Lopes Manuel M, Quaresma Vasco, Lorigo João, Nunes Pedro, Figueiredo Arnaldo
Urology and Renal Transplantation, Hospitais da Universidade de Coimbra, Coimbra, PRT.
Cureus. 2025 Aug 18;17(8):e90406. doi: 10.7759/cureus.90406. eCollection 2025 Aug.
Penile strangulation by constricting devices is a rare but potentially devastating urological emergency. The removal of such foreign bodies usually poses significant challenges, and late presentations may result in irreversible complications. We report the case of a 56-year-old man who presented to the emergency department with pain and necro-ischemic penile signs due to a metallic ring placed at the base of the penis for over 48 hours. Physical examination revealed grade IV-V ischemic injury and urinary retention. The constricting body was removed using an angle grinder under anesthesia. Ischemic changes led to partial skin necrosis, requiring debridement and circumcision on day 7 after admission, followed by a split-thickness skin graft on day 20 of hospital stay with reconstructive and plastic surgery collaboration. The patient was discharged home after 28 days, with no infections or functional complications. At one-year follow-up, the patient had preserved voiding and spontaneous erectile function. This case illustrates a multidisciplinary approach to a rare urological emergency and highlights the feasibility of unconventional yet safe surgical techniques for object removal.
使用紧缩装置导致阴茎绞窄是一种罕见但可能具有毁灭性的泌尿外科急症。移除这类异物通常极具挑战性，而延迟就诊可能导致不可逆转的并发症。我们报告一例56岁男性病例，该患者因阴茎根部放置金属环超过48小时，出现疼痛及阴茎坏死缺血体征后前往急诊科就诊。体格检查发现IV - V级缺血性损伤及尿潴留。在麻醉下使用角磨机移除紧缩物体。缺血性改变导致部分皮肤坏死，入院后第7天需要进行清创和包皮环切术，随后在住院第20天进行了中厚皮片移植，并与整形和重建外科协作。患者在28天后出院，无感染或功能并发症。在一年的随访中，患者排尿及自发勃起功能得以保留。该病例说明了对罕见泌尿外科急症的多学科处理方法，并强调了采用非常规但安全的手术技术移除异物的可行性。
