American Society of Hirudotherapy

Medicinal Leech Therapy in Urology: A PRISMA-Compliant Systematic Review

Systematic review published in African journal of urology : the official journal of the Pan African Urological Surgeons' Association (PAUSA) (2023)

Last Updated: March 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Clinical TrialsBattin A, Hobeika N, Zdilla M · African journal of urology : the official journal of the Pan African Urological Surgeons' Association (PAUSA), 2023

Abstract

PURPOSE: To systematically review cases of medicinal leech therapy, otherwise known as hirudotherapy or leeching, in the context of urology. METHODS: A systematic review of cases in MEDLINE / PubMed was performed in accordance with PRISMA guidelines. RESULTS: Of 46 search results, 10 articles detailing 12 unique cases of medicinal leech therapy used in the urological context were included. Leeching was conducted in 9 of 12 cases (75%) for the management of congested blood occurring in four cases post penile replantation, two cases of postoperative scrotal hematoma, two cases of venous congestion of the glans post neonatal bladder exstrophy repair, and one case of refractory priapism. Leeching in the remaining three cases was for the management of penoscrotal edema in patients with hormone refractory prostate carcinoma treated with radical radiation therapy. All 12 cases (100%) reported clinical improvement from leech therapy. Venous congestion / hematoma cases noted decreased displaced blood volume. The patient experiencing priapism reported decreased pain despite the persistence of cavernosal swelling. The three cases of penoscrotal edema reported significant decreases in swelling due to serous fluid drainage from leech puncture sites. No complications or side effects were reported in the nine adult patients. The three postoperative neonatal patients all required some form of blood product throughout treatment. CONCLUSIONS: The systematic review of the cases, though limited in number, suggests that medicinal leech therapy is a favorable treatment option for individuals with varied urological pathologies and that leeching may improve post-surgical outcomes in the urological setting.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal Article

Summary

To systematically review cases of medicinal leech therapy, otherwise known as hirudotherapy or leeching, in the context of urology. A systematic review of cases in MEDLINE / PubMed was performed in accordance with PRISMA guidelines.

Why This Matters for Hirudotherapy

Provides high-level synthesized evidence. Contributes clinical evidence for the therapeutic application of leech therapy.

Citation

Medicinal Leech Therapy in Urology: A PRISMA-Compliant Systematic Review.

Battin A, Hobeika N, Zdilla M · African journal of urology : the official journal of the Pan African Urological Surgeons' Association (PAUSA), 2023

Added to ASH library: March 18, 2026 · Site last updated: March 18, 2026

This website provides educational information and does not constitute medical advice, diagnosis, or treatment recommendations. Medicinal leech therapy carries clinically meaningful risks and should be performed only by qualified clinicians under institutionally approved protocols. FDA 510(k) clearance for medicinal leeches is limited to specific indications; investigational and off-label discussions are labeled accordingly. For patient-specific guidance, consult a qualified healthcare provider.

Medicinal Leech Therapy in Urology: A PRISMA-Compliant Systematic Review | ASH