Burning of the penis
If the severity of the burn is assessed by the area of the affected skin, the burn of the penis should be attributed to minor burn injuries, since together with the perineum occupies only 1% of the body surface.
But the severity of the burn of the penis should not be underestimated: such burns can be very serious, patients require specialized care, and negative consequences concern sexual function and urination.
Epidemiology
According to some reports, genital and perineal burns account for approximately 3.5% to 12.5% of all patients with burns of different etiologies; Burns, limited only by the penis, are possible, although quite rare.
As reported by the International Journal of Burns and Trauma, the circumcision adopted in some religions (circumcision) by radiofrequency ablation in approximately 7-8% of cases is accompanied by such a negative consequence as a burn of the penis.
Causes of the burn of penis
Isolated burn injuries of the male copulatory organ are relatively rare: they are more often associated with injuries of the lower part of the trunk and lower extremities involving the inguinal region and scrotum. Combustiologists note such basic causes of a burn of the penis as hot water (boiling water), heated oils, incandescent objects, open flame, molten metal or plastic materials causing thermal burns. Acid or alkali cause a chemical burn of the penis, high-voltage shock is an electrical burn, and the effect of increased doses of ionizing radiation is radiation.
According to medical statistics, most of the thermal burns of a given localization, first or second degree, are caused by flames; Burning a member with boiling water is the second most frequent case. Electric burns are deeper than thermal burns and refer to burn lesions of the third degree with a significant volume of burned tissues.
Risk factors
Risk factors for burns of the penis: careless handling of boiling water, any very hot liquid or chemicals, fire in home and at work (in particular, ignition of clothing), etc.
Some groups of the population - due to a slower reaction and lack of sufficient physical strength - are at increased risk of scalding, including young children, the elderly and people with disabilities.
Pathogenesis
Human skin can tolerate temperatures up to + 44 ° C for a relatively long time (6 hours) until irreversible damage occurs. Higher temperatures cause an almost exponential growth of tissue destruction, the pathogenesis of which is associated with the process of denaturation (coagulation) of their protein components and disorders in the structure of cells. The extreme degree of tissue damage is cytoplasmic catabolism and the development of direct coagulation necrosis.
Because of its thin skin, all the tissues of the penis are extremely susceptible to hyperthermia, which leads to second and third degree burns. A burn of a member with boiling water, as well as a burn of the glans penis, can lead to damage not only to the prepuce (foreskin), which has some similarity with the mucous epithelium: the connective tissue envelope of the cavernous (cavernous) bodies of which the penis consists is also affected.
But even a superficial burn leads to a disruption in the functions of Langerhans cells, which mediate local immune responses, so a burn injury increases susceptibility to serious infections.
A severe chemical burn of a member or a burn with open fire can damage tissues of cavernous bodies, including spongy ones, in which the urethra (urethra) is located.
Symptoms of the burn of penis
The first signs of a burn of the penis are instant hyperemia and unbearable pain, since this organ has a very high level of innervation. Especially tightly concentrated are the sensory cells in the dermal-mucous area of the penis, which is located near the tip of the foreskin, and also on the thin skin covering the spongy tissue of the glans penis.
Symptoms of burn of the first degree penis include redness and swelling of the skin, severe burning and pain (including with urination).
Point detachment of the upper layer of the epidermis and the appearance of vesicles with serous contents (due to increased permeability of the vascular walls) - with all the above symptoms - indicates a second degree burn. A third degree of burn injury is characterized by bleeding (due to damage to the branched system of blood vessels), large bubbles, their rupture and the formation of colliquative scabs. With such burns, infection often accompanies and can develop septicotoxemia with fever, increased white blood cell count and deterioration in general condition.
Complications and consequences
Despite the insignificant area of the burn of the penis, its consequences and complications include both short-term and long-term impairments of the organ's functions: loss of the capacity for erection due to the replacement of the tissue of the cavernous bodies with scar tissue; cicatricial narrowing (phimosis) of the foreskin; cicatricial changes in the frenum of the prepuce; decrease or total loss of sensitivity of the head of the penis.
There may also be complications such as lymphedema (swelling of the trunk of the penis, associated with poor outflow of the lymphatic fluid) and impaired urination (due to damage to the urethra).
Treatment of the burn of penis
Treatment of a burn of a sexual member is carried out in the burn or surgical department, where the victims are hospitalized. First of all, this is a conservative treatment: to relieve pain injectively, strong painkillers (Promedol) are injected, and in case of severe burn and painful shock, the necessary resuscitative measures are taken. Mandatory catheterization of the bladder, which ensures the excretion of urine until the puffiness of the tissues adjacent to the penis decreases.
To fill the volume of electrolytes and improve homeostasis, infusion therapy is performed, glucose solution, vitamins C, E, group B, PP are administered internally.
Read also - Treatment of burns
To care for the burn wound - before it clears from the dead tissue and begins the process of granulation - use anti-inflammatory antibacterial drugs in the form of ointments:
- Synthomycin (5-10% liniment chloramphenicol) - once a day.
- Levomekol (with chloramphenicol and methyluracil) or Sulfamecol (Dioxydin + methyluracil + trimecaine) - up to four times a day.
- Streptonitol (Nitacide) with nitazole and streptocid - a maximum of twice a day.
- Levosin (chloramphenicol + sulfadimethoxin + methyluracil + trimecaine) - twice a day.
- Sulfargin (sulfadiazine silver) - twice a day.
For a first degree burn, use a gel or Panthenol aerosol. For more details, see " Ointment for Burns"
Systemic antimicrobial therapy is carried out with antibiotics using Ampicillin, Gentamicin, Amoxiclav, Azithromycin, cephalosporin group drugs.
Surgical treatment of burns of the penis consists in a necrectomy (sanation of the wound with the removal of all dead tissue), tangential excision of the scab (to the living bleeding surface) with autodermoplasty (skin flap replanting in cases of too slow healing). Surgical intervention is performed when the demarcation zone of necrosis is clearly defined.
Depending on the severity of the burn, you may need to restore the urethra and scrotum.