Medicinal Leech Therapy for Glans Penis Congestion After Primary Bladder Exstrophy-Epispadias Repair in an Infant: A Case Report

Wagenheim, Gavin; Au, Jason; Gargollo, Patricio C.

doi:10.1016/j.urology.2015.09.010

Cited by 4 publications

(3 citation statements)

References 11 publications

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“…To reduce venous congestion in flap tissues, free and pediculed flaps (6,70,79,(85)(86)(87)(88)(89)(90)(91)(92)(93)(94)(95)(96)(97)(98)(99)(100)(101).…”

Section: Following Reconstructive Surgeriesmentioning

confidence: 99%

What Is Need To Be Known About Medicinal Leeches And Hirudotherapy?: A Comprehensive Review

BECANIM,

BERKTAŞ,

CEYLAN

2022

Journal of Anatol Medicine

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Since ancient times humans have used a variety of plants and animals to both prevent and treat ailments. Hirudotherapy is a traditional treatment modality using medicinal leeches. In both traditional and modern medicine, medicinal leeches have been important in the treatment of eczema, chronic ulcers, psoriasis, osteoarthritis, thrombosis, and hypertension. Hirudotherapy is a trustworthy, easy-to-use, helpful, and affordable treatment option for draining blood from deeper tissues in localized venous congestion related with surgical replantations and flap reconstructions. Hirudotherapy has also been commonly used to treat soft tissue oedema and haematomas in trauma situations. Throughout the feeding process, leeches secrete biologically and pharmacologically active components into the wound. This article aims to present a broad assessment of the potential use of hirudotherapy, indications, contraindications, and therapy-related complications. Providing detailed evidence-based information about the usage areas of hirudotherapy will help spread healthy medicinal leech practices and prevent possible complications, thus infectious diseases and public health problems.

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“…To reduce venous congestion in flap tissues, free and pediculed flaps (6,70,79,(85)(86)(87)(88)(89)(90)(91)(92)(93)(94)(95)(96)(97)(98)(99)(100)(101).…”

Section: Following Reconstructive Surgeriesmentioning

confidence: 99%

What Is Need To Be Known About Medicinal Leeches And Hirudotherapy?: A Comprehensive Review

BECANIM,

BERKTAŞ,

CEYLAN

2022

Journal of Anatol Medicine

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“…Medicinal leeches have been used for several purposes in previous studies, including improvement of venous congestion in rat epigastric flaps [ 20 ], glans penis congestion [ 21 ], replanted or revascularized digits [ 22 ], and various local flaps [ 23 ]. Moreover, leech therapy was employed in literature for plastic and reconstructive surgery, musculoskeletal diseases, migraine headaches, skin disorders, diabetic ulcers, priapism, cancer, wound healing, and osteoarthritis [ 24 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

Leech therapy (Hirudo medicinalis) attenuates testicular damages induced by testicular ischemia/reperfusion in an animal model

et al. 2021

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Background Testicular torsion/detorsion triggers tissue ischemia/reperfusion, leading to reactive oxygen species overgeneration and apoptosis. The saliva of leeches is full of anti-inflammatory, anticoagulants, antioxidants, and antimicrobial agents. Therefore, this study aimed to assess the protective mechanism of leech therapy on testicular ischemia/reperfusion damage. Methods 18 adult male rats were randomly divided into three groups: 1-Sham-operated group (SO). 2-Torsion/detorsion (T.D) group: two hours of testicular torsion with two hours of testicular detorsion was performed. 3-Torsion/detorsion + Leech therapy (TDL) group. Sperm parameters (motility, vitality, morphology, and concentration), oxidative stress biomarkers (MDA, CAT, GPx, and TAC), histopathological factors (Mean seminiferous tubular diameter, Germinal epithelial cell thickness, Testicular capsule thickness, Johnson’s score, and Cosentino’s score), and immunohistochemical markers for apoptosis detection (Bax, Bcl-2, and Caspase-3) were measured. Results There was a significant difference for all sperm parameters in the T. D group compared to the sham group. Leech therapy significantly increased progressive motility and normal morphology and reduced non-progressive motility. In the TDL group, MDA concentration significantly reduced, and levels of GPx, TAC, and CAT remarkably increased. All evaluated histopathological parameters in the TDL group significantly increased compared to the T. D group except for the testicular capsule thickness. T. D notably increased the expression of Bax and Caspase-3, while the treatment group slowed the rate of apoptosis compared to the control group. Bcl-2 expression in the T. D group was significantly lower than that in the sham group. Leech therapy increased the Bcl-2 expression. Conclusion Leech therapy attenuates damages to testicular tissue following torsion/detorsion due to its antioxidant, anti-inflammatory, and anti-apoptotic effects. Hence, it can be considered as an effective remedy for testicular ischemia/reperfusion. Graphical abstract

