PENECTOMY IN DIABETIC-PATIENTS UNDERGOING MAINTENANCE DIALYSIS

Penectomy was performed to sustain life in 2 patients with insulin-dep endent and non-insulin-dependent diabetes mellitus, respectively, who were undergoing maintenance hemodialysis. Both patients previously had manifested a series of serious macro- and microvascular diabetic comp lications. The histopathologic findings in both cases included gangren ous necrosis of penile tissue, while case 2 also evinced calcification of penile arteries. Penectomy has been reported as the result of peni le malignancy, anticoagulant toxicity, self-inflicted injury, and crim inal assault. Other reports document penectomies attributed to perinea l infection (Fournier's syndrome) in diabetic patients with uremia. In five previously reported cases of penectomy in diabetic patients unde rgoing dialysis, systemwide arteriopathy was present in all. There is an association between uremia in diabetics and predisposition to an is chemic-infectious lesion of the penis that fails to respond to antimic robial therapy.