Elsevier

Urology

Volume 64, Issue 3, September 2004, Page 591
Urology

Case report
Penile strangulation treated with the modified string method

https://doi.org/10.1016/j.urology.2004.04.058Get rights and content

Abstract

Penile strangulation by a nonmetallic or thin metallic ring is easily overcome by severing the object, but a heavy metal ring causing penile strangulation is very difficult to sever. Here we report 2 cases of penile strangulation by metal rings, involving a 38-year-old man and a 44-year-old man, both of whom were treated with the modified string method and glandular puncture.

Section snippets

Case 1

A 38-year-old man came to the emergency room complaining of being unable to remove a metal bearing from his penis. He had placed the bearing on his penis 5 hours earlier. Physical examination of the penis revealed a moderately edematous glans. The bearing was situated at the coronal sulcus (Fig. 1). The glans penis was hard in consistency, dark purplish, and had diminished sensation. We administered 10 mL of 1% lidocaine circumferentially in the penile shaft as a local anesthesia. With an

Comment

Entrapment of the penis by an encircling object leads to swelling of the penis distal to the object due to the initial blockage of the venous return and arterial supply. After several hours, penile strangulation can result in ischemic necrosis and fibrosis of the tissue. It therefore requires urgent treatment. If the constricting object is nonmetallic or thin, it can be easily cut off, but thick, hardened steel is very difficult to remove with a chisel, saw, or cutter. There are many methods

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