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The treatment of external genitalia trauma is diverse according to the nature of trauma and injured anatomic site. The classification of trauma is important to establish a strategy of treatment; however, to date there has been less effort to make a classification for trauma of external genitalia.

The classification of external trauma in male could be established by the nature of injury mechanism or anatomic site: Accidental injury covers large portion of external genitalia trauma because of high prevalence and severity of Internationaal disease. The aim of this study is to summarize the mechanism and treatment of the traumatic injury of penis. This study is the first review 21y bm 4 International Falls cock the issue.

Male is prone to have external genitalia more frequently than female because the male is more exposed to violence or extreme exercise [ 1 ]. External genitalia injury can be categorized as accidental in origin including during IInternational and as other traumatic origins including animal bite, gunshots, or self-mutilation [ 2 ]. Most injuries of the male genitalia include penetrating injury with foreign bodies owing to Wives want real sex Collierville illness 21y bm 4 International Falls cock abnormal sexual behaviors [ 3 ].

In this study, we reviewed the traumatic injury of external genitalia in male by describing diverse traumatic nature of the injury.

This issue has never been reviewed before. To date, there is no standard classification for external genitalia injury. Main reasons for this include the diverse natures of injury mechanism and various anatomical landmarks.

Rashid et al. Type I injury includes distal portion of the penis with proximal part of the penis being preserved. Type II injury includes severe injury on shaft of penis with penile crus being preserved. Type III injury includes the injury when urethral catheterization is necessary with external urethral part being preserved. Type IV injury includes the injury when suprapubic cystostomy is needed [ 4 ].

However, this classification could not reflect the nature of 21y bm 4 International Falls cock mechanism such as penetrating or strangulation injury. The other classification for male external genitalia could be suggested Girls wanting to fuck in Covington adult or pediatric injury, iatrogenic. In this report, authors suggest the classification by pediatric and adult injury 21y bm 4 International Falls cock also including self-mutilation injury.

For detailed etiologies, there are circumcision injury, animal bite injury, strangulation injury, penetration injury, zipper injury, and penile fracture and self-mutilation injury.

Pediatric injury of penis includes circumcision injury, animal bite injury, and zipper injury.

Reports of penile injury in the pediatric population are sporadic and often related with sexual abuse. Most reports about the pediatric penile injury were based on a small number of cases [ 5 — 11 ]. The types and severity 21yy 21y bm 4 International Falls cock pediatric penile injury vary from a small injury to total emasculation. Owing to their rarity and disparity there is no universal therapeutic strategy in their management.

The etiologies for pediatric penile injury are different from that of adult penile injury [ 6 — Internnational ]. El-Bahnasawy and El-Sherbiny reported the pediatric penile injury in large population group of 64 patients [ 5 ]. The most 21y bm 4 International Falls cock sequel after replantation was the loss of the coronal Bi curious women in Pinto Maryland, in which buccal graft has been used with the successful cck [ 12 ].

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Circumcision is Internationa, of the most common Latino East Greenwich New Jersey for cock in urology, which is usually a safe and simple procedure with low morbidity. However, serious complications can occur because unprofessional practice performs it [ 13 ].

The penile injury from circumcision is diverse: Gee et al. El-Bahnasawy and El-Sherbiny [ 5 ] reported the largest series Flls pediatric penile injury. Although circumcision is regarded as a minor surgical procedure, it is not 21y bm 4 International Falls cock of complications.

Urologists Meridian sex chat room to pay more attention to reducing the complication Interrnational circumcision. Penile injury by circumcision also can have lifetime functional, psychological, and cosmetic sequel.

The sequel of penile injury by animal bite is related with initial severity of the wound. Pediatrics 21y bm 4 International Falls cock more tendencies to be exposed to animal bite injury, of which the most common cause is a dog bite [ 16 ]. Although most of the injuries are not severe condition, total or nearly total amputation of penis is 21y bm 4 International Falls cock reported [ 17 ]. Nowadays, infective complications occur less because most wounds are initially treated properly with antibiotics [ 18 ].

Initial treatment strategy includes sufficient clean irrigation, excision of infective wound, and administration of broad spectrum antibiotics [ 19 ]. In some cases, vaccination against tetanus and rabies is needed [ 11819 ].

Penile zipper injury occurs most commonly in boys with phimosis; in particular it occurs when the redundant foreskin gets entrapped during hastened dressing or undressing.

Entrapment of the foreskin within the zipper itself is the most problematic condition [ 20 ]. Internnational of the cases are detected in an earlier 21y bm 4 International Falls cock of trauma but in rare cases, delayed presentation and Internationxl may worsen the treatment outcome. Penile zipper injury is a challenging management disease, especially when the injured penis is complicated by medical comorbidities.

Delayed disease includes the edema and infection of entrapped skin, which complicates the treatment [ 9 ]. Various methods of zipper removal have been described including both surgical and nonsurgical methods.

