Recurrence of Penile Hemangiomas: Risks and Treatment Options

Q: Recurrence of Penile Hemangiomas: Risks and Treatment Options

Hello： Can a hemangioma grow indefinitely? --> It can grow, but it won't grow to a severe extent. <br>Is there a possibility of it rupturing during sexual activity once it reaches its limit? --> Yes, there is a possibility. <br>How can it be treated to eliminate it completely? --

Recurrence of hemangioma after surgery?

Dear Doctor,
The patient is a young male.
During puberty, he discovered two hemangiomas approximately the size of a grain of rice at the glans of his penis.
The lesions have been slowly increasing in size over the past ten years, now reaching about the size of a mung bean, and they feel very tight.
There is concern about the risk of rupture if not handled carefully.
After surgery, the lesions recurred within a year, now the size of a grain of sand.
Two years later, the lesions have increased to about 0.1 cm in diameter, with two present.
I would like to ask the doctor if hemangiomas can continue to grow indefinitely, or if they will reach a limit after which there is a possibility of rupture during sexual activity.
What treatment options are available to completely eradicate them? If they were to rupture, would there be a risk of uncontrolled bleeding?
Thank you for taking the time to respond amidst your busy schedule.
A worried mother

Furen, 40~49 year old female. Ask Date: 2022/08/30

Dr. Jian Weihong reply Urology

Hello: Can a hemangioma grow indefinitely? --> It can grow, but it won't grow to a severe extent.
Is there a possibility of it rupturing during sexual activity once it reaches its limit? --> Yes, there is a possibility.
How can it be treated to eliminate it completely? --> It is possible that a medical center will first evaluate it, and if it ruptures, will there be uncontrollable bleeding? --> Applying pressure will usually stop the bleeding, similar to applying pressure after a blood draw.
Wishing you good health.

Reply Date: 2022/08/30

More Info

Understanding the recurrence of penile hemangiomas, particularly in young males, is crucial for both patients and their families. Hemangiomas are benign tumors composed of blood vessels and can occur in various locations, including the genital area. In this case, the patient has experienced a slow-growing hemangioma on the glans penis, which has raised concerns about its potential for rupture and the need for effective treatment.

Recurrence and Growth of Hemangiomas
Hemangiomas typically undergo a phase of rapid growth followed by a period of involution. However, in some cases, particularly in adults or in specific locations like the penis, they may not regress completely and can recur after treatment. The recurrence of hemangiomas, as seen in this patient, can be attributed to incomplete removal during surgery or the presence of residual vascular tissue that can lead to regrowth.

Risks of Rupture
The concern about the hemangioma rupturing, especially during sexual activity, is valid. While hemangiomas are generally benign, they can become engorged with blood, leading to increased pressure within the lesion. If the hemangioma is under significant tension, there is a risk of rupture, which could result in bleeding. The extent of bleeding would depend on the size of the hemangioma and the vascularity of the surrounding tissue. In most cases, while the bleeding may be significant, it is usually manageable with appropriate medical intervention.

Treatment Options
1. Surgical Excision: The most definitive treatment for hemangiomas is surgical excision. This involves removing the entire lesion along with a margin of healthy tissue to minimize the risk of recurrence. Given the patient's history of recurrence, a thorough surgical approach is essential.

2. Sclerotherapy: This is a less invasive option where a sclerosing agent is injected into the hemangioma to promote fibrosis and shrinkage of the lesion. This method can be effective, especially for smaller lesions or in patients who are not candidates for surgery.

3. Laser Therapy: Pulsed dye lasers can be used to treat hemangiomas by targeting the blood vessels within the tumor. This can reduce the size of the hemangioma and improve cosmetic outcomes, although it may not be as effective in completely eliminating the lesion.

4. Observation: In some cases, if the hemangioma is not causing significant symptoms or complications, a watchful waiting approach may be taken, especially if the lesion is stable.

Long-term Management and Monitoring
After treatment, regular follow-up is essential to monitor for any signs of recurrence. Patients and their families should be educated about the signs of complications, such as increased pain, swelling, or bleeding, which would necessitate immediate medical attention.

Conclusion
In summary, penile hemangiomas can recur, and while they are generally benign, there is a risk of rupture, particularly if they grow significantly. Surgical excision remains the most effective treatment to prevent recurrence. Families should maintain open communication with healthcare providers to ensure that any concerns are addressed promptly. With appropriate management, the risks associated with hemangiomas can be minimized, allowing for a better quality of life for the patient.

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