Penile necrosis may follow an aortic dissection. Viable tissue may remain so debridement may be superior than amputation.
The penis receives it blood from the internal pudendal artery that arises from the internal iliac arteries bilaterally. Normally the penis has a good collateral circulation.
Pathophysiology: ischemic necrosis occurs when there is complete obstruction of the aorta distal to the tear. Arterial emboli can also occur.
If the patient has necrosis of the penis, then ischemia of the testes, scrotum, other organs and the lower extremities is common.
The presence of extensive atherosclerotic disease increases the risk of gangrene.
Complications:
(1) complete penile gangrene
(2) infection with risk of sepsis
(3) erectile dysfunction
(4) multi-organ failure
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