{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T08:58:05Z","timestamp":1790413085730,"version":"4.1.0"},"reference-count":13,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:00:00Z","timestamp":1790380800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:00:00Z","timestamp":1790380800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["IJU Case Reports"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Penile strangulation is a rare urological emergency requiring prompt intervention. Stainless steel rings may resist conventional cutters because of their rigidity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>A 62\u2010year\u2010old man presented with severe penile pain after applying four stainless steel rings to treat phimosis. One ring was trapped at the coronal sulcus and three at the penile base. The glans was congested with partial blistering. Initial attempts using the string method and manual ring cutters failed. Aspiration of approximately 10\u2009mL of blood from the glans allowed removal of the distal ring. The remaining rings required general anesthesia, corporal blood aspiration, temporary penile\u2010base compression, partial cutting of one ring, and manual decompression. All rings were removed within approximately 6\u2009h after application. No clinical evidence of urethral injury was found, and no sensory disturbance was noted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A stepwise approach may be required for penile strangulation caused by multiple stainless steel rings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/iju5.70265","type":"journal-article","created":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T07:58:43Z","timestamp":1790409523000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Penile Strangulation by Four Stainless Steel Rings Requiring Multiple Approaches for Removal: A Case Report"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6622-1688","authenticated-orcid":false,"given":"Yoshifumi","family":"Miyauchi","sequence":"first","affiliation":[{"name":"Department of Urology Jichi Medical University  Shimotsuke Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0901-3209","authenticated-orcid":false,"given":"Toru","family":"Sugihara","sequence":"additional","affiliation":[{"name":"Department of Urology Jichi Medical University  Shimotsuke Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daichi","family":"Hirata","sequence":"additional","affiliation":[{"name":"Department of Urology Jichi Medical University  Shimotsuke Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3065-7835","authenticated-orcid":false,"given":"Hiroto","family":"Kishino","sequence":"additional","affiliation":[{"name":"Department of Urology Jichi Medical University  Shimotsuke Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Risako","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Urology Jichi Medical University  Shimotsuke Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6901-6735","authenticated-orcid":false,"given":"Masayuki","family":"Kurokawa","sequence":"additional","affiliation":[{"name":"Department of Urology Jichi Medical University  Shimotsuke Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5067-0241","authenticated-orcid":false,"given":"Hayato","family":"Hoshina","sequence":"additional","affiliation":[{"name":"Department of Urology Jichi Medical University  Shimotsuke Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eiichiro","family":"Takaoka","sequence":"additional","affiliation":[{"name":"Department of Urology Jichi Medical University  Shimotsuke Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Ando","sequence":"additional","affiliation":[{"name":"Department of Urology Jichi Medical University  Shimotsuke Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3421-8273","authenticated-orcid":false,"given":"Tetsuya","family":"Fujimura","sequence":"additional","affiliation":[{"name":"Department of Urology Jichi Medical University  Shimotsuke Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,26]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"1747","DOI":"10.1111\/j.1743-6109.2008.00848.x","article-title":"Penile Constriction Devices: Case Report, Review of the Literature, and Recommendations for Extrication","volume":"5","author":"Silberstein J.","year":"2008","journal-title":"Journal of Sexual Medicine"},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1590\/s1677-5538.ibju.2018.0667","article-title":"Treatment Options and Outcomes of Penile Constriction Devices","volume":"45","author":"Koifman L.","year":"2019","journal-title":"International Braz J Urol"},{"key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1080\/2090598X.2019.1647677","article-title":"Stepwise Approach in the Management of Penile Strangulation and Penile Preservation: 15\u2010Year Experience in a Tertiary Care Hospital","volume":"17","author":"Puvvada S.","year":"2019","journal-title":"Arab Journal of Urology"},{"key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"5811","DOI":"10.12998\/wjcc.v11.i24.5811","article-title":"Penile and Scrotal Strangulation by Stainless Steel Rings in an Human Immunodeficiency Virus Positive Man: A Case Report","volume":"11","author":"Usuda D.","year":"2023","journal-title":"World Journal of Clinical Cases"},{"key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1016\/j.urology.2004.04.058","article-title":"Penile Strangulation Treated With the Modified String Method","volume":"64","author":"Noh 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A.","year":"2004","journal-title":"Urology"},{"key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1111\/j.1464-410X.1991.tb15426.x","article-title":"Penile strangulation","volume":"68","author":"Bhat A. L.","year":"1991","journal-title":"British Journal of Urology"},{"key":"e_1_2_10_10_1","doi-asserted-by":"crossref","DOI":"10.1177\/15579883231223366","article-title":"Penile Strangulation: Analysis of Postextrication Follow\u2010Up, Sequelae, and a Review of Literature","volume":"18","author":"Campbell K. J.","year":"2024","journal-title":"American Journal of Men's Health"},{"key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"512","DOI":"10.4103\/0974-7796.192101","article-title":"Penile Constriction Injury: An Experience of Four Cases","volume":"8","author":"Sawant A. 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R.","year":"2025","journal-title":"Cureus"}],"container-title":["IJU Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/iju5.70265","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/iju5.70265","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/iju5.70265","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T07:58:46Z","timestamp":1790409526000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/iju5.70265"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,26]]},"references-count":13,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1002\/iju5.70265"],"URL":"https:\/\/doi.org\/10.1002\/iju5.70265","archive":["Portico"],"relation":{},"ISSN":["2577-171X","2577-171X"],"issn-type":[{"value":"2577-171X","type":"print"},{"value":"2577-171X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,26]]},"assertion":[{"value":"2026-07-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70265"}}