A 41-year-old married man with penile pain extending to the perineal and inguinal region that got worsen on erection referred by an urologist for sonographic evaluation of penis and testes.The pain started 3 days before he went to the urology clinic,following his first full erection for intercourse, after his positive Covid-19 PCR Test.

He didn’t have any other urologic symptoms such as discharge, hematuria or dysuria.He denied any trauma to the penis,previous pelvic surgery and history of recent immobilization..The patient reported positive nosopharyngeal swab test for Covid-19 Three weeks ago.He had mild symptoms of Covid-19 infection including muscle pain,fever,cough and fatigue.He had recieved conservative treatment and had not taken any anticoagulants,antivirals and corticosteroids.His medical history didn’t show any significant underlying disease and any risk factor for cardiovascular disease.He also didn’t have history of previous deep vein thrombosis.In physical examination of the penis and testes no pathologic finding was detected such as skin changes , discoloration,edema , tenderness or palpable nodularity.

Ultrasound evaluation showed thrombosis of deep dorsal penile vein while the superficial dorsal penile vein,Iliac veins and inferior vena cava were intact.(Fig1,2,3)

Laboratory tests reveled increased D-dimer level, normal levels of anti-thrombin III,protein S,Protein C,anticardiolipin antibodies and normal count of platelets and WBCs.Also Tests were negative for antinuclear antibodies, antiphospholipid-IgG and lupus anticoagulant.