Abstract
Penile necrosis secondary to calcification of medium- and small-caliber arteries supplying the organ is a rare and serious condition. It often occurs in patients with multiple comorbidities, carries a high mortality rate, and has a poor prognosis. We present two cases of male patients with multiple comorbidities who developed penile calciphylaxis. Both patients underwent various treatments, including total penectomy in one case and palliative management in the other. One patient declined surgery and was lost to follow-up, while the other required multiple surgical procedures due to infectious complications. A review of the literature suggests no clear survival benefit between surgical and conservative management. Therefore, surgical treatment should be reserved for cases with disabling pain or advanced infections at risk of severe complications.