Abstract
We report here a patient whose glans penis gangrene healed after autoamputation without surgery. The patient was a 52-year-old man who was diagnosed with acute exacerbation of chronic renal failure and underwent hemodialysis. Ulcers were observed on the glans penis and both toes with painful peripheral purpura. He underwent hyperbaric oxygen therapy and low-density lipoprotein apheresis while on pain management therapy. Healing of toe gangrene was achieved after percutaneous transluminal angioplasty followed by transmetatarsal amputation. Healing of glans gangrene was achieved by maintaining the affected area dry, thus enabling autoamputation. When penile or glans necrosis develops, treatment often involves surgical removal of the affected area, followed by stump plasty. In these cases, the penis or glans is shortened by the amount of skin used in the stump closure. In some cases, the suture wound does not heal due to ischemia, and additional resections may be required. On the other hand, autoamputation is less invasive and results in only minor tissue loss. If there are no symptoms of infection with glans gangrene, and if the affected areas can be kept dry, simple patient monitoring is sufficient for recovery.
