Necrosis of the Penis with Multiple Vessel Atherosclerosis

Abstract

Penile necrosis is a very rare complication because of its rich collateral supply. Conservative management is apt to be ineffective; thus penectomy is usually performed. We present a case of penile necrosis and claudication of both legs with multiple atherosclerosis in a type II diabetes mellitus patient who was successfully treated with angioplasty, penoplasty, and additional intracavernous injections of prostaglandin E1. The treatment resulted in relief of the leg pain and healing of the penile ischemic lesions. Penile necrosis may accompany health problems such as disseminated infections and circulatory disorders. Ische-mia of the penis is relatively rare because of its excellent collateral vessels [1]. Until recently, a surgical procedure such as penectomy was the only treatment option. The cure rate of conservative management was low. We report a case of diabetes mellitus (DM)-associated penile ne-crosis with severe multiple atherosclerosis, for which treatment by balloon angioplasty and a bypass graft was successful. Additional intracavernous injections (ICI) of prostaglandin E1 (PGE1) facilitated the circulation of blood flow, which was very important to stimulate penile healing.