A 25 year old man presented to our hospital with a seven day history of pain in the root of the penis and two day history of swelling of the penis. On questioning there was no history of prolonged intercourse, local trauma, insect bite, or infection. He had no relevant past medical history. General physical and abdominal examination were unremarkable. On local examination the penis was diffusely swollendue to oedema. A long, thick, firm, and cord like structure was felt along the dorsal aspect of the penis. It was not tender. There was no evidence of venous thrombosis elsewhere. Urine microscopy, full blood count, and coagulation studies were all within normal limits. Colour Doppler ultrasonography of the penis showed a prominent superficial dorsal vein of penis with no evidence of spontaneous flow. A clinical photograph of penis and Doppler ultrasound scan of the penis are shown in figs 1 and 2respectively.

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Figure 1

Photograph of swollen penis (reproduced with the patient's permission).

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Figure 2

Doppler ultrasound scan.