Abstract
Objectives
Penile strangulation with severe necrosis and concomitant significant tissue loss is a challenging problem for reconstructive surgery. Final reconstruction and tissue augmentation of the resected penis often require multi-step plastic reconstruction.
Methods
Severe damage of the phallus with gangrene and septic complication caused by a bronze ring were first conservatively treated to achieve dry gangrene. The glans of the penis, the whole penile skin, and distal third of the corpus spongiosum with the urethra were lost to necrosis, resulting in a missing urethral segment on the penis. Surgery was performed 3 months after removing the metal ring; a one-step skin and urethral reconstruction was done.
Results
Good functional and esthetic results could be achieved by mid-term follow-up.
Conclusion
In long-lasting penile strangulation with damaged blood supply, further surgery and treatment are needed in addition to immediate decompression. Most commonly in these situations, amputation seems to be the best and easiest action to be taken. However, our case shows that even in a most severe situation, careful conservative treatment allows preserving the phallus, and subsequently reconstruction enables reaching the best functional and esthetic results.
References
McClure WJ, Gradinger GP (1985) Hair strangulation of the glans penis. Plast Reconstr Surg 76:120–123
Shaeer O, El-Sebaie A (2005) Construction of neoglans penis: a new sculpturing technique from rectus abdominis myofascial flap. J Sex Med 2:259–265
Silver RI, Docimo SG (1997) Hair coil strangulation of the penis. Urology 49:773
Perabo FG, Steiner G, Albers P, Muller SC (2002) Treatment of penile strangulation caused by constricting devices. Urology 59:137
Osman M, al Kadi H, al Hafi R (1996) Gangrene of the penis due to strangulation by a metallic ring. Scnad J Urol Nephrol 30:77–78
Maruschke M, Seiter H (2004) Total infarction of the penis caused by entrapment in a plastic bottle. Urologe A 43:843–844
Barthelmes L, Chezhian C, Thomas KJ (2002) Progression to wet gangrene in penile necrosis and calciphylaxis. Int Urol Nephrol 34(2):231–235
Rogers HS, McNicholas TA, Blandy JP (1992) Long-term results of one-stage scrotal patch urethroplasty. Br J Urol 69:621–628
Mundy AR (1995) The long-term results of skin inlay urethroplasty. Br J Urol 75:59–61
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Barabás, J., Kelemen, Z., Bánfi, G. et al. Penis covering and simultaneous urethral replacement by scrotal skin for severe penile and urethral necrosis. Int Urol Nephrol 41, 537–540 (2009). https://doi.org/10.1007/s11255-008-9502-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11255-008-9502-0