Matsumoto M, Kyoku I, Yamagiwa K, Kashii T, Tanaka T, Uekado Y
Department of Urology, Kinan General Hospital.
Hinyokika Kiyo. 1994 Jan;40(1):87-90.
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.
患者为一名63岁男性。他于1987年被诊断患有糖尿病,并于1991年10月因糖尿病肾病开始进行血液透析。他自1992年5月中旬起诉说龟头疼痛。尽管使用了抗生素,但5月底龟头出现了一个小溃疡。到6月1日,整个龟头病变逐渐变黑并碳化,到6月底累及包皮。7月进行了部分阴茎切除术。组织病理学检查显示,阴茎背动脉终末分支明显狭窄并伴有钙化,小动脉壁因糖尿病导致的血管病变而增厚。患者术后临床状况普遍恶化,9月死于胃肠道出血。糖尿病患者的阴茎坏死非常罕见,包括我们自己的病例在内仅报道过10例。我们特别参考了与慢性肾衰竭的关系对文献进行了综述。