Four years old boy with penile hair tourniquet syndrome
B Özçift, K Ağras
Department of Urology, Pediatric Urology Unit, Ankara Atatürk Education and Research Hospital, Ankara, Turkey
AIM: Penile hair tourniquet syndrome (HTS) is a very rare entity and caused by a hair coil wrapped around the sulcus coronarious of penis causing progressive penile strangulation. Awareness of the etiology, presence of a high index of suspicion, careful inspection of the affected area with magnification are helpful for diagnosis. The patient usually presents penile HTS acutely. It may cause range from simple edema to necrosis. Treatment is removal of the tourniquet includes unwrapping, cutting or dissolving the offending hair coil.
CASE: A 4 year-old circumcised boy presented to the our pediatric urology clinic with an increasing swelling in his glans penis which had developed for 2 months. There was no history of voiding complaint or fever. Physical examination of the penis showed an edematous glans with suspicion of a constructed hair band around the sulcus coronarius of penis causing a tourniquet-like compression. During physical examination under general anesthesia, we observed sharp demercation line and a coil of hair was found deeply wrapped the sulcus coronarious of the penis. Pre-operatively, the patient was catheterized with an 8Fr urethral catheter, the urethra was intact at inspection. The hair coil was cut dorsally, unwrapped and removed carefully. The procedure was completed by circumferential firm wound dressing. The patient was discharged on the post-operative first day. Close follow up and observation advised. At postoperative first month follow up, complete recovery was observed.
Penile HTS is a rare entity and may cause severe deformities ranging from simple penile edema and swelling to penile necrosis and amputation. When the tourniquet like compression symptoms, such as edema and sharp demarcation line, are observed, penile HTS should be thought in the differential diagnosis. The penile HTS is must be considered as a surgical emergency. Early diagnosis and rapid treatment can prevent serious deleterious complications.
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