Abstract
INTRODUCTION: A penile cavernosal abscess is rare and typically attributable to sepsis, trauma, or intracavernosal injections. CASE PRESENTATION: A 65-year-old man with suspicion of non-muscle invasive bladder cancer underwent transurethral resection. Edematous and erythematous mucosa was noted on the posterior wall. The pathological findings showed significant inflammatory cell infiltration, and urothelial carcinoma was ruled out. Abdominal CT post-surgery revealed multiple diverticula in the sigmoid colon and bladder wall thickening, indicating the presence of a fistula. Although colonoscopy and cystography did not show any fistula, the patient developed a penile cavernosal abscess approximately 40 days post-transurethral resection. Emergency penile incision and subcutaneous drainage were performed, followed by laparoscopic sigmoid colectomy after inflammation improved. A complete cure was achieved with continued antibiotic therapy for 5 weeks. CONCLUSION: To our knowledge, this is the first report of a penile cavernous abscess associated with a sigmoid colovesical fistula definitively treated by drainage and colectomy.