Work

Management of prolonged wrench penile entrapment: A case report & literature review

Year: 2025

Type: article

Abstract: Penile entrapment is a rare urological emergency that may lead to mechanical and vascular complications. It commonly occurs due to the use of constrictive devices during sexual activity. Delayed presentation, often due to embarrassment or psychiatric disorders, can worsen outcomes. We present a case of prolonged penile entrapment involving a wrench, successfully managed using an electric grinder. A 61-year-old male presented with penile swelling and urinary retention for three days. He reported placing a wrench around the base of his penis three weeks prior during a delusional episode. Examination revealed significant oedema with the wrench firmly embedded. Laboratory evaluation showed type 2 diabetes mellitus, acute kidney injury, and electrolyte imbalances. The device was removed under local anesthesia using an electric grinder, with protective measures to avoid thermal injury. The patient experienced moderate erectile dysfunction postoperatively but reported no other urological complaints during follow-up. Prompt recognition and management of penile entrapment are crucial to prevent ischemia, necrosis, and permanent damage. The method of device removal should be tailored to the severity of injury and type of constricting object. Mild cases may respond to manual or non-invasive techniques, while severe cases require mechanical tools. A multidisciplinary approach, including surgical, urological, and psychiatric input, improves outcomes and addresses underlying causes. Penile entrapment requires timely and tailored management. Mechanical tools such as electric grinders can be safely used in selected cases. Comprehensive care, including psychiatric evaluation, is vital for optimal recovery and prevention of recurrence. • This case report discusses a rare urological emergency involving prolonged penile entrapment caused by a wrench, providing insight into emergency release techniques with an electric grinder. • Prompt management of penile entrapment is crucial to prevent severe complications, such as tissue necrosis and vascular damage, which can occur with delayed treatment. • The study emphasizes the need for multidisciplinary collaboration in complex cases, highlighting the importance of using unconventional tools and specialized personnel in emergency procedures. • Intraoperative use of continuous saline irrigation and protective barriers can significantly reduce the risk of thermal injury during device removal. • Psychiatric assessment plays a critical role in preventing recurrence, especially in self-inflicted penile injuries associated with dissociative disorders.

Source: International Journal of Surgery Case Reports

DOI: 10.1016/j.ijscr.2025.111985

Authors: Anugerah Afrianto, Johan Renaldo, Mohammad Ayodhia Soebadi

Institution: Universitas Airlangga

Language: English

Topic: Urological Disorders and Treatments

Subfield: Urology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,090