title: [Penile incarceration by multiple metal rings].
abstract: OBJECTIVE
  Penile incarceration is an infrequent clinical reality. Diagnosis is evident in most cases, and the challenges are to find the best way to retrieve the constrictive ring and repair the damage. Nevertheless, this event being curious has motivated us to report it.
  
  
  RESULTS
  We report the case of a 48 year old patient victim of a "joke" resulting in a 13 day penile incarceration produced by 7 double metallic rings, 24 mm in internal diameter and 4 mm wide, which required section and extraction of the rings as well as wide tissue debridement and posterior plastic reconstruction using partial thickness cutaneous grafts. We review diagnostic an therapeutic features from the literature.
  
  
  CONCLUSIONS
  Penile incarceration should be considered an emergency, so that the earlier the constrictive object is retrieved the lower the risk for complications secondary to penile devascularization, urinary retention and urethral damage. We emphasise the need to perform retrograde urethrography and suprapubic cystostomy if urethral lesion is suspected, a cutaneous vascular evaluation with doppler ultrasound or fluorescein test and the opportunity of cutaneous grafts to solve tissue lesion.
authors.affiliation: Servicio de Urología, Hospital de San Eloy, Barakaldo, Vizcaya, España.
authors.forename: José Gregorio
authors.initials: JG
authors.lastname: Pereira Arias
authors.forename: José María
authors.initials: JM
authors.lastname: Gutiérrez Díez
authors.forename: Vicente
authors.initials: V
authors.lastname: Ullate Jáime
authors.forename: Ricardo
authors.initials: R
authors.lastname: Ateca Díaz-Obregón
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Berreteaga Gallastegui
mesh_terms: D000435:Alcoholic Intoxication / Q000150:complications; D003250:Constriction; D003251:Constriction, Pathologic / Q000209:etiology* / Q000601:surgery; D003646:Debridement; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D006801:Humans; D007511:Ischemia / Q000209:etiology* / Q000601:surgery; D008209:Lymphedema / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D009765:Obesity / Q000150:complications; D010413:Penis / Q000098:blood supply / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D016038:Skin Transplantation; D013518:Surgery, Plastic