Penile strangulation by different objects and its removal by the modified string method: Management of four cases with review of literature

Abstract

Penile strangulation is a challenging clinical situation and usually requires prompt treatment. Penile strangulation by a nonmetallic or thin metallic ring is easily overcome by severing/cutting the object; however, a heavy and long metal ring causing penile strangulation is not only difficult to sever but also it may worsen the scenario if removal is tried with inappropriate method. Here, we report four cases of penile strangulation by different objects which were successfully removed by aspiration and string method. We found that instead of using heavy cutting instruments and other surgical methods, string and aspiration technique is much better.

Penile necrosis induced by rubber bands – Case report

“…The ischemic damage from strangulation compounded with poor blood flow to the ischemic tissue from the underlying diabetic vascular disease can lead to a progression to a necrotic or gangrenous state. 1 , 5 In this case, the best management is early surgical intervention and debridement which can slow the progression of disease and reduce morbidity as reported in a series of case reports. 5 …”

“…Whether it be from Penile Hair Tourniquet Syndrome in young children, sexual and erotic acts in adolescents and adults, or even due to underlying psychiatric disorders, severe injury is often expected but avoidable with appropriate recognition and treatment. 1 , 2 , 3 …”

“…In many cases, the initial grade of injury at presentation of the patient after removal of the constricting device can be helpful to identify likely complications and future treatment plans. 1 However, a thorough evaluation of a patient's medical history and other comorbid conditions can help identify low-grade injuries that are more likely to progress to a state in which surgical intervention may be required. The patient in our case presented with DKA and a likely history of uncontrolled diabetes.…”

“…Gangrenous necrosis presents as a common complication and ischemic injury can lead to permanent injury requiring significant wound debridement, skin grafting, and even penile amputation. 1 Herein, we report a case of penile strangulation using rubber bands and the resulting injury and treatment complicated by DKA.…”

“…The first case of this condition was identified in the literature in 1755, and numerous accounts of different objects used as PCDs and mechanisms of injury have been reported since. 1 Penile strangulation can occur pathologically as is common in children and infants from accidental strangulation from hair. In adults, PCDs in the literature comprise numerous objects such as rings, metal tubing, ball bearings, bottles, rubber bands and more.…”