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Case Reports
. 2020 Jul 17;99(29):e21340.
doi: 10.1097/MD.0000000000021340.

Acute glans ischemia after circumcision successfully treated with low-molecular-weight heparin and topical dihydrotestosterone: A case report

Zlatan Zvizdic  1 , Dusko Anic  2 , Nusret Popovic  1 , Semir Vranic  3
Affiliations
Case Reports

Acute glans ischemia after circumcision successfully treated with low-molecular-weight heparin and topical dihydrotestosterone: A case report

Zlatan Zvizdic et al. Medicine (Baltimore). .

Abstract

Rationale: Circumcision like any other surgical procedure is not devoid of complications. Serious complications are rare and include iatrogenic hypospadias, glans ischemia/necrosis, and glans amputation, all of which require an emergent treatment.

Patient concerns: We report here a case of 6 months-old-boy with a superficial glans ischemia following circumcision.

Diagnosis: Physical examination revealed a severely cyanotic glans with the moderate edema of the dorsal penile skin. Plasma levels of D-dimer were 8.57 mg/L. Urine passage was unremarkable while color Doppler ultrasonography revealed a normal blood flow.

Interventions: The patient was successfully treated with subcutaneous injection of enoxaparin (low-molecular-weight heparin) and topical 2.5% dihydrotestosterone.

Outcomes: The appearance of the glans penis on the 5th day was close to normal while the control levels of D-dimer dropped to the reference range. The patient was discharged from the hospital on the 6th day. At 6-month follow-up, the appearance of the glans penis was normal.

Lessons: Acute glans penis ischemia following circumcision is a rare complication. Its successful treatment with enoxaparin and topical dihydrotestosterone has not been previously reported in the literature.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
(A–D) A gross appearance of the glans penis on the second day (A), third day (B), fourth day (C), and fifth day (D) following the treatment with enoxaparin (low-molecular-weight heparin) and a topical 2.5% dihydrotestosterone.
See this image and copyright information in PMC

References

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