Glans Ischemia Treatment with Pentoxifylline Following Circumcision in a Neonate

Abstract

Introduction: Circumcision is the most common surgery in male infants in Islamic countries. Therefore, knowledge of its side effects and appropriate therapies is essential. Case Presentation: In this case report, we describe a 12-day neonate with glans ischemia, two days after circumcision. We admitted the neonate and treated him with oral pentoxifylline and antibiotic for three days. Conclusions: Thus, pentoxifylline can be implemented as a treatment in post-circumcision ischemia of the glans penis in neonates.

Management of penile post-circumcision ischemia by pentoxifylline infusion and hyperbaric oxygen therapy

“…The low incidence of glans ischemia (4.4%) with plastibell technique is not significant because this technique is not so popular in our locality (10% of the cases). It is proved that the malpractice associated with the use of plastibell rings leads to glans ischemia [ 2 ]. The improper use of local anesthesia that contains vasoconstrictors is a major cause of penile ischemia [ 3 ].…”

“…Vascular obstruction may occur secondary to the mass effect of the anesthetic solution or hematoma at the site of injection [ 15 ]. Any evidence of a possible vascular trauma at the time of the nerve block, dark coloration of the glans penis, or if the child had pain whose severity is disproportionate to physical findings; should draw attention to penile necrosis and mandate deferring the circumcision and close monitoring of penile perfusions [ 2 & 15 ].…”

“…The prevalence of MC in Egypt is approximately 94.7% [ 1 ]. The incidence of MC-related complications is variable and reported in about 1.5–5% [ 2 ]. These complications have a negative impaction on the sexual life and overall quality of life of the patients concerned, in addition to the besmirch that will follow the physicians responsible for these complications.…”

Management of Penile Post-circumcision Ischemia by Pentoxifylline Infusion and Hyperbaric Oxygen Therapy

“…It is proved that the malpractice associated with the use of plastibell rings leads to glans ischemia. 2 The improper use of local anesthesia that contains vasoconstrictors is a major cause of penile ischemia. 3 The etiology of this vascular insult may be vascular spasm at the glans, which is secondary to aggressive surgical manipulations.…”

“…1 The incidence of MC-related complications is variable and reported in around 1.5-5%. 2 These complications have a negative impact on the sexual life and overall quality of life of the patients concerned, in addition to the besmirch that will follow the physicians responsible for these complications. Early minor complications such as bleeding, inconvenient skin excision, and surgical area infection are common, while early severe complications include glandular amputation, urinary retention, urethral injuries, and penile necrosis.…”