Penile Incarceration Secondary to a Ring

Abstract

Penile incarceration by foreign objects for sexual stimulation purposes is a situation described in universal literature, however it is a rare situation that the urologist must face in the emergency room. A 75-year-old male is presented to whom his sexual partner had placed a ring in the coronal sulcus.

Penile self-harm: a case report and concise clinical review

“…He denied substance abuse. Previously published reports associate constriction rings with erection enhancement, although this typically involves more proximal ring placement [7]. Given his unusual presentation gender dysmorphia was suspected, although he denied this on direct questioning.…”

“…Reported sequelae include necrotizing fasciitis, ischaemic gangrene, urethrocutaneous fistula, erectile dysfunction and depression. Morbidity increases proportionally with both the duration and degree of constriction [7,8]. In this case, thanks to the placement of the subpreputial rigid plastic ring, on to which the band had constricted only the prepuce, the glans penis was spared.…”

Penoscrotal Strangulation Caused by a Steel Ring: A Case Report

“…The ring hinders venous return and leads to swelling, followed by arterial and lymphatic blockage and ischemia distal to the ring 3, 4. The corpora spongiosum cannot accommodate the pressure and the corpora cavernosa, which is protected by the deep penile (Buck) fascia and tunica albuginea, is ultimately damaged 5 . Timely removal of the offending object is paramount for full recovery of circulatory and urinary functions and in most cases further management is unwarranted.…”

“…Timely removal of the offending object is paramount for full recovery of circulatory and urinary functions and in most cases further management is unwarranted. Delay in removal can lead to penile necrosis, urethrocutaneous fistula, and even septic shock and death 3, 4, 5, 6…”

“…The literature describes four approaches for removal of the object: string technique, aspiration, cutting, and surgery 2, 5, 9, 10. Special implements are often needed, which are not always available in the emergency and urology departments 1, 3, 4, 9, 10.…”