Penile Strangulation by self-Placement of Metallic Nut
#MMPMID26339086
Kyei MY
; Asante EK
; Mensah JE
; Klufio GO
; Paintsil A
; Gepi-Atee S
; Morton B
; Ampadu K
; Toboh B
Ghana Med J
2015[Mar]; 49
(1
): 57-9
PMID26339086
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We report a case of a 37-year-old male who presented with a 12-hour history of a
strangulating 2cm wide by 0.8 cm thick metallic nut on the penile shaft at the
peno-scrotal junction. Unlike instances where these metallic objects are placed
to enhance sexual stimulation this nut was rather placed to prevent intercourse.
A Bosch electric circular grinder was successfully used for removal but a thermal
burn to the penile tissues was sustained in the process as the hardness of the
nut required a high energy to cut and its thickness did not allow for effective
cooling during the process of removal. This resulted in a circumferential
denudation of penile skin, a urethro-cutaneous fistula at the peno-scrotal
junction and a mid-bulbar urethral stricture. The penile wound was subsequently
covered with a split skin graft with a delayed closure of the urethrocutaneous
fistula and a buccal mucosa patch urethroplasty for the mid bulbar stricture.
Despite the degree of thermal burns sustained the patient has maintained good
erectile function with grade four rigidity. The tunica albuginea and the
underlying corpora cavernosa have shown a significant degree of resilience to
thermal burns compared to the corpora spongiosum where the thermal burns led to a
urethrocutaneous fistula.
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