|Year : 2015 | Volume
| Issue : 4 | Page : 210-212
Penoscrotal injury by stone (tiles) cutter machine
Venkat Arjunrao Gite, Saurabh Ramesh Patil, Sachin Madhukar Bote
Department of Urology, Grant Government Medical College, Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
|Date of Web Publication||21-Jan-2016|
Dr. Venkat Arjunrao Gite
Saikrupa, H-21, Tirupati Supreme Enclave, Jalan Nagar, Aurangabad - 431 005, Maharashtra
Source of Support: None, Conflict of Interest: None
Injury to penis is relatively uncommon, but several reports of penile injuries related to machinery accidents have been reported. Corporal injuries usually follow forceful injury to erect penis during coitus however tiles cutter injury is very rare and has not been reported in the literature. We report a case of corporal injury due to electrically driven stone (tiles) cutter machine. He sustained an injury of about 20 cm, extending from the coronal sulcus to the left thigh. There was associated corporal injury measuring 6 × 2 cm. Following resuscitation the patient was taken for repair of the penoscrotal wound under spinal anesthesia. The wound was thoroughly washed with normal saline and sutured in layers. The patient had a functionally and cosmetically normal penis at 6 months follow-up.
Keywords: Corporal injury, penoscrotal injury, tiles cutter machine
|How to cite this article:|
Gite VA, Patil SR, Bote SM. Penoscrotal injury by stone (tiles) cutter machine. Arch Int Surg 2015;5:210-2
| Introduction|| |
Traumatic injuries to the genitourinary tract are seen in 2.2-10.3% of the patients admitted to hospitals.  Out of these cases, one-third to two-third of the cases are associated with injury to the external genitalia. Corporal injuries usually follow forceful injury to erect the penis during coitus  but may rarely occur from other forms of injuries. In this report, we present a patient who sustained penoscrotal injury from an electrically driven tiles cutter machine.
| Case Report|| |
A 35-year-old male, wearing lungi and kurta, met with an accident while cutting tiles by an electrically driven cutter machine in a tiles factory. He immediately presented to the emergency department. On examination, he was hemodynamically stable and had a large wound over the penoscrotal area. The length of the wound was approximately 20 cm, extending to the left thigh from the coronal sulcus [Figure 1]. There was also a corporal injury measuring 6 × 2 cm [Figure 2] that was actively oozing. He had no history of hematuria or retention of urine. A diagnosis of injury to the external genitalia was made. After clinical evaluation, single dose of antibiotic, tetanus toxoid and analgesic injection were given. Per urethral catheter went easily, which drained clear urine. After obtaining informed consent, the patient was taken for repair of the penoscrotal area under spinal anesthesia. The wound was thoroughly washed with normal saline, reinspected, and the extent confirmed. The tunica albuginea was delineated all around and sutured with Vicryl 2-0 [Figure 3]. The second layer of Buck's fascia was sutured with Vicryl 3-0. The rest of the wound was closed in layers after refreshening the edges [Figure 4]. The urethral catheter was kept in situ for 3 days and the patient was discharged on the 7 th day after removal of sutures. Sexual activity was prohibited for 3 months, considering the large tunical tear to avoid complications in our case. The patient had a functionally and cosmetically a normal penis at 6 months follow-up.
|Figure 3: After closure of Buck's fascia, also shows the extent of injury|
Click here to view
| Discussion|| |
Injury to the penis is relatively uncommon but several reports of penile injuries related to machinery accidents have been reported.  The mechanism of injury affecting male genitals is not consistent with any particular pattern.  The different modes of injuries reported are road traffic accident and gunshot injury by Ahmed, et al.  and grinding machine by Adigun.  The possible mechanisms of penoscrotal injuries in our case could have been accidental entanglement of loose clothes in the machine and accidental fall of the machine on the genital area while cutting the tiles.
The need of appropriate clothes for machinery workers is well-recognized because many injuries have been reported among machine operators wearing loose clothes,  as was seen in our case as well. The Occupational Safety and Health Act (OSHA) also specifies appropriate garments at the workplace.  Appropriate garments and precautions to be taken while handling electrically driven tile cutter machine include proper training of the workers who handle the machine, use of appropriately fitting garments such as T-shirts, half shirts, and tight-fitting pants, and keeping the electrical tiles cutter machine always away from the body. In addition, the electrically driven machine for cutting tiles should not be used without support and the machine should not be switched on when not in use.
The current treatment recommendations for corporal injury is proper layered repair with delineation of tunica albuginea, local corporal debridement, and closure of tunical lacerations,  which was performed in our case too. There is no consensus on the time period for abstinence of sexual activity after repair of penile injury.  Patients with simple injury were counseled to resume sexual activity after 1 month.  Patients with complex fracture were advised to abstain from sexual activity for 3 months in order to prevent refracture. 
In this case study, we have presented one of the rarest modes (tile cutter) of traumatic injury to the male external genitalia, which has never been reported before. Prompt assessment and surgical intervention constitute the key to success in managing such cases.
| Conclusions|| |
Penoscrotal (corporal) injury due to electrically driven tiles cutter machines is very rare. Prompt attention and intervention will always be rewarding. Work safety rules should be applied in formal and informal sectors as well.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Ofoha CG, Shu′aibu SI, Akpayak IC, Dakum NK, Ramyil VM. Male external genital injuries; Pattern of presentation and management at the Jos University Teaching Hospital. IOSR-JDMS 2014; 13:67-72.
Jack GS, Garraway I, Reznichek R, Rajfer J. Current treatment options for penile fracture. Rev Urol 2004;6:114-20.
Dogra PN, Gautam G, Ansari MS. Penile amputation and emasculation: Hazards of modern agricultural machinery. Int Urol Nephrol 2004;36:379-80.
Ahmed A, Mbibu NH. Aetiology and management of injuries to male external genitalia in Nigeria. Injury 2008; 39:128-33.
Adigun IA, Kuranga SA, Abdul-Rahman LO. Grinding machine: Friend or foe. West Afr J Med 2002;21:338-40.
Popoola AA, Salawu ON, Babata AL, Kuranga SA, Abiola OO. Machinery penile injuries associated with traditional trousers of the Yoruba of South-western Nigeria: A consideration for proper work clothes. Afr J Urol 2012; 18:34-6.
Omisanjo OA, Bioku MJ, Ikuerowo SO, Sule GA, Esho JO. A prospective analyses of presentation and management of penile fracture at Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos, Nigeria. Afr J Urol 2015;21:52-6.
Shittu OB. Urologic trauma in Nigeria. Afr J Trauma 2003; 1:30-4.
Benefelloun M, Rabii R, Bennani S, Querfani B, Jonal A, El Mrini MN. Fractuer of corpuscavernosum: Reports of 123 cases. Afr J Urol 2003;9:1-10.
[Figure 1], [Figure 2], [Figure 3], [Figure 4]