case_images: PMC6211149_01
case_images: Preoperative appearance of the penis.
case_images: CRIU2018-9603680.001.jpg
case_images: PMC6211149_01_CRIU2018-9603680.001.jpg
case_images: fig1
case_images: 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.
case_images: Calcification of the penile vessels and tissues.
case_images: CRIU2018-9603680.002.jpg
case_images: PMC6211149_01_CRIU2018-9603680.002.jpg
case_images: fig2
case_images: 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).
case_images: Bilateral obstructive calcification of internal illiac vessels.
case_images: CRIU2018-9603680.003.jpg
case_images: PMC6211149_01_CRIU2018-9603680.003.jpg
case_images: fig3
case_images: 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).
case_images: Partial penectomy.
case_images: CRIU2018-9603680.004.jpg
case_images: PMC6211149_01_CRIU2018-9603680.004.jpg
case_images: fig4
case_images: 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).
case_images: Clots and sloughed necrotic tissues evacuated from the bladder.
case_images: CRIU2018-9603680.005.jpg
case_images: PMC6211149_01_CRIU2018-9603680.005.jpg
case_images: fig5
case_images: Additionally, a cystoscopy was done and showed sloughed necrotic bladder wall and diffuse hematuria uncontrolled by fulguration (Figure 5).