Ischemia of the glans penis following circumcision: case report and revision of the literature

Abstract

Ischemic complications of the glans penis are rare and commonly result from trauma, inadvertent administration of vasoconstrictive solutions, diabetes mellitus, circumcision and vasculitis; we refer about a young man with severe ischemia of the glans penis following circumcision. The patient had undergone circumcision 5 days before in a surgery department under local anesthesia (1% mepivacaine hydrochloride). The patient noticed a brownish color and edema of the glans penis at 24 h after he opened the wound dressing, but arrived to our hospital only 5 days after circumcision because these findings had progressed. Physical examination revealed the black color or necrotic appearance of the glans penis, and edema on the dorsal penile skin. The patient underwent antibiotic, antiplatatelet, corticosteroid and iperbaric therapy achieving a complete restitutio ad integrum.

Delayed gangrene and amputation of penile glans after a religious circumcision in male child – A case report

“…Surgical complications of circumcision include haemorrhage, haematoma formation, sepsis, penile glandular injury, meatal stenosis, phimosis, paraphimosis, urethral injury and fistula, glandular necrosis and amputation. 2–4 Unsatisfactory cosmetic results, including buried penis, are legion.…”

Ischemia of the glans 24 hours after circumcision: A case report and therapeutic solution

“…8 Other treatment options included intravenous infusion of PGI 2 analog or intracavernous injection of glycerol trinitrate associated to epidural bupivacaine. 4 Hyperbaric therapy has been chosen as an alternative treatment alone 9 or in a combination setting of hyperbaric therapy at 2.5 atmospheres, 4 h daily for 7 days and pentoxifylline infused in saline solution for 7 days and orally for other 10 days; this treatment was chosen after observing a case of glans ischemia partially responsive to an initial treatment with intracavernous PGI 2 . 5 Typically, the pharmacological medical treatments are effective, although complicated, expensive, and in many cases taking a long time to complete recovery of the patient.…”

Acute Ischemia of the Glans Penis after Circumcision Treated with Hyperbaric Therapy and Pentoxifylline: Case Report and Revision of the Literature

“…In a case report, Burke et al [11] described ischemia of the glans penis occurring 40 min after DPNB with 0.75% ropivacaine treated with intravenous infusion of vasodilator iloprost (a prostaglandin I2 analogous). Pepe et al [12] treated one guy with antiplatelet, a corticosteroid in combination with HBOT. Enoxaparin was revealed to be efficient after 5 days of treatment for a postcircumcision glans ischemia [13].…”