Penile constriction injury: An experience of four cases

Abstract

Penile injury due to constriction by a foreign object is a rare known complication, commonly seen in pediatric age group. We report four cases of penile constriction injury in adults due to various foreign objects and different indications. Between October 2014 and March 2016, four patients (mean age 42.5 years) presented with penile constriction injury with duration at presentation ranging from 18 h to 2 months. One patient had complete transection of the corpus and penile urethra. Three patients were managed successfully with daily dressings followed by split-skin grafting in one patient. One patient required delayed primary suturing after the resolution of local edema. The outcome was satisfactory in all patients with retained erectile function. Early medical attention and management is the key to success in penile constriction injury cases and to avoid complications and morbidity. Prompt removal can be challenging in cases of metal foreign bodies.

Austere Foreign Body Injuries in Children and Adolescents

“…This likely reflects the indication for more specialized urologic interventions such as visual internal urethrotomy or repair of strictures. 17 Our study also identified that RFBs (n = 88, 24%) required escalation of care more frequently than either PFB (n = 24, 12%) or VFB (n = 30, 11%). When considering care escalation, the most frequently identified RFB object was massage devices, vibrators, and back scratchers (product code 1610) (n = 35, 40%).…”

“…6,9,16 Penile FBs can cause an erosion-constriction injury, which can lead to gangrene and amputation. 17 Given these subtle presentations and risk for complications, AFBs warrant urgent evaluation and management.…”

The GEM ring cutter: An effective, simple treatment of penile strangulation caused by metal rings

“…A literature review revealed reported cases of penile strangulation from rubber bands, metal rings and drinking water plastic bottle neck. 2 Depending on the material of the constricting agent, management can be challenging. Methods that have been described include string techniques, 3 orthopaedic pin cutter 4 and dental drills.…”

Surgical reconstruction and follow-up of penile strangulation injury

“…Immediate penile extrication from the constricting mechanism is critical and time sensitive in the management of penile strangulation injury. 1 , 2 , 3 , 4 , 5 Temporary urinary diversion with suprapubic tube may be necessary. Reconstructive surgery can be successful in select cases, with outcomes ranging from complete recovery to total amputation.…”

“… 1 Previously reported mechanisms include metallic rings, washers, rubber bands, and hair tourniquets. 2 , 3 , 4 These injuries classically lead to progressive edema, ischemia, and tissue necrosis and must be recognized and treated immediately in order to avoid irreversible tissue loss. The current body of literature often documents a detailed mechanism of injury in such cases; however, the progression of the injuries beyond initial presentation to include management and results in longitudinal follow-up are rarely captured.…”