Asian Journal of Case Reports in Surgery

Penile Tourniquet Syndrome by Hair in Children: Case Report

Saad Annattah *

Department of Pediatric Urology and Visceral, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Abdelmalek Essaadi University, Tangier 40000, Morocco.

Abdkrim Haita

Department of Pediatric Urology and Visceral, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Abdelmalek Essaadi University, Tangier 40000, Morocco.

Saad Andaloussi

Department of Pediatric Urology and Visceral, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Abdelmalek Essaadi University, Tangier 40000, Morocco.

Aziz El Madi

Department of Pediatric Urology and Visceral, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Abdelmalek Essaadi University, Tangier 40000, Morocco.

*Author to whom correspondence should be addressed.

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Abstract

Aims: This case report aims to explore the rare occurrence of penile tourniquet syndrome caused by hair in children and to emphasize the necessity of early diagnosis and one-stage surgical management. Additionally, it seeks to contribute valuable insights to the existing literature on this topic, particularly regarding treatment approaches and outcomes.

Presentation of Case: An eleven-year-old circumcised boy was admitted to our department with progressive pain and urinary symptoms. Physical examination revealed hair coiling around the coronal sulcus, leading to complete transection of the urethra and corpora spongiosa. Despite the severity of the initial symptoms, there were no other remarkable findings on examination. Surgical intervention involved debridement of necrotic tissue, careful removal of the hair coil under general anesthesia, and one-stage repair of the urethra using silicone Foley catheter guidance and PDS sutures. The post-operative course was uneventful, Follow-up showed good outcomes.

Discussion: Penile tourniquet syndrome by hair is a rare but potentially devastating condition, typically affecting circumcised boys in early childhood. Diagnosis can be challenging due to the thinness of the hair and the presence of edema. The severity of complications varies, ranging from superficial lesions to complete urethral transection and penile amputation. Early recognition and treatment are crucial to prevent adverse outcomes. Surgical management often involves hair removal and repair of urethral or corporal injuries. Different approaches have been proposed, including multi-stage repair or one-stage repair, depending on the severity of the condition and institutional practices. Postoperative complications such as urethro-cutaneous fistula or skin necrosis can occur, emphasizing the importance of careful monitoring. In this case, the patient was closely monitored and received local antiseptic treatment until the inflammation subsided and the skin healed completely.

Conclusion: This case underscores the significance of penile tourniquet syndrome by hair in children and the effectiveness of one-stage surgical management, even in severe cases. It emphasizes the importance of early diagnosis and appropriate intervention to prevent long-term complications. Further studies and standardized treatment protocols are warranted to optimize outcomes in patients with this rare but potentially serious condition.

Keywords: Tourniquet syndrome, hair coil strangulation, child, penis, case report

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