Bullet in penis: uncommon site, unusual track and unexpected result

Kumar, Manjeet

doi:10.15406/unoaj.2020.08.00269

Cited by 2 publications

(4 citation statements)

References 9 publications

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“…Typically, gunshot wounds to the penis are through injuries, so having a retained bullet within the penis is a unique clinical scenario. During our review of the literature, we were able to find three other case reports similar to our patient in which the bullet was actually retained within the penis [ 5 - 7 ]. One of the cases involved an entry wound to the left buttocks with the bullet tracking to the penis but not exiting [ 5 ].…”

Section: Discussionmentioning

confidence: 53%

“…During our review of the literature, we were able to find three other case reports similar to our patient in which the bullet was actually retained within the penis [5][6][7]. One of the cases involved an entry wound to the left buttocks with the bullet tracking to the penis but not exiting [5]. Another case involved the bullet passing through another individual's abdomen and then lodging within the penis of the man standing behind him [6].…”

Section: Discussionmentioning

confidence: 70%

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Retained Bullet in the Penis

Eudy¹,

Nowak²

2021

Cureus

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Gunshot injuries to the genitourinary system are extremely rare among trauma cases and represent a complex clinical scenario to physicians. This rare case involves a 20-year-old male with a retained bullet in his penis following a close-range, low-velocity gunshot wound to the right lateral thigh. Our case report examines this unique clinical scenario and the diagnostic approach that should be taken to decrease the chances of negative cosmetic and functional outcomes.

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 70%

Retained Bullet in the Penis

Eudy¹,

Nowak²

2021

Cureus

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“…Only three other cases of retained bullets in the penis have been described in the literature. [3][4][5] In one of these cases, the bullet was superficial and was removed at the bedside without formal penile exploration. 3 The other two reports describe penile exploration with removal of the bullet and repair of the tunica albuginea.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5] In one of these cases, the bullet was superficial and was removed at the bedside without formal penile exploration. 3 The other two reports describe penile exploration with removal of the bullet and repair of the tunica albuginea. 4,5 Due to the rarity of the described injury, specific guidelines pertaining to diagnosis and management are lacking.…”

Section: Discussionmentioning

confidence: 99%

Case – Management of bullet retained in penile shaft after drive-by shooting

Levitt

Ying

Elzayat

2021

CUAJ

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scan was not performed. 5 Furthermore, early surgical exploration and reconstruction of the corpora cavernosa may prevent the development of undesired late complications, such as urethral stricture, penile deformity/curvature, and erectile dysfunction. 6,8,9 In our case, initial management by the trauma team included pelvic X-ray which revealed the presence of a retained bullet in the suprapubic region. A CT scan further localized it to the base of the penis, prompting surgical exploration, and revealed an additional bullet in the left thigh. Indeed, up to 90% of civilian gunshot injuries to the genitals have concomitant organ injuries, most commonly in the lower limb and scrotum. 1 Taken together, the importance of cross-sectional imaging in genital gunshot injury is paramount.The American Association for the Surgery of (AAST) injury severity score is useful for facilitating uniform treatment of traumatic injury to the genitalia. 10 Contusions and superficial lesions are classified as grade I and can be conservatively treated. Higher grades of injury include: grade II (Buck fascia lacerations without tissue loss), grade III (cutaneous avulsion or laceration through glands and meatus, or urethral or cavernosum lesions less than 2 cm in area), grade IV (partial penectomy or urethral or cavernosum lesions more than 2 cm in area), and grade V (total penectomy). The AAST states that injury grades II-V require surgical exploration, 10,11 however, some authors advocate for conservative management for both grade I and II injuries. 12 In our case, due to the suspicion of corporeal injury on imaging, we estimated the injury as an AAST grade III or IV. This injury severity was confirmed upon surgical exploration. ConclusionsPenile gunshot wounds are rare traumatic injuries. Rarer still are cases in which the bullet is retained in the penis. While specific guidelines for this scenario do not exist, we advocate for evaluation with detailed physical exam, cross-sectional imaging, and retrograde urethrogram or cystogram. Urgent penile exploration for removal of foreign body, debridement of devitalized tissue, and primary repair of corporeal defects is the preferred management strategy. The AAST injury severity score is another useful tool for guiding management.

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Bullet in penis: uncommon site, unusual track and unexpected result

Cited by 2 publications

References 9 publications

Retained Bullet in the Penis

Retained Bullet in the Penis

Case – Management of bullet retained in penile shaft after drive-by shooting

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