Progressive penile amputation: Tourniquet injury secondary to hair

doi:10.1016/0090-4295(77)90282-5

Urology

Volume 9, Issue 1, January 1977, Pages 42-44

https://doi.org/10.1016/0090-4295(77)90282-5 Get rights and content

Abstract

In the past three years we have treated 5 cases of penile strangulation secondary to entrapment by human hair in the coronal groove. All patients had been circumcised and were between fourteen months and five years of age. Total urethral transection occurred in 2 children. Their presentation and our method of management are discussed.

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Cited by (44)

Penile hair coil strangulation in a 9-year-old patient: Surgical management and review of the literature
2020, Annals of Medicine and Surgery
Citation Excerpt :
In non severe forms single-stage repair can be easily performed. However, in the case of severe forms the delayed repair may be favored to allow tissues to recover from the pressure ischemic effects after releasing the constricting hair coil [8]. The operations should be performed by surgeons experienced in hypospadias repair, following the same principles of dissection and applying a second layer coverage for the urethroplasty.
Strangulation of the penis is a rare situation that requires urgent treatment for penile decompression. The complications could range from simple edema to severe ones such as urethrocutaneous fistula, complete urethral transection, penile gangrene and penile amputation. This work has been reported in line with the SCARE criteria.
A 9-year-old patient was presented to the emergency service.During examination of the genitals, the glans was hanging to the penis by a very slim pedicle, its coloration was normal and the urethra was almost cut at the sulcus coronarius. The cause of strangulation was multiple hair coils.We performed single stage reparation which consists of refreshing the edges of the urethra and glans, followed by anastomosing the two cut urethral ends, reinforcement by interposing a well vascularized dartos layer was also performed. At the six months follow-up, the penis had a good cosmetic outcome and the glans sensation was present.
The penile tourniquet syndrome is one of the major causes of pediatric penile trauma. Ritual circumcision is basically the main cause of the series followed by penile strangulation. Surgical reparation can be performed in one or two stages. It should be performed by a surgeons experienced in hypospadias repair by following the same principles of dissection and applying a second layer coverage for the urethroplasty.
Hair-coil penile strangulation is an uncommon condition. The repair can be realized in one or two stages but it must be performed by a surgeon experienced in hypospadias surgery. Early surgical repair is required to achieve successful results.
Surgical Management of Hair-coil Penile Injury: Anatomical Insights and Grading System
2016, Urology
Citation Excerpt :
Bashir and El-Barbary recommended delaying the repair for 6 months following the acute injury.3 Especially in severe forms, the delayed repair may be favored to allow tissues to recover from the pressure ischemic effects after the release of the constricting hair coil.1 We adopted the technique of delayed repair in all grades of urethral injury, and we had a successful urethroplasty in all cases with no complications.
To report our experience in the surgical management of a group of patients with varying degrees of hair-coil penile injury, while applying a more detailed grading scale for the severity of injury.
The study included 16 boys with hair-coil penile injury who were managed during the period 2010 through 2016. In the acute state, the constricting hair coil was removed under general anesthesia. The repair was planned 6 months later after the acute injury. In 1 case presenting with severe form (near total glanular amputation), the glans was resutured to the penile shaft immediately after removal of the hair coil; the urethroplasty was performed six months later.
The patients' age ranged from 2 to 17 years (mean 4.8 years). The urethroplasty was always covered by a protective layer, which was derived from the ventral dartos fascia in all but 1 case. In the latter, we used a tunica vaginalis flap for covering the urethroplasty. A successful outcome (regarding both urethral reconstruction and cosmesis) was achieved in all cases.
Hair-coil penile injury is an uncommon condition with insidious course. Unawareness of such condition can lead to progression to serious complications. Delayed and staged surgical repair is associated with successful outcome.
Sex-related injuries
