Penile constriction devices: Case report, review of the literature, and recommendations for extrication

Jonathan Silberstein, Julia Grabowski, Charles Lakin*, Irwin Goldstein

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

64 Scopus citations


Introduction. Penile constriction devices often present significant challenges to urologic surgeons. Failure to remove such devices can lead to significant ischemia and loss of tissue. Patients often present after several days of ischemia and swelling have developed. Aim. This articlere views previously published data on penile constriction devices and strategies for their removal. Additionally, we present new methodologies for extrication. Methods. A comprehensive review of the English language literature was performed using MEDLINE. "Penile incarceration" and "penile strangulation" were used as search terms, and a manual bibliographic review of cross-referenced items was performed. Publications prior to 1970 were excluded from our search. Main Outcome Measures. Review of published literature on penile constriction devices and their removal. Results. Penile incarceration is frequently described in the literature as an isolated case report or small series describing the approach of a single physician or group of physicians for dealing with these problems. Penile incarceration has been reported in a wide spectrum of age groups, with the incarcerating object most frequently placed for erotic or autoerotic purposes. While the most commonly reported devices causing incarceration are metal rings, higher-grade penile injuries are more frequently sustained by nonmetallic objects. Patients who present with incarceration after 72 hours are more likely to sustain higher-grade injuries than those who seek more timely treatment. Strategies for extrication depend on the type of device used, the length of time of incarceration, the patient's ability to remain calm, and the tools available to the presenting physicians. Conclusion. Penile incarceration is a urologic emergency with potentially severe clinical consequences. With rapid intervention and removal of the foreign body, most patients do extremely well and need no further intervention. Removal of such devices can be challenging and often requires resourcefulness and a multidisciplinary approach.

Original languageEnglish (US)
Pages (from-to)1747-1757
Number of pages11
JournalJournal of Sexual Medicine
Issue number7
StatePublished - Jul 2008


  • Penile constriction devices
  • Penile incarceration
  • Penile strangulation

ASJC Scopus subject areas

  • General Medicine


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