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Rare disease
Case report
Penile gangrene due to calciphylaxis: a multidisciplinary approach to a complex clinical challenge
  1. Rowan David1,
  2. Jake Nowicki2,
  3. Jason Lee1 and
  4. Nicola Dean2
  1. 1 Urology Surgery, Flinders Medical Centre, Bedford Park, South Australia, Australia
  2. 2 Plastic and Reconstructive Surgery, Flinders Medical Centre, Bedford Park, South Australia, Australia
  1. Correspondence to Dr Rowan David; rowan.david319{at}gmail.com

Abstract

Penile calciphylaxis is a rare but clinically challenging condition to manage. While multiple treatment options have been proposed, the underlying evidence is anecdotal, and the overall prognosis remains extremely poor. We describe the case of a patient who underwent urgent debridement of a suspected gangrenous penile tip, who was intraoperatively found to have penile calciphylaxis. The necrosis progressed and the patient had a glans amputation. A non-healing wound developed, requiring reconstruction with two skin grafts using foreskin by the plastic and reconstructive surgical unit. The patient was commenced on sodium thiosulfate and his wound had completely healed 2 months following his last operation. We review the literature to determine the biochemical features, management options and outcomes in patients with penile calciphylaxis.

  • urological surgery
  • plastic and reconstructive surgery
  • chronic renal failure
  • dialysis
  • renal system

https://doi.org/10.1136/bcr-2019-232138

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    Footnotes

    • Contributors RD wrote the case synopsis, background and discussion sections of the manuscript. JN wrote the summary and follow-up sections of the manuscript. Both RD and JN performed the literature review. ND supervised the draft submissions and provided information regarding the reconstructive procedure. JL co-supervised the paper and provided a detailed description of the preoperative and intraoperative findings.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.