Ischemia of the glans penis

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Ischemia of the glans penis is a complication of circumcision.[1]

Disruption of blood circulation

Male circumcision frequently includes excision of the frenulum, which carries the frenular artery.[2] The frenular artery supplies arterial blood to 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."[3] Moreover, the dorsal veins from the acroposthion are severed and excised by circumcision. This frequently results in post-circumcision lymphoedema due to the reduction in blood circulation. Ferhatoglu et al. (2019) reported edema in 108 of 198 patients or 54.5 percent, indicating substantial impairment of circulation.[4]

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 a circumcision. He was treated with intravenous pentoxifyllin and hyperbaric oxygenation.[5]

Aslan et al (2005) reported the case of an eleven-year-old boy who experienced ischemia of the glans penis within 24 hours of a circumcision. The boy was successfully treated with pentoxifylline injection for 5 days.[6]



References

  1. ↑ REFjournal Pepe, Pietro, Pietropaolo, Francesco, Candiano, Guiseppe, Pennisi, Michele. Ischemia of the glans penis following circumcision: case report and revision of the literature. Arch Ital Urol Androl. 31 March 2015; 87(1): 93-4. PMID. DOI. Retrieved 20 February 2022.
    Quote: The patient had undergone circumcision 5 days before in a surgery department under local anesthesia.
  2. ↑ REFjournal Shenoy SP, Marla, PK, Sharma P, et al. Frenulum Sparing Circumcision: Step-By-Step Approach of a Novel Technique. J Clin Diagn Res.. December 2015; 9(12): PC01-PC03. PMID. PMC. DOI. Retrieved 20 February 2022.
  3. ↑ REFbook McGrath, Ken (2001): The Frenular Delta: A New Preputial Stucture. Work: Understanding Circumcision: A Multi-Disciplinary Approach to a Multi-Dimensional Problem. Denniston GC, Hodges FM, Milos MF, editors. (ed.). New York: Kluwer/Plenum,. Retrieved 20 February 2022.
  4. ↑ REFjournal Ferhatoglu Mf, Kartal A, Gurkan A. Evaluation of Male Circumcision: Retrospective Analysis of One Hundred and Ninety-eight Patients. Cureus. 27 April 2019; 11(4): e4555. PMID. PMC. DOI. Retrieved 20 February 2022.
  5. ↑ REFjournal Tzeng, Yuan-Sheng, Tang, Shou-Hung, Meng, En, et al. Ischemic glans penis after circumcision. Asian J Androl. June 2004; 6(2): 161-3. PMID. Retrieved 20 February 2022.
  6. ↑ REFjournal Aslan, Karagüzel g, Melikoglu M. Severe ischemia of the glans penis following circumcision: a successful treatment via pentoxifylline. Int J Urol. July 2005; 12(7): 705-07. PMID. DOI. Retrieved 20 February 2022.
    Quote: We suggest that pentoxifylline might be considered as a treatment of choice for severe ischemia of glans penis.
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