Use Of Dental Drill handpiece To Remove Steel Nut Causing Penile Strangulation: A Case Report And review Of The Literature

Luan Kinh Thai, Xuan Thai Ngo, Minh Sam Thai, Quy Thuan Chau, Khac Chuan Hoang, Le Quy Van Dinh, Hoai Tam Ly, Tien Dat Hoang, Ryan W. Dobbs, Phuoc Huu Le, Tuan Thanh Nguyen

Penile strangulation, Penile incarceration, Penile entrapment, Dental drill handpiece, Metallic nut, Case report

Penile strangulation is a rare but serious urological emergency that requires prompt intervention to prevent complications such as ischemia, necrosis, and potential loss of the distal penis. This video presents three cases of penile strangulation caused by metallic objects, with a focus on the innovative use of a dental drill handpiece for successful removal.

The first case involves a 24-year-old male who presented with a thick hexagonal steel nut entrapping the penile shaft for 10 hours, leading to urinary retention and decreased sensation. Traditional removal methods were ineffective due to severe penile swelling and the nut's thickness. A dental diamond drill handpiece was employed to carefully cut the nut without injuring the penile skin, aided by continuous water irrigation to prevent thermal damage. The procedure lasted approximately 45 minutes, resulting in successful removal with no subsequent complications.

The second and third cases further demonstrate the application of the dental drill handpiece in managing similar emergencies involving different metallic objects. Each case highlights the challenges posed by the objects' size, material, and the degree of penile swelling, as well as the importance of innovative techniques and interdisciplinary collaboration.

The video also reviews the literature on penile strangulation, discussing grading systems, treatment options, and potential complications. These cases underscore the critical need for prompt intervention and creative problem-solving in urological emergencies to preserve penile function and prevent severe outcomes.

This video serves as an educational tool for urologists and emergency physicians, demonstrating the effective use of a dental drill handpiece in managing penile strangulation caused by metallic objects. It emphasizes the importance of surgical technique, interdisciplinary collaboration, and post-operative care to achieve optimal outcomes in treating this rare but serious condition.

None

None

1.     Nguyen, T. T., et al. (2022). Use of dental drill handpiece to remove steel nut causing penile strangulation: a case report and review of the literature. Journal of Medical Case Reports, 16(1), 158.

2.     Bhat, A. L., et al. (1991). Penile strangulation. British Journal of Urology, 68(6), 618-621.

3.     Silberstein, J., et al. (2008). Penile constriction devices: case report, review of the literature, and recommendations for extrication. Journal of Sexual Medicine, 5(7), 1747-1757.

4.     Eteafía, G. O., & Novalelo, C. O. (2014). Successful removal of strangulating metal penile ring using a dental handpiece. BMJ Case Reports, 2014, bcr2014205030.

5.     Paonam, S., et al. (2017). Penile strangulation by iron metal ring: a novel and effective method of management. Urology Annals, 9(1), 74-76.