Search

Penile calciphylaxis is a rare and highly morbid condition mainly affecting diabetic patients with chronic renal failure (CRF). It is characterized by ischemic skin ulceration and necrosis secondary to dystrophic calcification of the subcutaneous penile tissue and penile arterioles. We report a 52-yearold male with a 6-year history of diabetes mellitus and CRF on hemodialysis, who presented with a painful penile necrotic lesion in the last three weeks. He firstly treated with medical treatment, which was failed. Then underwent total penectomy. The histopathology result confirmed the diagnosis of penile calciphylaxis. Unfortunately, he passed away due to septic shock and multisystem organ failure ten days after surgery. In conclusion, the diagnosis of penile calciphylaxis must be evoked in the presence of any minimal necrotic penile lesion in a patient with CRF; this will initiate quick medical and/or minimally invasive surgical treatment to improve the patient's prognosis and avoid serious complications. [ABSTRACT FROM AUTHOR]

Penile calciphylaxis is a rare cause of penile gangrene that presents in patients with end-stage renal disease. The rates of comorbidity and mortality of penile calciphylaxis are extremely high. Unlike other penile gangrene, such as Fournier’s gangrene, the benefit of aggressive surgical therapy is controversial. Here we present a case of penile calciphylaxis in a 43-year-old man with end-stage renal disease on hemodialysis. He received total penectomy but died due to multisystem complications 2 weeks after surgery. We review the literature on the management options and outcomes in patients with penile calciphylaxis. [ABSTRACT FROM AUTHOR]

Introduction Calciphylaxis, a rare obliterative small vessel vasculopathy associated with diabetes mellitus ( DM), end-stage renal disease ( ESRD), portends a poor prognosis. Because penile involvement is rare, agreement on appropriate diagnosis and management is unclear. Aim To determine the role and effect of penile biopsy for diagnosis and management of penile calciphylaxis. Methods Medical records of three penile calciphylaxis patients from our institution were evaluated. Data collected included age, history of DM, ESRD, and hemodialysis ( HD) status, serum calcium ( Ca), Ca × phosphorous product ( C × P), parathyroid hormone ( PTH), performance of biopsy, presence of non-penile cutaneous lesions, intervention, survival, and time from diagnosis to death. Pub Med Search for relevant publications from 1995 to 2012 was performed to identify case reports of penile calciphylaxis that provided the same clinical data obtained from the 3 patients from our institution. Main Outcome Measures Clinical evidence for outcomes in patients with penile calciphylaxis after biopsy of penile lesion compared to those without biopsy. Results A total of sixteen patients were identified in the literature and in our institution with clinical data of interest. Overall, 10/16 (62.5%) patients identified with penile calciphylaxis had a penile biopsy, and 7/10 (70%) experienced disease progression, while only 3/10 (30%) stabilized. Mean time to death in this patient population was short, approximately 6.5 months, regardless of type of intervention. Conclusion Based on the results of our study, we argue that conservative measures should be employed as first line therapy for penile calciphylaxis. More importantly, secondary to likely resultant progression of necrosis, penile biopsy is not only unnecessary for diagnosis of penile calciphylaxis, but is also harmful and contraindicated. Cimmino CB and Costabile RA. Biopsy is contraindicated in the management of penile calciphylaxis. J Sex Med 2014;11:2611-2617. [ABSTRACT FROM AUTHOR]

For small lesions, conservative management including local wound care, debridement, and adjustment of renal replacement therapy may suffice. Consulting palliative care is encouraged to help establish goals of care among patient, family, and medical team. [ABSTRACT FROM AUTHOR]

Penile calciphylaxis is a difficult urologic condition to manage. First described by Wood et al in 1997, penile calciphylaxis is a rare cause of penile gangrene.1 One study found the overall mortality rate associated with penile calciphylaxis to be 64%, with a mean time to death of 2.5 months.2 Additionally, no statistically significant difference in survival has been seen between patients treated with penectomy and those treated nonoperatively.3 We report a case of penile calciphylaxis in a patient treated with partial penectomy with scrotoplasty who has survived greater than 1 year without any complication or progression of disease. [ABSTRACT FROM AUTHOR]