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Case Reports
. 2019 Apr 10;2(4):171-173.
doi: 10.1002/iju5.12064. eCollection 2019 Jul.

Long-term follow-up of penile glans necrosis due to paraphimosis

Yoshikazu Sato  1 , Seiji Takagi  2 , Kosuke Uchida  1 , Masaki Shima  2 , Musashi Tobe  1 , Kazunori Haga  1 , Ichiya Honama  1 , Megumi Hirobe  1
Affiliations
Case Reports

Long-term follow-up of penile glans necrosis due to paraphimosis

Yoshikazu Sato et al. IJU Case Rep. .

Abstract

Introduction: Paraphimosis is a urologic emergency in which the foreskin of the penis becomes trapped behind the coronal sulcus and forms a tight band of constricting tissue. Surgical or conservative release of this constriction is required for the treatment. Delayed treatment will cause devastating outcomes, such as penile glans necrosis. A few studies have reported penile glans necrosis/gangrene, but long-term follow-up of the recovery from glans necrosis due to paraphimosis has not been previously reported.

Case presentation: A 25-year-old man who experienced glans necrosis following paraphimosis was not treated promptly with circumcision. The patient underwent conservative treatment with debridement of necrotic tissue and cystostomy for urethral meatal necrosis. We were able to prevent partial penectomy. His penile glans was covered with healthy epithelium and retained its natural shape and voiding and erectile functions were normal 2 years after the treatment.

Conclusion: We report successful conservative management of penile glans necrosis.

Keywords: cystostomy; debridement; long‐term follow‐up; paraphimosis; penile necrosis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Surface of the glans covered with a hard black dried scab. Deeper necrotic tissues were observed when the scab was removed.
Figure 2
Figure 2
Position of the external urethral meatus returning to the coronal sulcus level due to glandular necrosis.
Figure 3
Figure 3
Surface of the penile glans was covered with healthy tissue without infection. The external urethral meatus was repositioned at the level of the coronal sulcus without stenosis 2 months after starting treatment.
Figure 4
Figure 4
The penis has retained the natural shape of the penile glans and shaft at 1 year after treatment.
See this image and copyright information in PMC

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