A twelve-year experience in the management of calciphylaxis resulting in penile gangrene

Mostafa M. Khalil, Sundus Hussein, Elijah O. Kehinde, Yousef Ali, Khaleel A. Al-Awadi

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To analyze the mode of presentation of patients with calciphylaxis induced penile gangrene and the outcome of management of the disease. Design: Prospective study (1998 - 2010). Setting: Urology Unit, Mubarak Hospital, Kuwait Subjects: Patients presenting with penile gangrene secondary to calciphylaxis were analyzed. Intervention(s): Patients with moderate to severe penile gangrene had penile amputation. Main Outcome Measure(s): Etiological factors, mode of presentation, patient characteristics and the outcome of management. Results: Eleven patients were managed in the 12-year period. All patients (100%) had end stage renal failure (ESRF) and nine patients (81.8%) were on chronic dialysis at presentation. Poorly controlled diabetes mellitus was a co-morbidity in 10 patients (90.9%). Areas of gangrene were limited to the glans penis in nine patients (81.8%) and extending to the scrotum in two patients (19.2%). All patients had generalized calcifiedblood vessels on plain X-ray of the abdomen and pelvis. Eight patients (72.7%) required partial or total amputation of the penis. Three patients were successfully managed by debridement while one of them was too ill for surgical intervention. Seven patients (63.6%) were dead within three months of the diagnosis of penile gangrene. Conclusion: Penile gangrene due to calciphylaxis is a rare disease seen mostly in patients with ESRF on chronic dialysis. Poorly controlled diabetes is a risk factor for the onset of penile gangrene. The disease has a high mortality in older patients with other co-morbid medical diseases. Immediate penile amputation may result in a satisfactory outcome in less than 50% of all patients.

Original languageEnglish
Pages (from-to)197-201
Number of pages5
JournalKuwait Medical Journal
Volume42
Issue number3
Publication statusPublished - Sep 2010
Externally publishedYes

Keywords

  • Calciphylaxis
  • Chronic renal failure
  • Penile amputation

ASJC Scopus subject areas

  • Medicine(all)

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