Penis burn

If we evaluate the severity of a burn based on the area of affected skin, then a burn of the penis should be classified as a minor burn injury, since together with the perineum it occupies only 1% of the body surface.

But the severity of a penile burn should not be underestimated: such burns can be very serious, patients require specialized care, and the negative consequences concern sexual function and urination.

[ 1 ]

Epidemiology

According to some data, burns of the genitals and perineum account for approximately 3.5% to 12.5% of all patients with burns of various etiologies; burns limited to the penis are possible, although quite rare.

As reported in the International Journal of Burns and Trauma, circumcision (cutting off the foreskin) by radiofrequency ablation, which is accepted in some religions, is accompanied by such a negative consequence as a burn of the penis in approximately 7-8% of cases.

Causes penis burn

Isolated burn injuries to the male copulative organ are observed relatively rarely: they are more often associated with injuries to the lower part of the body and lower limbs with the involvement of the groin area and scrotum. Combustiologists note the following main causes of penis burns: hot water (boiling water), heated oils, hot objects, open flame, molten metal or plastic materials causing thermal burns. Acid or alkali causes a chemical burn of the penis, high-voltage current causes an electrical burn, and exposure to high doses of ionizing radiation causes radiation burns.

According to medical statistics, most thermal burns of this localization - first or second degree, are caused by flame; a burn of the penis with boiling water is the second most common. Electrical burns are deeper than thermal burns and are classified as third degree burns with a significant volume of burned tissue.

Risk factors

Risk factors for penis burns: careless handling of boiling water, any very hot liquid or chemicals, fires at home and at work (in particular, ignition of clothing), etc.

Certain groups of the population are at increased risk of scald injury due to slower reaction times and lack of physical strength, including young children, the elderly, and people with disabilities.

[ 2 ], [ 3 ], [ 4 ]

Pathogenesis

Human skin can tolerate temperatures up to +44°C for a relatively long time (6 hours) before irreversible damage occurs. Higher temperatures cause an almost exponential increase in tissue destruction, the pathogenesis of which is associated with the process of denaturation (coagulation) of their protein components and disruption of the cell structure. The extreme degree of tissue damage is cytoplasmic catabolism and the development of direct coagulative necrosis.

Because of its thin skin, all tissues of the penis are extremely susceptible to hyperthermia, which leads to second- and third-degree burns. A burn of the penis with boiling water, as well as a burn of the head of the penis, can lead to damage not only to the prepuce (foreskin), which has some similarity to the mucous epithelium: the connective tissue (protein) membrane of the cavernous (cavernous) bodies, of which the penis consists, can also be damaged.

But even a superficial burn disrupts the function of Langerhans cells, which mediate local immune responses, so burn injury increases susceptibility to serious infections.

A severe chemical burn of the penis or an open fire burn can damage the tissues of the cavernous bodies, including the spongy body, which contains the urethra (urinary canal).

[ 5 ], [ 6 ], [ 7 ], [ 8 ], [ 9 ], [ 10 ], [ 11 ]

Symptoms penis burn

The first signs of a penis burn are immediate hyperemia and unbearable pain, since this organ has a very high level of innervation. Sensory cells are especially densely concentrated in the skin-mucous zone of the penis, which is located near the tip of the foreskin, as well as on the thin skin covering the spongy tissue of the head of the penis.

Symptoms of a first-degree burn of the penis include redness and swelling of the skin, severe burning and pain (including when urinating).

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 symptoms listed above - indicates a second-degree burn. And the third degree of burn injury is characterized by bleeding (due to damage to the branched system of blood vessels), large blisters, their rupture and the formation of colliquative scabs. With such burns, infection often joins in and septicotoxemia with fever, an increase in the level of leukocytes in the blood and a deterioration in the general condition can develop.

[ 12 ], [ 13 ]

Complications and consequences

Despite the small area of the penis burn, its consequences and complications include both short-term and long-term dysfunctions of the organ: loss of erectile function due to replacement of the cavernous body tissue with scar tissue; cicatricial narrowing (phimosis) of the foreskin; cicatricial changes in the frenulum of the prepuce; decreased or complete loss of sensitivity of the head of the penis.

There may also be complications such as lymphedema (swelling of the penis shaft associated with poor lymphatic drainage) and urinary dysfunction (due to damage to the urethra).

[ 14 ]

Diagnostics penis burn

Diagnosis of a penis burn is carried out on the basis of an examination of the victim and does not cause any difficulties for burn specialists, traumatologists and surgeons.

[ 15 ], [ 16 ], [ 17 ], [ 18 ]

Treatment penis burn

Treatment of a penis burn is carried out in a burn or surgical department, where the victims are hospitalized. First of all, this is conservative treatment: strong painkillers (Promedol) are injected to relieve pain, and in case of a severe burn and pain shock, the necessary resuscitation measures are taken. Catheterization of the bladder is mandatory, which ensures the removal of urine until the swelling of the tissues adjacent to the penis decreases.

To replenish the volume of electrolytes and improve homeostasis, infusion therapy is carried out; glucose solution, vitamins C, E, group B, PP are prescribed orally.

Read also – Burn Treatment

To care for a burn wound - until it is cleared of dead tissue and the granulation process begins - anti-inflammatory antibacterial drugs are used in the form of ointments:

• Syntomycin (5-10% chloramphenicol liniment) – once a day.
• Levomekol (with chloramphenicol and methyluracil) or Sulfamekol (dioxidine + methyluracil + trimecaine) – up to four times a day.
• Streptonitol (Nitacid) with nitazole and streptocide – maximum twice a day.
• Levosin (chloramphenicol + sulfadimethoxine + methyluracil + trimecaine) - twice a day.
• Sulfargin (silver sulfadiazine) – twice a day.

For first degree burns use Panthenol gel or aerosol. For more details see – Ointment for burns

Systemic antimicrobial therapy is carried out with antibiotics using Ampicillin, Gentamicin, Amoxiclav, Azithromycin, and cephalosporin group drugs.

Surgical treatment of penile burns consists of necrectomy (wound sanitation with removal of all dead tissue), tangential excision of the scab (to the living bleeding surface) with autodermoplasty (transplantation of a skin flap 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, reconstruction of the urethra and scrotum may be necessary.

Prevention

The main prevention of burns, including burns of the penis, is careful handling of boiling water, fire, and chemicals.

[ 19 ], [ 20 ]

Forecast

The prognosis for this type of burn injury depends on its severity, and unfortunately, it is often unfavorable, as a penis burn can lead to complete impotence.

[ 21 ]