NDP102: Paratesticular dedifferentiated liposarcoma : a rare case report
孫浩議1、許哲維2、陳生文1、李文凱2、楊智凱2、鄭惠升2、柯明中2、劉志光2
1臺北市立聯合醫院忠孝院區外科部泌尿科
2臺北市立聯合醫院中興院區外科部泌尿科
When Enhancement
Turns Hazardous:
Managing a Severe Case of Penile Strangulation from a Steel Ring
Hao-Yi Sun 1, Che-Wei Hsu 2, Sheng-Wen Chen 1, Wen-Kai Lee 2, Chih-Kai Yang 2, Huey-Sheng Jeng 2, Ming-Chung Ko 2, Chih-Kuang Liu 2
1 Division of Urology, Department of Surgery, Zhongxiao Branch, Taipei City Hospital
2 Division of Urology, Department of Surgery, Zhongxing Branch, Taipei City Hospital
Introduction
Penile strangulation is a rare but serious urological emergency that occurs when an object encircles the penis, obstructing blood flow, lymphatic drainage, and potentially leading to severe complications such as inflammation, edema, and tissue necrosis. This condition has been observed across various age groups, often resulting from different motivations, such as sexual curiosity in younger males and attempts to enhance sexual performance in adults. Self-applied objects, including metallic rings and plastic bottles, are commonly implicated in these incidents.
Case presentation
A 44-year-old male presented to the Emergency Room (ER) with penile swelling that had persisted for three days. The penis had become approximately eight times bigger than its normal size due to strangulation caused by a steel ring. Due to the ring's constriction at the penile base, the extreme swelling was consistent with vascular obstruction and lymphatic congestion.
A bolt cutter with a handle length exceeding 50 cm was used to remove the steel ring. It was carefully cut into three segments, allowing for safe extraction from the penile root. During the removal process, it was noted that the ring had caused a circumferential erosion around the affected area, yet no additional lacerations or acute injuries were inflicted during extraction.
This case aligns with documented instances where middle-aged men employed penile rings to enhance sexual performance, unaware of the potential dangers of prolonged strangulation. The absence of lacerations upon removal, despite significant swelling and erosion, is notable and speaks to the care taken during the extrication process.
Conclusion
Penile strangulation, while uncommon, poses significant health risks, particularly when left untreated for extended periods. This case emphasizes the dangers of using constricting metallic rings as erection aids and underscores the need for patient education on safer alternatives. Furthermore, it highlights the importance of proper extrication techniques to minimize additional injury during removal. Future studies are necessary to develop detailed management protocols for penile strangulation cases, as well as to establish guidelines for follow-up care to monitor and manage potential long-term effects.