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Nguyen TT, Ngo XT, Chau QT, Hoang KC, Dinh LQV, Ly HT, Hoang TD, Dobbs RW, Thai MS. Use of dental drill handpiece to remove steel nut causing penile strangulation: a case report and review of the literature. J Med Case Rep 2022; 16:158. [PMID: 35440026 PMCID: PMC9020065 DOI: 10.1186/s13256-022-03342-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 02/21/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Penile strangulation is an uncommon urological emergency that requires prompt intervention to avoid potentially serious sequelae including loss of the distal penis secondary to ischemia and subsequent gangrene. We present a case report of a patient who presented to the hospital with penile strangulation injury of 10-hour duration secondary to the presence of a thick hexagonal steel nut. This case is presented in accordance with Consensus Surgical Case Report guidelines. CASE PRESENTATION A 24-year-old Vietnamese man presented to the emergency room with urinary retention and decreased penile sensation following a 10-hour history of penile strangulation due to the presence of a thick hexagonal steel nut that he had placed around the shaft of the penis for the purpose of sexual enhancement during masturbation. The hexagonal nut was tightly entrapping the penile shaft, resulting in edema, congestion, and swelling of the distal 5 cm of the phallus. Given the thickness of the foreign body as well as the degree of penile swelling, we were unable to remove the hexagonal nut using traditional methods of alleviating penile strangulation injuries. Following consultation with a dental colleague, a dental diamond drill handpiece was utilized to cut the foreign body without injury to the underlying penile skin. Subsequent follow-up in clinic demonstrated no significant urinary or sexual sequalae from this episode. CONCLUSION We report a case of penile strangulation requiring novel instrumentation and collaboration for successful treatment.
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Affiliation(s)
- Tuan Thanh Nguyen
- Cho Ray Hospital, Ho Chi Minh City, Vietnam.,University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Xuan Thai Ngo
- Cho Ray Hospital, Ho Chi Minh City, Vietnam.,University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | | | | | | | | | | | - Ryan W Dobbs
- Cook County Health and Hospitals System, Chicago, IL, USA
| | - Minh Sam Thai
- Cho Ray Hospital, Ho Chi Minh City, Vietnam. .,University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
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Mbwambo OJ, Kiattu E, Mbwambo J, Bright F, Mteta AK, Ngowi BN. Penile strangulation by a metallic nut in an 8-year-old male: A rare case report of urological emergency. Int J Surg Case Rep 2021; 89:106581. [PMID: 34823162 PMCID: PMC8627972 DOI: 10.1016/j.ijscr.2021.106581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/02/2021] [Accepted: 11/04/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION AND IMPORTANCE Penile strangulation due to metallic objects in pediatric age groups is a rare urological emergency that warrant emergency management. Removal of metallic ring from strangulated penis poses a great challenge to urologist as it may require industrial gadgets. Multidisciplinary management involving psychiatrist is required. To the best of our knowledge, this is the first reported novel case of penile strangulation by a metallic nut in children in Tanzania. Furthermore, this case report shows that Industrial Manual Scissor metal (IMSMC) cutter offers a safe way of removing metallic nut from strangulated penis with few complications. CASE PRESENTATION We report a case report of penile strangulation in an 8 year-old boy by a metallic nut which stayed for 11 h prior to arriving at a tertiary hospital in Northern Tanzania. The reason for insertion of nut by a child was not clear. CLINICAL DISCUSSION On arrival to the hospital the child was clinically stable but in pain. Local examination revealed a metallic nut at proximal penis with grossly edematous penis. A diagnosis of penile strangulation by metallic nut was reached and the child was planned for emergency surgery to remove the metallic nut. The metallic nut was successful removed by IMSMC. This technique has been used in adult with success with few complications and therefore opted in our setting. The child was also diagnosed with oppositional defiant disorder. CONCLUSION Industrial Manual Scissor Metal cutter is a safe way of managing penile strangulation by a metallic nut in children.
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Affiliation(s)
- Orgeness Jasper Mbwambo
- Department of Urology, Faculty of Medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania; Department of Urology, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, United Republic of Tanzania.
| | - Edward Kiattu
- Department of Urology, Faculty of Medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania
| | - Jasper Mbwambo
- Department of Urology, Faculty of Medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania; Department of Urology, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, United Republic of Tanzania
| | - Frank Bright
- Department of Urology, Faculty of Medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania; Department of Urology, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, United Republic of Tanzania
| | - Alfred K Mteta
- Department of Urology, Faculty of Medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania; Department of Urology, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, United Republic of Tanzania
| | - Bartholomeo Nicholaus Ngowi
- Department of Urology, Faculty of Medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania; Department of Urology, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, United Republic of Tanzania
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