Penile incarceration is uncommon. The diagnosis is obvious, but extraction of the constrictive ring and repair of the damage can be challenging. The authors present the case of a 61-year-old man wh presented with pain and swelling of the penis 3 weeks after applying a metal ring (double key rings) at the base of penis for the purposes of self-mutilation. The key ring was removed immediately under local anaesthesia. One week later, a urethral fistula was observed, requiring suprapubic cystostomy. It was decided to perform secondary surgical closure of the fistula and reconstruction of the skin of the base of the penis after treatment of local sepsis. Penile incarceration should be considered to be an emergency, as the more rapidly the constrictive object is removed, the lower the risk of complications secondary to penile devascularization, urinary retention and urethral damage. The authors review the literature concerning this unusual injury and its management.
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