{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T12:13:00Z","timestamp":1789560780719,"version":"build-2803163510"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 2","license":[{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Penile strangulation by foreign objects is a rare but serious urological emergency, most often associated with attempts to enhance sexual performance. Metallic rings are common offenders, and delayed intervention can lead to vascular compromise, ischemia, necrosis, and even penile loss. Management is particularly challenging when standard equipment is insufficient. We report the case of a 23-year-old male who presented with penile swelling and mild pain 5 h after symptom onset, following self-application of a metallic ring 12 h earlier. Manual removal attempts using lubrication were unsuccessful. Examination revealed marked edema with the ring firmly lodged at the penile base, without signs of necrosis or gangrene. Emergency removal was performed under spinal anesthesia. Tissue viability was confirmed intraoperatively. Due to the hardness of the ring and the lack of appropriate cutters, orthopedic instruments were utilized. An Alis bone gouge protected the underlying tissue while a Harrington jumbo rod cutter was used to cut the ring at two opposing points. The ring was successfully removed with minimal skin excoriation. Postoperatively, at 1-month follow-up, the patient had normal urinary and erectile function. Early intervention and innovative use of available tools are essential for the successful management of complex penile strangulation cases, especially in resource-limited settings.<\/jats:p>","DOI":"10.4103\/aam.aam_836_25","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T05:00:10Z","timestamp":1775797210000},"page":"S397-S401","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["The Iron Grip: A Rare Case of Penile Strangulation by a Metallic Ring"],"prefix":"10.4103","volume":"25","author":[{"given":"Suraj","family":"Bhondave","sequence":"first","affiliation":[{"name":"Department of Urology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhar","family":"Salvi","sequence":"additional","affiliation":[{"name":"Department of Urology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,4,9]]},"reference":[{"key":"R1-20260916","doi-asserted-by":"crossref","first-page":"105609","DOI":"10.1016\/j.ijscr.2021.01.103","article-title":"Penile strangulation injury by metallic ring: A study of 4 cases","volume":"80","author":"Noegroho","year":"2021","journal-title":"Int J Surg Case Rep"},{"key":"R2-20260916","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","year":"2008","journal-title":"J Sex Med"},{"key":"R3-20260916","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.1111\/j.1743-6109.2007.00601.x","article-title":"Penile strangulation: Two case reports and review of the literature","volume":"4","author":"Ivanovski","year":"2007","journal-title":"J Sex Med"},{"key":"R4-20260916","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1111\/j.1464-410X.1991.tb15426.x","article-title":"Penile strangulation","volume":"68","author":"Bhat","year":"1991","journal-title":"Br J Urol"},{"key":"R5-20260916","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/S0090-4295(01)01485-6","article-title":"Treatment of penile strangulation caused by constricting devices","volume":"59","author":"Perabo","year":"2002","journal-title":"Urology"},{"key":"R6-20260916","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","year":"2004","journal-title":"Urology"},{"key":"R7-20260916","first-page":"803","article-title":"Penile incarceration with metal objects: A review of procedure choice based on penile trauma grade","volume":"58","author":"Detweiler","year":"2001","journal-title":"Urology"},{"key":"R8-20260916","first-page":"1148","article-title":"Penile gangrene following prolonged strangulation: A case report","volume":"4","author":"Nuhu","year":"2013","journal-title":"Int J Surg Case Rep"},{"key":"R9-20260916","first-page":"444","article-title":"Penile strangulation: Report of a successful management of four cases","volume":"29","author":"Barros","year":"2003","journal-title":"Int Braz J Urol"}],"container-title":["Annals of African Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_836_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T12:00:51Z","timestamp":1789560051000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_836_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,9]]},"references-count":9,"journal-issue":{"issue":"Suppl 2","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/aam.aam_836_25","relation":{},"ISSN":["1596-3519","0975-5764"],"issn-type":[{"value":"1596-3519","type":"print"},{"value":"0975-5764","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,9]]},"assertion":[{"value":"2025-12-18","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-13","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}