ISI Impact Factor (2004): 1.096

Editor-in-Chief
Prof. Yi-Fei WANG,

Severe burn of penis caused by excessive short-wave diathermy

Asian J Androl  2004 Dec; 6: 377-378        

Keywords: burn; penis; short-wave diathermy

1 Introduction

Penis burn is not rare and usually caused by boiling water and fire. To our knowledge we report the first case of severe burn of penis secondary to excessive short wave diathermy.

2 Case report

A 38-year-old man was admitted to this Hospital for severe penile burn caused by excessive short-wave diathermy. Five days ago, the patient visited a clinic for recurrent genital herpes simplex. Circumcision was performed and local short wave diathermy given immedia-tely. The frequency of short wave source was 13.56 MHz with a penile exposing time of about 2.5 hours. Blisters and extravasation at the penile skin were seen 1 day and became black 3 days after short-wave diathermy. The patient could micturate without hematuria. The whole penis was burned black and became indurated with a clear margin with the normal skin at the base of the penis (Figure 1). He felt no pain in the penis even with needle puncture. Doppler sonography revealed no blood flow in the penis and severe burn and penile gangrene was diagnosed.

Figure 1. The whole penis burned black and hard and had a clear margin with normal skin at the base of the penis.

At day 31 after the treatment, the necrotic part of penis was resected with only about 1 cm of the penile stump left. Thrombi were found in the two deep arteries of the corpora cavernosa and deep dorsal arteries and the veins beneath Buck's fasica. Scrotal skin was mobilized and shifted to repair the penile stump. Pathological examination showed necrosis of the penis tissue and thrombi formation in the corpora cavernosa.

Convalescence was uneventful. The patient could micturate in standing position by pushing skin around the stump of the penis backward.

3 Discussion

The penetration of electromagnetic waves depends on their frequency and the tissue composition. The higher the frequency, the less tissue penetration will be. The following factors, such as tissue density and vascularity, pulse enduing time, irradiation time and the distance between the short wave source and the target tissue all affect the heating effects. Thermal effect of short wave can improve blood circulation and metabolism, reduce inflammation reaction and relieve pain when lower energy of short wave and short irradiation time are used. It is usually used for physical therapy in these diseases, including soft tissue contusion, chronic and subacute inflammation, diseases in the lumbodorsal fasciae and the joint, spasticity and chronic neurological pain, etc. It can also be used to treat superficial vascular diseases and skin pigmentation. It should not be used in patients with cardiac pacemaker and metal foreign body in the tissue. It is also prohibited to be used in the areas such as eye, brain, spine, ear, external genitalia and healing bone, local sensory disorder of the skin, etc.

In general, short wave diathermy has no side effects in the hand of experienced physiotherapist when appropriate physical parameters are selected. Up to date, there is no definite safe time limit about short wave diathermy. Generally, It could not be used more than 20 minutes. Thrombi formation in deep arteries of corpora cavernosa and deep dorsal arteries caused vascular occlusion, ischemia and necrosis of penile tissue. It should not be used for treating genital herpes simplex. In addition, the patient losed the safe-guard alert to heat due to local anesthesia for circumcision. We emphasize that short wave diathermy is prohibited to be used in male external genitalia and local sensory disorder of the skin.

References

[1] Kamedula M, Pawlaczyk-Luszczynska M. Magnetic field intensity and energy absorption due to short-wave induction diathermy. Pol J Occupa Med 1988; 1: 255-63.
[2] Goats GC. Continuous short-wave (radio-frequency) diathermy. Br J Sports Med 1989; 23: 123-7.
[3] Hovind H, Nielsen SL. Local blood flow after short-wave diathermy: preliminary report. Arch Phys Med Rehabil 1974; 55: 217-21.

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Correspondence to: Jun Jiang, Department of Urology, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing 400042, China.
Tel: +86-23-6875 7364
Email: Jiangjun1964@yahoo.com.cn
Received 2003-10-21   Accepted 2004-06-18