Rare isolated anterior urethral ischemic necrosis following prolonged local cryotherapy in scrotal infection: A case report

We report a unique case of isolated anterior urethral ischemic necrosis in a 71-year-old man after prolonged local cryotherapy for orchitis. Persistent orchitis unresponsive to antibiotics led to repeated ice-pack application. Surgical exploration revealed edematous but viable scrotal and testicular tissues; unexpectedly, the anterior urethra was completely necrotic. Anterior urethrectomy with perineal urethrostomy and suprapubic diversion was performed. Histopathology confirmed ischemic necrosis with surrounding abscess. Initial recovery was favourable. The patient later died from postoperative peritonitis, unrelated to urological care. This case shows that anterior urethral necrosis can occur without classic risk factors and urethrectomy with perineal urethrostomy is effective.