Male patient, aged 54 years, with a history of type 2 diabetes mellitus since the age of 30, chronic renal failure for 2 years, treated with haemodialysis. He had undergone supracondylar amputation of the right pelvic limb 4 years earlier.
He came to our department for symptoms of 1 month's evolution, characterised by the presence of blistering lesions on the glans penis, asymptomatic, which progressed to ulcers a week later; subsequently, he reported intense pain in the glans penis and hypochromia, which was the reason for which he consulted us.
Physical examination revealed a hypochromic, hypothermic, hypochromic glans penis with a necrotic lesion of approximately 1.5 cm on the ventral side, as well as transurethral purulent discharge and induration of the distal third of the penile shaft.
Blood biometry reported: haemoglobin 10.1 g/dl, leucocytes 4,890, platelets 283,000; blood chemistry: glucose 55 mg/dl, creatinine 7.88 mg/dl, BUN 65.5 mg/dl; serum electrolytes: sodium 145.3 mmol/l, potassium 4.81 mmol/l, chlorine 99 mmol/l, calcium 8.3, mmol/l and phosphorus 9.21 mmol/l. Liver function tests reported: TGO 18, TGP 14 and alkaline phosphatase 64.
A penile Doppler ultrasound was performed with Caverject, showing a total absence of flow in 100% of the penis.
Surgical management was proposed to the patient and he decided to go to another institution.