Man, 43, is left with a ‘penile stump’ after surgeons cut off gangrene-riddled tip because rare disease blocked his circulation
- The man’s kidney failure meant calcium built up and blocked his blood vessels
- Lack of oxygen to the penis caused gangrene and surgeons had to amputate
- His condition kills around six out of 10 patients, according to the doctors
A man had to have the end of his penis cut off because of a rare disease which blocked his circulation.
The unfortunate 43-year-old went to a hospital in South Australia for a routine dialysis appointment to treat his kidney failure.
But when doctors examined him they discovered he had gangrene on the tip of his penis.
The flesh had started to turn white with black spots and surgeons urgently had to slice off the dead skin to try and stop the gangrene from spreading.
He was left with a ‘penile stump’, the doctors wrote in a gruesome case report, but he was lucky to have survived a condition which kills around six in 10 patients.
Doctors diagnosed the patient with gangrene by chance at a routine appointment and surgeons had to act quickly to slice off the rotting flesh and stop it from spreading (stock image)
The man was diagnosed with penile calciphylaxis by doctors at Flinders Medical Centre near Adelaide.
Calciphylaxis is a condition in which calcium builds up inside the blood vessels and cuts off circulation.
It can be caused by kidney failure because the organs stop filtering the calcium out of the blood.
WHAT IS CALCIPHYLAXIS?
Calciphylaxis is a condition in which calcium is not filtered out of the blood properly and builds up inside blood vessels, such as arteries, veins or capillaries.
This build-up acts in a similar way to blood clots and cuts off the circulation to various parts of the body.
Without blood, flesh doesn’t get any oxygen and so it cannot survive.
This starvation causes ulcers and bits of tissue and skin to rot and die – a condition called gangrene – and can spread.
Gangrene is usually incurable and the only way to treat it once flesh has already died is to operate to cut off the affected area and to slice around it to stop the tissue death from spreading.
Symptoms of calciphylaxis include purple net-like patterns on the skin, deep painful lumps which form to ulcers, and slow-healing infections.
Risk factors for calciphylaxis include being obese, having type 2 diabetes, having kidney failure and taking certain medications, such as warfarin.
It is not clear how many people get the condition, but it’s estimated to affect one to four per cent of kidney failure patients.
When this builds up and stops blood flow, flesh and skin can be starved of oxygen and start to die off, causing gangrene – gangrene can spread quickly and is often incurable.
Medics, led by Dr Rowan David, said in their case report that calciphylaxis, when it affects the penis, has a fatality rate of around 64 per cent.
‘The majority of patients who develop penile calciphylaxis progress to gangrene and sepsis,’ the doctors wrote in the journal BMJ Case Reports.
The condition is so rare, they said, that it was first recorded in 1997 and there have only been 81 mentions of it in English-language scientific reports.
It had been caused by the man’s underlying medical conditions – he was obese, had type 2 diabetes, high blood pressure and end-stage kidney disease.
After he had the original surgery to remove the gangrenous parts of his penis, the man’s wound got worse and he had to have the entire tip of his genitals removed.
‘Reconstruction of the penile stump was performed four days later with a… skin graft,’ the doctors wrote.
The man survived his ordeal against the odds and took two months to recover.
But the calciphylaxis continued to develop in his body and he had to have part of his large intestine removed a year later. The doctors said the man ‘remains alive’.
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