A Case of Penile Pyoderma Gangrenosum Treated by Urethrocutaneostomy without Penectomy

We herein report a case of penile pyoderma gangrenosum that was successfully treated with prednisolone and by urethrocutaneostomy without penectomy. A man in his 50s visite dour department because of painful urination. Pyuria and redness of the external urethral meatus were present. Treatment for ur...

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Veröffentlicht in:Hinyokika kiyo. Acta urologica Japonica. - 1962. - 67(2021), 7 vom: 05. Juli, Seite 331-337
1. Verfasser: Hatano, Shotaro (VerfasserIn)
Weitere Verfasser: Kanematsu, Akihiro, Takada, Hideaki, Mizuno, Kei, Tsuchihashi, Kazunari, Nishikawa, Nobuyuki, Takao, Noriyasu, Ogura, Keiji, Ishitoya, Satoshi
Format: Online-Aufsatz
Sprache:Japanese
Veröffentlicht: 2021
Zugriff auf das übergeordnete Werk:Hinyokika kiyo. Acta urologica Japonica
Schlagworte:Case Reports Journal Article Prednisolone 9PHQ9Y1OLM
Beschreibung
Zusammenfassung:We herein report a case of penile pyoderma gangrenosum that was successfully treated with prednisolone and by urethrocutaneostomy without penectomy. A man in his 50s visite dour department because of painful urination. Pyuria and redness of the external urethral meatus were present. Treatment for urethritis with antibiotics did not improve his symptoms, and a painful ulcer and fistula formation between the glans and urethra subsequently developed. Microbiological cultures revealed no growth, and punch biopsy showed only nonspecific inflammation, leading to a diagnosis of penile pyoderma gangrenosum. We initiated prednisolone (PSL) at 40 mg once daily following placement of an indwelling suprapubic cystostomy tube for dysuria. However, the treatment was ineffective. Therefore, the dosage of PSL was increased to 65 mg once daily. The ulcer disappeared, but urethral stricture remained. Six hundred days after PSL treatment, we performed urethrocutaneostomy. The patient became free of the cystostomy and was able to urinate spontaneously. In recent years, there has been an increasing number of reports of penile preservation in the treatment of penile pyoderma gangrenosum, but knowledge regarding which patients require urethral surgery is lacking. Urologists should keep in mind increased susceptibility to infection, pathergy and possible recurrence, when considering urethral surgery for penile pyoderma gangrenosum
Beschreibung:Date Completed 09.08.2021
Date Revised 09.08.2021
published: Print
Citation Status MEDLINE
ISSN:0018-1994
DOI:10.14989/ActaUrolJap_67_7_331