PARTIAL PENECTOMY IN A DIABETIC PATIENT WITH CALCIPHYLACTIC GLANS NECROSIS

Penile necrosis is a rare condition with different etiologies such as warfarin use, cholesterol emboli, cocaine consumption, post-TURP complication, and even circumcision. Calciphylaxis is a rare cause of penile necrosis and affects primarily patients with end-stage renal disease. Calciphylaxis is a serious condition characterized by ischemic ulceration of the skin and necrosis secondary to dystrophic calcification of the subcutaneous tissues and small arteries. A 56 year old man with two year history of ESRD due to HTN and diabetes mellitus admitted with glans necrosis initiated 40 days before admission. The necrosis was painful and refractory to medical therapy.He underwent partial penectomy and the pathologic examination showed necrosis of glans tissue and extensive fibrosis of glans with extensive calcification of arteriole walls. Post-operative course was uneventful and the patient voided well without any necrotic lesion after 3 months.Calciphylactic penile necrosis is a rare condition, and to the best of our knowledge, only 37 cases have been reported worldwide. Our case was a diabetic patient with ESRD who underwent partial penectomy with satisfactory wound healing in spite of compromised distal blood flow.