Zhao Yi, Xue Xiao-Qiang, Huang Hou-Feng, Xie Yi, Ji Zhi-Gang, Fan Xin-Rong
Department of Urology, Peking Union Medical College Hospital, Beijing 100730, China.
World J Clin Cases. 2022 Jan 14;10(2):747-752. doi: 10.12998/wjcc.v10.i2.747.
Penial incarceration (PI) is a rare situation. It is usually caused by a foreign object which strangulates at the base of the penis. PI may derive from pranks, sexual demand, mental disease, or intention to prohibit urinary disease. Generally, these situations are emergent and immediate treatments are needed. Cases of chronic PI are less reported, and their treating methods are yet to be discussed.
We reported a case on treating a 73-year-old male who had PI with a metallic hoop for three months. After multidisciplinary consultation, the operation was performed successfully with the help of a fretsaw. Despite the chronic strangulation, the prognosis of the patient was satisfying. To the best of our knowledge, this case was rare and precious as it featured the longest strangulating time, which might enlighten the treating process of future PI cases. Also, we have reviewed and summarized major published cases to encapsulate appropriate approaches when facing diverse strangulation situations.
The selection of surgical tools depends on the material of the strangulating objects, the availability of equipment, and the severity of the penial damage. The urination function may not be affected after three months of incarceration as in our case, whilst prudent preoperative measures and multidisciplinary evaluations are always essential. Although using a fretsaw is comparatively slow, it is safe and feasible to treat metallic penial incarceration.
阴茎嵌顿是一种罕见的情况。它通常由异物在阴茎根部勒压所致。阴茎嵌顿可能源于恶作剧、性需求、精神疾病或预防泌尿系统疾病的意图。一般来说,这些情况较为紧急,需要立即治疗。慢性阴茎嵌顿的病例报道较少,其治疗方法仍有待探讨。
我们报告了一例治疗一名73岁男性的病例,该男性阴茎被金属箍嵌顿长达三个月。经过多学科会诊后,在弓锯的帮助下成功实施了手术。尽管存在长期勒压情况,但患者预后良好。据我们所知,该病例十分罕见且珍贵,因其勒压时间最长,这可能会为未来阴茎嵌顿病例的治疗过程提供启示。此外,我们回顾并总结了主要已发表的病例,以归纳面对不同勒压情况时的合适处理方法。
手术工具的选择取决于勒压物体的材质、设备的可用性以及阴茎损伤的严重程度。如我们的病例所示,嵌顿三个月后排尿功能可能未受影响,然而术前谨慎的措施和多学科评估始终至关重要。虽然使用弓锯相对较慢,但治疗金属所致的阴茎嵌顿是安全可行的。