Penile Hair Thread Tourniquet Syndrome in an Older Child: A Case Report and Review of Clinical Variability Across Age Groups.

A Case Report

Abstract

Penile Hair Thread Tourniquet Syndrome (PHTTS) is a rare pediatric urological emergency caused by constriction of the penis by a hair or thread, resulting in edema, ischemia, tissue necrosis, and, in severe cases, urethral injury or penile amputation. Most reported cases occur in infants and young children. We report a rare case of a 10-year-old circumcised boy who presented with penile swelling, redness, and pain caused by a circumferential thread tightly wrapped around the penoscrotal junction. The condition was initially misdiagnosed at a primary healthcare facility. Careful urological examination revealed a constricting thread causing localized infection and edema without urethral involvement. The thread was removed surgically, followed by debridement, catheterization, antibiotic therapy, analgesia, and wound care. The patient demonstrated excellent recovery with complete healing at three-week follow-up and preservation of urinary function. This case highlights the importance of maintaining a high index of suspicion for penile tourniquet syndrome in older children presenting with unexplained penile swelling and emphasizes the need for prompt diagnosis and timely intervention to prevent serious complication