Penile Strangulation with Metallic Objects in Adults: 2 Case Reports and Literature Review

Abstract

Background: Penile strangulation by various metallic and non-metallic objects poses real challenge to the physicians in the Emergency Department. The removal of the offending objects requires imaginative mind, innovative thought process, improvised skill and resources often outside the department and even outside the hospital. Cases have been reported from across the globe and among various age groups ranging from adolescents to geriatric. The underlying motive is usually autoerotic stimulation or sometimes psychiatric disturbances. The incarcerating injury results in reduced blood flow distal to the injury, leading to edema, ischemia, and sometimes gangrene. Unfortunately, patients often present late, when the damage has progressed quite far. Two cases of penile strangulation by metallic objects that resulted in penile edema and were treated successfully are presented here. A search was made for available papers and publication in English language for various methods of management of such cases using keywords "penile strangulation" on PUBMED and PMC database and 72 relevant articles were retrieved. Objective: These cases present lessons to be learned for Accident and Emergency Department doctors in particular and even primary care physicians in general. Conclusion: The cases should be approached and managed on an emergent basis in order to preserve normal function and prevent or minimize further complications.