An unusual (and somewhat piercing) cause of paraphimosis

Adenovirus-associated paraphimosis

We present the first reported case of paraphimosis associated with concurrent adenoviral urethritis and conjunctivitis in a heterosexual man. This case reinforces the need to consider adenovirus in the differential diagnosis of non-gonococcal urethritis and describes a potentially serious complication.

Emergency Management of Paraphimosis

Objective

To review the treatment modalities available for paraphimosis, with special emphasis on those applicable to the emergency department.

Data source

Relevant medical literature was searched through MEDLINE, EMBASE, CINAHL, and Cochrane Database. Manual search was performed in books on Urology, General Surgery and Emergency Medicine available in the Hospital Library. Further information was obtained through the Internet at < www.infoseek.com >. References cited in articles were also retrieved.

Study selection

Key words for the literature, Internet and textbook search were ‘paraphimosis’ and ‘treatment’. All available years of study were reviewed.

Data extraction

Relevant full text articles were obtained through the hospital library network. Original articles, review papers, medical practice, case reports, and relevant book chapters were reviewed.

Data synthesis

There were no prospective, randomised, controlled studies available. The majority were case series and expert experience or opinions only. Currently, a multitude of non-invasive and invasive treatment options are available, including manual reduction, help of non-crushing tissue forceps, puncture technique and dorsal slit.

Conclusion

All treatment methods are within the capability of the emergency physician. Hospitalization should rarely be required, unless there are serious complications.

Adolescent and Young Adult Tattooing, Piercing, and Scarification

Tattoos, piercing, and scarification are now commonplace among adolescents and young adults. This first clinical report from the American Academy of Pediatrics on voluntary body modification will review the methods used to perform the modifications. Complications resulting from body modification methods, although not common, are discussed to provide the pediatrician with management information. Body modification will be contrasted with nonsuicidal self-injury. When available, information also is presented on societal perceptions of body modification.

Penile emergencies

The penis is a very sensitive organ and even minor injury or discomfort may cause a patient to seek emergency evaluation. Emergency practitioners must be most concerned with the entities that, if left untreated, can result in ischemia and necrosis of the penis, namely ischemic priapism, paraphimosis, and entrapment injury. Any penile trauma should be considered an emergency until proven otherwise. This article discusses emergent penile complaints in adults, with emphasis on the most serious and common conditions.

[Genital piercings: epidemiology, sociocultural aspects, sexuality and complications]

Body piercing has gained tremendous popularity since the mid nineties. Genital piercings constitute a peculiar variant of piercing due to its sensitive localization. Health care providers are often very little informed about those piercings. Besides, negative stereotypes are often attributed to the bearers of such piercings. This review focuses not only on the medical aspects of genital piercings but also on the social, cultural and psychological background that surround those piercings.

Body-modifying concepts and dermatologic problems: tattooing and piercing

Recently, piercing and tattooing have gained increasing popularity worldwide, through all social classes and age groups. Besides pierced ear lobes, piercing of the tongue, nose, nipples, belly button, and even the genitals is quite common. The variety of tattoos range from temporary henna tattoos to permanent makeup and permanent tattoos, where the pigments are deposed in the dermis. These trends are supplemented by more invasive methods of body modification such as implanting, scarification, or branding. Parallel with the increasing popularity of piercing and tattoos, the knowledge about associated complications rose. Complications depend substantially on the circumstances in which body modifications are applied, the materials used, and the body region concerned. This article gives an overview of the most common complications of body modification methods, which mainly result from shortcomings in the application itself or in hygiene regimens. Consequences may be as severe as life-threatening events or permanent malfunction of different organs.

Adverse consequences of tattoos and body piercings

Body piercings and tattoos are becoming more common in the adolescent population today. Despite their movement into mainstream society, literature to aid in counseling of teens about these issues is scant. The practitioner dealing with this population of patients must be armed with the information necessary that will help adolescents make informed decisions about tattoos and piercings.

Treatment options for paraphimosis

Paraphimosis is a frequently presented complaint in the emergency department. This review outlines the treatment options available for resolving this condition: manual reduction methods, osmotic methods, puncture and aspiration methods and treatments using sharp incision. The technique of penile block local anaesthesia is described. A technique sequence for treatment is suggested.

The Case of the Missing “Prince Albert”

BACKGROUND

Body piercing is increasing and so are its complications. We describe a case in which the female partner of an individual who had penile piercing was affected.

CASE

A young female presented to the emergency department with the possibility of a lost/missing foreign body in the vagina. Her partner had had a "Prince Albert" type of penile piercing, which was found to be missing after sexual intercourse. Prince Albert penile piercing is a metallic bead, which is anchored to the urethral opening. On clinical examination, the bead was not found in the vagina but was seen on pelvic X-ray. A thorough sexual history resolved the mystery of the missing Prince Albert.

