[A case of penile necrosis in a patient with diabetic nephropathy]

The patient was a 63-year-old male. He was diagnosed as having diabetes mellitus in 1987, and hemodialysis was begun in October 1991 for diabetic nephropathy. He complained of glans pain from the middle of May 1992. Although he was administered antibiotics, a small ulcer arose on the glans penis at the end of May. The lesion became progressively black and carbonized on the whole glans penis by the first of June and involved the prepuce by the end of June. Partial penectomy was performed in July. Histopathological examination showed marked stenosis with calcification in the terminal branches of the dorsal penile artery and thickened wall of the small arteries due to vascular lesions as a result of diabetes mellitus. The patient was in generalized deterioration of clinical condition postoperatively and died of gastrointestinal bleeding in September. Penile necrosis in patients with diabetes mellitus is very rare and only ten cases including our own case have been reported. We reviewed the literature with special reference to the relationship with chronic renal failure.