Glans necrosis following penile procedures: a systematic review of etiology, frequency, and management

This systematic review aimed to evaluate the current evidence on the etiology, frequency, and management of glans necrosis (GN). A comprehensive search was conducted in Medline (via PubMed), Web of Science, and Embase (via Scopus) for studies on GN as a penile procedure complication. This study involved articles in English published between May 1967 and January 2025. Articles reporting GN following penile procedures were included, whereas those describing GN due to metabolic causes or non-surgical interventions were excluded. Nine of 321 identified articles met the inclusion criteria, enrolling 34 GN cases among 2582 patients. The etiologies were penile prosthesis implantation (n = 24), grafting procedures for Peyronie's disease (n = 2), penile brachytherapy for penile cancer (n = 4), and penile paraffinoma removal (n = 4). None of the studies reported conservative management. Surgical interventions included prosthesis removal (n = 6), prosthesis replacement combined with glans resurfacing (n = 1), debridement (n = 17), glans reconstruction (n = 1), scrotal skin free grafting (n = 4), and partial penectomy (n = 4). Therefore, although GN is rare, its consequences can be severe. Immediate surgical intervention is warranted for effective management.