Penile Ossification: Unanticipated Bone-hardness

0
Penile ossification: Severe and asymmetric degenerative changes of the right hip is noted

Penile Ossification is an extremely rare condition. Uptil now only 40 cases have been reported.

A 63 years old man was presented to the ER of Lincoln Medical and Mental Health Center in Bronx in New York City. He complained of knee pain after a fall. He explained that he was walking with the help of a cane on a side-walk when he fell onto his buttocks. With the help of a passerby he got up. He didn’t notice any pain. He reported no unconsciousness or head injury. While giving history he reported alcohol consumption in the past. Later, after the fall he experienced knee pain for which he consulted the emergency department.

X-Ray report revealed ossification.

Upon physical examination the patient confirmed no penile pain. Since the patient had landed on his buttocks therefore doctors ordered a pelvic X-ray to confirm any fracture in the concerned area. The results of pelvic X-ray revealed astonishing results. It showed severe, asymmetric degeneration of right hip bone. The doctors explained the condition as an extensive, plaque-like calcification along the length of the penis. However, there was no abnormal penile discharge, no lymphadenopathy, no costo-vertebral angle (CVA) tenderness and the prostrate was also normal. Physical examination didn’t reveal any signs and symptoms to reach a diagnosis. However, pelvic X-Ray convinced the doctors to conclude the diagnosis of Penile Ossification (PD) along the entire length of shaft. Nature allowed growth of bone in the most unwelcomed organ!

Pelvic X-ray exam provided accidental diagnosis of Penile Ossification. As bizarre as it sounds, penile ossification is a quite rare condition. Each of these cases differs from one another. The pattern and extent of ossification is not the same in each case. Ossification begins in the mid part of shaft and increases along the entire length. The pain associated with it causes Erectile Dysfunction (ED) which puts the patient into a miserable condition.

Knowing hallmarks of Penile Ossification is necessary.


The hallmark of PD includes acquired penile deformity, consisting of curvature during erection, with associated findings including loss of flaccid stretched penile length and pain in flaccid or stretched state.

In this case, the patient didn’t permit conduction of medical protocol due to which doctors could not assess the etiologies. However, since the condition occurred due to deposition of calcium therefore calcification grading system was employed initially. To diagnose this condition, simple radiograph is sufficient while ultrasound and ultrasonography are the methods of choice for accuracy.

Penile ossification: Extensive plaque-like calcification along the expected distribution of the penis.
Extensive plaque-like calcification along the entire length of penis.
Source: Urology Case Reports

The accidental diagnosis of patient’s condition didn’t convince him to allow the medical practitioners to treat him. Instead, he preferred to leave the situation as it is by dismissing the medical advice. Since the patient didn’t approve of any medical treatment therefore no laboratory investigation, histological examination or follow-up was possible. The response was quite expected as any man no matter what his age is would never want a bone to grow right there.
In case of chronic pain oral analgesics, topical agents, intralesional injections, mechanical stretching or vacuum devices, and extracorporeal shockwave therapy would have been opted. Pharmaceutical, surgical and Inflatable Penile Prosthesis (IPP) remain the feasible options for treatment of PD.

Penile ossification and necrosis are quite unbelievable conditions. The latter case involves a real life event in which doctors successfully reattached a penis a day after its amputation.

SOURCEUrology Case Reports
Previous articleNeonate’s Dual Colored Body
Next articleHeart Perfused Outside the Body!
Kashmala Khan is a student of Bachelors of Medicine and Surgery at Karachi Medical and Dental College (KMDC), Pakistan. She is an amalgam of medicine and literature. Her inquisitive nature towards health-oriented issues ignited her interest to pursue medical writing. Kashmala owns deep interest in literature. She is an avid reader of novels and newspapers since young age and equally adores spending time under open sky to let the nature cherish her leisure. Currently, she is immersed in the student life that happens to occupy most part of her day. Years later from today, she sees herself as a recognized medical professional.

LEAVE A REPLY

Please enter your comment!
Please enter your name here