2013, Progres en Urologie
Décrire les traumatismes survenant lors des rapports sexuels consentis ou non, ou dans le cadre de pratiques sexuelles particulières et les conditions médicales, chirurgicale et médicolégale de leur prise en charge.
Nous avons revu la littérature internationale en utilisant PubMed concernant : (1) chez l’homme, la fracture des corps caverneux, les corps étrangers péniens (piercing, anneaux de verge) et urétraux ainsi que sur les amputations de verge pour préciser l’attitude thérapeutique ; (2) chez la femme, les traumatismes dans le cadre de rapport sexuel consenti ou non.
Chez l’homme, la pathologie la plus fréquente est la rupture de l’albuginée des corps caverneux sur une verge en érection. La diversité des pratiques sexuelles expose toutefois les urologues à la rencontre de traumatismes moins ordinaires : strangulation de la verge par des anneaux, complications de piercing génitaux ou d’introduction de corps étrangers dans l’urètre ou sous-cutanés. Plus rares sont les amputations traumatiques du pénis. Chez la femme, les traumatismes sexuels sont souvent bénins dans leur présentation clinique mais surviennent en général dans le cadre de violences sexuelles et nécessitent une prise en charge psychologique, médicolégale et de prévention des infections sexuellement transmissibles.
La littérature repose essentiellement sur des avis d’experts et des séries rétrospectives monocentriques. Nous avons résumé pour chaque situation l’épidémiologie, le diagnostic et le traitement.
To describe the injuries occurring during consensual or not sexual intercourses, or during particular sexual practices and their medical, surgical and forensic care.
We reviewed the literature using PubMed database to clarify the diagnostic and therapeutic approach of: (1) in men: fracture of the corpora cavernosa, penile and urethral foreign bodies (piercing, rings) as well as amputation of penis; (2) in women: trauma during consensual or not sexual intercourses.
In men, the most common pathology is the rupture of the tunica albuginea of the corpora cavernosa on the erect penis. The diversity of sexual practices, however, exposes urologists to meet trauma less ordinary: strangulation of the penis by rings, genital piercing complications or introduction of foreign bodies into the urethra or under the skin. Less common are traumatic amputations of the penis. In women, sexual trauma are often benign in their clinical presentation but generally occur in the context of sexual violence and require psychological support, forensic and prevention of sexually transmitted infections.
The literature is mainly based on expert opinion and single-center retrospective series. We summarized for each situation epidemiology, diagnosis and treatment.
Hair tourniquet of the uvula
2003, Journal of Emergency Medicine
Clinical management of foreign bodies of the genitourinary tract
2000, Journal of Urology
The variety of foreign bodies inserted into or externally attached to the genitourinary tract defies imagination and includes all types of objects. The frequency of such cases renders these objects an important addition to the diseases of the urinary organs.
We performed a computerized MEDLINE search followed by a manual bibliographic review of cross-references. These reports were analyzed and the important findings summarized.
Our review encompassed approximately 800 single case reports on foreign bodies in the English world literature published between 1755 and 1999. We structured the range of introduced objects, by referring to origin and material as well as the genitourinary organs involved. Furthermore, we noted symptomatology and diagnoses, including psychological involvement, as well as possible treatment options.
The most common motive associated with foreign bodies of the genitourinary tract is sexual or erotic in nature. The most suitable method of removing a urethral foreign body depends on the size and mobility of the object applied to the genitourinary tract. When possible, endoscopic and minimal invasive techniques of removal should be used. However, surgical retrieval of a foreign body may be required, particularly when there is a severe associated inflammatory reaction.
Tourniquet syndrome in children (literature review and own observation)
2023, Ukrainian Journal of Perinatology and Pediatrics

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Scientific articleProgressive penile amputation: Tourniquet injury secondary to hair

Abstract

J. Urol.

J. Urol.

J. Urol.

Urology

J. Pediatr. Surg.

Incarceration of penis by foreign body

Urology

Scientific article
Progressive penile amputation: Tourniquet injury secondary to hair