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Acute arterial insufficiency of the male genitalia
J L Kaufman1, B B Chang, D M Shah
1Department of Surgery, Albany Medical College, New York 12208.
Insights
Severe penile or scrotal ischemia from acute arterial occlusion is rare but serious. This vascular complication indicates significant arterial disease and can result from major pelvic or groin artery procedures.
Area of Science:
- Vascular Surgery
- Urology
- Arterial Disease
Background:
- Acute arterial occlusion leading to severe ischemia of the male genitalia is a rare clinical event.
- The rich collateral circulation in the pelvic and groin regions typically protects these structures from ischemia.
Observation:
- This report details three cases of severe penile or scrotal ischemia resulting from acute arterial occlusion.
- Causes included atheroembolism to the dorsal penile artery, ligation of collateral circulation during aortic aneurysm repair, and thromboembolism during aortoenteric fistula repair.
Findings:
- Only seven cases of acute arterial occlusion with severe male genital ischemia have been previously reported.
- The observed cases highlight the potential for severe ischemic complications despite rich collateral supply.
Implications:
- Acute ischemia of the genitalia serves as a critical sign of underlying severe vascular disease.
- Recognition of this condition is vital for managing patients undergoing major arterial interventions in the pelvis and groins.
Abstract:
Three patients developed severe ischemia of the penis or scrotum from acute arterial occlusion. In one case, nonhealing ulceration of the glans developed after atheroembolism to the dorsal penile artery. One patient had penile ischemia after ligation of pelvic and femoral collateral circulation during repair of an aorto-bilateral-iliac artery aneurysm. A third patient had ischemia of the penis and scrotum from thromboembolism to the iliac arteries during repair of an aortoenteric fistula. Only seven patients have been described with acute arterial occlusion and severe ischemia of the male genitalia. A rare phenomenon because of rich collateral circulation, acute ischemia of the genitalia nevertheless must be recognized as a sign of severe vascular disease and a consequence of major arterial ligation or occlusion in the pelvis and groins.