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Penile Gangrene

Penis Gangrene


Presentation

  • We present in the current study, a patient who presented with progressive penile gangrene and skin necrosis due to CUA.[ncbi.nlm.nih.gov]
  • Data obtained include the patients' ages initial presentation, detailed histories, comorbidity, renal status, other vascular diseases, coagulation profile, treatment course, histology presentations, and prognosis were obtained.[ncbi.nlm.nih.gov]
  • We report an additional case of distal penile gangrene in a 41-year-old man who presented with chronic renal disease and pulmonary tuberculosis.[ncbi.nlm.nih.gov]
  • Abstract We presented a case of a 63-year-old man with type 2 diabetes mellitus and end-stage renal disease on hemodialysis.[ncbi.nlm.nih.gov]
  • He presented with late development of penile gangrene requiring partial amputation of his penis. The stress urinary incontinence subsided on subsequent follow-up. The patient is now doing well. 2015 BMJ Publishing Group Ltd.[ncbi.nlm.nih.gov]
Hemophilia A
  • Stay up to date with new chapters on Clotting Disorders and Hemophilia, Patient-Centered Care, Health Disparities and Diversity in Emergency Medicine, Cost-Effectiveness Analysis, Antibiotic Recommendations for Empirical Treatment of Selected Infectious[books.google.it]
Urge Urinary Incontinence
  • Abstract An elderly diabetic man with a 67 g prostate developed a moderate degree of stress urinary incontinence along with urge urinary incontinence after transurethral resection of the prostate.[ncbi.nlm.nih.gov]
  • He developed right hemiparesis and intractable urge urinary incontinence. After stabilization, he was put on anticoagulants and was discharged with a condom catheter.[urotoday.com]
Renal Injury
  • His blood investigations were suggestive of infection and acute renal injury secondary to dehydration. Urine analysis was clear of infection. Parenteral Ampicillin and Metronidazole was given empirically.[irep.iium.edu.my]

Workup

Soft Tissue Calcification
  • There is radiological evidence of blood vessel and soft tissue calcification. Predisposing factors are obesity and diabetes. It is rarely encountered by a urologist and closely resembles penile gangrene.[ncbi.nlm.nih.gov]
  • Subtotal parathyroidectomy is indicated for patients in whom progressive arterial and soft tissue calcification develops despite medical therapy.[ncbi.nlm.nih.gov]
Pericardial Effusion
Diffuse Vasculitis
  • Secondary hyperparathyroidism may cause diffuse vasculitis and vascular calcification, which can lead to widespread ischemic necrosis and gangrene.[ncbi.nlm.nih.gov]

Treatment

  • BACKGROUND: Penile entrapment and subsequent strangulation is a serious injury that requires a prompt treatment to avoid gangrene.[ncbi.nlm.nih.gov]
  • The treatment algorithm is controversial because of limited case numbers.[ncbi.nlm.nih.gov]
  • Expectant management of affected patients affords the best treatment.[ncbi.nlm.nih.gov]
  • Since some authors have emphasized that aggressive surgical treatment in such cases has a significant mortality rate, we took a more conservative approach to treatment.[ncbi.nlm.nih.gov]
  • Penile Gangrene due to Strangulation by a Metallic Nut: A Case Report Abstract BACKGROUND: Penile entrapment and subsequent strangulation is a serious injury that requires a prompt treatment to avoid gangrene.[ajol.info]

Prognosis

  • MAIN OUTCOME MEASURES: Comparison of the patients' ages, presentations, underlying diseases, the duration of conservative treatments, surgical options, resected penile length, and prognosis.[ncbi.nlm.nih.gov]
  • The prognosis in cases of this type is thought to be extremely poor.[ncbi.nlm.nih.gov]
  • It is considered a urological emergency with a poor prognosis due to its high mortality rate (ranging 15-50% 3 ).[radiopaedia.org]
  • KEYWORDS: Fournier's gangrene; Laor Fournier's gangrene severity index; Prognosis; Risk factors CORRESPONDENCE: Mahmood Molaei, M.D., Department of Urology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran ( ).[urotoday.com]
  • PROGNOSIS • Delays in diagnosis or treatment increase the mortality rate. o A 24-hour delay in radical debridement increases the mortality rate by 11.5%; o A 6-day delay is associated with a mortality rate of 76%. • Additional factors associated with[slideshare.net]

Etiology

  • The final chapter deals with the etiology, pathology, clinical diagnosis, and treatment of priapism. This book is a valuable resource for physicians.[books.google.it]
  • The etiologies could be infectious, traumatic, or vasculogenic. The treatment algorithm is controversial because of limited case numbers.[ncbi.nlm.nih.gov]
  • The main etiological factors were urethral stricture in 8 (50%) patients, associated with diabetes mellitus in 2 (13%), impacted urethral calculus in 3 (19%), circumcision in 2 (13%), priapism in sickle cell disease in 2 (13%) and trauma in 1 (6%).[ajol.info]
  • Epidemiology Elderly adults (male and female), immunocompromised (particularly diabetes) or those with depressed mental status Sites Dartos and penile fascia are preferred sites Etiology 50 - 60% of infections have GI or GU source of infection Usually[pathologyoutlines.com]

Epidemiology

  • Epidemiology of thrombosis in children with acute lymphoblastic leukemia. Thromb Res. 2003;111(3):125-31. Review. PMID:14678808 Athale U.H. & Chan AKC.[medresearch.in]
  • "Fournier's gangrene: Population based epidemiology and outcomes" . The Journal of Urology . 181 (5): 2120–6. doi : 10.1016/j.juro.2009.01.034 . PMC 3042351 . PMID 19286224 .[en.wikipedia.org]
  • Epidemiology Elderly adults (male and female), immunocompromised (particularly diabetes) or those with depressed mental status Sites Dartos and penile fascia are preferred sites Etiology 50 - 60% of infections have GI or GU source of infection Usually[pathologyoutlines.com]
  • Epidemiological aspects of Fournier's gangrene at Kenyatta National Hospital, Nairobi . East Afr. Med. J. 75 , 586–589 (1998). 9. Czymek, R. et al . New insights into the epidemiology and etiology of Fournier's gangrene: a review of 33 patients .[nature.com]
  • However, understanding of the disease has changed with increasing elucidation on the epidemiology, causative organisms, and pathogenesis.[jcsjournal.org]
Sex distribution
Age distribution

Pathophysiology

  • Abstract Despite advances in the evaluation, treatment, and pathophysiological understanding of necrotizing soft-tissue infections, Fournier's gangrene remains a life-threatening urological emergency.[nature.com]
  • In published reports, the factors affecting survival or death from FG were not clearly identified until the study of Laor and colleagues in 1995 (2), in which measurable pathophysiologic data between survivors and non survivors of FG were compared.[latunisiemedicale.com]

Prevention

  • Avoidance of pressure dressing, local infection, and the use of urethral catheter should probably prevent this serious complication.[ncbi.nlm.nih.gov]
  • We report a case of mycotic penile gangrene in a diabetic child to highlight its potentially preventable disastrous outcome. Copyright 2013 Elsevier Inc. All rights reserved.[ncbi.nlm.nih.gov]
  • Early partial penectomy and correction of the underlying disease can prevent wound liquefaction, preserve more penile length, and improve quality of life.[ncbi.nlm.nih.gov]
  • It is usually associated with vascular insufficiency and amputation is required to prevent spread of infection from the necrotic tissue.[irep.iium.edu.my]
  • Prevention of the problem is best done by maintaining strict hygiene and frequent monitoring of the device.[urotoday.com]

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