Acute Ischemia of the Glans Penis after Circumcision Treated with Hyperbaric Therapy and Pentoxifylline: Case Report and Revision of the Literature

Migliorini, Filippo; Bianconi, Francesco; Bizzotto, Leonardo; Porcaro, Antonio Benito; Artibani, Walter

doi:10.1159/000444399

Cited by 20 publications

(19 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Hyperbaric oxygen, methylprednisolone, and pentoxifylline injection have been proved to be effective treatments for the patient with glanular skin necrosis. 15,16 Considering the cases studied in this report, one of the patients was brought to our center 10 days after the incident; so, as mentioned earlier, we had missed the golden time to manage it with routine management. Generally, all forms of genital cutting performed on children (including unnecessary sex reduction circumcision surgery and sexassignment/reassignment surgery) may have serious physical, sexual, and psychological consequences, which could be last for the rest of the patient's life.…”

Section: Discussionmentioning

confidence: 87%

<p>Penile Injury During Ritual Circumcision</p>

Ahmed¹,

Al‐wageeh²,

Al-shami³

et al. 2020

RRN

View full text Add to dashboard Cite

Purpose: Circumcision is one of the most prevalently performed surgeries worldwide. It is a common non-therapeutic procedure, which, based on the cultural and social background of people, could be performed by individuals at different levels of skill ranging from trained medical professionals to non-specialists. Therefore, this surgery could cause complications of varying frequencies and types. For example, penile damage during the circumcision procedure is a severe and rare complication leaving patients with morbidity and lifelong consequences. Here, we reported two cases of penile injury during a ritual circumcision. Patients and Methods: This study was approved by the ethics committee of Ibb University of Medical Sciences. Case 1: A 6-month-old child was brought to hospital by parents with complaints of purulent discharge around the penis after ritual circumcision performed 3 days ago with complete skin loss in the whole part of the penis extended to the scrotum and suprapubic area. Case 2: A 2-month-old child was brought to hospital with complaints of penile discharge and gangrene after ritual circumcision performed 10 days ago. Results: Case 1: He was treated with daily debridement and wound irrigation followed by a surgical procedure to bury the penis in the scrotum for future reconstructive surgery. Case 2: A suprapubic cystostomy was inserted into the bladder. Then, daily debridement and wound irrigation was performed for the child. To treat penile gangrene, two options were available. The first option was to bury the penis in the scrotum and do reconstructive surgery later. The second option was to change the child's anatomical sex from male to female. Conclusion: We suggest that every child, before a circumcision procedure, should be evaluated by a medically trained professional. This procedure should also be carried out in aseptic conditions. Additionally, the circumcision procedure needs to be performed by an experienced medical professional.

show abstract

Section: Discussionmentioning

confidence: 87%

<p>Penile Injury During Ritual Circumcision</p>

Ahmed¹,

Al‐wageeh²,

Al-shami³

et al. 2020

RRN

View full text Add to dashboard Cite

show abstract

“…4 6 However, indication and dosage of PTX in children remain controversial. 3 4 6 8 11 Hence, in our patient we used the selective phosphodiesterase inhibitor (PDE 5) sildenafil as a vasodilative agent with success and did not appreciate side effects.…”

Section: Discussionmentioning

confidence: 99%

“… 10 Other authors also report on ischemia of the glans penis following DPNB for circumcision. 6 7 11 As an alternative for DPNB, topical anesthetics have been evaluated but did not provide sufficient perioperative analgesia. 12 Kaplanian et al suggested to limit the volume of local anesthetic solution to an amount of 0.2 mL/kg (up to maximum of 10 mL).…”

Section: Discussionmentioning

confidence: 99%

Glans Ischemia after Circumcision in a 16-Year-Old Boy: Full Recovery after Angiography with Local Spasmolysis, Systemic Vasodilatation, and Anticoagulation

Gnatzy

Fuchs

Siekmeyer³

et al. 2018

European J Pediatr Surg Rep

View full text Add to dashboard Cite

Circumcision is one of the most frequent procedures performed by pediatric surgeons. A dorsal penile nerve block (DPNB) is commonly used for perioperative analgesia. We report the case of a 16-year-old boy with ischemia of the glans who presented on the first postoperative day after circumcision under DPNB (0.25% bupivacaine) at an outside hospital. The patient underwent immediate angiography under sedation. An intra-arterial spasmolysis was performed with alprostadil and nitroglycerine and a sufficient perfusion of the glans penis was confirmed. Subsequently, systemic sildenafil, arginine, and heparin were given. Following this 3-day medical treatment, ischemia resolved completely. Our case emphasizes the role of invasive angiography in the diagnostic workup and the therapeutic possibilities of local spasmolysis, systemic vasodilatation, and anticoagulation.

