Extensive corporal necrosis in penile ischemic gangrene: a case report of total penectomy in an octogenarian

Penile gangrene is a rare but severe clinical emergency, typically linked to advanced diabetes or chronic renal failure. We report the case of an 85-year-old male with a severe cerebrovascular history who presented with apparently localized glans gangrene. Although a standard partial penectomy was initially planned, intraoperative exploration revealed extensive deep corporal necrosis, ultimately necessitating an immediate conversion to a total penectomy. This case strongly highlights that surface clinical signs frequently underestimate deep tissue damage. Therefore, advanced preoperative imaging, particularly MRI, is crucial, and informed consent must explicitly include the potential need for total penectomy during unexpected surgical findings.