Silberstein Jonathan, Grabowski Julia, Lakin Charles, Goldstein Irwin
Department of Surgery, University of California, San Diego Medical Center, San Diego, CA, USA.
J Sex Med. 2008 Jul;5(7):1747-57. doi: 10.1111/j.1743-6109.2008.00848.x.
Penile constriction devices often present significant challenges to urologic surgeons. Failure to remove such devices can lead to significant ischemia and loss of tissue. Patients often present after several days of ischemia and swelling have developed.
This article reviews previously published data on penile constriction devices and strategies for their removal. Additionally, we present new methodologies for extrication.
A comprehensive review of the English language literature was performed using MEDLINE. "Penile incarceration" and "penile strangulation" were used as search terms, and a manual bibliographic review of cross-referenced items was performed. Publications prior to 1970 were excluded from our search.
Review of published literature on penile constriction devices and their removal.
Penile incarceration is frequently described in the literature as an isolated case report or small series describing the approach of a single physician or group of physicians for dealing with these problems. Penile incarceration has been reported in a wide spectrum of age groups, with the incarcerating object most frequently placed for erotic or autoerotic purposes. While the most commonly reported devices causing incarceration are metal rings, higher-grade penile injuries are more frequently sustained by nonmetallic objects. Patients who present with incarceration after 72 hours are more likely to sustain higher-grade injuries than those who seek more timely treatment. Strategies for extrication depend on the type of device used, the length of time of incarceration, the patient's ability to remain calm, and the tools available to the presenting physicians.
Penile incarceration is a urologic emergency with potentially severe clinical consequences. With rapid intervention and removal of the foreign body, most patients do extremely well and need no further intervention. Removal of such devices can be challenging and often requires resourcefulness and a multidisciplinary approach.
阴茎缩窄装置常常给泌尿外科医生带来重大挑战。未能移除这类装置可能导致严重缺血和组织丧失。患者通常在出现缺血和肿胀数天后前来就诊。
本文回顾先前发表的关于阴茎缩窄装置及其移除策略的数据。此外，我们还介绍了新的解脱方法。
使用MEDLINE对英文文献进行全面检索。以“阴茎嵌顿”和“阴茎绞窄”作为检索词，并对交叉引用的文献进行手工书目审查。我们的检索排除了1970年以前发表的文献。
回顾关于阴茎缩窄装置及其移除的已发表文献。
阴茎嵌顿在文献中经常被描述为孤立的病例报告或小系列病例，描述了单个医生或一组医生处理这些问题的方法。阴茎嵌顿在广泛的年龄组中均有报道，嵌顿物放置的目的最常见的是出于色情或自慰目的。虽然最常报道导致嵌顿的装置是金属环，但非金属物体导致的阴茎损伤等级更高。与寻求更及时治疗的患者相比，在72小时后出现嵌顿的患者更有可能遭受更高级别的损伤。解脱策略取决于所用装置的类型、嵌顿时间的长短、患者保持冷静的能力以及接诊医生可用的工具。
阴茎嵌顿是一种泌尿外科急症，可能产生严重的临床后果。通过快速干预和移除异物，大多数患者恢复良好，无需进一步干预。移除这类装置可能具有挑战性，通常需要足智多谋和多学科方法。
