Penile Strangulation

SavageGlow · #1 ● 09-28-2024, 08:52 PM

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CASE DESCRIPTION
A 42-year-old unmarried man presented to our emergency outpatient department with a strangulated penis of 6-h duration. After placing a piece of metallic plumbing pipe, he was unable to remove it from his engorged penile shaft after autostimulation. He was having severe pain in the penis and was unable to void. Physical examination showed a thick metallic ring, 4 cm in length stuck at the base of the penis. The whole of the penis distal to metallic object was grossly swollen and congested [Figure 1]. In the emergency room, removal of the ring was initially attempted using lubricants but was unsuccessful due to the long pipe and grossly engorged penis. The patient was admitted and immediately taken to emergency operation theater. Under spinal anesthesia, we used modified string and aspiration method and were able to remove the metallic pipe within 20 min of time [Figure 2]. Following removal of the ring, it was noticed that there was loss of epidermis at the site of impaction. He was discharged on postoperative day 2 with an advice of regular dressing, oral anti-inflammatory drug, and antibiotics. Ten-day follow-up showed a partial-thickness skin loss at the site of impaction [Figure 3]. There was no loss of distal penile sensation and no voiding difficulty, and he could attain a normal erection. He is waiting for a split-thickness skin grafting by the plastic surgeons.