Severe Penile Ischemia After Metallic Ring Strangulation: A Rare Case of Complete Functional Recovery.

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.