Ito Takuya, Aoki Katsunori, Yamaguchi Yuichiro, Shikata Yuko, Yoshida Yasuyuki, Takehara Yuki, Fujimoto Nobumasa
The Department of Urology, Japan Community Health Care Organization Osaka Hospital.
The Department of Nephrology, Japan Community Health Care Organization Osaka Hospital.
Hinyokika Kiyo. 2023 Jun;69(6):163-167. doi: 10.14989/ActaUrolJap_69_6_163.
In the present case of a 56-year-old male, hemodialysis was introduced from December 20XX-2 due to chronic renal failure caused by diabetic nephropathy. In February 20XX, a glans penis ulcer was observed. It gradually expanded. Angiography conducted in April revealed complete occlusion of the left internal pudendal artery and poor visualization of the bilateral penile arteries. Given the high risk of obstruction, endovascular treatment was not conducted. The glans penis ulcer continued to expand, and maintenance dialysis became difficult due to intractable pain. Opioids were introduced, but the pain could not be controlled. In May 20XX, the patient was referred to our department for surgical treatment, and partial penile resection was performed. The patient was diagnosed with penile calciphylaxis based on clinical findings and pathological diagnosis. After the surgery, the pain subsided considerably, and the patient is being followed on an out-patient basis.
在本病例中，一名56岁男性因糖尿病肾病导致慢性肾衰竭，于20XX年12月2日开始进行血液透析。20XX年2月，发现阴茎头溃疡，溃疡逐渐扩大。4月进行的血管造影显示左侧阴部内动脉完全闭塞，双侧阴茎动脉显影不佳。鉴于阻塞风险高，未进行血管内治疗。阴茎头溃疡持续扩大，由于顽固性疼痛，维持性透析变得困难。使用了阿片类药物，但疼痛无法控制。20XX年5月，患者因手术治疗转诊至我科，接受了部分阴茎切除术。根据临床表现和病理诊断，患者被诊断为阴茎钙化防御。手术后，疼痛明显减轻，患者正在门诊随访。
