Surgical Management of Hair-coil Penile Injury: Anatomical Insights and Grading System

Abstract

© 2016 Elsevier Inc. Objective To report our experience in the surgical management of a group of patients with varying degrees of hair-coil penile injury, while applying a more detailed grading scale for the severity of injury. Patients and Methods The study included 16 boys with hair-coil penile injury who were managed during the period 2010 through 2016. In the acute state, the constricting hair coil was removed under general anesthesia. The repair was planned 6 months later after the acute injury. In 1 case presenting with severe form (near total glanular amputation), the glans was resutured to the penile shaft immediately after removal of the hair coil; the urethroplasty was performed six months later. Results The patients' age ranged from 2 to 17 years (mean 4.8 years). The urethroplasty was always covered by a protective layer, which was derived from the ventral dartos fascia in all but 1 case. In the latter, we used a tunica vaginalis flap for covering the urethroplasty. A successful outcome (regarding both urethral reconstruction and cosmesis) was achieved in all cases. Conclusion Hair-coil penile injury is an uncommon condition with insidious course. Unawareness of such condition can lead to progression to serious complications. Delayed and staged surgical repair is associated with successful outcome.