PENILE STRANGULATION DEVICES: AN ALTERNATIVE ALGORITHM TO CLAMPING AND CUTTING

Dr. Ankush Gupta; Dr. Anshuman Vajpeyi; Dr. Abhishek Yadav; Dr. Prashant Lavania

Volume : X, Issue : VIII, August - 2020

PENILE STRANGULATION DEVICES: AN ALTERNATIVE ALGORITHM TO CLAMPING AND CUTTING

Dr. Ankush Gupta, Dr. Anshuman Vajpeyi, Dr. Abhishek Yadav, Dr. Prashant Lavania

Abstract :

OBJECTIVES: Penile strangulation by penile constriction devices presents uncommonly but requires urgent intervention to minimize risk of developing erectile dysfunction and penile gangrene. Non–invasive methods with use of cutting tools have been attempted successfully. However, these cutting tools are fraught with problems of availability, technical skills and risk of inadvertent organ injury. Here, a stepwise algorithm is presented for removal of these devices as an alternative to cutting. MATERIAL AND METHODS: Within a span of one year three cases presented to the emergency room between Jan 2018 to Jan 2019 with history of use of different types of constriction device on the penile shaft. A systematic approach to reverse the pathophysiological changes arising from penile constriction was followed. RESULTS: The constriction devices were effectively removed in all cases (without the need of any fancy equipment. Any kind of collateral damage was avoided. Patchy superficial skin necrosis was the only residual injury which manifested in the post–operative period. This healed completely with regular dressings and without any scarring. CONCLUSION: Penile strangulation injury is of relatively rare occurrence. However, it requires emergent treatment in order to avoid delayed but significant vascular complications and erectile dysfunction. Following a systematic approach, the devices can be successfully removed avoiding the need of specific tools which are usually unavailable.