Indian Journal of Urology
CASE REPORT
Year
: 2000  |  Volume : 16  |  Issue : 2  |  Page : 164--165

Hair coil penile injury in children with underlying urological problems


KL Narasimhan, A Pimpalwar, Yoginder Singh, SK Chowdhary, KLN Rao 
 Department of Paediatric Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Correspondence Address:
K L Narasimhan
Dept. of Paediatric Surgery, PGIMER, Chandigarh - 160 012
India

Abstract

Hair coil penile injury has been reported with circum­cised and uncircumcised penises. Association of this clini­cal entity in patients with underlying urological problems is being reported for the first time. There is overlap of symptoms between the urological problems and hair coil penile strangulation and hence it is very important to be aware of this entity to avoid potential penile loss. Penile hair coil injury has been described in circum­cised and uncircumcised penises. [1],[2],[3] We encountered three children, two with posterior urethral valves and the one with exstrophy-epispadias complex who had associated penile hair coil strangulation during the course of their treatment. The association of hair coil injury with under­lying urological problems is hitherto unreported and is an important problem to be aware of to avoid potentially serious problem as there is significant overlap of symp­toms.



How to cite this article:
Narasimhan K L, Pimpalwar A, Singh Y, Chowdhary S K, Rao K. Hair coil penile injury in children with underlying urological problems.Indian J Urol 2000;16:164-165


How to cite this URL:
Narasimhan K L, Pimpalwar A, Singh Y, Chowdhary S K, Rao K. Hair coil penile injury in children with underlying urological problems. Indian J Urol [serial online] 2000 [cited 2019 Sep 21 ];16:164-165
Available from: http://www.indianjurol.com/text.asp?2000/16/2/164/22224


Full Text

 Case Report



A 12-year-old Sikh child with posterior urethral valves had been in our follow-up from 3 years of age. He pre­sented to us with pain at the tip of the penis and dribbling of urine of I week duration. He had earlier undergone transurethral fulguration of posterior urethral valves, a (L) nephro-ureterectomy for non-functioning (L) kidney, cir­cumcision and (R) Politano-Leadbetter ureteric reimplanta­tion for persisting (R) vesicoureteric reflux. He had stable renal functions at this presentation. An examination of the ventral aspect of the penis revealed a cut in the glandular urethra with a coil of hair in the coronal sulcus. The coil of hair was removed and 4 weeks later the urethral fistula was repaired.

Another Sikh child had closure of exstrophy without osteotomy at 2 years of age. He presented at 4 years of age with painful swelling of the penis. Careful examina­tion of the penis showed a hair coil embedded in the cor­pora at the level of the coronal sulcus with a cut in the urethral plate. The hair coil was removed and subsequently the child had a Cantwell Ransley's epispadias repair. He is awaiting subsequent stages of the management.

A 3-year-old Muslim child from Kashmir who was cir­cumscised at one week of life presented with dribbling of urine since birth. After evaluation it was found that the child was having retarded growth, raised blood urea & creatinine and a distended bladder. A micturating cysto­urethrogram showed dilated posterior urethra suggestive of posterior urethral valves. He was transurethrally fulgu­rated. Two years later the child presented with dribbling of urine but this time from the under surface of the penis. On examination, there was a deep groove in the coronal sulcus with a hair which had cut through the corpus spongiosium resulting in a urethral fistula. The hair coil was removed and the urethra fistula was repaired subse­quently.

 Discussion



Penile tourniquet injury by human hair is reported. [1],[2],[3] Potentially serious complications like amputation of the penis are mentioned and can be averted by early diagno­sis. Bashir and EL-Barbary have classified the injuries into 4 grades. [1] Hair coil injury in patients with underlying urological problems can be easily overlooked. The symp­toms of haircoil overlap the symptoms of the original dis­ease and can be easily missed. The consequence can be disastrous. Sikhs grow long hairs for religious reasons and the incidence of urological problems in this group is no different from other Asian children. With worldwide mi­gration of these people this association must also be taken note of. Circumcision is an important predisposing factor for hair coil injury and two of the three children were cir­cumcised.

References

1Bashir AY, El-Barbary M. Hair coil strangulation of the penis. J Roy Coll Surg Edin 1980; 25:47-51.
2Kirtane JM. Samue KV. Hair coil strangulation of the penis. J Paediatr Surg 1994: 29:1317-1318.
3Narasirnhan KL. Bhat HS, Chatterjee H. Coil strangulation of pe­nis - a case report. Indian J Urol 1991: 7: 84-85.