{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T23:04:04Z","timestamp":1785279844494,"version":"3.55.0"},"reference-count":19,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T00:00:00Z","timestamp":1673308800000},"content-version":"unspecified","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,12,22]]},"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:p>Acute ischaemia of the glans penis is a rare and serious complication following circumcision. We report the case of a teenage boy with glanular ischaemia shortly after circumcision with dorsal penile nerve block. This was successfully treated with total 11 days of topical 2% nitroglycerin ointment, 14 days of oral pentoxifylline 400\u2009mg three times a day and 3\u2009days of epidural (0.2% ropivocaine). There was marked clinical improvement at 4\u2009days with a few patches of cyanosis remaining. Surgical intervention was not required, and the patient was discharged with follow-up review. At 12 days, there was complete resolution of ischaemia and the glans penis appeared normal. We suggest that oral, topical and epidural regimen of vasodilators and anti-sympathomimetic agents can be used in combination for acute ischaemia of the glans penis.<\/jats:p>","DOI":"10.1136\/bcr-2022-249049","type":"journal-article","created":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T10:07:00Z","timestamp":1673345220000},"page":"e249049","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Acute ischaemia of the glans penis post-circumcision managed with pentoxifylline, topical nitroglycerin and epidural"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3784-2477","authenticated-orcid":false,"given":"Kirsten","family":"Carlaw","sequence":"first","affiliation":[{"name":"General Surgery, Nepean Hospital, Kingswood, New South Wales, 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