244 Penile Entrapment by Metal Ring: A Video Guide to Surgical Removal

ABSTRACT Introduction Penile rings may be used to enhance sexual function. Prolonged constriction greater than 30 minutes may lead to pain, edema and ultimately ischemic end organ damage. Failure to remove the ring warrants prompt evaluation and can be a surgical emergency. Objective The purpose of this video abstract is to review and demonstrate the management strategies to remove a constricting penile ring. Methods Conservative interventions which can be attempted at the bedside are reviewed. These include but are not limited to sliding the penile ring off of the penis using available lubrication as well as cutting the rings using pliers or bolt cutters. Interventions performed under general anesthesia include repeated attempts at sliding off or cutting the ring, and when these maneuvers fail, utilization of mechanical drills or saws may be indicated. Results The case presented is a 41 year old gentleman who presented with a thick silver metallic ring placed on the base of his penis. The penis had been entrapped for greater than 24 hours. Conservative measures at the bedside were not successful and the ring was ultimately removed in the operating room using a microsurgical saw. The patient experienced a complete cosmetic recovery and did not experience any long-term detriment to his voiding habits. Conclusions Prolonged penile entrapment by placement of a constricting ring risks ischemic end organ damage and is a rare surgical emergency. The conservative and more invasive management approaches are demonstrated in this video. Disclosure No