CONCLUSION

Our case suggests that the gynecologist should be aware of the practice of genital piercing and stresses the importance of proper sexual history taking.

Self-reported characteristics of women and men with intimate body piercings

AIM

The purpose of this paper is to report the findings of a study exploring factors associated with female and male intimate body piercing, with particular emphasis on health issues.

BACKGROUND

Nipple and genital piercings (intimate piercings) have become common types of body art. Scant medical and nursing literature is available, leading to little understanding of these body modifications by health care providers.

METHOD

A convenience sample of intimately pierced individuals (63 women and 83 men) from 29 states in the United States of America was surveyed via an author-developed questionnaire. Questions focused on demographic characteristics, decision factors and health problems related to intimate piercings. Self-reported characteristics were compared between female and male participants, and participants were compared demographically to United States general population.

RESULTS

Participants reported wearing nipple piercings (43%), genital piercings (25%) and both types (32%). Respondents were significantly younger, less ethnically diverse, better educated, less likely to be married, more often homosexual or bisexual and they initiated sexual activity at a younger age than the US population. Deliberate, individual decisions for procurement of the intimate piercings were made. Average purchase consideration was at age 25 (nipple) and 27 (genital); average age to obtain the piercing was 27 (nipple) and 28 (genital) years. Purposes for obtaining the piercings included uniqueness, self-expression and sexual expression. Most participants still liked their piercing (73-90%). Health concerns related to intimate piercings were described by both those with nipple piercings (66%) and with genital piercings (52%) and included site sensitivity, skin irritation, infection and change in urinary flow (male genital). Few STDs (3%) were reported and no HIV or hepatitis. Usually non-medical advice was sought for problems -- often from the body piercer.

CONCLUSIONS

Understanding client rationale is not a necessary prerequisite for providing quality patient care; however, awareness of purposes and decision-making in intimate piercing can help nurses to be sensitive to client needs and plan appropriate health education.

An unusual complication of penile piercing: a report and literature review

Body piercing has been practiced for many centuries and is thought to have its origins in the Hindu religion. As traditional ear piercings have given way to more adventurous anatomical sites, so too have the associated complications of these practices. We present the case of a 35 year old man who presented 12 months after a penile piercing with an extensive fistula of the glans penis resembling an acquired glanular hypospadius.

Jewelry-induced diseases of the head and neck

The desire to modify a person's outer appearance is a phenomenon that can be traced back to the beginning of humankind. Body modifications have been practiced among all cultures around the globe to differing extents. The authors present medical complications through jewelry in a series of 35 consecutive patients. Patient charts were evaluated for age, gender, type and sequelae of injury, complications, and treatment results. The male-to-female ratio was 1:2.2. Most of the recorded complications were related to the new vogue of piercing, with the ear affected most commonly. Usually the complications were minor; however, 2 patients sustained disfiguring damage to their auricular cartilage as a result of high ear piercing, a child nearly asphyxiated on an aspirated earring, and 2 patients experienced severe dysphagia as a result of tongue piercing. The most severe complication was a lethal strangulation injury in a female patient whose necklace got trapped in the headrest of her car seat during a front-end collision.

Case report. Paraphimosis due to erotic dancing

Paraphimosis usually develops when a tight foreskin is retracted over the glans penis for a prolonged period. Many esoteric aetiologies have been implicated in the development of paraphimosis including piercing the foreskin, Plasmodium falciparum infection, application of celadine juice to the foreskin, chancroid, pessaries and the implantation of pearls. We report the first two cases of paraphimosis developing during wining, an erotic dance native to Trinidad & Tobago.

Body piercing: what nurse practitioners need to know

Body piercing is a growing trend among today's youth. Chances are, nurse practitioners will be in contact with someone who has a body piercing and/or complication relating to piercing. This article includes the history of body piercing, the environment of piercing parlors, the methods commonly used, site-specific explanations of select piercings, complications, treatment and practice implications. Nurse practitioners need to establish collaborative working relationships with their clients as well as those who do the piercings.

Body piercing medical concerns with cutting-edge fashion

OBJECTIVE

To review the current information on medical complications, psychological implications, and legislative issues related to body piercing, a largely unregulated industry in the United States.

METHODS

We conducted a MEDLINE search of English language articles from 1966 until May 1998 using the search terms "body piercing" and "ear piercing." Bibliographies of these references were reviewed for additional citations. We also conducted an Internet search for "body piercing" on the World Wide Web.

MAIN RESULTS

In this manuscript, we review the available body piercing literature. We conclude that body piercing is an increasingly common practice in the United States, that this practice carries substantial risk of morbidity, and that most body piercing in the United States is being performed by unlicensed, unregulated individuals. Primary care physicians are seeing growing numbers of patients with body pierces. Practitioners must be able to recognize, treat, and counsel patients on body piercing complications and be alert to associated psychological conditions in patients who undergo body piercing.