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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]
  • The case report presents the history and clinical images of a patient with diabetes and multiple medical co-morbidities who presented with bilateral lower extremity ulcerations and dry gangrene of the glans penis.[omicsonline.org]
Arm Pain
  • Case A 65-year-old man presented with right arm pain after falling over. He had end-stage renal disease secondary to type II diabetes mellitus and had required haemodialysis for 1 year.[academic.oup.com]
Asymptomatic
  • At 3 months follow up the patient is asymptomatic with good cosmesis of Penis (Figure 5) The patient is having normal erectile and ejaculatory function. Fig-5 Figure 5: 3 months follow up photograph of penis.[jemds.com]
Nightmare
  • GETTY/BMJ HEALTH NIGHTMARE: A scan (right) shows how the patient's penis began to rot away (Pic: GETTY/BMJ) Ten days after his surgery, the patient was admitted to King George’s Medical University Hospital.[dailystar.co.uk]
Purpura
  • On further evaluation, the patient was diagnosed with thrombotic thrombocytopenic purpura. This was treated with plasma exchange and steroids.[ncbi.nlm.nih.gov]
  • Priapism and penile gangrene due to thrombotic thrombocytopenic purpura. Urology. 2010; 75: 71-72. Meyer J, Lymberopoulos S. On an ascending leg-pelvis vein thrombosis with priapism and penile gangrene. Med Welt. 1969; 1485-1488.[meducator3.net]
Papule
  • A 69-year-old man had an ulceration at the base of the penis and papules involving the glans penis 1 month after injection of intravesical BCG.[ncbi.nlm.nih.gov]
Chancre
  • Gangrene of the penis and scrotum should be distinguished from cancer, complicated form of solid chancre, chancriniform pyoderma. Treatment of gangrene of the penis and scrotum.[iliveok.com]
Urge Urinary Incontinence
  • 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]
Chordee
  • (b) Healing by secondary intention without chordee Click here to view Fournier's gangrene of the penis still remains a rare entity.[njcponline.com]

Workup

Soft Tissue Calcification
  • Subtotal parathyroidectomy is indicated for patients in whom progressive arterial and soft tissue calcification develops despite medical therapy.[ncbi.nlm.nih.gov]
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

  • Penile entrapment and subsequent strangulation is a serious injury that requires a prompt treatment to avoid gangrene.[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

  • Comparison of the patients' ages, presentations, underlying diseases, the duration of conservative treatments, surgical options, resected penile length, and prognosis. All of the five patients underwent partial penectomy.[ncbi.nlm.nih.gov]
  • Penile gangrene is a manifestation of widespread vascular calcifications associated with end-stage renal disease and is a marker of poor prognosis. Keywords: Calciphylaxis, gangrene, penis How to cite this article: Agarwal MM, Singh SK, Mandal AK.[indianjurol.com]
  • It is considered a urological emergency with a poor prognosis due to its high mortality rate (ranging 15-50% 3 ).[radiopaedia.org]
  • 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]
  • We concluded that this was a rare etiology of Fournier's gangrene and examined the complications of pelvic bone fracture in this context. Keywords: Etiology, foam, Fournier's gangrene, hematoma, osteomyelitis How to cite this article: Fang CL.[e-fjs.org]

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]
  • Epidemiological aspects of Fournier's gangrene at Kenyatta National Hospital, Nairobi. East Afr Med J. 1998; 75 :586–9. [ PubMed ] [ Google Scholar ] 3. Ayumba BR, Magoha GA.[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • Reduction of paraphimosis: a technique based on pathophysiology. Br J Surg. 1996;83:1247. Copyright 2000 by the American Academy of Family Physicians. This content is owned by the AAFP.[aafp.org]
  • Symptoms and Pathophysiology The etiology of, and predisposing factors for, FG provide a favorable environment for infection.[uspharmacist.com]
  • Pathophysiology The following are pathognomonic findings of Fournier gangrene upon pathologic evaluation of the involved tissue: Necrosis of the superficial and deep fascial planes, Fibrinoid coagulation of the nutrient arterioles, Polymorphonuclear cell[intechopen.com]
  • 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

  • We report a case of mycotic penile gangrene in a diabetic child to highlight its potentially preventable disastrous outcome.[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]
  • […] the primary surgical treatment. 11 This case confirmed that penile gangrene is the disease which is followed by severe intoxication and predisposed to fast progression; Immediate surgical intervention with excision of the necrotizing tissues allows to prevent[slideplayer.com]

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