Delayed Retrieval of Fragment After Needle Breakage During Intracavernous Self-Injection

Abstract

Intracavernous self-injection of vasoactive drugs for erectile dysfunction is now widespread due to its effectiveness and low rate of complications. We report 2 cases of intracavernous needle breakage with delayed retrieval. CASE REPORTS Case 1. A 69-year-old man presented with a needle fragment in the penis. During self-injection he felt unusual pain, and he discovered that the 28 gauge needle had broken and a portion remained in the penis. An attempt to retrieve it through a 4 cm. incision failed elsewhere 2 hours before hospital admission. There was a large hematoma over the incision but no metal fragment was palpable. Needle position was confirmed by x-ray (fig. 1). The patient was discharged home with instructions to return for followup. Six weeks later the fragment was protruding and palpable beneath the skin. The needle was dislodged through a superficial 1 mm. incision without local anesthesia or x-ray guidance. Case 2. An 80-year-old man presented with a needle fragment in the penis. He felt a sharp pain during the second self-injection for erectile dysfunction, and he then discovered that the 28 gauge needle had broken and a portion was embedded in the penis. A hematoma was present over the injection site but no metal fragment was palpable. Needle position was confirmed by x-ray (fig. 2, A). The patient refused surgical intervention. Four days later he reported needle protrusion beneath the skin. A 1 mm. superficial skin incision was made over the palpable needle point without local anesthesia or x-ray guidance and the fragment slipped out effortlessly (fig. 2, B).