Nicorandil and prepuce ulcers

Abstract

The authors provide an illustrated account of three elderly patients on long‐term high‐dosage nicorandil therapy who presented with eroding foreskin ulcers.

Nicorandil-induced penile ulceration – surgical excision: case series and review of literature

“…Two hypotheses have been commonly postulated 3–13 : Direct local toxicity of nicorandil and its metabolites Vascular steal phenomenon – nicorandil induces redistribution of both arterial and venous flow, affecting the penis which is supplied by end arteries. The first case of a nicorandil-induced penile ulceration was reported by Birnie et al. Since then, a total of 17 cases have been reported (Table 1).…”

“…However, the larger ulcers where the glans had eroded through the ulcerated skin defect (as described in our case series) eventually required surgical intervention in the form circumcision. 6,7,10,12,13 O’Neill and Brown also suggest insertion of a urethral catheter to prevent herniation of the glans through the ulcer, thus helping with re-epithelialisation.…”