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Case Reports
. 2020 Oct 15:60:50-55.
doi: 10.1016/j.amsu.2020.10.020. eCollection 2020 Dec.

Penile hair coil strangulation in a 9-year-old patient: Surgical management and review of the literature

Khaireddine Bouassida  1 , Khaled Ben Ahmed  1 , Mouna Ben Othmen  1 , Mehdi Jaidane  1
Affiliations
Case Reports

Penile hair coil strangulation in a 9-year-old patient: Surgical management and review of the literature

Khaireddine Bouassida et al. Ann Med Surg (Lond). .

Abstract

Introduction: Strangulation of the penis is a rare situation that requires urgent treatment for penile decompression. The complications could range from simple edema to severe ones such as urethrocutaneous fistula, complete urethral transection, penile gangrene and penile amputation. This work has been reported in line with the SCARE criteria.

Case presentation: A 9-year-old patient was presented to the emergency service.During examination of the genitals, the glans was hanging to the penis by a very slim pedicle, its coloration was normal and the urethra was almost cut at the sulcus coronarius. The cause of strangulation was multiple hair coils.We performed single stage reparation which consists of refreshing the edges of the urethra and glans, followed by anastomosing the two cut urethral ends, reinforcement by interposing a well vascularized dartos layer was also performed. At the six months follow-up, the penis had a good cosmetic outcome and the glans sensation was present.

Discussion: The penile tourniquet syndrome is one of the major causes of pediatric penile trauma. Ritual circumcision is basically the main cause of the series followed by penile strangulation. Surgical reparation can be performed in one or two stages. It should be performed by a surgeons experienced in hypospadias repair by following the same principles of dissection and applying a second layer coverage for the urethroplasty.

Conclusion: Hair-coil penile strangulation is an uncommon condition. The repair can be realized in one or two stages but it must be performed by a surgeon experienced in hypospadias surgery. Early surgical repair is required to achieve successful results.

Keywords: Hair tie; Penile trauma; Reconstructive surgical procedures.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Multiple hair coils causing penile strangulation, the glans was hanging to the penis by a very slim pedicle and the urethra was totally sectioned.
Fig. 2
Fig. 2
Removal of the constrictive hair coils responsible for strangulation and refreshing the edges of the glans.
Fig. 3
Fig. 3
The proximal and the distal parts of the urethra are dissected after putting a urethral catheter. End-to-end anastomoses were performed later.
Fig. 4
Fig. 4
Reinforcement by interposing a well vascularized dartos layer was performed and finally the fascial layer and skin were sutured.
Fig. 5
Fig. 5
Penile aspect after 6 months of following up.
See this image and copyright information in PMC

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