PMC6211149_01
Preoperative appearance of the penis.
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On examination, he had a tight meatus, blackish discoloration of the tip of the glans, and tender hard gangrenous mass of the glans (Figure 1), which was proven to be a calciphylaxis gangrene by histopathological assessment.
Calcification of the penile vessels and tissues.
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Due to the history of hematuria, CT urography was done and it showed extensive calcification of the corpus cavernosa, penile vessels, and soft tissues (Figure 2), obstructive calcified of bilateral internal iliac vessels both anterior and posterior branches (Figure 3).
Bilateral obstructive calcification of internal illiac vessels.
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Due to the history of hematuria, CT urography was done and it showed extensive calcification of the corpus cavernosa, penile vessels, and soft tissues (Figure 2), obstructive calcified of bilateral internal iliac vessels both anterior and posterior branches (Figure 3).
Partial penectomy.
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Conservative therapy was initiated in form of wound debridement, systemic antibiotics and sodium thiosulfate, and tight blood sugar control, but due to severe penile pain we proceeded with partial penectomy (Figure 4).
Clots and sloughed necrotic tissues evacuated from the bladder.
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Additionally, a cystoscopy was done and showed sloughed necrotic bladder wall and diffuse hematuria uncontrolled by fulguration (Figure 5).