Postcircumcisional Ischemia of the Glans Penis Treated with Pentoxifylline

Abstract

Ischemia of the glans penis is a rare postcircumcision complication. We describe a four-year-old boy developing ischemia of the glans penis 48 h after circumcision. The ischemia completely resolved following treatment with iv pentoxifylline (PTX) for six days, and the patient was discharged without any problems. PTX treatment should be kept in mind as an alternative treatment modality in ischemia of the glans penis which is a serious potential post-circumcision complication.

Glans Ischemia after Circumcision in a 16-Year-Old Boy: Full Recovery after Angiography with Local Spasmolysis, Systemic Vasodilatation, and Anticoagulation

“…4 6 However, indication and dosage of PTX in children remain controversial. 3 4 6 8 11 Hence, in our patient we used the selective phosphodiesterase inhibitor (PDE 5) sildenafil as a vasodilative agent with success and did not appreciate side effects.…”

“…Several therapeutic approaches have been described including pentoxifylline, hyperbaric therapy, iloprost, enoxaparin, anticoagulation, local testosterone, and peridural anesthesia. 2 3 4 5 6 7 8 …”

“… 1 In contrast, ischemia or even necrosis of the glans is a rare complication; in the past 15 years, nine pediatric cases have been reported in the literature. 2 3 4 5 6 7 8 We report the case of a boy with ischemia of the glans penis after circumcision at an outside hospital.…”

Ischemia of the glans penis following circumcision: case report and revision of the literature

“…Ischemia of the glans penis is a rare condition; the most frequent causes are circumcision, trauma, penile strangulation, and application of vasoconstrictive agents (1)(2)(3)(4)(5)(6). Additionally, there are several pathologies which cause glanular ischemia or necrosis in adults, including diabetes mellitus (7), acute arterial occlusion, foreign bodies, Fournier' s gangrene, spider bite (8) and topical treatment with 1% gentian violet (9).…”

“…Ischemic complications of the glans penis are rare and commonly result from trauma, inadvertent administration of vasoconstrictive solutions, diabetes mellitus, circumcision and vasculitis (1)(2)(3)(4)(5)(6). We refer about a young man with severe ischemia of the glans penis following circumcision.…”