Kyomukama Lauben Amagara, Ssebuufu Robinson, Wani Shaban Abdullah, Waziri Musa Abbas, Lule Herman
Department of Surgery, Kampala International University Teaching Hospital, P.O. Box 71, Bushenyi, Uganda.
Department of Surgery, Kampala International University Teaching Hospital, P.O. Box 71, Bushenyi, Uganda; Department of Surgery, Muhammad Shuwa Memorial Hospital, Maiduguri, Nigeria.
Int J Surg Case Rep. 2021 Mar;80:104982. doi: 10.1016/j.ijscr.2020.09.080. Epub 2020 Sep 19.
Penile ring entrapment during self-sexual satisfaction is one of the rare cases in general and urologic surgery. When the penile shaft is entrapped in a metal ring, one risks possible complete loss of distal penis to strangulation and gangrene. We present management of a case of entrapped penile ring with penile strangulation in resource limited set up amidst absence of management guidelines. The case has been reported in line with SCARE criteria (1).
A 43-year-old male presented after 72 h of pilot ball bearing ring penile insertion for sustainability of an erection, with 24 -h history of painful penile swelling and acute urine retention. The patient had history of using recreational drugs and erectile dysfunction with evidence of high-grade penile injuries at presentation. The ring was cut using electrically powered angled grinder, with full penile recovery on conservative management in eight months of follow up.
Entrapped penile ring is clinically diagnosed but establishing incentive of insertion is difficult just like identifying a correct technique to remove it. Entrapped ring obstructs blood and lymphatic flow leading to oedema and ischaemia with associated penile tissue injuries. High grade penile injuries or penile amputation are sequels of delayed ring removal and good outcomes are tangible through timely multidisciplinary approach.
Eroticism and erectile dysfunctions are known incentive to using penile rings to sustain erection. Delayed ring removal results in its entrapment and penile strangulation and related complications. Timely removal of ring requires multidisciplinary approach and local management protocols.
在自慰过程中阴茎被环卡住是普通外科和泌尿外科手术中罕见的病例之一。当阴茎被金属环卡住时，存在阴茎远端因绞窄和坏疽而完全丧失的风险。我们介绍了在缺乏管理指南的资源有限环境下，一例阴茎被环卡住并伴有阴茎绞窄病例的处理情况。该病例已按照SCARE标准进行报告（1）。
一名43岁男性在将导球轴承环插入阴茎以维持勃起72小时后就诊，伴有阴茎疼痛肿胀和急性尿潴留24小时的病史。患者有使用消遣性药物和勃起功能障碍的病史，就诊时存在重度阴茎损伤的证据。使用电动角磨机切断环，在八个月的随访中经保守治疗阴茎完全恢复。
阴茎被环卡住可通过临床诊断，但确定插入环的动机以及找到正确的取出技术都很困难。被卡住的环会阻碍血液和淋巴流动，导致水肿和缺血，并伴有阴茎组织损伤。重度阴茎损伤或阴茎截肢是环取出延迟的后果，通过及时的多学科方法可取得良好效果。
色情癖和勃起功能障碍是使用阴茎环维持勃起的已知动机。环取出延迟会导致其卡住并造成阴茎绞窄及相关并发症。及时取出环需要多学科方法和当地的管理方案。
