Penial incarceration (PI) is a rare situation. It is usually caused by a foreign object which strangulates at the base of the penis. PI may derive from pranks, sexual demand, mental disease, or intention to prohibit urinary disease. Generally, these situations are emergent and immediate treatments are needed. Cases of chronic PI are less reported, and their treating methods are yet to be discussed.

We reported a case on treating a 73-year-old male who had PI with a metallic hoop for three months. After multidisciplinary consultation, the operation was performed successfully with the help of a fretsaw. Despite the chronic strangulation, the prognosis of the patient was satisfying. To the best of our knowledge, this case was rare and precious as it featured the longest strangulating time, which might enlighten the treating process of future PI cases. Also, we have reviewed and summarized major published cases to encapsulate appropriate approaches when facing diverse strangulation situations.

The selection of surgical tools depends on the material of the strangulating objects, the availability of equipment, and the severity of the penial damage. The urination function may not be affected after three months of incarceration as in our case, whilst prudent preoperative measures and multidisciplinary evaluations are always essential. Although using a fretsaw is comparatively slow, it is safe and feasible to treat metallic penial incarceration.

• Penial incarceration
• Chronic penial strangulation
• Fretsaw
• Surgical treatment
• Literature review
• Case report

Strangulation of the penis and scrotum by a constricting object has been rarely reported.

To describe a man with penoscrotal strangulation caused by a steel ring and its successful removal.

A 28-year-old man presented to the emergency department with a 7-hour history of a steel ring lodged at the base of his penis and scrotum. Removal was accomplished with the assistance of fire brigade personnel who used their hydraulic cable cutter to shear the ring. During the removal, there were no complications.

The hydraulic cable cutter avoided thermal injury and shortened removal time compared with procedures described in the literature. The patient's recovery was uneventful, with erectile function restored after 1 week.

Genital incarceration is an urgent clinical situation requiring prompt treatment. However, suitable tools for removing the foreign object are not readily available in emergency and urology departments. Cooperation with other disciplines, even non-medical disciplines, can result in creative and timely measures for removal of the object.

Zhang J, Wang X, Zhang J, et al. Penoscrotal Strangulation Caused by a Steel Ring: A Case Report. Sex Med 2017;5:e131–e133.

• Hydraulic Cable Cutter
• Metal Ring
• Penoscrotal Strangulation
• Steel Ring

• Circumcision
• genital
• penile injury
• self-harm