Pediatric penile pain secondary to idiopathic arterial thrombosis

Penile pain in the pediatric population can result from a variety of causes. Although urinary tract infection, urethral stricture and trauma are well-recognized etiologies, they are typically not identified. Most discomfort is therefore attributed to referred pain secondary to dysfunctional voiding behavior. Supporting this frequent conclusion is the often concomitant complaint by the family and patient of intermittent penile tumescence - itself typically the result of bladder over-distension. We present the first pediatric case of penile pain with intermittent penile tumescence secondary to arterial thrombosis and emphasize the critical need for a high index of suspicion in order to identify this unusual condition.