Meilika Kirolos N, Eid Jean-Francois
Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States.
Department of Urology, Lenox Hill Hospital, Zucker School of Medicine at Hofstra/Northwell, New York, NY, United States.
Sex Med. 2023 Mar 22;11(2):qfad008. doi: 10.1093/sexmed/qfad008. eCollection 2023 Apr.
Although the breakage and entrapment of the needles inside the penis during intracavernosal self-injection for erectile dysfunction treatment is a rare complication, when it happens, it can cause significant distress and anxiety to the patients who experience it.
Our work aims to report a case of retained penile needle and to compare it with similar cases in the literature to define the risk factors and the best practice to prevent and treat this complication.
We are reporting successful surgical removal of a deeply retained penile needle with the aid of intraoperative fluoroscopy after an unsuccessful attempt of ultrasound-guided removal in the emergency room. We searched the PubMed and Embase databases for similar cases and compared the findings across all the cases.
In our case, the needle was initially superficial; however, excessive manipulation in the emergency room resulted in deep displacement into the corpus cavernosum. We were able to successfully localize the needle using intraoperative fluoroscopic guidance. The needle was then surgically removed via a small skin incision with minimal dissection of cavernosal tissue. We identified 15 reported cases of retained penile needles in the literature and performed a comprehensive comparison among all the cases. It is critical to search for specialized treatment with a urologist to avoid great damage due to erroneous manipulation of the corpora cavernosa.
Selecting patients with good manual dexterity is essential to avoid breakage and entrapment of penile needles during intracavernosal self-injection for erectile dysfunction treatment. The management of retained penile needles should be individualized depending on the clinical picture at the time of presentation. It is critical to avoid excessive manipulation as it can push the needle deeper into the penis and make the extraction more demanding.
尽管在阴茎海绵体内自我注射治疗勃起功能障碍时，针在阴茎内折断和嵌顿是一种罕见的并发症，但一旦发生，会给经历此情况的患者带来极大的痛苦和焦虑。
我们的工作旨在报告一例阴茎内滞留针的病例，并将其与文献中的类似病例进行比较，以确定危险因素以及预防和治疗该并发症的最佳做法。
我们报告了在急诊室超声引导下取出失败后，借助术中透视成功手术取出深部滞留阴茎针的病例。我们在PubMed和Embase数据库中搜索类似病例，并比较所有病例的结果。
在我们的病例中，针最初位置较浅；然而，急诊室的过度操作导致其深深移位至海绵体。我们能够在术中透视引导下成功定位针。然后通过一个小皮肤切口，在尽量少解剖海绵体组织的情况下手术取出针。我们在文献中确定了15例报告的阴茎内滞留针病例，并对所有病例进行了全面比较。寻求泌尿科医生的专业治疗以避免因对海绵体的错误操作造成巨大损害至关重要。
选择手部灵活性好的患者对于在阴茎海绵体内自我注射治疗勃起功能障碍时避免阴茎针折断和嵌顿至关重要。阴茎内滞留针的处理应根据就诊时的临床表现个体化。避免过度操作至关重要，因为这可能会将针更深地推入阴茎，使取出更加困难。
