V11-04 ORTHOPEDIC DRILL FOR REMOVAL OF A STEEL PENILE CONSTRICTION RING AFTER PROLONGED ENTRAPMENT

Abstract

You have accessJournal of UrologyCME1 Apr 2023V11-04 ORTHOPEDIC DRILL FOR REMOVAL OF A STEEL PENILE CONSTRICTION RING AFTER PROLONGED ENTRAPMENT Stephen Harrington, Hershey, Pa Ashley Matthew, Susan Macdonald, Hershey Pa, and Tyler Roseman Stephen HarringtonStephen Harrington More articles by this author , Hershey, Pa Ashley MatthewHershey, Pa Ashley Matthew More articles by this author , Susan MacdonaldSusan Macdonald More articles by this author , Hershey PaHershey Pa More articles by this author , and Tyler RosemanTyler Roseman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003337.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Penile incarceration or strangulation due to an external device is a rare urologic emergency. There are many different types of constriction rings that vary in composition and form. Metal constriction rings are particularly challenging to remove once the penis becomes entrapped as they are not only a harder material, but often are of increased thickness compared to typical constriction rings. We detail a case of prolonged penoscrotal incarceration due to a steel constriction ring and the method utilized for the ring’s removal. We aim to describe a specific and actionable technique for removing metal constriction rings. METHODS: We report the technique used to remove a stainless steel ring that cause penoscrotal entrapment and subsequent edema after being in place for 12 hours. RESULTS: The patient was prepped in an operating room and a combination of saline soaked gauze and blue towels were used to protect the surrounding skin. The skin below and surrounding the ring was coated in lubricating jelly to prevent scatter of heated metal fragments. An army navy retractor was placed between the ring and the skin to protect the genitals from injury. An Ortho Core Metal Cutting Pneumatic Drill with a 3.2 mm x 18.3 mm metal cutting helicoidal rasp was used to cut the ring at the 3 and 9 ‘o clock positions. Cooled saline irrigation was applied throughout removal to prevent thermal injury. The patient was seen 6-weeks post-operatively. There were no visible external injuries, palpable penoscrotal pathology or voiding complaints. All swelling had resolved. The patient did endorse worsened erectile dysfunction, but no other complications were noted. CONCLUSIONS: Penile incarceration due to a constriction ring is a urologic emergency that necessitates timely evaluation and management. The Stryker Ortho Core Metal Cutting Drill with a metal cutting helicoidal rasp is a reliable tool for the removal of metal constriction rings. Measures to protect the genitals and surrounding skin from both direct mechanical injury and indirect thermal injury are critical. Lastly, staff should wear appropriate protective gear. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1000 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Stephen Harrington More articles by this author Hershey, Pa Ashley Matthew More articles by this author Susan Macdonald More articles by this author Hershey Pa More articles by this author Tyler Roseman More articles by this author Expand All Advertisement PDF downloadLoading ...