Figure - available from: Journal of Clinical Interventional Radiology ISVIR
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Source publication
Internal pudendal artery (IPA) is a branch of internal iliac artery that mainly supplies the perineal organs and external genitalia. Any obstruction in the artery seen in diabetics, hypertensives, or chronic kidney disease-induced calciphylaxis leads to decreased blood flow and may cause gangrene. IPA angioplasty is a known therapeutic procedure fo...
Similar publications
The penis is one of the end-artery organs in the human body. The blood supply of the penis depends on the internal pudendal artery, which arises from the anterior division of the internal iliac artery. Subsequently, the penis is one of the organs that are highly affected by peripheral vascular disease. Furthermore, erectile dysfunction is a clinica...
Citations
... Shah and colleagues reported a known case of hypertension, diabetes, and chronic renal failure who underwent circumcision for phimosis and developed gangrene of the glans penis two weeks later. The patient underwent internal pudendal artery angioplasty and a partial penectomy [10]. Kim et al. reported unexpected penile glans ischemic necrosis after internal pudendal arterial embolization in a patient with a post-traumatic internal pudendal artery-urethral fistula [11]. ...
Background
Penile glans and corpus spongiosum necrosis is an extremely rare urologic condition associated with substantial morbidity.
Case presentation
We report a rare case presenting extensive penile glans and corpus spongiosum necrosis following catheter traction in a 71-year-old male patient who had a laparoscopic radical cystoprostatectomy for muscle-invasive bladder cancer. The patient has no preexisting diabetes mellitus or chronic renal failure. The case was successfully managed with penile preservation. During the procedure, it was observed that the necrosis was not limited to the glans. The necrosis had spread to the entire penile urethra and corpus spongiosum, and an excision of approximately 14 cm of corpus spongiosum was performed.
Conclusion
This is the first case presenting extensive length of penile glans and corpus spongiosum necrosis managed successfully with penile preservation, enabling reaching the best functional and esthetic results reported in the literature. Early detection and urgent imaging with a high index of suspicion ensure a favorable outcome. The main treatment steps are careful evaluation, appropriate therapy, and prompt intervention depending on the severity.
