Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 14, 2022; 10(2): 747-752
Published online Jan 14, 2022. doi: 10.12998/wjcc.v10.i2.747
Using a fretsaw in treating chronic penial incarceration: A case report
Yi Zhao, Xiao-Qiang Xue, Hou-Feng Huang, Yi Xie, Zhi-Gang Ji, Xin-Rong Fan
Yi Zhao, Xiao-Qiang Xue, Hou-Feng Huang, Yi Xie, Zhi-Gang Ji, Xin-Rong Fan, Department of Urology, Peking Union Medical College Hospital, Beijing 100730, China
Author contributions: Zhao Y and Xue XQ are co-first authors who contributed equally to this work, reviewed the literature, acquired the data, and contributed to manuscript drafting; Huang HF, Ji ZG, and Xie Y contributed to manuscript drafting; Fan XR managed the patient, performed the operation, and was responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin-Rong Fan, MD, Associate Professor, Surgeon, Department of Urology, Peking Union Medical College Hospital, No. 1 Shuaifuyuan Road, Dongdan, Dongcheng District, Beijing 100730, China. fxr_pumch@163.com
Received: August 21, 2021
Peer-review started: August 21, 2021
First decision: November 1, 2021
Revised: November 4, 2021
Accepted: December 7, 2021
Article in press: December 7, 2021
Published online: January 14, 2022
Processing time: 143 Days and 13.6 Hours
Abstract
BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

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.

Keywords: Penial incarceration; Chronic penial strangulation; Fretsaw; Surgical treatment; Literature review; Case report

Core Tip: Penial incarceration (PI) is a rare clinical situation. We report a case of chronic PI, where a multidisciplinary task force was established for surgical strategy planning. We adopted the orthopedic fretsaw to split the metallic hoop. The patient reported no complications one year after the surgery. As the treatment of PI has not been summarized yet, we also performed a mini review of the literature regarding the treating approaches under certain circumstances. This case was unique because it featured the longest reported strangulating time, and it offered some first-hand experience on treating chronic penial incarceration.