show abstract

“…44 Benzer şekilde Pepe ve ark.nın ça-lışmasında, 5 gün önce lokal anestezi ile sünnet olan bir hastada postoperatif 1. gün gözlenen glans penis ve penis dorsal kısımda yer alan nekroz görünümü-nün tedavisi sunulmuştur. Araştırmacılar, hastaya HBOT ile beraber antibiyotik, kortikosteroid ve antiagregan tedavi verildiğini, bununla birlikte başarılı bir sonuç elde ettiklerini bildirmişlerdir.…”

Section: Peni̇s İyi̇leşmesi̇ Pri̇api̇zm Ve Erekti̇l Di̇sfonksi̇yonunclassified

Hyperbaric Oxygen Therapy and Applications in Urology: Review

Kati¹,

Pelit²,

Güneş³

2017

J Reconstr Urol

View full text Add to dashboard Cite

8Hiperbarik Oksĳen Tedavisi ve Ürolojideki Uygulamalar Ö ÖZ ZE ET T Hiperbarik oksijen tedavisi (HBOT), özetle oksijenin farmakolojik bir uygulamasıdır. Hastalara uygun ortamda, tekli veya çok hastalı gruplar olarak, deniz seviyesinden daha yüksek basınçta, %100 oksijen kullanılarak uygulanan bir tedavi çeşididir. Yaklaşık 50 yıldan fazladır hipoksi kaynaklı hastalıklarda dokulara oksijen sağlamak amacıyla kullanılmıştır. Bu tedavideki başarılı gelişmelere paralel olarak özellikle son 30 yıl içinde ürolojik bazı hastalıklarda da başarılı bir şekilde uygulanmaktadır. Yapılan çalışmalarda antimikrobiyal etkisinin de belirlenmesiyle birlikte genel olarak konakçı savunma ve onarım mekanizmalarının uyarılmasını tetiklediği ve böylece doku direncini arttırdığı bildirilmektedir. Bu derleme Nisan 2016 tarihine kadar olan ve pubmed içinde indekslenen 'hiperbarik oksijen tedavisi' ve 'üroloji' başlığı altında yapılan arama sonucunda ürolojik hastalıklarda kullanılan HBOT'un, çok vakalı ve deneysel çalışmaların sonuçları araştırıldı. Ek olarak ilginç olgu sunumlarıyla beraber toplamda yaklaşık 51 adet çalışma değerlendirildi. 9 adet deneysel çalışma yanında toplamda yaklaşık 730 hastayı içeren çalışmalar incelendi. Ürolojik hastalık bölgesi veya hastalık kategorisi olarak sınıflandırıldı ve topluca bir değerlendirme açısından yardımcı olması sağlandı. Yapılan birçok çalışmada, başta radyasyona bağlı hemorajik sistit tedavisi ve fornier gangreni tedavisi olmak üzere başarısı yüksek olduğu belirtilse de kanıt düzeyleri çok yüksek çalışmaların sayısı azdı. Patofizyolojisinde hipoksi olan birçok ürolojik hastalıkta başarıyla uygulandığı, spontan ama literatüre girememiş ilginç olgu sunumları ile yakın gelecekte kanıtlanabilirse, birçok organ ve doku alanında rutin kullanımının genişletilebileceği belirlenmiştir.A An na ah ht ta ar r K Ke el li im me el le er r: : Üroloji; hiperbarik oksijenasyon; hücre hipoksisi A AB BS ST TR RA AC CT T Hyperbaric oxygen therapy (HBO) is a pharmacological application of the oxygen. It is a kind of treatment modality that is applied to the single or multiple patients in a suitable environment, using 100% oxygen at higher pressure than sea level. It has been used for more than 50 years to provide oxygen to tissues in hypoxic diseases. In parallel to the development of this application, it has been applied successfully in some urological diseases for 30 years. It has been reported in current studies that the antimicrobial effect of this treatment modality triggers host defense and repair mechanisms in general and thus increases tissue resistance. In this review, we searched multi-trial and empirical studies about HBOT used in urological diseases indexed in PubMed under the heading "hyperbaric oxygen therapy and urology" on April 2016. A total of about 51 studies were evaluated with addition of interesting case studies. Besides to 9 experimental studies, studies that wereevaluated contain 730 patients. It is classified as urological disease region or disease category and it would be helpful in ter...

show abstract

Acute Ischemia of the Glans Penis after Circumcision Treated with Hyperbaric Therapy and Pentoxifylline: Case Report and Revision of the Literature

Cited by 20 publications

References 13 publications

<p>Penile Injury During Ritual Circumcision</p>

<p>Penile Injury During Ritual Circumcision</p>

Glans Ischemia after Circumcision in a 16-Year-Old Boy: Full Recovery after Angiography with Local Spasmolysis, Systemic Vasodilatation, and Anticoagulation

Hyperbaric Oxygen Therapy and Applications in Urology: Review

Contact Info

Product

Resources

About