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      Gangrene of the penis in a diabetic male with multiple amputations and follow up

      case-report

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          Abstract

          A 60-year-old insulin dependent, diabetic male with severe atherosclerosis requiring multiple amputations in the extremities in the past, with normal renal function presented with gangrene of glans penis. He was initially treated with debridement but as the gangrene progressed, partial penile amputation was performed. He showed no further progress of the disease and had no voiding difficulties even after 4 years of follow up.

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          Surgical management of ischemic penile gangrene in diabetics with end stage atherosclerosis.

          D Weiner, F C Lowe (1996)
          We determined whether early surgical intervention for ischemic penile gangrene in diabetics can be successful and limit morbidity. A retrospective review was done of 7 diabetic patients with ischemic penile gangrene. Three patients underwent early distal penectomy without complications. All 4 patients initially observed suffered liquefaction and progression from dry to wet gangrene, and 2 underwent surgery (subtotal penectomy in 1 and distal penectomy in 1 who required reoperations for wound complications). With appropriate patient selection, surgical intervention can be successful and provide a better quality of life for those without terminal disease. Delaying intervention will usually require more extensive surgery and increase the risk of wound complications. However, observation is indicated for moribund hospitalized patients.
          Article 0 comments Cited 15 times – based on 0 reviews     Review now
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            Ischemia and gangrene of the penis.

            Constantine F Harris, Jack H Mydlo (2003)
            Article 0 comments Cited 12 times – based on 0 reviews     Review now
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              Penile gangrene associated with chronic renal failure: report of 7 cases and review of the literature.

              Elizabeth Stein, C Anderson, R. Ricciardi … (1994)
              Distal penile gangrene associated with renal failure is a rare entity with only 3 cases reported in the literature. Certain physiological abnormalities are commonly found in association with this condition, including secondary hyperparathyroidism, diabetes and peripheral vascular disease. We report our experience with 7 patients who presented with this condition. All patients had end stage renal disease with 5 on hemodialysis, 1 on peritoneal dialysis and 1 with a functioning cadaveric renal transplant. Six patients had diabetes mellitus and all had derangements of the calcium and phosphate metabolism, with the calcium-phosphorus product being greater than 70. Five patients were treated expectantly with resolution of gangrene in 2 and stable disease in 3. Three of the 5 patients managed expectantly and both patients treated with penectomy died of unrelated causes within 3 months. We conclude that there is no advantage to aggressive surgical treatment of penile gangrene associated with renal failure, since the outcome is the same. The overall mortality for this group is high due to associated co-morbid disease regardless of the type of treatment. Furthermore, subtotal parathyroidectomy is not indicated, since spontaneous improvement and mortality rates reported in our series were similar to those of previously reported cases. Expectant management of affected patients affords the best treatment.
              Article 0 comments Cited 9 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Indian J Urol
                Journal ID (publisher-id): IJU
                Title: Indian Journal of Urology : IJU : Journal of the Urological Society of India
                Publisher: Medknow Publications (India )
                ISSN (Print): 0970-1591
                ISSN (Electronic): 1998-3824
                Publication date (Print): Jan-Mar 2009
                Volume: 25
                Issue: 1
                Pages: 123-125
                Affiliations
                Department of Urology, St Philomena's Hospital, Mother Theresa Road, Bangalore-560 047, India
                Author notes
                For correspondence: Dr. P. Vijayan, Department of Urology, St Philomena's Hospital, Mother Theresa Road, Bangalore-560 047, India. E-mail: docvijay60@ 123456gmail.com
                Article
                Publisher ID: IJU-25-123
                DOI: 10.4103/0970-1591.45550
                PMC ID: 2684300
                PubMed ID: 19468442
                SO-VID: fb99a075-a1bb-475a-9787-77c36d94bce3
                Copyright © © Indian Journal of Urology
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Urology
                Keywords: penis,gangrene,diabetic,amputation
                Data availability:
                ScienceOpen disciplines: Urology
                Keywords: penis, gangrene, diabetic, amputation

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