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Penile strangulation, a study of two cases
Ganesh Bhakta Acharya1, Suman Baral2, Abishek Poudel3
1Department of Urology, Manipal College of Medical Sciences, Pokhara, Nepal.
Introduction:
Penile strangulation is one of the rarest clinical findings. So, we aimed to present the clinical case of two cases that we encountered at our institute.
Presentation Of Cases:
Case 1. A 26-year-male with bipolar disorder presented to emergency room with complaints of metallic ring entrapment in the penis for 4 days. A gold-plated metallic ring measuring 1 × 0.25 cm was found encircling the coronal sulcus along with foul-smelling pus and slough underneath as a result of necrosis of the skin. Jumbo cutter was used to cut the ring. Loose sutures were applied to the injured part with debridement.
Case 2:
A 66-year-old man presented to emergency with complaints of penile swelling and poor urinary stream for the last 2 days. Local examination showed a plastic ring of water bottle seen stuck at the root of penis. Distal penis was edematous with multiple areas of skin discoloration and petechia. The ring was cut with simple surgical scissor.
Discussion:
This clinically emergency condition may lead to wide range of vascular and mechanical injuries if the treatment is delayed. Plastic rings can be easily cut out whilst metallic objects which are thick and hard are difficult to remove. Pliers' application or use of jumbo cutter as in one of our cases is beneficial for prompt release of edematous pressure and salvage of the penis.
Conclusion:
Penile strangulation due to foreign body is a rare clinically emergency condition. Urgent intervention is necessary to remove the object causing constriction along the penis.
Insights
Penile strangulation from foreign objects is rare but requires urgent removal to prevent severe injury. Prompt intervention, like cutting rings, can salvage the penis.
Area of Science:
- Urology
- Emergency Medicine
- Trauma Surgery
Background:
- Penile strangulation by foreign bodies is an exceptionally rare clinical emergency.
- Delayed treatment can result in significant vascular and mechanical penile injuries.
Purpose of the Study:
- To present two clinical cases of penile strangulation encountered at our institute.
- To highlight the importance of urgent intervention in managing penile strangulation.
Main Methods:
- Case 1: A 26-year-old male with a metallic ring entrapped for 4 days, requiring a jumbo cutter for removal.
- Case 2: A 66-year-old male with a plastic bottle ring at the penile root, removed with surgical scissors.
- Both cases involved debridement and wound management post-removal.
Main Results:
- Successful removal of constricting foreign bodies in both cases.
- Management involved prompt surgical intervention to relieve pressure and prevent further damage.
- Case 1 presented with necrosis requiring debridement; Case 2 showed edema and discoloration.
Conclusions:
- Urgent removal of constricting foreign bodies is critical to prevent penile compromise.
- Plastic rings are easier to remove than thick metallic objects.
- Surgical tools like jumbo cutters are effective for prompt release and penile salvage.
