Mittino Irene, Sangalli Mattia, Fabbri Fabio, Sozzi Francesco, Ghezzi Massimo, Zanni Giuseppe, Cestari Andrea
Department of Urology, Advanced Urotechnology Centre, IRCCS Istituto Auxologico Italiano, Milan, Italy.
Urologia. 2018 Nov;85(4):174-176. doi: 10.1177/0391560318761288. Epub 2018 Mar 26.
: Circumcision is a common surgical procedure, typically performed under local anesthesia and somehow also as outpatient clinic. Although complications are rare and most frequently related to the procedure itself, ischemia of the glans may occur as a major complication and can be related to local ischemia following dorsal penile nerve block.
: We describe the case of a 33-year-old patient who underwent circumcision at our institution and, 24 h after the procedure, developed an acute ischemia of the glans; a re-intervention was performed in emergency setting to ensure a large, not-tightened circular suture under the glans, and low-molecular-weight heparin and antiplatelet therapy was introduced to achieve anti-coagulative/antiaggregant effects. After 48 h, the skin returned to its normal color and in 7 days the penile glans achieved complete remission of the ischemic aspect. A 6-month follow-up confirmed regular outcomes with normal erectile functions.
: The treatment we proposed to treat acute post-circumcision ischemia of the glans is a simple and effective one, with a perfect aesthetic and functional outcome observed within 4 weeks and confirmed at 6-month follow-up.
包皮环切术是一种常见的外科手术,通常在局部麻醉下进行,也可在门诊进行。尽管并发症很少见,且大多与手术本身有关,但龟头缺血可能作为一种主要并发症出现,并且可能与阴茎背神经阻滞后的局部缺血有关。
我们描述了一名33岁患者的病例,该患者在我院接受了包皮环切术,术后24小时出现了龟头急性缺血;在紧急情况下进行了再次干预,以确保在龟头下方进行大的、未收紧的环形缝合,并采用低分子量肝素和抗血小板治疗以达到抗凝/抗聚集效果。48小时后,皮肤恢复正常颜色,7天后阴茎龟头缺血症状完全缓解。6个月的随访证实了勃起功能正常的常规结果。
我们提出的治疗包皮环切术后龟头急性缺血的方法简单有效,在4周内观察到了完美的美学和功能结果,并在6个月的随访中得到证实。