Penile Gangrene due to Strangulation by a Metallic Nut: A Case Report

Abstract

BACKGROUND: Penile entrapment and subsequent strangulation is a serious injury that requires a prompt treatment to avoid gangrene. OBJECTIVE: We report our experience dealing with a case of penile gangrene following strangulation by a metallic nut in a middle aged Nigerian. METHODS: We summarise the case history, physical findings, investigations and operative treatment of a middle aged man who slipped a round metallic nut over his penis, entrapping it for five days causing strangulation and subsequent gangrene. The literature on penile entrapment, strangulation and gangrene is also reviewed. RESULTS: The patient presented with acute urinary retention and had complete gangrene of the penis. Suprapubic cystostomy was done and he had total penile amputation and perineal urethrostomy CONCLUSION: Entrapment of the penis leading to strangulation is a rare condition that needs urgent relief, otherwise penile gangrene sets in, the treatment of which has very serious consequences.

Neglected Penile Constricting Injury in a 9 Year Old Child; a Case Report and Challenges of Management

“…Penile constricting injury is a true urologic emergency as the intervention time to remove the constricting object determines if the penis could be salvaged [5]. This is especially where patient present early before the onset of ischaemia.…”

“…AL Bhat et al (1999) graded these injuries as follows [2,5]: Grade I Oedema of distal penis. No evidence of skin ulceration or urethral injury.…”

Successful removal of strangulating metal penile ring using a dental handpiece

“…Strangulation of the penis may be caused by materials such as thread, hair, a rubber band, wedding ring, engine bearing, hammerhead, bull ring, plastic bottle or metal plumbing cuff, with each requiring a different type of cutting device. Delay in relieving the penis of strangulation can result in various adverse effects ranging from simple oedema to bruises, abrasions, urethral injury, urethral stricture, urethral fistula, retention of urine, postobstructive diuresis, lymphoedema, gangrene of the penis and penile amputation,9 hence a swift yet safe method of relieving the strangulation is highly recommended. Penile rings are used for various reasons including erectile dysfunction or hyperfunction to prolong erection.…”

Strangulation of Penis by a Ball Bearing Device

“…Prompt careful removal of the constricting device is imperative to restore normal penile vascularity, micturition, and preservation of erectile function. If not relieved urgently, penile entrapment can lead to strangulation and culminate in penile necrosis necessitating total amputation of the penis with perineal urethrostomy [9].…”