Management of accidental penile incarceration due to unusual masturbation practices

OBJECTIVE

We aimed to discuss the unusual masturbation practices performed by methods such as penile devices causing incarceration and its emergency management.

MATERIAL AND METHODS

It is a retrospective study of cases who presented to the emergency department with penile incarceration by metallic and nonmetallic encircling objects from September 2015 to October 2020. The cases were analyzed for age, marital status, motive, type of object used, duration of incarceration, associated urinary retention, type of anesthesia used, methods of removal, complications of incarceration, and secondary procedures required to treat complications.

RESULTS

A total of nine cases had paid emergency visit to our hospital for the past 4 years. The average age of the patients was 36.78 years. Unusual masturbation practices that underwent wrong were the common cause in most cases (77.7%). Most of cases presented after 24 hours of incident. All foreign bodies were removed under spinal anesthesia except one that was removed under penile block. Two cases (22.9%) required skin grafting and one (11.1%) underwent partial penectomy following the removal of encircling objects.

CONCLUSION

This study emphasizes that the penile incarceration because of unusual masturbation practices is rare as it is sparsely reported as only a few case reports in the literature. Most of the patients presented late because of the embarrassment associated with it. This emergency requires urgent intervention, and the method used to remove the foreign body depends on the resources available, duration of incarceration, grade of injury, and the type of foreign body.

A Rare Case of Penile Strangulation Managed by Orthopedic Jumbo Cutter

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.

Stepwise approach in the management of penile strangulation and penile preservation: 15-year experience in a tertiary care hospital

Objective: To present our stepwise approach to the management of penile strangulation and penile preservation with 15 years’ experience in a tertiary care hospital, as penile strangulation is a rare urological emergency that requires immediate attention.

Patients and methods: A prospective observational study was performed from March 2003 to December 2018 of patients presenting with penile strangulation to our hospital.

Results: Nine patients with penile strangulation presented to us between March 2003 and December 2018. The most common motive for the application of a foreign body was sexual gratification (four patients). Three of the nine patients had a mental disorder. Objects used for strangulation included: metallic nut (three), metallic ring (two), plastic bottle (two), wooden hole (one), hammer head (one), and horse hair to control bleeding during circumcision (one). Most of the foreign bodies were located in the proximal penile region. The mean operative time was 38 min and three of the nine patients had complications.

Conclusions: Penile strangulation is one of the rare urological emergencies experienced by a urologist. Removal of the foreign body can be difficult and there is no universal method of removal, as each case differs. So, following our stepwise approach can aid in removal of foreign body quickly and preserve the penis from fatal outcomes. Urologist should be aware of all the available armamentarium used for the removal of such foreign bodies.

Abbreviation: SPC: suprapubic cystostomy