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Laik JK, Kerketta AH, Kumar R, Kausal R, Agarwal A, Rajak M. A Rare Case of Penile Strangulation Managed by Orthopedic Jumbo Cutter. Cureus 2021; 13:e15659. [PMID: 34277252 PMCID: PMC8281108 DOI: 10.7759/cureus.15659] [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] [Accepted: 06/15/2021] [Indexed: 11/18/2022] Open
Abstract
Penile strangulation is not commonly encountered in orthopedic practice. Quick decision and immediate removal of the metallic ring with readily available instruments is the key to a successful outcome. Jumbo cutter is a commonly available instrument. It can be used with ease without causing any thermal or soft tissue damage, giving satisfactory results.
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Affiliation(s)
- Jayanta K Laik
- Department of Joint Replacement and Orthopedics, Tata Main Hospital, Jamshedpur, IND
| | - Abhay H Kerketta
- Department of Joint Replacement and Orthopedics, Tata Main Hospital, Jamshedpur, IND
| | - Ritesh Kumar
- Department of Joint Replacement and Orthopedics, Tata Main Hospital, Jamshedpur, IND
| | - Ravi Kausal
- Department of Joint Replacement and Orthopedics, Tata Main Hospital, Jamshedpur, IND
| | - Ajay Agarwal
- Department of Urology, Tata Main Hospital, Jamshedpur, IND
| | - Manoj Rajak
- Department of Joint Replacement and Orthopedics, Tata Main Hospital, Jamshedpur, IND
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Forrester MB. Penis Ring Injuries Treated at Emergency Departments. JOURNAL OF SEX & MARITAL THERAPY 2021; 48:103-111. [PMID: 33734034 DOI: 10.1080/0092623x.2021.1900003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The purpose of this study was to determine the pattern of penis ring-related injuries in the US. During 2000-2019, 162 penis ring-related injuries (for a national estimate of 6,344 such injuries) were treated at US emergency departments (EDs). Of the estimated injuries, 32.3% occurred during 2000-2011 and 67.7% during 2012-2015. The patients were 49.8% age 30-49 years. The most common types of injuries were ring stuck on the penis or scrotum (75.3%), edema (29.9%), pain (18.7%), and contusion or abrasion (7.6%). In 81.9% of the estimated injuries, the patient was treated or examined at the ED and then released.
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Dawood O, Tabibi S, Fiuk J, Patel N, El-Zawahry A. Penile ring entrapment - A true urologic emergency: Grading, approach, and management. Urol Ann 2019; 12:15-18. [PMID: 32015611 PMCID: PMC6978966 DOI: 10.4103/ua.ua_16_19] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 09/30/2019] [Indexed: 11/07/2022] Open
Abstract
Penile rings are used to sustain erection in order to enhance sexual pleasure. They work by reducing the outflow of blood from the cavernosal tissue. However, if left for extended periods of time severe edema, urethral fistula, gangrene, and even complete loss of the distal penis can ensue, this is known as penile ring entrapment (PRE). Management poses particular challenges due to its rarity. Herein, we report our experience with three patients from our institution that presented with PRE and include a review of the approaches others have taken. We also propose a simpler and more effective grading scale to allow for easier communication between providers, as the current grading scales do not do so.
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Affiliation(s)
- Omar Dawood
- Department of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Seena Tabibi
- Department of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Julia Fiuk
- Department of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Neil Patel
- Department of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Ahmed El-Zawahry
- Department of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA
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Sarkar D, Gupta S, Maiti K, Jain P, Pal DK. Penile strangulation by different objects and its removal by the modified string method: Management of four cases with review of literature. Urol Ann 2019; 11:1-5. [PMID: 30787563 PMCID: PMC6362780 DOI: 10.4103/ua.ua_178_17] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Penile strangulation is a challenging clinical situation and usually requires prompt treatment. Penile strangulation by a nonmetallic or thin metallic ring is easily overcome by severing/cutting the object; however, a heavy and long metal ring causing penile strangulation is not only difficult to sever but also it may worsen the scenario if removal is tried with inappropriate method. Here, we report four cases of penile strangulation by different objects which were successfully removed by aspiration and string method. We found that instead of using heavy cutting instruments and other surgical methods, string and aspiration technique is much better.
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Affiliation(s)
- Debansu Sarkar
- Department of Urology, IPGME and R, Kolkata, West Bengal, India
| | - Sandeep Gupta
- Department of Urology, IPGME and R, Kolkata, West Bengal, India
| | | | - Pritesh Jain
- Department of Urology, IPGME and R, Kolkata, West Bengal, India
| | - Dilip Kumar Pal
- Department of Urology, IPGME and R, Kolkata, West Bengal, India
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Singh I, Suman D, Gupta S, Garg G. Penile strangulation by multiple steel ball bearings: desperate situation-desperate measures. BMJ Case Rep 2018; 2018:bcr-2018-227586. [PMID: 30344163 DOI: 10.1136/bcr-2018-227586] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Affiliation(s)
- Iqbal Singh
- Urology Division, Department of Surgery, UCMS and GTB Hospital, New Delhi, India
| | - Dhirendra Suman
- Department of Plastic Surgery, UCMS and GTB Hospital, New Delhi, India
| | - Sanjay Gupta
- Department of Surgery, UCMS and GTB Hospital, New Delhi, India
| | - Gaurav Garg
- Department of Urology, King George's Medical University, Lucknow, India
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Kim JH, Park JY, Song YS. Traumatic penile injury: from circumcision injury to penile amputation. BIOMED RESEARCH INTERNATIONAL 2014; 2014:375285. [PMID: 25250318 PMCID: PMC4164514 DOI: 10.1155/2014/375285] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 08/16/2014] [Accepted: 08/16/2014] [Indexed: 02/07/2023]
Abstract
The treatment of external genitalia trauma is diverse according to the nature of trauma and injured anatomic site. The classification of trauma is important to establish a strategy of treatment; however, to date there has been less effort to make a classification for trauma of external genitalia. The classification of external trauma in male could be established by the nature of injury mechanism or anatomic site: accidental versus self-mutilation injury and penis versus penis plus scrotum or perineum. Accidental injury covers large portion of external genitalia trauma because of high prevalence and severity of this disease. The aim of this study is to summarize the mechanism and treatment of the traumatic injury of penis. This study is the first review describing the issue.
