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Kraske S, Müller F, Schellerer V. Glans ischemia in a 7-month-old boy who underwent correction of megaprepuce: case report and review of the literature. Front Pediatr 2025; 12:1460717. [PMID: 40083563 PMCID: PMC11903402 DOI: 10.3389/fped.2024.1460717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2024] [Accepted: 12/26/2024] [Indexed: 03/16/2025] Open
Abstract
Acute glans ischemia is a severe complication that can occur after penile surgery, such as circumcision, hypospadias repair, or disassembly of the corpora in epispadias. This rare condition is described in the current literature, especially after circumcision, although it is the less invasive procedure among those previously mentioned. We present a case of 7-month-old boy who developed glans ischemia after correction of megaprepuce. The condition was treated by intravenous unfractionated heparin. In our case, the complication of ischemia was complete dehiscence of the suture line at the coronal sulcus. Glans penis recovered completely and secondary intention wound healing occurred within 4 weeks. We reviewed the literature over the past 43 years (1981-2023) to describe the current options of surveillance, treatment, and outcome of glans ischemia after penile surgery in boys.
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Affiliation(s)
- Susanne Kraske
- Department of Pediatric Surgery, University Medicine Greifswald, Greifswald, Germany
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Hașegan A, Mihai I, Bratu D, Bacilă C, Roman MD, Mohor CI, Teodoru A, Birsan S, Mutu C, Chibelean C, Totan M, Grigore N, Iancu G, Dura H, Boicean A. Severe Acute Ischemia of Glans Penis after Achieving Treatment with Only Hyperbaric Oxygen Therapy: A Rare Case Report and Systematic Literature Review. J Pers Med 2023; 13:1370. [PMID: 37763138 PMCID: PMC10533140 DOI: 10.3390/jpm13091370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 09/05/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Acute ischemia of the glands is a severe complication after circumcision. We outline the challenging case of a seventeen-year-old boy with glandular ischemia (GI) that appeared shortly after circumcision. Methods: We present a case report and literature review related to glans ischemia, and the complications of circumcision are reviewed. We note that there are very few cases described in the literature. Our patient was successfully treated with hyperbaric oxygen therapy (HBOT) after four days of no positive effect after all medical and surgical treatments written in the literature: Subcutaneous enoxaparin, local application of a glyceryl trinitrate, continuous epidural perfusion, intravenous pentoxifylline, alprostadil, intraoperative drainage, and aspiration with saline solution and epinephrine. Clinical improvement was noted at the first session of HBOT. A number of days after the operation, the penis looked normal and was healing. Complete healing of the penile glans was successfully realized one month after surgery. Conclusion: Based on the review and the case presented, we conclude that HBOT is the treatment of choice for acute ischemia of the penile glans, especially when other treatments do not work.
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Affiliation(s)
- Adrian Hașegan
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Ionela Mihai
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Dan Bratu
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Ciprian Bacilă
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Mihai Dan Roman
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Cosmin Ioan Mohor
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Adrian Teodoru
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Sabrina Birsan
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Cosmin Mutu
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Călin Chibelean
- Faculty of Medicine, University of Medicine and Farmacy, 540139 Targu Mures, Romania;
| | - Maria Totan
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Nicolae Grigore
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Gabriela Iancu
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Horatiu Dura
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Adrian Boicean
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
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