A MAN was forced to have his penis amputated after developing gangrene.
The 65-year-old, who had uncontrolled type 2 diabetes and an enlarged prostate, was rushed to hospital following "excessive alcohol consumption".
Doctors "traumatically" fitted a transurethral catheter and, after a flood of "turbid, foul-smelling urine", he was prescribed antibiotics and sent home.
Seven days later, the unnamed patient returned to A&E with a 39C fever and a "substantial" crunching sound in his pubis bone.
He also had "copious" amounts of "purulent, greenish and foul-smelling discharge emanating from the urethra and skin of the prepuce, the scrotum, digital rectal".
Tests revealed his vital signs were stable, but he had an enlarged prostate with "multiple abscesses" and was given a blood transfusion, further antibiotics and insulin.
The man then had his gangrene-ridden, rotting foreskin removed, before undergoing a full penis amputation.
Medics had hoped to save his manhood, but the tissue turned black and resulted in "total penile necrosis".
He was discharged from hospital one week later, with check-ups at an outpatient clinic.
Writing in , doctors said: "The development of localised ischemic gangrene on the penis is an extremely rare occurrence due to the organ's abundant blood supply and has a high morbidity and mortality due to the high risk of sepsis.
"In this case, the presentation of penile ischemic gangrene was attributed to a combination of factors: fournier's gangrene secondary to traumatic transurethral catheter placement, uncontrolled diabetes mellitus, and peripheral arterial disease.
"A total penectomy was performed due to the lack of viable tissue for partial penectomy or reconstruction.
"The patient was extensively counselled regarding the surgical indication, its potential short-term and long-term consequences, and the placement of a cystostomy catheter.
";The psychological impact of the procedure was also emphasised.
"The patient fully understood the information provided and consented to the surgical treatment."
Following this man's ordeal, the team urged doctors to "strictly avoid forceful urethral catheterisation", which involves putting a flexible tube into the bladder to drain urine, when insertion is "difficult".
"Early consultation with a urologist is recommended to minimise the risk of severe complications," they added.
"Ischemic, or dry, gangrene of the penis is a rare complication, and this case highlights the potential for devastating psychological and functional outcomes."
Gangrene is a serious condition where a loss of blood supply causes body tissue to die.
There are three main types - dry, wet and gas.
Fournier's gangrene, first identified in 1883, is a specific type of necrotising fasciitis - or flesh-eating disease - caused by a bacterial infection.
Initially, it was thought to affect only the scrotum, but experts now understand it spreads rapidly through the tissues of the genitals, perineum, and anus, potentially reaching the abdomen.
It mostly affects men with underlying health issues, and requires immediate medical and surgical attention.
Fournier's gangrene has a high mortality rate of 4.7 to 40.4 per cent.
Common risk factors include diabetes, cardiovascular disease, chronic alcohol misuse, a weakened immune system, and kidney disease.
GANGRENE is a serious condition where a loss of blood supply causes body tissue to die.
It is common in the toes, feet, fingers and hands, but it can occur anywhere, including in the genitals.
Symptoms include red, purple or black skin, swelling, loss of sensation or severe pain, sores or blisters.
Gangrene can affect anyone, but it usually develops after an injury, infection or long-term condition that affects blood circulation in people with diabetes, atherosclerosis, peripheral arterial disease, and Raynaud's.
Treatment usually involves surgery, antibiotics and sometimes amputation.
According to the NHS, many gangrene cases can actually be prevented.
"If you have a condition that increases your risk of getting gangrene, such as diabetes, it's important you have regular check-ups to assess the state of your feet," it says.
"Report any problems to your GP as soon as possible.
"Stopping smoking if you smoke and adopting a healthy lifestyle, with a low-fat diet and regular exercise, can also improve your circulation and reduce your risk of developing gangrene."
Source:
