World J Mens Health.  2014 Apr;32(1):66-68.

Necrosis of the Penis with Multiple Vessel Atherosclerosis

• Kim SD
• Huh JS
• Kim YJ

Abstract

Penile necrosis is a very rare complication because of its rich collateral supply. Conservative management is apt to be ineffective; thus penectomy is usually performed. We present a case of penile necrosis and claudication of both legs with multiple atherosclerosis in a type II diabetes mellitus patient who was successfully treated with angioplasty, penoplasty, and additional intracavernous injections of prostaglandin E1. The treatment resulted in relief of the leg pain and healing of the penile ischemic lesions.

Keyword

Atherosclerosis; Necrosis; Penis

MeSH Terms

Alprostadil
Angioplasty
Atherosclerosis*
Diabetes Mellitus
Humans
Leg
Male
Necrosis*
Penis*
Alprostadil

Figure

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  Fig. 1 The penile meatal areas were covered by necrosis and ventral portion of the penis were dusky with discharge.

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  Fig. 2 Arteriogram showed severe narrowing of the common and external iliac arteries. Both internal iliac arteries were diffusely narrowed with sluggish flow. The pudendal arteries were occluded proximally with no visualization of the penile vessels.

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  Fig. 3 Arterial flow was not visualized in the both foot.

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  Fig. 4 Necrotic eschars were peeled off and transformed into normal penis.

Reference

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2. Ohta A, Ohomori S, Mizukami T, Obi R, Tanaka Y. Penile necrosis by calciphylaxis in a diabetic patient with chronic renal failure. Intern Med. 2007; 46:985–990.

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4. Sanchez LA, Veith FJ. Diagnosis and treatment of chronic lower extremity ischemia. Vasc Med. 1998; 3:291–299.

5. Linet OI, Neff LL. Intracavernous prostaglandin E1 in erectile dysfunction. Clin Investig. 1994; 72:139–149.