Copyright
©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Penile and scrotal strangulation by stainless steel rings in an human immunodeficiency virus positive man: A case report
Daisuke Usuda, Nobuyoshi Kaminishi, Masashi Kato, Yuto Sugawara, Runa Shimizu, Tomotari Inami, Shiho Tsuge, Riki Sakurai, Kenji Kawai, Shun Matsubara, Risa Tanaka, Makoto Suzuki, Shintaro Shimozawa, Yuta Hotchi, Ippei Osugi, Risa Katou, Sakurako Ito, Kentaro Mishima, Akihiko Kondo, Keiko Mizuno, Hiroki Takami, Takayuki Komatsu, Jiro Oba, Tomohisa Nomura, Manabu Sugita
Daisuke Usuda, Masashi Kato, Yuto Sugawara, Runa Shimizu, Tomotari Inami, Shiho Tsuge, Riki Sakurai, Kenji Kawai, Shun Matsubara, Risa Tanaka, Makoto Suzuki, Shintaro Shimozawa, Yuta Hotchi, Ippei Osugi, Risa Katou, Sakurako Ito, Kentaro Mishima, Akihiko Kondo, Keiko Mizuno, Hiroki Takami, Jiro Oba, Tomohisa Nomura, Manabu Sugita, Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima 177-8521, Tokyo, Japan
Nobuyoshi Kaminishi, Clinical Training Center, Juntendo University Nerima Hospital, Nerima 177-8521, Tokyo, Japan
Takayuki Komatsu, Sports Medicine, Juntendo University, Bunkyo 113-8421, Tokyo, Japan
Author contributions: Usuda D wrote the manuscript; All authors; Kaminishi N, Kato M, Sugawara Y, Shimizu R, Inami T, Tsuge S, Sakurai R, Kawai K, Matsubara S, Tanaka R, Suzuki M, Takano H, Hotchi Y, Shimozawa S, Tokunaga S, Osugi I, Katou R, Ito S, Mishima K, Kondo A, Mizuno K, Takami H, Komatsu T, Oba J, Nomura T, and Sugita M proofread and revised the manuscript; All authors approved the final version to be published.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report and any accompanying images. Both written and verbal informed consent were obtained from the patient for publication of this case report and any accompanying images.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors 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: Daisuke Usuda, MD, MSc, PhD, Associate Professor, Doctor, Senior Lecturer, Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, 3-1-10, Takanodai, Nerima 177-8521, Tokyo, Japan.
d.usuda.qa@juntendo.ac.jp
Received: June 7, 2023
Peer-review started: June 7, 2023
First decision: July 18, 2023
Revised: July 21, 2023
Accepted: July 31, 2023
Article in press: July 31, 2023
Published online: August 26, 2023
Processing time: 78 Days and 21.2 Hours
BACKGROUND
Penoscrotal constriction devices are either used as autoerotic stimuli or to increase sexual pleasure or performance by maintaining an erection for a longer period, and a variety of metallic and non-metallic objects are used. On the other hand, penile strangulation is a rare urologic emergency that requires prompt evaluation and intervention to prevent long-term complications. The goal of treating penile incarceration is to remove the foreign object as soon as possible. On the other hand, removal can be very challenging, and often requires resourcefulness and a multidisciplinary approach.
CASE SUMMARY
A 47-year-old man who has sex with men was transferred to our hospital for persistent phallodynia and scrotal pain, accompanying swelling due to strangulation by stainless steel rings. His medical history included acquired immunodeficiency syndrome. One day prior, he had put three stainless steel rings on his penis and scrotum before sexual intercourse. After sexual intercourse, he was unable to remove them, due to swelling of his penis and scrotum. The swelling persisted, and he felt pain in the affected area the next day, then he was transferred to our hospital by ambulance. The emergency department found that his penis and scrotum were markedly engorged and swollen. We established a diagnosis of penile and scrotal strangulation by stainless steel rings. We unsuccessfully attempted to cut the rings using a cutter, then requested a rescue team via emergency medical service. They cut through each ring in two places, using an electric-powered angle grinder, and successfully removed all of the pieces. Finally, he was discharged and went home.
CONCLUSION
We report the first case of penile and scrotal strangulation by stainless steel rings in an human immunodeficiency virus positive person.
Core Tip: Penoscrotal constriction devices are either used as autoerotic stimuli or to increase sexual pleasure or performance by maintaining an erection for a longer period, and a variety of metallic and non-metallic objects are used. On the other hand, penile strangulation is a rare urologic emergency that requires prompt evaluation and intervention to prevent long-term complications. The goal of treating penile incarceration is to remove the foreign object as soon as possible. On the other hand, removal can be very challenging, and often requires resourcefulness and a multidisciplinary approach. Here, we report the first case of penile and scrotal strangulation by stainless steel rings in an Human immunodeficiency virus-positive person.
