Vol. 45 (2): 384-391, March – April, 2019
Leandro Koifman 1, Daniel Hampl 1, Maria Isabel Silva 1, Paulo Gabriel Antunes Pessoa 1, Antonio Augusto Ornellas 2, Rodrigo Barros 1
1 Hospital Municipal Souza Aguiar, Rio de Janeiro, RJ, Brasil; 2 Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brasil
Purpose: To study the effect of penile constriction devices used on a large series of patients who presented at our emergency facility. We explored treatment options to prevent a wide range of vascular and mechanical injuries occurring due to penile entrapment.
Materials and Methods: Between January 2001 and March 2016, 26 patients with pe¬nile entrapment were admitted to our facility and prospectively evaluated.
Results: The time that elapsed from penile constrictor application to hospital admis¬sion varied from 10 hours to 6 weeks (mean: 22.8 hours). Non-metallic devices were used by 18 patients (66.6%) while the other nine (33.4%) had used metallic objects. Acute urinary retention was present in six (23%) patients, of whom four (66.6%) un¬derwent percutaneous surgical cystotomy and two (33.4%) underwent simple bladder catheterization. The main reason for penile constrictor placement was erectile dysfunc¬tion, accounting for 15 (55.5%) cases. Autoerotic intention, psychiatric disorders, and sexual violence were responsible in five (18.5%), five (18.5%), and two (7.4%) cases, respectively. The mean hospital stay was 18 hours (range, 6 hours to 3 weeks).
Conclusion: Penile strangulation treatment must be immediate through the extraction of the foreign body, avoiding vascular impairments that can lead to serious complica¬tions. Most patients present with low-grade injuries and use penile constrictors due to erectile dysfunction. Removal of constrictor device can be challenging. The use of specific tools for achieving penile release from constrictors is a fast, safe and effective method. Patients with urinary retention may require urinary diversion.
Keywords: Penis; Constriction; Therapeutics