Neupane Durga, Singh Sudhir Kumar, Kafle Awaj, Chaudhary Samir, Subedi Sushil Sharma, Chhetri Sunit
B.P. Koirala Institute of Health Sciences, Dharan, Nepal.
Department of Surgery (Urology Division), B.P. Koirala Institute of Health Sciences, Dharan, Nepal.
Int J Surg Case Rep. 2021 Aug;85:106189. doi: 10.1016/j.ijscr.2021.106189. Epub 2021 Jul 8.
Strangulation of penis, a surgical emergency, is often encountered in patients with psychiatric disorders and patients attempting to increase sexual arousal. Materials ranging from metallic to non-metallic like plastic bottles are used by the patients. The important factors to be considered for the successful treatment include the availability of instruments and the surgical skills of the doctor.
A 45 year-old man with a comorbidity of severe depression presented to Emergency with a two months long history of penile strangulation with a plastic bottle neck. The gross appearance of the penis showed edema and proliferative growths. He was intervened with a cable wire cutter as standard instrument failed to do so. The patient was discharged on the same day of intervention. However, he was lost to subsequent follow up.
Penile strangulation which is common in people with mental disorders should be considered as a surgical emergency as it can present with devastating complications. No specific methods and tools have been recommended for the removal of those objects. The shame felt by patient is the root cause for late surgical consultation and are prone to develop complications. Simple instruments can be used for the intervention provided good surgical skills are demonstrated.
Common in psychiatric patients who deny medical attention due to shame, penile strangulation should be intervened quickly and simple instruments not routinely used in surgical practice can be effectively used to remove the offending objects.
阴茎绞窄是一种外科急症，在精神疾病患者以及试图增强性唤起的患者中经常出现。患者使用从金属到塑料瓶等非金属材料。成功治疗需考虑的重要因素包括器械的可用性和医生的手术技能。
一名患有重度抑郁症合并症的45岁男性因阴茎被塑料瓶颈绞窄长达两个月就诊于急诊科。阴茎外观显示水肿和增生性肿物。由于标准器械无法操作，遂用电缆剪进行干预。患者在干预当天出院。然而，随后失访。
阴茎绞窄在精神障碍患者中常见，应被视为外科急症，因为可能出现严重并发症。对于移除这些物体，尚未推荐特定方法和工具。患者感到羞耻是延迟手术咨询的根本原因，且容易发生并发症。若具备良好的手术技能，简单器械可用于干预。
阴茎绞窄在因羞耻而拒绝就医的精神病患者中常见，应迅速进行干预，手术实践中不常用的简单器械可有效用于移除致伤物体。
