Penile gangrene: An unusual complication of priapism in a patient with bladder carcinoma

Ajape, Abdulwahab Akanbi; Bello, Ahmad

doi:10.4103/2006-8808.78470

Cited by 15 publications

(7 citation statements)

References 21 publications

(24 reference statements)

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“…This condition is associated with priapism, intense external pressure on the penis (clothing, suction devices), Wegener's granulomatosis, septic emboli in IV drug users, perivascular invasion of the penis by a tumour, penile surgery, and, most commonly, diabetes mellitus (DM) [11–15]. Several factors can act simultaneously causing gangrene of the penis.…”

Section: Discussionmentioning

confidence: 99%

Ischemic Gangrene of the Glans following Penile Prosthesis Implantation

Gómez

Otero

Sicilia

et al. 2013

Case Reports in Urology

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The development of ischemic gangrene of the penis following implantation of prosthesis is unusual, and very few cases are available in the literature. As a result, no established treatment protocol is available. We report our experience within a case of gangrene of the glans following implantation of a three-component prosthesis. We present a 53-year-old male, smoker with diabetes and hypercholesterolemia, who underwent surgery for the insertion of a penile prosthesis with 3 components to correct his erectile dysfunction and severe Peyronie's disease. The procedure was carried out without incidents. During the postoperative period, the patient began to complain from penile and perineal pain. He developed avascular necrosis of the glans. The necrosed area was excised. Four weeks later, he developed fever and perineal pain arriving to the emergency room with the prosthesis extruding through the glans. He had emergency surgery to remove the prosthesis plus surgical lavage and was prescribed broad-spectrum antibiotic therapy. Four weeks later, the penis was completely revascularized and reepithelialized. Ischemic gangrene following penile prosthesis implantation takes place in patients with poor peripheral vascularisation. Diabetes mellitus has been the common denominator to all of the reported cases.

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Section: Discussionmentioning

confidence: 99%

Ischemic Gangrene of the Glans following Penile Prosthesis Implantation

Gómez

Otero

Sicilia

et al. 2013

Case Reports in Urology

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“…Ischemic priapism is usually associated with many concomitant diseases and risk factors, such as hematological, traumatic, surgical, neoplastic, neurological, infective and pharmacological factors. Numerous studies 7,8 have indicated that leukemia and malignant tumors are associated with priapism, and several psychotropic drugs have also been reported to cause priapism as a side effect. 9,10 In our series, seven patients had primary diseases, and the other two denied obvious precipitating factors, including three with CML, two with a malignant tumor, one with infection and one with schizophrenia.…”

Section: Discussionmentioning

confidence: 99%

Unsatisfactory outcomes of prolonged ischemic priapism without early surgical shunts: our clinical experience and a review of the literature

Zheng¹,

Yao²,

Zhang³

et al. 2012

Asian J Androl

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Ischemic priapism is a rare occurrence which can cause severe erectile dysfunction (ED) without timely treatment. This retrospective study reports our experience in treating prolonged ischemic priapism and proposes our further considerations. In this paper, a total of nine patients with prolonged ischemic priapism underwent one to three types of surgical shunts, including nine Winter shunts, two Al-Ghorab shunts and one Grayhack shunt. During the follow-up visit (after a mean of 21.11 months), all patients' postoperative characters were recorded, except one patient lost for death. Six postoperative patients accepted a 25-mg oral administration of sildenafil citrate. The erectile function of the patients was evaluated by their postoperative 5-item version of International Index of Erectile Function Questionnaire (IIEF-5), which were later compared with their premorbid scores. All patients had complete resolutions, and none relapsed. The resolution rate was 100%. Seven patients were resolved with Winter shunts, one with an Al-Ghorab shunt and one with a Grayhack shunt. The mean hospital stay was 8.22 days. There was only one urethral fistula, and the incidence of postoperative ED was 66.67%. Four patients with more than a 72-h duration of priapism had no response to the long-term phosphodiesterase type 5 (PDE-5) inhibitor treatment. These results suggest that surgical shunts are an efficient approach to make the penis flaccid after prolonged priapism. However, the severe ED caused by prolonged duration is irreversible, and long-term PDE-5 inhibitor treatments are ineffective. Thus, we recommend early penile prosthesis surgeries for these patients.

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“…The aetiology were idiopathic (6/14), sickle cell disease (5/14), traumatic (1/14), urethral carcinoma (1/14) and unknown in one patient. The other two cases reported in the literature were as a result of thrombotic thrombocytopenic purpura3 and the other due to metastasis into the penis from a primary bladder malignancy 4. All patients had undergone intervention to relieve priapism in the form of aspiration and irrigation or creation of distal shunt prior to development of gangrene.…”

Section: Discussionmentioning

confidence: 99%

Anticoagulant-induced priapism progressing to penile gangrene: a devastating complication!

et al. 2012

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SummaryA 35-year-old man developed priapism with the use of low-molecular-weight heparin and warfarin following repair of left brachial artery sustained after gunshot injury. Priapism progressed to penile gangrene despite decompression and distal shunt procedure leading to total penectomy and perineal urethrostomy. We describe the mechanism of anticoagulant (heparin and warfarin)-induced penile gangrene and the possible methods to avert such a devastating complication. BACKGROUND

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Penile gangrene: An unusual complication of priapism in a patient with bladder carcinoma

Cited by 15 publications

References 21 publications

Ischemic Gangrene of the Glans following Penile Prosthesis Implantation

Ischemic Gangrene of the Glans following Penile Prosthesis Implantation

Unsatisfactory outcomes of prolonged ischemic priapism without early surgical shunts: our clinical experience and a review of the literature

Anticoagulant-induced priapism progressing to penile gangrene: a devastating complication!

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