title: Acute Ischemia of the Glans Penis after Circumcision Treated with Hyperbaric Therapy and Pentoxifylline: Case Report and Revision of the Literature.
abstract: Acute severe ischemia of glans penis after circumcision is a very rare event and, if not treated, can lead to irreversible necrosis with severe consequences such as loss of part of the penis. The possible causes for this condition could be blood-vessel binding or cauterization, dorsal penile nerve block (DPNB), local anesthesia with vasoconstricting agents and wound dressing compression. The aim of the treatment is to provide good blood supply and thus, oxygen delivery to the ischemic penis. The therapeutic options include hyperbaric therapy (HBOT), pentoxifylline (PTX), enoxaparina, iloprost, antiplatelet, corticosteroids and peridural anesthesia. We report the case of a 24-year-old male who developed an acute severe glans penis ischemia after circumcision done under DPNB. The patient was successfully treated with HBOT in combination with PTX.
authors.affiliation: Department of Urology, University Hospital, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Migliorini
authors.forename: Francesco
authors.initials: F
authors.lastname: Bianconi
authors.forename: Leonardo
authors.initials: L
authors.lastname: Bizzotto
authors.forename: Antonio Benito
authors.initials: AB
authors.lastname: Porcaro
authors.forename: Walter
authors.initials: W
authors.lastname: Artibani
mesh_terms: D000328:Adult; D000772:Anesthesia, Local / Q000009:adverse effects; D001458:Bandages; D002944:Circumcision, Male / Q000009:adverse effects*; D006801:Humans; D006931:Hyperbaric Oxygenation; D007511:Ischemia / Q000601:surgery; D008297:Male; D009336:Necrosis; D009407:Nerve Block / Q000009:adverse effects; D010413:Penis / Q000098:blood supply* / Q000503:physiopathology*; D010431:Pentoxifylline / Q000627:therapeutic use*; D010688:Phimosis / Q000601:surgery; D014662:Vasoconstrictor Agents / Q000009:adverse effects; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D014662:Vasoconstrictor Agents; D014665:Vasodilator Agents; D010431:Pentoxifylline
keywords: Circumcision; Glans penis; Hyperbaric therapy; Ischemia; Pentoxifylline