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#1
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08-28-2011, 11:04 AM
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Metal Ring Stuck On Penis
A 60-year-old male patient with complaints of pain in the penis with persistent erection. He had applied an encircling metal ring around his penis so as to achieve erection Encircling metal object around the penile base: After reduction of erection: On examination, this patient had a thick metallic ring around the base of his penis. There was proximal venous engorgement causing a painful persistent priapism. First aim was to reduce his pain and decrease the distal penile engorgement. Under cover of antibiotics and pain relief, they introduced needles in the glans entering the corpora cavernosa, eventually draining the blood. This decreased the distal penile engorgement; however, they were unable to pull out the encircling object. As the encircling body persisted, it caused obstruction to the penile venous outflow leading to distal edema and recurrence of painful priapism. The option they had was to administer anaesthesia and try to pull out the object or cut the object using metal cutters. Looking at the clinical picture, it seemed that the possibility of pulling out the object was less likely. Under anaesthesia, the venous priapism was drained using needles in the corpora cavernosa through the glans. The underlying paraphimosis was reduced using multiple punctures on the prepuce. Lignocaine jelly was applied to the metal ring underneath and on the distal penile surface so as to make the skin slippery and less resistant for pulling out the foreign body. A steady force was applied on the metal ring. To surprise, the metal ring got dislodged. The penile edema gradually decreased. The patient was discharged next day. He has been advised regular follow-up for possibility of ischaemic urethral stricture at the site of constriction caused by the encircling metal ring. |