Glandular amputation by strangulating tied suture: a case report of late-onset complication in the Plastibell circumcision technique

Jalil Hosseini,Saeid Haghdani,Nima Narimani

doi:10.1186/s12887-019-1554-z

Abstract

BackgroundCircumcision is considered to be a procedure with minimal morbidity but may be associated with catastrophic complications in inexpert hands.Case presentationWe presented a 9-year-old boy with a past medical history of circumcision at the age of one year with Plastibell clamp who was referred with severe chronic penile injury due to neglected plastibell string. After string removal under a loupe magnification (4×), we saw a deep circular injury at distal penile shaft which led to painless glandular autoamputation 45 days later. The patient was managed conservatively with daily urethral self-dilation until future reconstructive surgery.ConclusionThis complication emphasized the importance of the follow-up visit by a physician for any probable string remnant.

Highlights

Circumcision is considered to be a procedure with minimal morbidity but may be associated with catastrophic complications in inexpert hands
We present a 9-year-old boy with chronic penile injury due to a missed Plastibell string that lead to glandular autoamputation within one month after string removal
* Correspondence: Nima_dr2001@yahoo.com; narimani.n@iums.ac.ir 2Department of Urology, Hasheminejad Kidney Center (HKC), Iran University of Medical Sciences (IUMS), Tehran, Iran Full list of author information is available at the end of the article

Summary

Introduction

Circumcision is considered to be a procedure with minimal morbidity but may be associated with catastrophic complications in inexpert hands. Background Circumcision is the most common pediatric surgery worldwide, and performed due to cultural, religious and medical reasons [1]. Circumcision in newborn and in infancy has fewer complications due to their impressive healing capability and simpler techniques [3].

Results

Conclusion