Hair Strangulation Research Articles

Penile Hair Strangulation in an Adult Male: An Interesting Case

Penile hair strangulation is a rare clinical entity seen in infants and young children caused by entanglement of maternal hair around coronal sulcus. It is mostly accidental, and circumcision is a risk factor. An interesting case of penile hair strangulation in a 64-year-old adult uncircumscribed paraplegic male with erectile dysfunction has been described.

Outcomes and special techniques for treatment of penile amputation injury

IntroductionManagement of severe penile trauma presents great challenges for reconstructive urologists since these injuries vary from abrasions to total emasculation. A review of our case experience with penile amputation is presented, emphasizing techniques used to salvage or reconstruct the most difficult of penile injury cases. Materials and methodsA total of 13 patients with penile amputation injury referred to us between 2007 and 2016 were analyzed. Mean age at surgery was 16 years (ranged from 4 to 29 years). Etiology of penile amputation (partial or total) combined with management and outcomes were evaluated. Management included different surgical procedures with the aim to achieve good functional and esthetical outcomes. Postoperative questionnaire was used for assessment of patient's overall satisfaction. ResultsFollow-up ranged from 13 to 182 months (mean 53). Causes of penile injury were iatrogenic trauma (8), self-amputation (2), electrocution (1), intentional sexual assault (1) and mother's hair strangulation (1). Outcome criteria including aesthetic appearance, urinary function and ability to engage in satisfactory coitus, were noted in 11 cases (85%). Two cases with ensuing complications relating to the total phalloplasty required additional treatment due to urethral fistula. ConclusionsSevere penile injuries should be treated on a case by case basis utilizing the most propitious techniques. We respectfully propose that the needs of such patients are best served by referral centers with extensive experience.

Penile hair strangulation: A prodigious cause of pediatric agitation.

Penile hair strangulation is secondary to a hair tourniquet effect. Albeit a rare presentation in pediatric emergency units, penile hair strangulation must be cautiously noted in any penile pain and edema, to avoid inevitable damage to external genitalia, including penile necrosis, urethrocutaneous fistula, and even amputation.

Penile strangulation by hair.

To know the causes and results of treatment of complications from a penile strangulation by hair in seven boys. From April 2000 to December 2012, seven boys presenting serious penile complications by hair strangulation have been operated in two centers. All seven boys had transection of the urethra at the coronal level. And none of our patients were at the stage of necrosis or amputation of the glans. The age of the patients at surgery ranged from 34 to 134 months (mean 96 months). Four children presented urethrocutaneous fistulas (57% of cases), and the innervation and vascularization of the glans remained poor after repair in three patients. The penile strangulation by hair was due to a simple accident. However, several predisposing factors were discovered in our patients: lack of cleanliness; a moist environment with nocturnal enuresis; the presence of pubic hair in young children reported in the four children, and a coronal sulcus not covered by the foreskin in circumcised children.

Severe Penile Injuries in Children and Adolescents: Reconstruction Modalities and Outcomes

To review our experience with severe penile trauma, mechanism of injury, and their treatment modalities in 16 children younger than 18 years. Management of penile trauma poses diverse challenges to the reconstructive urologist, as injuries vary from abrasions to total emasculation. Analysis of 16 patients with severe penile injuries referred to us between 2002 and 2011 was undertaken. The median age at surgery was 13 years (range, 5-17). Etiology of penile trauma and choice of treatment were evaluated. The management included a wide variety of surgical techniques that were tailored to the individual patient. Results were analyzed to define etiology, that is, mechanism of penile injury and to estimate modalities of surgical management and postoperative outcomes. Also, postoperative questionnaire was used, which included questions on functioning and esthetical appearance of participating patients and overall satisfaction. The causes of penile injury in these series were traffic accidents (2), iatrogenic trauma (5), self-amputation (1), electrocution (1), burns (3), dog bite (2), zipper injury (1), and mother's hair strangulation (1). The mean follow-up was 46 months (range, 14-122), and examinations were uneventful, except for 2 fistulae formation after neophallic urethral reconstruction. The main goal of reconstructive surgery is to have a penis with normal appearance and functions. Severe penile injuries should be treated on a case-by-case basis using the most propitious techniques.

