指輪による陰茎絞扼症の1例

概要

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A 42-year-old man was hospitalized with urinary retention due to strangulation of the penis in December, 1981. He placed a stainless steel ring on the base of the penis to prolong erection one month earlier, but subsequent penile edema made it impossible to remove the ring. On admission the penis was extremely swollen (15 cm in length and 7 cm in diameter). Gangrenous patches covered the surface of the penis almost completely and the ring had cut through all the tissues superficial to Buck's fascia. Even slight tension would have probably divided the penis at the site of obstruction and we thought that amputation would be necessary. However, we decided to try conservative therapy since pulsation was felt in the glans. A high-speed airdriven drill with a diamond tip was used to sever the ring. This took ninety minutes. The ring was 2 cm in diameter. The wound was sutured in one layer after through debridement. The skin ulceration healed slowly and a urethral fistula was present in the penoscrotal region until the 66th postoperative day when it closed spontaneously. At discharge the patient had no problems with urination or erection.