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阴茎绞窄:两例病例报告及文献综述

Penile strangulation: two case reports and review of the literature.

作者信息

Ivanovski Ognen, Stankov Oliver, Kuzmanoski Marjan, Saidi Skender, Banev Saso, Filipovski Vanja, Lekovski Ljupco, Popov Zivko

机构信息

University Clinical Centre Skopje--Department of Surgery, Clinic of Urology, Skopje, Macedonia.

出版信息

J Sex Med. 2007 Nov;4(6):1775-80. doi: 10.1111/j.1743-6109.2007.00601.x. Epub 2007 Sep 21.

Abstract

INTRODUCTION

Entrapment or strangulation of the penis is a rare emergency situation that can lead to a wide range of vascular and mechanical injuries.

AIM

The aim of this article is to present our experience dealing with penile strangulation. A review of the literature is also summarized in this report. Current treatment options and outcomes are also evaluated.

METHODS

We performed a computerized MEDLINE search followed by a manual bibliographic review of cross-references. These reports were analyzed and the important findings summarized.

RESULTS

Penile strangulation has been first time reported in 1755. Since that time, sporadic reports have appeared in the literature describing a variety of foreign bodies on the penis that have in common only the property of circularity. We noted motives, types of objects, types of strangulation, symptomatology, trauma grades, diagnoses, including psychological involvement, as well as possible treatment options. Furthermore, two cases of penile strangulation from our clinical practice are presented involving different degrees of vascular insult leading to different pathogenesis, clinical presentation, and surgical approach.

CONCLUSION

Penile strangulation is an unusual clinical condition and the consequences can be severe. Penile strangulation could lead to different degrees of vascular obstruction. Consequently, several clinical syndromes can occur: from mild nonsignificant vascular obstruction that resolves after decompression to severe gangrene of the penis accompanied with impaired renal function. The most common motive associated with foreign bodies on the penis is sexual or erotic in nature. The choice of method for removal depends upon type, size, incarceration time, trauma grade, and availability of the equipment. Prompt diagnosis and early treatment are essential to avoid the potential complications of ischemic necrosis and autoamputation.

摘要

引言

阴茎绞窄或勒缢是一种罕见的紧急情况,可导致多种血管和机械性损伤。

目的

本文旨在介绍我们处理阴茎绞窄的经验。本报告还总结了文献综述。同时评估了当前的治疗选择和结果。

方法

我们进行了计算机化的医学文献数据库检索,随后对手动检索的交叉参考文献进行了综述。对这些报告进行了分析,并总结了重要发现。

结果

阴茎绞窄于1755年首次被报道。从那时起,文献中陆续出现了一些零星报道,描述了阴茎上的各种异物,这些异物唯一的共同特性就是呈环状。我们记录了动机、异物类型、绞窄类型、症状、创伤分级、诊断(包括心理因素)以及可能的治疗选择。此外,还介绍了我们临床实践中的两例阴茎绞窄病例,它们涉及不同程度的血管损伤,导致了不同的发病机制、临床表现和手术方法。

结论

阴茎绞窄是一种不常见的临床情况,后果可能很严重。阴茎绞窄可导致不同程度的血管阻塞。因此,可能会出现几种临床综合征:从减压后可缓解的轻度无明显意义的血管阻塞到伴有肾功能损害的阴茎严重坏疽。与阴茎上异物相关的最常见动机本质上是性或色情方面的。去除方法的选择取决于异物的类型、大小、嵌顿时间、创伤分级以及设备的可用性。及时诊断和早期治疗对于避免缺血性坏死和自行断离等潜在并发症至关重要。

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