A Case Series on Penile Garroting: Causes, Considerations, and Consequences

Abstract

Penile injuries from self-inflicted strangulation or garroting are uncommon. Children are more likely than young adults or elderly patients to sustain such injuries. Numerous foreign things, including hair, thread, rubber bands, metallic rings, nuts, and vacuum erection devices, have been reported to be used for garroting in the literature search. Determining the precise cause of such anomalous behavior can be difficult. If there is an underlying mental disorder, the situation becomes even more complex. While such mishaps in the elderly population may be for the relief of lower urinary tract symptoms such as frequency or incontinence, in young persons, they may be for sexual stimulation and erection augmentation. These devices tightly constrict the penis root, obstructing the venous return and causing corpora congestion that leads to ischemia, gangrene, or necrosis. We describe our observations of three incidents of penile garroting and its aftereffects. Here, we also talk about the several gadgets that our patients use and the methods that we employ to remove the constriction.

Keywords: garroting; grading; injury; management; penis.

Figure 1. (a, b) Paraphimosis with a tight pink-colored constricting rubber band (red arrow) at the penile shaft; (c) post circumcision.

Figure 2. (a) Grossly edematous penis with constricting steel ring at the base of the penis; (b) Hacksaw ridge; (c) skin abrasion at the base of the penis after removal of the ring.

Figure 3. (a) Gold ring at the base of the penis causing penile oedema; (B) cut ring; (c) penis after removal of the ring; (d) rib cutter.