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Penile Strangulation by Four Stainless Steel Rings Requiring Multiple Approaches for Removal: A Case Report
Yoshifumi Miyauchi1, Toru Sugihara1, Daichi Hirata1
1Department of Urology Jichi Medical University Shimotsuke Japan.
Introduction:
Penile strangulation is a rare urological emergency requiring prompt intervention. Stainless steel rings may resist conventional cutters because of their rigidity.
Case Presentation:
A 62-year-old man presented with severe penile pain after applying four stainless steel rings to treat phimosis. One ring was trapped at the coronal sulcus and three at the penile base. The glans was congested with partial blistering. Initial attempts using the string method and manual ring cutters failed. Aspiration of approximately 10 mL of blood from the glans allowed removal of the distal ring. The remaining rings required general anesthesia, corporal blood aspiration, temporary penile-base compression, partial cutting of one ring, and manual decompression. All rings were removed within approximately 6 h after application. No clinical evidence of urethral injury was found, and no sensory disturbance was noted.
Conclusion:
A stepwise approach may be required for penile strangulation caused by multiple stainless steel rings.
