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274507

Hair coil strangulation of the penis in children: Single center experience in a decade.

Article

Last updated: 22 Jan 2023

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Abstract

Background: Penile hair coil strangulation is a rare condition that might culminate in penile gangrene and amputation.
Aim of work: To report clinical presentation, management, complications and outcomes of hair coil strangulation of the penis in the pediatric age.
Material and Methods: We reviewed the data of 31 patients who presented with penile hair coil strangulation between January 2010 and December 2020 to the Urology Department at Cairo University Specialized Pediatric Hospital. Injury was graded as proposed by Bashir and El Barbary. Data regarding presentation, surgical intervention, complications and the outcomes were recorded.
Results: Mean age at presentation was 4.43 ±2.5 years. Thirty (97%) patients presented in the strangulation phase. Onset of symptoms was estimated to be 1-4 weeks earlier. All boys were circumcised. None had any neurological disease. Hair coil removal and medical management (antiseptic, antibiotics, anti-inflammatory) was done for all patients on the day of presentation. Examination under anesthesia and hair removal was done for 7 (22.5%) boys. Urinary diversion was not done on day of presentation. Mean follow up period was 22.5±8.65months (6 - 36). Five (16%) boys had superficial skin injury grade (0) and were managed conservatively, 19 (61%) had partial transection of the urethra grade (1), 6 (19%) had complete transection of the urethra grade (2) and 1 (3%) had transection of the spongiosum and the cavernosum with amputated glans grade (3). Surgical intervention was delayed for 3 months after hair coil removal. Twenty six boys (84%) needed surgical intervention. Mean duration until catheter removal was 7.65±3.05 days (5-14). Twenty four boys (92%) had satisfactory cosmetic outcome (normal looking glans, no constriction ring), 2 (8%) had persistent constriction ring which was surgically corrected later and 4 (15.38%) had small urethrocutaneous fistula which was repaired after 6 months. None of our boys developed anastomotic strictures. Success rate was 77% after primary surgery.
Conclusion: Penile hair coil strangulation is a rare condition that can be easily misdiagnosed as balanitis, proper diagnosis requires high index of suspicion. Delayed single stage surgical intervention gives chance for inflammation to subside with satisfactory functional and cosmetic outcome.

DOI

10.21608/cupsj.2022.175457.1084

Keywords

Hair coil, strangulation of the penis, constriction ring, urethrocutaneous fistula, Cairo University

Authors

First Name

Ahmed

Last Name

Shouman

MiddleName

M.

Affiliation

Urology Department, Cairo University, Cairo, Egypt

Email

ashouman@kasralainy.edu.eg

City

-

Orcid

0000-0002-6085-0782

First Name

Mohamed

Last Name

Abd El Wahab

MiddleName

-

Affiliation

Urology Department, Cairo University, Cairo, Egypt

Email

m.abdelwahab@kasralainy.edu.eg

City

-

Orcid

, 0000-0003-0597-564

First Name

Mohamed

Last Name

Elgharably

MiddleName

Aboul Fotouh

Affiliation

Urology Department, Cairo University, Cairo, Egypt

Email

m.a.grably@kasralainy.edu.eg

City

-

Orcid

0000-0002-7228-4431

First Name

Amr

Last Name

Mostafa

MiddleName

-

Affiliation

Urology Department, Cairo University, Cairo, Egypt

Email

amrmostafa1981@yahoo.com

City

-

Orcid

0000-0003-2019-0385

Volume

3

Article Issue

1

Related Issue

35726

Issue Date

2023-01-01

Receive Date

2022-11-18

Publish Date

2023-01-01

Page Start

57

Page End

63

Print ISSN

2805-279X

Online ISSN

2682-3985

Link

https://cupsj.journals.ekb.eg/article_274507.html

Detail API

https://cupsj.journals.ekb.eg/service?article_code=274507

Order

8

Type

Original Research

Type Code

1,229

Publication Type

Journal

Publication Title

Pediatric Sciences Journal

Publication Link

https://cupsj.journals.ekb.eg/

MainTitle

-

Details

Type

Article

Created At

22 Jan 2023