Management of penile post-circumcision ischemia by pentoxifylline infusion and hyperbaric oxygen therapy.
BMC Urol
; 23(1): 117, 2023 Jul 12.
Article
em En
| MEDLINE
| ID: mdl-37438810
ABSTRACT
BACKGROUND:
Post-circumcision penile ischemia is a devastating complication. We will present our experience in managing children with various forms of penile ischemia. MATERIALS ANDMETHODS:
This cohort prospective observational and interventional study was performed on all male children with post-circumcision penile ischemia between April 2017 and October 2021. A designed and approved protocol includes a combination of early pentoxifylline infusion, hyperbaric oxygen inhalation, early catheterization, and appropriate surgical debridement were applied for patients with deep ischemia 11/23, mainly the necrotic skin and subcutaneous tissues. Data of patient age, anesthesia method, monopolar diathermy usage, early presentation and positive wound culture were collected and analyzed statistically.RESULTS:
During the study period 3,382 children were circumcised for non-medical reasons; 23 children were diagnosed with penile ischemia (0.7%), among other complications (9%). Most of the penile ischemia is associated with the use of monopolar diathermy (74%). The use of compressive wound dressing to control post-circumcision bleeding and infections is also responsible for ischemia in 52.2% and 43.5% of the cases. Inexperienced physicians were commonly responsible for ischemia (73.9%). Patients managed at first 24 h had better outcomes than those who were presented later (p = 0.001).CONCLUSION:
In children with post-circumcision penile ischemia, a combination of hyperbaric oxygen therapy and pentoxifylline is especially effective for patients with skin and facial necrosis, this management reduces penile tissue loss.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Pentoxifilina
/
Circuncisão Masculina
/
Oxigenoterapia Hiperbárica
/
Hipertermia Induzida
Tipo de estudo:
Guideline
/
Observational_studies
Limite:
Child
/
Humans
/
Male
Idioma:
En
Revista:
BMC Urol
Assunto da revista:
UROLOGIA
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Egito