Journal of Urological Surgery (Mar 2024)

Penil Entrapment with A Steel Nut and Its Treatment with A Dental Micro Motor

  • İlker Akarken,
  • Fatih Karaöz,
  • Hüseyin Tarhan,
  • Hasan Deliktaş,
  • Hayrettin Şahin

DOI
https://doi.org/10.4274/jus.galenos.2023.2023.0020
Journal volume & issue
Vol. 11, no. 1
pp. 55 – 57

Abstract

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Entrapment or strangulation of the penis is an uncommon condition that requires prompt medical intervention to avoid mechanical and/or vascular injuries. Severe complications such as edema, necrosis, skin infection, penile amputation, and urethral fistula may occur. There is no universally accepted method for treatment, and medical treatment can be delayed due to feelings of humiliation or self-attempt to release the entrapment. Intracavernosal aspiration is a surgical procedure used to evacuate blood from the obstructed corpus cavernosum. This procedure reduces penile size making it easier to remove the ring. However, it does not alleviate the inflammatory idea in the interstitial spaces and penile skin. This paper describes a case study of a 34-year-old male patient who was evaluated in the department of emergency with penile entrapment in a thick steel ring that was placed for prolonged erection. Removing the ring manually was attempted in the emergency department but failed, causing more engorgement in the distal part of the penis. The following admission, the patient was expeditiously transferred to the operating room where the surgical team interposed a wooden tongue depressor between the penile shaft and the ring. Subsequently, a manual hacksaw was used to excise the constriction device. Nevertheless, owing to the substantial diameter of the ring, the hacksaw became fractured and subsequently, a micromotor was employed for the ring removal procedure. Throughout the cutting process involving the micromotor, the ring was continuously cooled with an iced isotonic solution. Within thirty minutes, the ventral and dorsal sides of the steel ring were cut, and it was removed in two pieces.

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