Penile calciphylaxis: A severe case managed with partial penectomy

Adler, Kerry; Flores, Viktor; Kabarriti, Abdo

doi:10.1016/j.eucr.2020.101456

Cited by 7 publications

(11 citation statements)

References 5 publications

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“…The treatment of PC includes conservative measures such as calcium binders and sodium thiosulfate, topical wound care, hyperbaric oxygen, antibiotics to prevent bacterial proliferation, as well as surgical treatment like parathyroidectomy, penile debridement, revascularisation, partial penectomy with or without reconstruction, and total penectomy 9 12–20…”

Section: Discussionmentioning

confidence: 99%

Penile calciphylaxis in a patient with concurrent haemodialysis and Coumadin treatment

et al. 2023

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A man in his 30s, with a medical history of end-stage renal disease on haemodialysis three times a week after kidney transplant rejection, anaemia of inflammatory disease, hypertension, atrial fibrillation, hyperlipidaemia, subtotal parathyroidectomy and aortic valve replacement on Coumadin treatment, presented to our institution with glans penis pain. Examination of the penis revealed a painful black eschar with ulceration on the glans penis with surrounding erythema. CT scan of the abdomen and pelvis and penile Doppler ultrasound revealed calcifications of the abdominal, pelvic and penile blood vessels. He was diagnosed with penile calciphylaxis, a very rare manifestation of calciphylaxis characterised by penile blood vessel calcification leading to occlusion, ischaemia and necrosis. Treatment with low calcium dialysate and sodium thiosulfate was initiated with haemodialysis. Five days after the treatment started, the patient’s symptoms improved.

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Section: Discussionmentioning

confidence: 99%

Penile calciphylaxis in a patient with concurrent haemodialysis and Coumadin treatment

et al. 2023

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“…This involves local wound debridement and analgaesia. Some treatment success has been shown with hyperbaric oxygen therapy in promoting tissue healing and sodium thiosulphate as an anti-chelating agent, however the evidence supporting this is lacking [ 13 ]. In a review of 34 cases managed conservatively the majority of them died, compared to 25% who underwent early surgery who died, suggesting that surgical intervention may be superior [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Penile calciphylaxis—a complicated case managed with circumcision and glansectomy

O’Beirn

Muheilan

Casey

2022

Journal of Surgical Case Reports

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Penile calciphylaxis is a serious manifestation of calcifying uremic arteriolopathy, with only a small number of cases reported in the literature. It is rare, characterized by calcification within the walls of small vessels, resulting in ischaemic changes to the skin, and is mainly seen in patients with end-stage renal failure (ESRF). Management of penile calciphylaxis is difficult, with both conservative and surgical approaches advocated for. Due to their comorbidity profile, patients with penile calciphylaxis can present multiple management challenges. We present a case of penile calciphylaxis in a patient with ESRF who was initially managed conservatively, and then underwent circumcision and glansectomy due to a necrotic glans penis and non-resolving penile pain. The patient was spared a partial penectomy and went on to make a full recovery.

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“…10 It must be noted that surgical treatment is controversial in the literature, and a penectomy does not clearly provide a definite benefit over conservative treatment. 11 But for patients who are at high risk for gangrene and sepsis, a penectomy may be necessary for improved quality of life and sometimes survival. A penectomy is offered on a case-bycase basis, but it was not offered as an option for this patient.…”

Section: Managementmentioning

confidence: 99%