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“…Taking advantage of its enzymatic secretions, “hirudotherapy,” as it is known, has been trialed for use in gout, exorcism, hearing loss, bloodletting, inflammatory disease, tuberculosis, epilepsy, hysteria, sexually transmitted infection, and most prominently surgical salvage of venous engorged tissue 1 . More recently reported applications include arthritides, 2 hemorrhoids, 3 glans congestion following urologic repair, 4 diabetic foot ulcers, 5,6 microcirculatory‐free tissue failure 7 and other applications. After falling out of favor in the 18th century, there is clearly renewed interest in the modern era, with a significant uptrend in hirudotherapy publications since 2009 that includes 951 citations as of 2015 by scientometric analysis 8 .…”

Section: Introductionmentioning

confidence: 99%

Hirudotherapy for neonatal limb ischemia during ECMO support: A word of caution

Resch

Said

Steiner

et al. 2021

Journal of Cardiac Surgery

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Introduction: Disordered coagulation, clot formation and distal limb ischemia are complications of extracorporeal membrane oxygenation (ECMO) with significant morbidity and mortality. Medicinal leech therapy (hirudotherapy) has been attempted in plastic and orthopedic surgeries to improve venous congestion and salvage ischemic flaps. To our knowledge this has not been reported in pediatric cardiac surgery or during ECMO support. We present a complex neonate whose ECMO course was complicated by distal limb ischemia for whom leech therapy was attempted.Patient and Intervention: A 2-week-old 2.7 kg infant required ECMO support secondary to perioperative multiorgan system dysfunction following repair of critical coarctation and ventricular septal defect. Despite systemic anticoagulation, his clinical course was complicated by arterial thrombus, vasopressor-induced vascular spasm and bilateral distal limb ischemia. Medicinal leech therapy was tried after initially failing conventional measures.Result: Following the third leech application, this patient developed significant hemorrhage from the web space adjacent to the left great toe. An estimated 450 ml of blood loss occurred and more than 300 ml of blood product transfusions were required. He ultimately progressed to irreversible systemic end organ dysfunction and comfort care was provided. Conclusion:The use of medicinal leech therapy in pediatric cardiac surgery may be considered to minimize the consequences of advanced limb ischemia and venous congestion. However, this should be used with caution while patients are systemically anticoagulated during ECMO support. A directed review is presented here to assist in determining optimal application and potential course of therapy.

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Medicinal Leech Therapy for Glans Penis Congestion After Primary Bladder Exstrophy-Epispadias Repair in an Infant: A Case Report

Cited by 4 publications

References 11 publications

What Is Need To Be Known About Medicinal Leeches And Hirudotherapy?: A Comprehensive Review

What Is Need To Be Known About Medicinal Leeches And Hirudotherapy?: A Comprehensive Review

Leech therapy (Hirudo medicinalis) attenuates testicular damages induced by testicular ischemia/reperfusion in an animal model

Hirudotherapy for neonatal limb ischemia during ECMO support: A word of caution

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