Department of Urology, ASST Sette Laghi - Circolo e Fondazione Macchi Hospital, Varese, Italy.
University of Insubria, Varese, Italy.
Urologia. 2024 Nov;91(4):852-860. doi: 10.1177/03915603241273611. Epub 2024 Aug 22.
Glans necrosis after circumcision is an exceedingly rare complication among adult males, with only a handful of cases being reported in the literature.
We present here two cases of glans ischaemia observations after circumcision in both a 19-year-old and a 26-year-old patient; both were managed with oral medications in the outpatient setting, with complete restitutio-ad-integrum. A narrative review of the literature was also performed to better describe the possible predisposing factors; the treatment/management options; and the typical outcomes among the adult males experiencing with this complication.
Penile dorsal anaesthetic blocks, monopolar cautery usage and compressive wound dressing are all reported to play a role as co-factors for glans ischaemia after circumcision, hence their adoption should be mindful. There is no consensus on the management of ischaemia of the glans after male circumcision.
The favourable outcomes being reported for most of the literature cases of glans ischaemia after circumcision among adults despite the adoption of diverse empirical therapeutic strategies suggest that the role of the proactive management may be questionable.
阴茎头坏死是成年男性行包皮环切术后一种罕见的并发症,文献中仅有少数病例报道。
我们在此报道 2 例 19 岁和 26 岁患者包皮环切术后发生的阴茎头缺血观察病例;均在门诊接受口服药物治疗,完全恢复正常。我们还进行了文献回顾,以更好地描述可能的诱发因素、治疗/管理选择以及经历这种并发症的成年男性的典型结局。
阴茎背侧局部麻醉阻滞、单极电灼和压迫性伤口敷料均被报道为包皮环切术后阴茎头缺血的协同因素,因此应谨慎采用。对于男性包皮环切术后发生的阴茎头缺血,目前尚无统一的管理方法。
尽管采用了不同的经验性治疗策略,但大多数文献报道的成年男性包皮环切术后发生的阴茎头缺血病例结局良好,这表明积极治疗的作用可能存在争议。