title: Surgical Management of Hair-coil Penile Injury: Anatomical Insights and Grading System.
abstract: OBJECTIVE
  To report our experience in the surgical management of a group of patients with varying degrees of hair-coil penile injury, while applying a more detailed grading scale for the severity of injury.
  
  
  METHODS
  The study included 16 boys with hair-coil penile injury who were managed during the period 2010 through 2016. In the acute state, the constricting hair coil was removed under general anesthesia. The repair was planned 6 months later after the acute injury. In 1 case presenting with severe form (near total glanular amputation), the glans was resutured to the penile shaft immediately after removal of the hair coil; the urethroplasty was performed six months later.
  
  
  RESULTS
  The patients' age ranged from 2 to 17 years (mean 4.8 years). The urethroplasty was always covered by a protective layer, which was derived from the ventral dartos fascia in all but 1 case. In the latter, we used a tunica vaginalis flap for covering the urethroplasty. A successful outcome (regarding both urethral reconstruction and cosmesis) was achieved in all cases.
  
  
  CONCLUSIONS
  Hair-coil penile injury is an uncommon condition with insidious course. Unawareness of such condition can lead to progression to serious complications. Delayed and staged surgical repair is associated with successful outcome.
authors.affiliation: Pediatric Surgery Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt. Electronic address: amrabdelhamid@hotmail.com.
authors.forename: Amr Abdelhamid
authors.initials: AA
authors.lastname: AbouZeid
authors.affiliation: Pediatric Surgery Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.
authors.forename: Mohamed Hisham
authors.initials: MH
authors.lastname: Soliman
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic; D006197:Hair; D006801:Humans; D008297:Male; D010409:Penile Diseases / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D010413:Penis / Q000293:injuries* / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000601:surgery