Penile glans necrosis following prostatic artery embolization for benign prostatic hyperplasia: case series and review of current literature

Eric Chung*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

3 Citations (Scopus)
22 Downloads (Pure)

Abstract

Purpose: To report a case series of 6 patients with penile glans necrosis (PGN) following prostatic artery embolization (PAE) and review the current literature relating to PAE and PGN, including the emerging role of hyperbaric oxygen therapy (HBOT) for PGN. Materials and Methods: All patients have failed medical BPH therapy and chose to undergo PAE over other minimally invasive BPH surgery. Patient demographics, preoperative and postoperative validated questionnaires such as the International Prostate Symptom Severity (IPSS) and International Index of Erectile Function (IIEF) scores, treatment-related adverse events (TRAE) and subsequent treatment for PGN were reviewed. All patients were follow-up with a minimum of 12 months post- PAE. Results: Between January 2018 and June 2020, six males with a mean age of 52.3 years (44-66 y) received PAE for BPH therapy. An immediate postoperative PGN was recognised in 4 out of 6 patients with the mean penile glans pain score of 3 and 4 patients reported altered penile glans sensitivity. Comparing the mean (and median) IPSS and IIEF-5 scores were 16.5 (16) and 21.3 (21) pre-PAE, there was improvements in IPSS and IIEF-5 scores at 12.0 (12) and 18.0 (18) at 12 months review. All patients reported normal penile glans sensitivity and only 1 patient reported an on-going penile glans pain (score 2). Four patients received HBOT while 2 patients elected for conservative care. All patients reported worse erectile function scores despite complete resolution of PGN. Conclusions: PGN is a rare but serious complication of PAE with ensuing erectile dysfunction. HBOT appears to expedite the recovery process in men with PGN related to PAE with better erection scores compared to conservative measure.

Original languageEnglish
Article numberA1
Pages (from-to)396-402
Number of pages7
JournalWorld Journal of Men's Health
Volume41
Issue number2
Early online date20 May 2022
DOIs
Publication statusPublished - Apr 2023

Bibliographical note

Copyright Korean Society for Sexual Medicine and Andrology 2023. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

  • Benign prostatic hyperplasia
  • Endovascular procedures
  • Erectile dysfunction
  • Necrosis
  • Penile diseases

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