Ischemia of the glans penis: Difference between revisions
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'''Ischemia of the glans penis''' is a not-so-rare [[iatrogenic]] complication of [[circumcision]].<ref name="pepe2015">{{REFjournal | '''Ischemia of the glans penis''' is a not-so-rare [[iatrogenic]] [[complication]] of [[circumcision]].<ref name="pepe2015">{{REFjournal | ||
|last=Pepe | |last=Pepe | ||
|first=Pietro | |first=Pietro | ||
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|DOI=10.7860/JCDR/2015/14972.6860 | |DOI=10.7860/JCDR/2015/14972.6860 | ||
|accessdate=2022-02-20 | |accessdate=2022-02-20 | ||
}}</ref> The frenular artery supplies arterial blood to the [[glans penis]], so the excision of the frenulum reduces the supply of arterial blood to the glans penis. | }}</ref> The frenular artery supplies arterial blood to the [[glans penis]], so the excision of the [[frenulum]] reduces the supply of arterial blood to the glans penis. | ||
Circumcision also disrupts the return flow of blood to the heart. Veins in the prepuce provide "at least part of the drainage of the glans surface."<ref name="mcgrath2001">{{REFbook | [[Circumcision]] also disrupts the return flow of blood to the heart. Veins in the [[prepuce]] provide "at least part of the drainage of the [[glans]] surface."<ref name="mcgrath2001">{{REFbook | ||
|last=McGrath | |last=McGrath | ||
|first=Ken | |first=Ken | ||
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==Case reports== | ==Case reports== | ||
Tzeng et al. (2004) reported the case of a 33-year-old man who experienceed ischemia of the [[glans penis]] within 24 hours after | Tzeng et al. (2004) reported the case of a 33-year-old man who experienceed ischemia of the [[glans penis]] within 24 hours after an [[adult circumcision]]. He was treated with intravenous pentoxifyllin and hyperbaric oxygenation.<ref name="tzeng2004">{{REFjournal | ||
|last=Tzeng | |last=Tzeng | ||
|first=Yuan-Sheng | |first=Yuan-Sheng | ||
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}}</ref> | }}</ref> | ||
Devarakonda & Aghavendra (2010) reported a case of ischemia of the glans penis.<ref name="devarakonda2010">{{REFjournal | Devarakonda & Aghavendra (2010) reported a case of ischemia of the [[glans penis]].<ref name="devarakonda2010">{{REFjournal | ||
|last=Devarakonda | |last=Devarakonda | ||
|first= | |first= | ||
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}}</ref> | }}</ref> | ||
Pepe et al. (2015) reported the case of a young man who had ischemia of the glans five days after circumcision. He was treated with hyperbaric therapy.<ref name="pepe2015"/> | Pepe et al. (2015) reported the case of a young man who had ischemia of the [[glans]] five days after [[circumcision]]. He was treated with hyperbaric therapy.<ref name="pepe2015"/> | ||
Cárdenas Elías et al. (2016) reported a case of ischemia of the glans penis in a ten-year-old patient with symptoms appearing two hours after circumcision. The boy was treated with pentoxifylline (PTX) that is maintained for 6 days, topical testosterone and a caudal blocking (for 48 hours).<ref>{{REFjournal | Cárdenas Elías et al. (2016) reported a case of ischemia of the [[glans penis]] in a ten-year-old patient with symptoms appearing two hours after circumcision. The boy was treated with pentoxifylline (PTX) that is maintained for 6 days, topical testosterone and a caudal blocking (for 48 hours).<ref>{{REFjournal | ||
|last=Cárdenas Elías | |last=Cárdenas Elías | ||
|first= | |first= | ||
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}}</ref> | }}</ref> | ||
Polak et al. (2021) present two cases of ischemia of the glans penis after medically-unnecessary, non-therapeutic circumcision in which hyperbaric oxygen was used as salvage therapy to save the penises of the newborn boys.<ref name="polak2021">{{REFjournal | Polak et al. (2021) present two cases of ischemia of the [[glans penis]] after medically-unnecessary, non-therapeutic [[circumcision]] in which hyperbaric oxygen was used as salvage therapy to save the penises of the newborn boys.<ref name="polak2021">{{REFjournal | ||
|last=Polak | |last=Polak | ||
|first=Nir | |first=Nir | ||
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==Conclusion== | ==Conclusion== | ||
The medical literature has a number of reports of successful treatment of ischemia of the glans penis. But what of the cases in which treatment was not timely instituted and the case progressed to [[necrosis]] and gangrene of the [[glans penis]] | The medical literature has a number of reports of successful treatment of ischemia of the [[glans penis]]. But what of the cases in which treatment was not timely instituted and the case progressed to [[necrosis]] and [[gangrene]] of the [[glans penis]]? | ||
Ischemia of the glans penis after [[circumcision]] is not an act of God. It is an [[iatrogenic]] occurrence that happens when medical personnel intentionally sever blood vessels in the [[penis]] and reduce the blood circulation into and through the glans penis. | Ischemia of the glans penis after [[circumcision]] is not an act of God. It is an [[iatrogenic]] occurrence that happens when medical personnel intentionally sever blood vessels in the [[penis]] and reduce the blood circulation into and through the [[glans penis]]. | ||
A surgical operation which severs blood vessels and impedes circulation cannot be viewed as other than harmful. The first rule of medical ethics is ''premum non nocere''. First do no harm. The typical infant [[circumcision]] is a non-therapeutic amputation that harms without providing a benefit such as prevention or treatment of disease. | A surgical operation which severs blood vessels and impedes circulation cannot be viewed as other than harmful. The first rule of medical ethics is ''premum non nocere''. First do no harm. The typical infant [[circumcision]] is a non-therapeutic amputation that harms without providing a benefit such as prevention or treatment of disease. | ||
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}}</ref> Medical doctors should be aware than such cases may be viewed by a future court as malpractice. | }}</ref> Medical doctors should be aware than such cases may be viewed by a future court as malpractice. | ||
The public is reminded that the usual infant [[circumcision]] | The public is reminded that the usual infant [[circumcision]] cannot treat or cure disease, because disease is not present. It is classified as without medical indication, non-therapeutic, and medically-unnecessary, but puts the patient at risk. | ||
{{REF}} | {{REF}} | ||
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[[Category:Circumcision complication]] | [[Category:Circumcision complication]] | ||
[[Category:Circumcision risk]] | [[Category:Circumcision risk]] | ||
[[Category:Circumcision term]] | |||