Progressive Hair Coil Penile Tourniquet Syndrome: Multi Center Experience With 25 Cases

PURPOSE Penile hair tourniquet syndrome is uncommon syndrome characterized by progressive penile strangulation by a hair tie. Complications were reported including urethrocutaneous fistula, complete urethral transaction, penile gangrene and penile amputation. Prevention of such major complications depends on awareness by the aetiology and presence of high index of suspicion for early diagnosis. MATERIAL AND METHODS Twenty five children presenting with different degrees of hair coil penile strangulation syndrome have been operated upon in the period from 2000 to 2007 in two tertiary care centres in the city of Alexandria. Eighteen boys had complete transection of the urethra at the coronal sulcus. Seven boys had partial transaction of the ventral wall of the urethra at the coronal sulcus. Repair of the penis was done in all children in single stage. RESULTS The mean age of boys is 3, 9 year (2-5 SD: 2, 1). the mean follow up is 20, 7 months (6-48 SD: 12, 3). Urethral catheter was left for a mean of 5.5 days (4-7 SD: 1, 15).In the mean follow up period we had 4 complications in the form of 2 tiny urethrocutaneous fistulas and 2 anastomotic urethral strictures. The fistulae are closed surgically after the primary surgery by one year in the two cases and closed with no recurrence. Urethral strictures were managed by endoscopic visual urethrotomy with no recurrence. CONCLUSIONS Penile tourniquet syndrome can cause serious penile complications. Awareness by this rare syndrome can help in preventing such complications. Being familiar with the surgical reconstruction guarantees high success rate.