Abstract
Background: Penile necrosis is a rare condition that may present in patients with diabetes mellitus or chronic kidney disease (CKD). The recommended treatment is controversial. We report a case of penile necrosis in a diabetic patient caused by episode of paraphimosis associated with uremic arteriopathy treated with partial amputation. Clinical Case: A 53-year-old male with a background of arterial hypertension, diabetes mellitus and CKD in hemodialysis. The patient presented with paraphimosis and glans necrosis. An emergency circumcision was carried out. A doppler ultrasound found fluid collection in the left corpus cavernosum, parietal vascular calcifications and vascular insufficiency in the corpus cavernosum that suggested necrosis. A partial amputation of the penis was carried out. After three years of follow-up, the outcome has remained favorable. Conclusions: Penile necrosis is a rare but serious complication of terminal CKD. In these patients, systemic calciphylaxis is usually observed. The main take-away lesson is that a multidisciplinary approach is necessary.
Highlights
Calciphylaxis is the process of calcification in small and medium vessels, resulting in necrosis in distal regions of the body such as the lower extremities and the penis, the latter being very infrequent[1]
We report a case of a patient with end stage renal disease (ESRD) that developed calciphylaxis and distal necrosis of the penis and was treated with an amputation, which resulted in a favorable outcome
In ESRD, the origin of the calciphylaxis is related to secondary hyperparathyroidism, as a result of chronic hyperphosphatemia[10]
Summary
Calciphylaxis is the process of calcification in small and medium vessels, resulting in necrosis in distal regions of the body such as the lower extremities and the penis, the latter being very infrequent[1]. This condition may present in patients with diabetes mellitus and/or chronic kidney disease (CKD). We report a case of a patient with end stage renal disease (ESRD) that developed calciphylaxis and distal necrosis of the penis and was treated with an amputation, which resulted in a favorable outcome.
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