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Affiliation(s)
- Jae Heon Kim
- Department of Urology, Soonchunyang University Hospital, College of Medicine, Soonchunhyang University, Seoul, Republic of Korea
| | - Jae Young Park
- Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
| | - Yun Seob Song
- Department of Urology, Soonchunyang University Hospital, College of Medicine, Soonchunhyang University, Seoul, Republic of Korea
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Shukla P, Lal S, Shrivastava GP, Singh LM. Penile incarceration with encircling metallic objects: a study of successful removal. J Clin Diagn Res 2014; 8:NC01-5. [PMID: 25121021 DOI: 10.7860/jcdr/2014/8755.4447] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 03/20/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVE This article aimed to study the various treatment options according to the grading scale for penile incarceration. MATERIALS AND METHODS A retrospective review, of all the case files of patients presented with penile incarceration with encircling metallic object was performed. The patients were analyzed for age, marital status, motive, object used, who applied it, trauma grade, duration of incarceration, removal technique, removal time, anesthesia used and recovery time. RESULT A total of seven patients were identified. The average age was 46.71 years. Self-sexual gratification was the most common motive (five patients). Six patients presented within 24 hours. Grade II of injury was commonest type of injury seen in five patients.The technique of removal chosen was according to grade of penile injury, duration of incarceration and type of object used. Spinal anesthesia was used in most of the cases (five patients). CONCLUSION Penile incarceration with encircling metallic objects is a rare presentation and requires urgent intervention according to trauma grade to prevent complications.
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Affiliation(s)
- Pushpendra Shukla
- Assistant Professor, Department of Surgery, Shyam Shah Medical College , Rewa (M.P.),India
| | - Shyam Lal
- Associate Professor, Department of Surgery, ESI-PGIMSR Hospital , Basaidarapur, New Delhi,India
| | - G P Shrivastava
- Professor, Department of Surgery, Shyam Shah Medical College , Rewa (M.P.),India
| | - Lal Mani Singh
- Assistant Professor, Department of Surgery, Shyam Shah Medical College , Rewa (M.P.),India
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Successful removal of metal objects causing penile strangulation by a silk winding method. Case Rep Urol 2013; 2013:434397. [PMID: 24288646 PMCID: PMC3833198 DOI: 10.1155/2013/434397] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 09/29/2013] [Indexed: 11/17/2022] Open
Abstract
Penile strangulation is a challenge to urologists. The decompression of the penis is required to prevent long-term complications. Metal objects are difficult to remove. Cutting is the most common method described. Appropriate cutting tools may be difficult to obtain, and the process may be time-consuming with the possibility of iatrogenic penile injury. In this paper, we will present a simple method to remove such objects by use a silk winding method and subcutaneous puncture.
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Roushias S, Veeratterapillay R, McCracken S, Heer R. Penile strangulation by a substantial metal napkin ring: successful removal with medtronic midas rex ® legend ® stylus ® drill system. JOURNAL OF CLINICAL UROLOGY 2013. [DOI: 10.1016/j.bjmsu.2012.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We report the case of a 34-year-old with penile constriction by a large solid steel ring napkin holder in whom attempts of removal by conventional techniques failed. Standard instruments available in urology and general surgical theatres proved too weak to sever the ring and those offered by the fire services were grossly oversized and dangerous to use around the genitalia. Orthopaedic staff offered an instrument not previously used within our urology department: the Medtronic Midas Rex© Legend EHS Stylus High-Speed Surgical Drill. This intricate electronic powered drill allowed quick, controlled and safe incision of the metal ring, relieving the constriction. In addition to this first report of a metal penile constriction device removed using the Medtronic Midas Rex® Legend® Drill System, we review the literature on penile constriction and management strategies.
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Affiliation(s)
- S Roushias
- Department of Urology, Freeman Hospital, Newcastle Upon Tyne, UK
| | | | - S McCracken
- Department of Urology, Freeman Hospital, Newcastle Upon Tyne, UK
- Northern Institute for Cancer Research, Newcastle University, UK
| | - R Heer
- Department of Urology, Freeman Hospital, Newcastle Upon Tyne, UK
- Northern Institute for Cancer Research, Newcastle University, UK
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Successful remove of a metal axletree causing penile strangulation in a 19-year-old male by degloving operation. Case Rep Med 2012; 2012:532358. [PMID: 22924045 PMCID: PMC3423872 DOI: 10.1155/2012/532358] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Accepted: 07/17/2012] [Indexed: 02/07/2023] Open
Abstract
Penile strangulation caused by foreign bodies mostly occurs in adolescents and adult males. When it happens, foreign bodies are often not easy to be removed. Penile strangulation is a rarely described urological emergency, especially in the adolescent population. This paper demonstrates the successful removal of a metal axletree causing penile strangulation in a 19-year-old male with the help of degloving operation.
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