Thread-induced penile injury in a child: Surgical management and outcomes in a hair-thread tourniquet syndrome.

INTRODUCTION AND

IMPORTANCE

Hair-thread tourniquet syndrome (HTTS) represents a rare entity that can result in significant morbidity if not promptly identified and treated. Characterized by constriction of appendages by hair or thread, resulting in vascular compromise, ischemia, and potential tissue necrosis.

CASE PRESENTATION: We present the case of a 9-year-old circumcised male who developed penile HTTS, manifesting as severe edema, erythema, partial ischemia, and near-complete urethral transection. The constricting thread was excised emergently, and termino-terminal urethral anastomosis was performed. Multilayered reconstruction, including coverage with a dartos flap, was employed. The postoperative recovery was unremarkable, with imaging confirming entire urethral continuity and voiding symptoms resolved.

CLINICAL DISCUSSION: Early identification is critical since it can resemble infections and lead to serious consequences. Conservative treatment options include depilatory creams and mechanical removal, as well as surgical treatment, such as phased urethral restoration. In severe situations, microsurgical replantation is necessary to restore vascular integrity, nerve function, and urethral alignment.

CONCLUSION

This example demonstrates the possibility of one-stage repair in complicated cases and the importance of keeping a high degree of suspicion for HTTS in individuals presenting with unexplained penile edema.