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Penectomy in diabetic patients undergoing maintenance dialysis
I Bali1, A F Abdu, E S Gloster
1Department of Medicine, State University of New York, Brooklyn 11203, USA.
American Journal of Nephrology
|January 1, 1995
Summary
Life-saving penectomy was performed on two patients with diabetes mellitus undergoing hemodialysis due to severe penile necrosis. Uremia in diabetics predisposes to penile ischemic-infectious lesions unresponsive to treatment.
Area of Science:
- Nephrology
- Endocrinology
- Vascular Surgery
Background:
- Diabetes mellitus (DM) is associated with severe macro- and microvascular complications.
- Patients with DM undergoing maintenance hemodialysis are at risk for advanced diabetic complications.
- Uremia in diabetic patients can predispose to severe penile pathology.
Observation:
- Two patients with insulin-dependent and non-insulin-dependent DM on hemodialysis required penectomy.
- Both patients exhibited serious diabetic vascular complications.
- Histopathology revealed penile gangrenous necrosis; one case showed penile artery calcification.
Findings:
- Penectomy was necessary to sustain life in these diabetic patients on dialysis.
- Penile ischemic-infectious lesions in uremic diabetics may be unresponsive to antimicrobial therapy.
- Systemic arteriopathy is common in diabetic patients on dialysis who undergo penectomy.
Implications:
- Highlights the severe penile complications possible in diabetic patients with end-stage renal disease.
- Suggests a link between uremia, diabetes, and the development of non-healing penile lesions.
- Underscores the importance of vigilant monitoring and management of vascular complications in this patient population.