Labial Hair Tourniquet

Hair tourniquet syndrome has been recognized as a medical entity since the 1600 s. Appendages develop acute ischemia from tightening of hair strands circumferentially wrapped around them. Most commonly affected sites are fingers, toes, and penis, but limited reports have described involvement of the female genitalia. Although hair strangulation involving the labia minora or clitoris has been described, it typically occurs in young children. We present a case of an adolescent girl with a labial appendage hair tourniquet resulting from a previous unrepaired genital laceration. This is one of the oldest patients in whom a genital hair tourniquet has been reported, as well as description of a posttraumatic genital appendage. Genital hair tourniquets are medical emergencies that require prompt diagnosis and treatment to avoid tissue necrosis and possible amputation. Genital trauma in general requires surgical evaluation.

Hair strangulation injury of the penis

Penile strangulation secondary to a strand of hair acting as a tourniquet is an uncommon injury in young boys. Paraphimosis most commonly produces vascular congestion and edema without strangulation. However, serious penile and urethral injury can occur when a human hair becomes wrapped around a child's penis. We present a three-year-old, circumcised boy who presented with a swollen glans penis thought to be due to infection, and who ultimately was found to have a constricting hair coil at the coronal edge. The purpose of this report is to call attention to hair as a potential source of injury in the pediatric population and to stress the importance of early diagnosis and treatment, which are necessary to prevent a potentially devastating injury to the penis.

A survey of health care and child protective services provider knowledge regarding the toe tourniquet syndrome

Recent efforts to increase public awareness of child abuse may result in an increased number of inappropriate reports of suspected child abuse. The authors believe that digital hair strangulation should be included among the conditions that may be confused with child abuse. Digital hair strangulation (toe tourniquet syndrome) occurs primarily in infants and is characterized by a constricting band of foreign material that becomes tightly wrapped around a digit or digits (most often the toes). The consensus in the medical literature is that this condition is not the result of intentional injury. As no reference to the toe tourniquet syndrome exists in the child abuse literature, it was hypothesized that child welfare workers would be more likely than physicians and public health nurses to misinterpret this condition as resulting from intentional injury. A survey was conducted to test this hypothesis. Professionals from the fields of medicine, nursing, and child welfare were provided with a history and photographic findings of a child with a typical case of the toe tourniquet syndrome. Participants were surveyed regarding their interpretation of the described injuries. More than 50% of all respondents indicated that they would report this case as suspected abuse. Child welfare workers responded that the injuries were suggestive of abuse (83%), significantly more often than public health nurses did (45%), (x2 - 4.55, p = .03). Child welfare workers were significantly more likely to make a referral for suspected child abuse (89%) than Osteopathic physicians (56%), (x2 = 3.8, p = .05), Allopathic physicians (53%), (x2 = 4.28, p = .03), or public health nurses (48%), (x2 = 6.35, p = .01). This indicates a need for information regarding the toe tourniquet syndrome to appear in the child abuse literature. Recognition of the toe tourniquet syndrome may prevent unjustified reporting of child abuse.

Distal Digital Occlusion

Hair strangulation of an appendage has been reported by Alpert et al.1 Although this problem is probably seen by pediatricians and family physicians, the cause may not be appreciated and, therefore, treatment may be inadequate. CASE REPORTS Case 1 A 4-month-old boy was seen in the office with a swollen, red, warm middle toe. The toe was edematous and oozing purulent material near the attachment to the foot (Fig. 1). On close inspection, several small hairs were found encircling the toe. These were removed with a forceps and scalpel and the infant was treated with intravenous cloxacillin. The edema and redness promptly resolved.