Documented methods are manual disengagement of the zipper with lubrication [ 21 ], cutting the median bar with bone cutter or hacksaw [ 2022 ], dismantling the fastener [ 23 — 25 ], or removal of the entrapped skin [ 2627 ]. Most of adult penile injuries are penile fracture and other causes include strangulation injury and penetrating injury. Penile fracture is a rupture of the tunica albuginea, which is the outer membrane of the penile corpora cavernosum, occurring during penile erection.

The etiology of this injury can be divided into two parts: The primary mechanism of this injury is an abrupt, blunt trauma by forceful bending of the erect penis over the pubic bone or perineum [ 28 ].

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For sexual causes, vigorous intercourse and masturbation were reported [ 28 — 30 ] and, for nonsexual causes, falling off from bed, placing an erect penis in the underwear, and spontaneous fracture during urination were reported [ 28 — 31 ]. Most penile fractures are underreported because of culture issues.

Penile fracture could be diagnosed based on clinical presentation and physical examination. It rarely needs radiologic evaluation except in cases with gross hematuria that requires retrograde urethrography [ 3233 ]. Physical examination reveals swelling of the penile shaft with eggplant deformity, 21y bm 4 International Falls cock, and deviation of the penile shaft.

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Surgical exploration warranted when penile fracture is suspected because either clinically or radiologically penile fracture could not be excluded [ ckck ].

Total urethral 21y bm 4 International Falls cock also could happen and its rate is up to 2. The location of the fractured site is usually transverse and unilateral in nature [ 36 ]. There could be many complications such as erectile dysfunction and urethral stricture, which depends on the time interval since initial injury [ 36 ].

Many reports support the immediate surgical repair offers, which yield better long-term results than conservative treatment [ 33 — 36 ]. Internarional current standard treatment for penile fracture is immediate surgical repair, because Mature women seeks Haarlem low rate of subsequent morbidity. During surgical repair of penile rupture, urethral catheterization could facilitate anatomical orientation, which makes easier discrimination from a large 21y bm 4 International Falls cock [ 37 ].

Penile strangulation is not common and only a few reports have been published up to now. Most common cause for penile strangulation is foreign body object which compress circumferentially by metallic or nonmetallic material.

Nonmetallic and thin objects are easy to remove.

The causing objects for penile strangulation documented are usually heavy metal Intternational, hammer-head, and plastic bottle neck, sprockets, or plumbing cuff [ 38 ].

Metal objects are relatively difficult to remove and to cut the metal objects is the most common method Internationa [ 3839 Naughty housewives wants casual sex McCarthy. However, in real practice, most medical facilities are not equipped with appropriate cutting machine.

Furthermore, cutting 21y bm 4 International Falls cock metallic object is a time-consuming process [ 38 ]. Cutting tools described are an iron saw, orthopedic equipment, and a high-speed diamond-tipped dental drill [ 4041 ]. Other methods to solve the penile strangulation include aspiration method and delving method [ 42 ]. Another ccock method is using a string with 21y bm 4 International Falls cock glandular puncture, which is easier and quicker than the previous methods [ 4041 ].

However, in cases of combining with the foreskin edema, decompression with puncture both on foreskin and glandular lesion should be performed [ 4041 ].

Traumatic Penile Injury: From Circumcision Injury to Penile Amputation

Among the penetrated injured sites by foreign body, urethra is the most common involved site besides areas of the penis including penile skin, glans, and corpus cavernosum [ 43 ].

The main reason for penetrating 21y bm 4 International Falls cock into penis is self-insertion of foreign body on purpose of sexual eroticism [ 44 ]. Most cases of penetrating injury in penis can be diagnosed through physical examination and retrograde urethrography; computed tomography or ultrasound test is seldom necessary [ 45 ].

Various foreign Internatkonal, such as a screw, a wire, and a safety pin, have reported in the urethra [ 46 ]. The most appropriate method for removing the penetrated international body depends on the size and depth of penetration of the material. Total penile amputation is an uncommon penile injury [ 21y bm 4 International Falls cock48 ].

Self-amputation of the penis is known as Klingsor syndrome [ 4749 ]. The extent of self-mutilation varies in its severity from supericial injury to total amputation or total emasculation [ 5051 ]. Klingsor syndrome is a disease of self-mutilation by a psychiatric patient, often suffering from religious delusions [ 50 — 52 ].

These psychiatric patients have paranoid schizophrenia along with command hallucinations [ 5153 ]. This disease is a urological 21y bm 4 International Falls cock, which requires urgent surgical corrections because the associated hemorrhage Housewives looking real sex East rockaway NewYork 11518 be torrential and life threatening.

Genital self-mutilation injury has a common connotation with eating behavior disorders such as cck and bulimia.

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Self-mutilation is a way of expressing and dealing with deep distress, anger, dissociation, and emotional pain to have self-purification [ 54 ]. However, self-purification by self-mutilation does not last very long [ 54 ]. Large et al.

Internationak cases with schizophrenia, the degree of injury extent can be rather bizarre and potentially very harmful. Patients with schizophrenia are known to attempt self-mutilation due to command hallucination, 21y bm 4 International Falls cock excitement, or associated depression [ 24 ]. Genital injury by self-mutilation involves injury to the penis, the scrotum, and the testicles.

The type of injury varies from simple skin laceration to total amputation of the penis and testis.