Retained Penile Ring: A Case Report.

Abstract

Introduction: Penile constriction rings have been used to prolong erection with vacuum devices in the treatment of erectile dysfunction. Some have also employed it for recreational purposes with the attendant risks of penile edema, strangulation and necrosis. We present a case of an entrapped phallus by a penile ring. Case report : A 16year old with pain and swelling of the phallus of 12 hours duration. This started after placement of a phallic ring to purportedly prolong erection. He was later unable to remove the ring despite several attempts and developed progressive swelling and pain in the phallus. He was also unable to pass urine. Examination revealed a circumcised phallus that was detumescent but grossly edematous, tender with shiny skin. The phallus appears viable with a tight ring at the base of the phallus. Initial simple manoeuvres in the casualty proved abortive and ring had to be cut with the aid of an orthopaedic instrument. He was subsequently able to void without difficulty or any haematuria. He was advised on use of cold compress on the phallus. He was also given silver sulphadiazine cream for some minor abrasions on the phallus. The patient however promptly discharged himself from the casualty and was not seen at follow up in clinic. Conclusion: Successful management of retained penile ring depends on early presentation by the patient to avoid adverse outcomes. It may require instruments not normally found in the urologist armamentarium.