Treatment Options and Outcomes of Penile Constriction Devices

Int Braz J Urol. 2019 Mar-Apr;45(2):384-391. doi: 10.1590/S1677-5538.IBJU.2018.0667.

Abstract

Purpose: To study the effect of penile constriction devices used on a large series of patients who presented at our emergency facility. We explored treatment options to prevent a wide range of vascular and mechanical injuries occurring due to penile entrapment.

Materials and methods: Between January 2001 and March 2016, 26 patients with penile entrapment were admitted to our facility and prospectively evaluated.

Results: The time that elapsed from penile constrictor application to hospital admission varied from 10 hours to 6 weeks (mean: 22.8 hours). Non-metallic devices were used by 18 patients (66.6%) while the other nine (33.4%) had used metallic objects. Acute urinary retention was present in six (23%) patients, of whom four (66.6%) underwent percutaneous surgical cystotomy and two (33.4%) underwent simple bladder catheterization. The main reason for penile constrictor placement was erectile dysfunction, accounting for 15 (55.5%) cases. Autoerotic intention, psychiatric disorders, and sexual violence were responsible in five (18.5%), five (18.5%), and two (7.4%) cases, respectively. The mean hospital stay was 18 hours (range, 6 hours to 3 weeks).

Conclusion: Penile strangulation treatment must be immediate through the extraction of the foreign body, avoiding vascular impairments that can lead to serious complications. Most patients present with low-grade injuries and use penile constrictors due to erectile dysfunction. Removal of constrictor device can be challenging. The use of specific tools for achieving penile release from constrictors is a fast, safe and effective method. Patients with urinary retention may require urinary diversion.

Keywords: Constriction; Penis; Therapeutics.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Amputation, Surgical
  • Constriction, Pathologic
  • Foreign Bodies / complications
  • Foreign Bodies / therapy*
  • Humans
  • Male
  • Middle Aged
  • Penile Diseases / etiology*
  • Penile Diseases / pathology
  • Penis / injuries*
  • Penis / pathology
  • Penis / surgery
  • Self-Injurious Behavior / complications
  • Self-Injurious Behavior / surgery
  • Self-Injurious Behavior / therapy*
  • Sexual Behavior
  • Young Adult