A 33-year-old male receiving dorsal penile nerve block (DPNB) for circumcision exhibited a postoperative ischemic change over the glans penis. The event occurred nearly 24 hours after the procedure. The patient was treated with intravenous pentoxifyllin and hyperbaric oxygenation. Total reverse of the ischemia was observed. The complications associated with circumcision and DPNB were reviewed and discussed.
Adult ; Circumcision, Male ; adverse effects ; Humans ; Infection ; etiology ; pathology ; Ischemia ; etiology ; pathology ; Male ; Nerve Block ; adverse effects ; Penis ; blood supply ; pathology ; Pentoxifylline ; pharmacology ; Vasodilator Agents ; pharmacology

A case is presented of Wegener's granulomatosis limited to the testis and epididymis, simultaneously, in a 69-year-old man. Orchiectomy was carried out through an inguinal incision under the presumptive diagnosis of a right testicular tumor. A hard, irregular mass occupied the upper testicle and a portion of the epididymal head was visualized. Histopathologic examination of the specimen showed granulomatous inflammation of the testis and epididymis with prominent angiocentric granulomata in the walls of arteries, veins and foci of fibrinoid necrosis, surrounded by palisading inflammatory cells with a few giant cells. The diagnosis of limited Wegener's granulomatosis was considered, although antineutrophil cytoplasmic antibody (c-ANCA) test was negative 2 weeks after orchiectomy. The patient showed an excellent response after local complete excision. He remains free of disease 18 months after orchiectomy.
Aged ; Antibodies, Antineutrophil Cytoplasmic ; analysis ; Epididymis ; Genital Diseases, Male ; pathology ; surgery ; Granulomatosis with Polyangiitis ; pathology ; surgery ; Humans ; Male ; Orchiectomy ; Testicular Diseases ; pathology ; surgery