Surgical management of ischemic penile gangrene in diabetics with end stage atherosclerosis

Purpose: We determined whether early surgical intervention for ischemic penile gangrene in diabetics can be successful and limit morbidity. Materials and Methods: A retrospective review was done of 7 diabetic patients with ischemic penile gangrene. Results: Three patients underwent early distal penectomy without complications. All 4 patients initially observed suffered liquefaction and progression from dry to wet gangrene, and 2 underwent surgery (subtotal penectomy in 1 and distal penectomy in 1 who required reoperations for wound complications). Conclusions: With appropriate patient selection, surgical intervention can be successful and provide a better quality of life for those without terminal disease. Delaying intervention will usually require more extensive surgery and increase the risk of wound complications. However, observation is indicated for moribund hospitalized patients.