Necrosis de pene por calcifilaxis en paciente nefrópata

Abstract

Necrosis of the penis secondary to calciphylaxis is an infrequent entity that has been associated with chronic degenerative diseases due to intravascular calcium deposits. Few cases have been described in the literature. We describe herein the management of and complications in a 61-year-old man presenting with this pathology secondary to terminal chronic kidney disease.The 61-year-old patient had a high smoking index of long progression and a past history of diabetes mellitus and high blood pressure, both uncontrolled, and terminal kidney disease presently being treated with hemodialysis. He also had a history of acute myocardial infarction (AMI), femoropopliteal bypass, and the amputation of the right lower extremity. He first presented with glans penis necrosis that was treated with partial surgery, but upon observing urethral and surrounding tissue involvement, a lack of irrigation, and tissue infection, the decision was made to perform a total penectomy with perineal urethrostomy. The patient had the complication of Fournier's syndrome with poor progression, resulting in his death. Penile necrosis due to calciphylaxis is not very well known and its management is complicated due to the fact that the general condition of patients is poor. Partial or total phallectomy is a therapeutic option for this type of patient because they present with peripheral microangiopathy. However, there is a high complication rate due to complications from uncontrolled underlying pathologies.