RESUMO
To analyze the mode of presentation of patients with calciphylaxis induced penile gangrene and the outcome of management of the disease Prospective study [1998 - 2010] Urology Unit, Mubarak Hospital, Kuwait Patients presenting with penile gangrene secondary to calciphylaxis were analyzed. Intervention[s]: Patients with moderate to severe penile gangrene had penile amputation Main Outcome Measure[s]: Etiological factors, mode of presentation, patient characteristics and the outcome of management Eleven patients were managed in the 12-year period. All patients [100%] had end stage renal failure [ESRF] and nine patients [81.8%] were on chronic dialysis at presentation. Poorly controlled diabetes mellitus was a co-morbidity in 10 patients [90.9%]. Areas of gangrene were limited to the glans penis in nine patients [81.8%] and extending to the scrotum in two patients [19.2%]. All patients had generalized calcified blood vessels on plain X-ray of the abdomen and pelvis. Eight patients [72.7%] required partial or total amputation of the penis. Three patients were successfully managed by debridement while one of them was too ill for surgical intervention. Seven patients [63.6%] were dead within three months of the diagnosis of penile gangrene. Penile gangrene due to calciphylaxis is a rare disease seen mostly in patients with ESRF on chronic dialysis. Poorly controlled diabetes is a risk factor for the onset of penile gangrene. The disease has a high mortality in older patients with other co-morbid medical diseases. Immediate penile amputation may result in a satisfactory outcome in less than 50% of all patients