This case report appeared in the most recent edition of the Urology Case Reports .
Earlier this year, an unidentified 63-year-old checked himself into the A&E at the Lincoln Medical and Mental Health Center in Bronx, New York. He’d suffered a fall and had landed on his buttocks. At his age, he could have easily broken something or slipped one or two discs, so he decided to get checked out.
He complained of pain in his left knee and penile area. Other than the pain, there were no other symptoms indicating the presence of an STD, so the doctors carried out an X-ray on his pelvic region to make sure he didn’t break any bones. He was later diagnosed with penile ossification following the discovery of hard calcium strips along his penis. Ossification is the process of salts building in soft tissue, calcifying, and forming new bone. It’s an extremely rare condition that’s more commonly seen in dogs than in humans, but since most lower mammals already have a bone in their penises, it’s not so awful for them.
The patient was deeply upset by the diagnosis, however, choosing to leave the hospital immediately rather than sit for a consultation.
“We couldn’t assess the [causes] since our patient decided to leave against medical advice,” one of the doctors said to Mail Online .
Medical opinions on the case
According to Richard Viney, a urological surgeon in Birmingham, the man’s condition was most likely caused by Peyronie’s disease. From the details of the case as seen on in the case report, he concluded that there was bone formation in the patient’s Bucks fascia, the inner lining of the penal shaft.
“In very rare cases, the scarring process [of Peyronie’s disease] is so excessive it can involve the deposition of calcium, toughening the scar tissue and this is what is being described in this case,” he told Mail Online. “It is easy to think that the patient’s entire penis is calcifying but it is only the fibrous Bucks fascia just below the skin. These plaques would be palpable and hard to the touch. They can be quite extensive and it is possible with time that all of Bucks fascia could be involved, but this is unlikely.”
Dr. Georges El Hasbani from the American University of Beirut, lead author of the report also says that Peyronie’s disease is the most likely cause of this patient’s condition.
“Bone tissue is known to originate even in places having nothing in common with the skeleton, including the mammary gland, salivary gland, and the testes. Penile ossification remains a relatively rare condition being mentioned in very few journals, with less than 40 published case reports,” he wrote.
More on Penile ossification
There are supposed to be only 206 bones in the adult human body, so a bone growing anywhere else has no business being there. It will most likely cause pain and discomfort, and if it grows in an essential area, serious actions would have to be taken to extract it.
Heterotopic ossification (also knowns as osteogenesis) is the abnormal growth of bone in the non-skeletal tissues including muscle, tendons, or other soft tissue. It occurs mostly in patients with serious spinal cord injuries and neurological disorders. It may also be caused by accident, trauma, and burns. It is characterized by the build-up of calcium salts in these areas of the body. Other possible causes may include cancer, kidney disease, hyperparathyroidism, and genetic conditions .
- Decreased mobility
- Pain or swelling in the affected area
- Reduced function of the organ containing that tissue (erectile dysfunction in penile cases)
- Increased spasticity
According to Dr. El Hasbani in the case report, “The treatment of penile ossification depends on the extent of corporal ossification and the symptoms of the patient. Those with a bothersome acute pain or chronic mild pain may be managed with oral analgesics, topical agents, intralesional injections, mechanical stretching or vacuum devices, and extracorporeal shockwave therapy. Severe cases of chronic pain or erectile dysfunction are usually managed surgically.”
Viney further explained that the only solution to this problem is usually surgical removal of the penis. However, for this particular patient, surgery wouldn’t have been a feasible option as his condition was already too advanced.
“As the stretchiness of the fascia is lost, erections would be limited in their scope and there may be considerable bend,” Viney said. “Indeed there may well be complete erectile failure. The whole penis won’t turn to bone as it only involves Bucks fascia so, at worst, it would only be a boney cylinder filled with the two spongy corpora [cylinders inside the shaft] and the urethra itself.”
The patient’s doctors were disappointed with his departure against medical advice, but they couldn’t hold him against his will. Hopefully, he finds the treatment he needs.
- Hasbani et al. Penile ossification of the entire penile shaft found incidentally on pelvic x-ray. Science Direct. https://www.sciencedirect.com/science/article/pii/S2214442019301925#! Retrieved 14-08-19
- Sam Blanchard. Man discovers his penis is turning to BONE when doctors X-ray his hips after a fall. Mail Online. https://www.dailymail.co.uk/health/article-7340605/X-ray-reveals-mans-penis-turning-BONE.html. Retrieved 14-08-19
- John Speed. Heterotopic Ossification. Medscape. https://emedicine.medscape.com/article/327648-overview. Retrieved 14-08-19
- Satyanarayan et al. Penile ossification: A reconstructive challenge. PMC. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5434841/. Retrieved 14-08-19
- Admin. Peyronie’s disease. Web MD. https://www.webmd.com/men/peyronies-disease. Retrieved 14-08-19
- Admin. Diagnostic approach to disorders of extraskeletal bone formation. Mayo Clinic. https://www.mayoclinic.org/medical-professionals/endocrinology/news/diagnostic-approach-to-disorders-of-extraskeletal-bone-formation/MAC-20429760. Retrieved 14-08-19
- Admin. Hyperparathyroidism. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/hyperparathyroidism/symptoms-causes/syc-20356194. Retrieved 14-08-19