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.

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http://dx.doi.org/10.14989/ActaUrolJap_69_6_163DOI Listing

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Article Synopsis
  • Calciphylaxis is a serious condition associated with end-stage renal disease (ESRD), often occurring in patients on hemodialysis, where calcium builds up in small blood vessels causing pain and reduced blood flow.
  • The disease typically affects fatty areas of the body, like the abdomen, but can appear on any skin surface, including rare locations like the genital region.
  • A case study of a 53-year-old man with ESRD and painful lesions on the glans penis illustrates the quick deterioration of calciphylaxis and the challenges in treating this uncommon condition.
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Penile calciphylaxis is a rare and life-threatening condition, most commonly seen in patients with end-stage renal disease (ESRD) undergoing dialysis. The pathophysiology includes calcification of small blood vessels, leading to ischemic changes, most commonly affecting the extremities. Treatment modalities vary based on the history and condition of the patient.

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Article Synopsis
  • - Calciphylaxis is a serious condition characterized by the calcification of small blood vessels, leading to tissue damage and ulcers, often seen in individuals with end-stage renal disease but can also affect those without kidney issues.
  • - Risk factors for calciphylaxis include diabetes, hyperparathyroidism, certain cancers, use of warfarin, liver disease, and autoimmune disorders, making it essential to recognize these factors for effective diagnosis and treatment.
  • - A case study describes a 58-year-old man with end-stage renal disease who developed penile calciphylaxis, leading to rapid tissue necrosis; he chose conservative treatment over surgery, opting for local wound care and antibiotics instead.
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Article Synopsis
  • Penile calciphylaxis is a rare but serious condition seen in patients with end-stage renal disease (ESRD), particularly those on dialysis.
  • A 50-year-old man with a history of hypertension, diabetes, and ESRD experienced severe penile pain and was diagnosed after a circumcision revealed necrotic tissue.
  • Despite treatment efforts, his condition progressed to gangrene, leading to a partial penectomy, highlighting the need for awareness of calciphylaxis in ESRD patients with penile symptoms.
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Calciphylaxis, also known as calcific uremic arteriolopathy, is a rapidly progressive, rare, and severe condition characterized by vascular calcification and skin necrosis. The pathophysiology involves cutaneous arteriolar calcification followed by subsequent tissue ischemia and infarction, which eventually causes extremely painful skin lesions. The condition is associated with substantial morbidity due to severe pain, non-healing wounds, increased susceptibility to infections, and frequent hospitalizations.

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