Operative management of penile strangulation caused by a rigid metallic ring: a case report

Penile strangulation is a time-critical emergency in which delayed intervention risks vascular compromise and tissue injury. Management is heterogenous, varying with device characteristics, duration of incarceration, and severity of effects. We report a man in his seventies with penile strangulation caused by a metallic ring at the distal shaft, immediately proximal to the glans. Bedside removal (lubrication, topical 50% dextrose gel, and standard ring-cutter use) were unsuccessful owing to device rigidity. Given persistent entrapment, urinary difficulty, and evolving ischaemic changes, urgent operative removal was performed under general anaesthesia. Intraoperative findings included marked distal oedema, glans congestion, and early ischaemic changes, with resolution after division and removal. This case highlights the limitations of bedside intervention with rigid devices and the value of timely operative escalation. As a single case, these observations are intended to raise clinical awareness rather than establish generalizable escalation criteria, which would require larger, systematic series.