ESPU Congress 2018 - Abstract Book

31 11–14 APRIL, 2018, HELSINKI, FINLAND 14:40–14:42 S2-11 (CP) CASE OF PENILE TOURNIQUET SYNDROME AND NEAR TOTAL AMPUTATION Benslimane HAMMOU  1 , Haouari HAFIDA  2 , Hamidou FAYCEL  3 , Benmohamed NEDDAR  2 , Ramdane REBIHA  2 , Hadjou FATMA  1 and Mallah NOURIA  1 1) Medical School of Oran, Pediatric Surgery, Oran, ALGERIA - 2) Children Hospital of Oran, Pediatric Surgery, Oran, ALGERIA - 3) Medical School of Oran, Medecine Department, Oran, ALGERIA PURPOSE Hair tourniquet syndrome is the threw coined to describe an unusual phenomenon caused by miscellaneous metallic object or nonmetallic (hair…) around the coronal sulcus of penis. It was significantly encountred in circumcised boys (0–6 years) and all injuries are minimal or severe. Urethrocutaneous fistula or penile amputations if not diagnosed and treated appropriately. Near total penile amputation caused by hair tourniquet is presumed to be accidental or a original abuse. Four grade of penile strangulation (Bashir and EL-Barbary) Grade 0: Constriction of skin without urethral injury. Grade 1: Partial division of the corpus spongiosum with a urethra-cutaneous fistula. Grade 2: Complete division of the corpus spongiosum and constriction of the copus cavernosum. Grade 3: Gangrene, necrosis and complete amputation of the glans. MATERIAL AND METHODS We report the delayed treatment of a boy with Down syndrome 21, aged 07 years, who presented with a partial amputation of his penis (Grade 2). The diagnosis of hair choke was laid 08 months after circumcision with almost total amputation of the glans. The treatment was done in two sequences. Starting with a suture of the glans to the body of the penis and urethral advancement 04 months after. This delayed diagnosis and treatment was caused by a difficult to see the hair in our boy who is circumcised and a mental retardation. RESULTS The circumcision has been considered to be a major risk factor of strangulation. The hair or other agents seem to constrict more easily a circumcised penis thaw one with a normal prejudice. CONCLUSIONS The diagnostic and treatment are after delayed, however repair is still possible in a single time and urethroplasty suture when diagnosis is established quickly or wait. The choise of the final procedure depends on the severity of the injury.