第17巻 2021年2月　第1号

■症例報告

高齢者の陰茎絞扼症の1例
柴�ｱ　幹生¹, 赤塚　純¹, 遠藤　勇気¹, 上田　貴之¹, 長谷川　裕也¹, 三神　晃¹, 大林　康太郎¹, 林　達郎¹, 土肥　輝之², 近藤　幸尋^1
1日本医科大学付属病院泌尿器科
²日本医科大学付属病院形成外科

Penile Strangulation in an Elderly Patient
Mikio Shibasaki¹, Jun Akatsuka¹, Yuki Endo¹, Takayuki Ueda¹, Hiroya Hasegawa¹, Hikaru Mikami¹, Kotaro Obayashi¹, Tatsuro Hayashi¹, Teruyuki Dohi² and Yukihiro Kondo^1
1)Department of Urology, Nippon Medical School Hospital
²⁾Department of Plastic Surgery, Nippon Medical School Hospital

We report a case of penile strangulation in an 82-year-old man who inserted the penis up to the penile base into a plastic bottle to obtain sexual pleasure and prolonged erection. He developed edema of the distal penis, which resulted in penile entrapment at the neck of the bottle. He was unable to remove the penis from the bottle and presented to our hospital 3 days after this event. On examination, the penis was edematous with foul odor, and the penile skin appeared black. He was diagnosed with penile strangulation and suspected sepsis. The neck of the plastic bottle strangled the penile root, and we could not manually release the penile strangulation. The patient was transferred to the operating room, and an orthopedic ring cutter was used to cut the neck of the plastic bottle. We observed necrosis at the distal penile root and performed emergency total penectomy. The patient was administered postoperative antibiotics; however, his general condition did not improve, necessitating additional debridement and removing residual urethra for management of the skin infection. The patient recovered completely following this multidisciplinary treatment approach.

日医大医会誌 2021; 17(1), 21-24

Key words
penile strangulation, penile necrosis, sepsis, penectomy

Correspondence to
Mikio Shibasaki, MD, Department of Urology, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
E-mail：m-shibasaki@nms.ac.jp

受付：2020年11月26日　受理：2021年1月18日