Penile Glans Necrosis Developing after Internal Pudendal Arterial Embolization: A Case Report

Tae Nam Kim, Chan Ho Lee, Seung Ryong Baek, Kyung Min Lee, Sangmin Choe, Nam Cheol Park, Hyun Jun Park



Penile glans ischemia or necrosis developing after internal pudendal arterial embolization is very rare; no relevant
report has yet appeared. A 53-year-old male who visited our emergency room because of massive urethral bleeding
was diagnosed with an internal pudendal artery-urethral fistula; he underwent selective embolization of the internal
pudendal artery. However, unexpected penile glans ischemic necrosis developed after embolization. We successfully
treated the patients with intravenous infusion of alprostadil, oral pentoxifylline and tadalafil.

Full Text:




Aslan A, Karaguzel G, Melikoglu M. Severe ischemia of the glans penis following circumcision: a successful treatment via pentoxifylline. Int J Urol. 2005;12:705-7.

Takao T, Osuga K, Tsujimura A, Matsumiya K, Nonomura N, Okuyama A. Successful superselective arterial embolization for posttraumatic

high-flow priapism. Int J Urol. 2007;14:254-6.

Mitropoulos D, Pappas P, Banias C, Leonardou P, Alamanis C, Giannopoulos A. Delayed presentation of posttraumatic internal pudendal artery-urethral fistula treated by selective embolization. J Trauma.


Celtikci P, Ergun O, Tatar IG, Conkbayir I, Hekimoglu B. Superselective arterial embolization of pseudoaneurysm and arteriovenous fistula caused by transurethral resection of the prostate. Pol J Radiol 2014;79:352-5.

Garrido-Abad P, Suarez-Fonseca C. Glans ischemia after circumcision and dorsal penile nerve block: Case report and review of the literature. Urol Ann. 2015;7:541-3.

Aminsharifi A, Afsar F, Tourchi A. Delayed glans necrosis after circumcision: role of testosterone in salvaging glans. Indian J

Pediatr. 2013;80:791-3.

Burnett AL. Molecular pharmacotherapeutic targeting of PDE5 for preservation of penile health. J Androl. 2008;29:3-14.

Rajfer J, Gore JL, Kaufman J, Gonzalez-Cadavid N. Case report: Avoidance of palpable corporal fibrosis due to priapism with upregulators of nitric oxide. J Sex Med. 2006;3:173-6.

Savoca G, Pietropaolo F, Scieri F, Bertolotto M, Mucelli FP, Belgrano E. Sexual function after highly selective embolization of cavernous artery in patients with high flow priapism: long-term followup. J Urol. 2004;172:644-7.

Chen J, Wang S, Wu D, Wu J. Bilateral internal pudendal artery-urethral fistula formation by pseudoaneurysm. Acta Orthop Traumatol

Turc. 2015;49:456-8. Penile glans necrosis after pudendal embolization -Kim et al.


Creative Commons License 
This work is licensed under a Creative Commons Attribution 3.0 License