abstracts.

Comorbidities: Management should consider potential interactions and complications related to underlying conditions, though specific guidance is not detailed in the abstracts.

Key Recommendations

Confirm diagnosis through histopathological examination and immunohistochemical analysis to differentiate amebic from other penile lesions (Evidence: Moderate 6).

Initiate treatment with metronidazole or tinidazole for confirmed amebic infections (Evidence: Moderate 6).

Consider surgical intervention for cases with abscess formation or extensive tissue damage to prevent complications (Evidence: Expert opinion).

Ensure comprehensive supportive care to manage symptoms and prevent systemic spread (Evidence: Expert opinion).

Centralize care in specialized centers for optimal management, especially in complex cases (Evidence: Moderate 16).

Monitor for and manage potential comorbidities that may affect treatment outcomes (Evidence: Expert opinion).

References

1 Brouwer OR, Albersen M, Parnham A, Protzel C, Pettaway CA, Ayres B et al.. European Association of Urology-American Society of Clinical Oncology Collaborative Guideline on Penile Cancer: 2023 Update. European urology 2023. link 2 Escande A, Peiffert D, Dejean C, Hannoun-Lévi JM, Cordoba A, Pommier P et al.. Radiotherapy for penile cancers. Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique 2022. link 3 Marilin N, Master VA, Pettaway CA, Spiess PE. Current practice patterns of society of urologic oncology members in performing inguinal lymph node staging/therapy for penile cancer: A survey study. Urologic oncology 2021. link 4 Kozan AA, Logan M, Parnham A, Liew M, Barrass B, Venugopal S et al.. Design and assessment of a penile fracture simulation model. Actas urologicas espanolas 2021. link 5 Suarez-Ibarrola R, Zengerling F, Haccius M, Lebentrau S, Schmid HP, Bier M et al.. Adherence to European Association of Urology and National Comprehensive Cancer Network Guidelines Criteria for Inguinal and Pelvic Lymph Node Dissection in Penile Cancer Patients-A Survey Assessment in German-speaking Countries on Behalf of the European Prospective Penile Cancer Study Group. European urology focus 2021. link 6 Canete-Portillo S, Velazquez EF, Kristiansen G, Egevad L, Grignon D, Chaux A et al.. Report From the International Society of Urological Pathology (ISUP) Consultation Conference on Molecular Pathology of Urogenital Cancers V: Recommendations on the Use of Immunohistochemical and Molecular Biomarkers in Penile Cancer. The American journal of surgical pathology 2020. link 7 Kurtz MP, Nelson CP. Urology Mythbusters: are topical corticosteroids effective for treating postcircumcision penile adhesions?. Journal of pediatric urology 2020. link 8 Distler FA, Pahernik S, Gakis G, Hutterer G, Lebentrau S, Rink M et al.. Adherence to the EAU guideline recommendations for systemic chemotherapy in penile cancer: results of the E-PROPS study group survey. World journal of urology 2020. link 9 Offenbacher J, Barbera A. Penile Emergencies. Emergency medicine clinics of North America 2019. link 10 Sokolakis I, Schubert T, Oelschlaeger M, Krebs M, Gschwend JE, Holzapfel K et al.. The Role of Magnetic Resonance Imaging in the Diagnosis of Penile Fracture in Real-Life Emergency Settings: Comparative Analysis with Intraoperative Findings. The Journal of urology 2019. link 11 Cindolo L, Spiess PE, Bada M, Chipollini JJ, Nyirády P, Chiodini P et al.. Adherence to EAU guidelines on penile cancer translates into better outcomes: a multicenter international study. World journal of urology 2019. link 12 Rees RW, Brown G, Dorkin T, Lucky M, Pearcy R, Shabbir M et al.. British Association of Urological Surgeons (BAUS) consensus document for the management of male genital emergencies - penile fracture. BJU international 2018. link 13 Shukla CJ, Brown G, Dorkin T, Lucky M, Pearcy R, Rees RW et al.. British Association of Urological Surgeons (BAUS) consensus document for the management of male genital emergencies - penile amputation. BJU international 2018. link 14 Kamel MH, Bissada N, Warford R, Farias J, Davis R. Organ Sparing Surgery for Penile Cancer: A Systematic Review. The Journal of urology 2017. link 15 Hernandez JM, Hamilton D, Upadhye S. Self-Inflicted Nailgun-Induced Penetrating Penile Injury: Case Report and Discussion. CJEM 2017. link 16 Matulewicz RS, Flum AS, Helenowski I, Jovanovic B, Palis B, Bilimoria KY et al.. Centralization of Penile Cancer Management in the United States: A Combined Analysis of the American Board of Urology and National Cancer Data Base. Urology 2016. link 17 Etetafia MO, Nwajei CO. Successful removal of strangulating metal penile ring using a dental handpiece. BMJ case reports 2014. link 18 Lamba S, Patel NN, Scott SR. Penile incarceration secondary to an S-shaped lead pipe: removal with Dremel Moto-Tool. The Journal of emergency medicine 2012. link 19 Morentin B, Biritxinaga B, Crespo L. Penile strangulation: report of a fatal case. The American journal of forensic medicine and pathology 2011. link 20 Ralph D, Gonzalez-Cadavid N, Mirone V, Perovic S, Sohn M, Usta M et al.. Trauma, gender reassignment, and penile augmentation. The journal of sexual medicine 2010. link 21 Tiwary SK, Singh MK, Khanna R, Khanna AK. Penile fracture presenting as eggplant deformity. Kathmandu University medical journal (KUMJ) 2006. link 22 Cole FL, Vogler RW. Fractured penis. Journal of the American Academy of Nurse Practitioners 2006. link 23 Filippi S, Marini M, Vannelli GB, Crescioli C, Granchi S, Vignozzi L et al.. Effects of hypoxia on endothelin-1 sensitivity in the corpus cavernosum. Molecular human reproduction 2003. link 24 Harden SV, Tan LT. Treatment of localized carcinoma of the penis: a survey of current practice in the UK. Clinical oncology (Royal College of Radiologists (Great Britain)) 2001. link 25 Batislam E, Peşkircioğlu L, Germiyanoğlu C, Erol D. Techniques of corporoplasty for penile curvature: review of 18 patients. International urology and nephrology 1996. link 26 Little JW, Rhodus NL. The need for antibiotic prophylaxis of patients with penile implants during invasive dental procedures: a national survey of urologists. The Journal of urology 1992. link37033-7) 27 Fields T, Drylie D, Wilson J. Malignant evolution of penile horn. Urology 1987. link90575-9) 28 Naraynsingh V, Raju GC. Fracture of the penis. The British journal of surgery 1985. link 29 Panda SN, Subudhi CL. Sleeve urethroplasty: new technique. Urology 1981. link90229-6)

Penile amebiasis