Supplementary Material for: Glans Penis Ischemia after Circumcision in a 15-Year-Old Patient Managed with Intravenous Pentoxifylline: A Case Report and a Diagnostic-Therapeutic Guideline Proposal

Glans ischemia is an extremely infrequent complication characterized by a total or partial compromise in the penile arterial perfusion. A 15-year-old male patient suffered an episode of ischemia in the glans penis post-circumcision 24 h after surgery. Intravenous treatment with continuous perfusion of pentoxifylline was started for 4 days, with favorable evolution. Complete resolution was observed with no sequelae. There is no consensus on the best therapeutic management. The favorable evolution reported in most of the cases despite different therapeutic approaches leads us to think that the role of the treatments proposed so far is probably less than we believe. Additionally, we present a proposal for a diagnostic and therapeutic guide for this entity. Although the evidence in the literature is scarce and this guideline should be interpreted with caution, we believe that it can constitute a support resource for cases similar to ours.

龟头缺血（Glans ischemia）是一种极为罕见的并发症，以阴茎动脉灌注完全或部分受损为特征。1例15岁男性患者于包皮环切术后24小时出现龟头缺血症状，遂给予己酮可可碱（pentoxifylline）持续静脉灌注治疗，疗程共4天，患者病情转归良好，症状完全缓解且未遗留任何后遗症。目前针对该并发症的最佳治疗方案尚未达成共识；尽管不同病例采用的治疗手段存在差异，但多数病例均报告了良好转归，这提示目前已提出的各类治疗方案的实际价值可能低于此前预期。此外，本文针对该病症提出了一套诊疗指南方案。尽管现有文献证据较为匮乏，应用本指南时需谨慎，但我们认为其可为类似病例提供参考支持。