Successful Release of Penile Strangulation Caused by Rigid Constriction Device Using a Modified String Method: A Case...

Penile strangulation is a rare urological emergency that may lead to ischemia or gangrene if not promptly treated. We report a case of a 52-year-old man with schizophrenia who presented 36 h after placing a metallic ring at the base of his penis for sexual stimulation. Physical examination revealed marked distal penile edema without evidence of necrosis. Initial attempts at manual removal were unsuccessful due to severe swelling. The device was subsequently removed safely using a modified string method combined with needle puncture for decompression. This approach enabled reduction in penile volume and facilitated successful removal without complications or the need for surgical intervention. The modified string method represents a minimally invasive, effective, and safe technique for the management of rigid constriction devices, particularly in cases of low-grade penile strangulation.