<div>TITLE PAGE</div><div>Article Type</div><div>Clinical picture</div><div>Title</div><div>Penile Injury Caused by Neodymium
Magnets</div><div>Authors</div><div>Yuki Akiyama1, Ryo Ichibayashi2</div><div>Affiliations</div><div>1. Department of Orthopaedic Surgery, Toho University Medical Center,
Sakura Hospital, Chiba, Japan</div><div>2. Division of Emergency Medicine Department of Internal Medicine, Toho
University Medical Center, Sakura Hospital, Chiba, Japan</div><div>Corresponding Author</div><div>Ryo Ichibayashi, MD, PhD</div><div>ORCID iD https://orcid.org/0000-0002-1273-4875</div><div>Division of Emergency Medicine Department of Internal Medicine</div><div>Toho University Medical Center, Sakura Hospital</div><div>564-1 Shimosizu</div><div>Sakura-shi, Chiba 285-8741, Japan</div><div>Phone: +81-43-462-8811</div><div>Fax: +81-43-462-8835</div><div>e-mail: ryou.ichibayashi@med.toho-u.ac.jp</div><div>Running title</div><div>Damage caused by neodymium magnets</div><div>Keywords</div><div>Neodymium magnet, Penile foreign body, Emergency, Treatment</div><div>Conflict of interest</div><div>The authors have no conflict of interest to disclose.</div><div>Financial support</div><div>The author(s) received no financial support for this article’s research,
authorship, and publication.</div><div>Patient consent</div><div>Written informed consent was obtained from the patient to publish this
report by the journal’s patient consent policy.</div><div>Author contribution</div><div>YA wrote and drafted the manuscript. RI helped draft the manuscript. All
authors read and approved the final manuscript.</div><div>Data availability statement</div><div>The data presented in this study are available on request from the
corresponding author. The data are not publicly available due to privacy
and ethical considerations.</div><div>Acknowledgments</div><div>None.</div><div>Key clinical message</div><div>Multiple neodymium magnets can pinch tissue and cause barotrauma. Be
careful if the tissue of the penis or foreskin is pinched, as this may
cause foreskin necrosis or damage to the urethra.</div><div>Clinical picture</div><div>11-year-old boy. He has no history of developmental disabilities or
mental illness. The boy played with a neodymium magnet attached to his
penis in the bathroom out of curiosity. However, the neodymium magnet
remained attached to his penis and could not be removed, and he was
transported to our hospital by ambulance with the chief complaint of
penile pain. Emergency crews tried to remove it, but it was impossible
because it was painful, and there were concerns that it might damage the
foreskin. Two hours had passed since he was transferred to our hospital
because he was refused admission by multiple medical institutions. At
the time of his visit, his penis had two circular neodymium magnets,
each approximately 1 cm in diameter, placed against the foreskin of his
penis (Figure 1A). Although it was difficult to remove it by pulling it
in the opposite direction, it was possible to remove it by shifting the
ground surface. After the foreskin was released, there was a crushed
wound, so ointment was applied（Figure 1B）. After confirming that there
was no problem with the color tone of his glasses, he returned home. The
next day, he returned to the outpatient clinic and confirmed that the
color of his glans was standard and that he could urinate. Neodymium
magnets were developed in Japan in 1982 and have become famous worldwide
due to their effectiveness. It is said to be the strongest magnet
currently in use. Neodymium magnets are used in various fields and
children’s toys [1]. For this reason, accidents such as accidental
ingestion by children and insertion into the urinary tract or anus due
to sexual preference are problems in the medical field. Accidents caused
by multiple neodymium magnets, especially when accidentally swallowed or
inserted with a foreign object, are dangerous because they adhere to
each other and pinch tissue, resulting in pressure necrosis [2].
This case also had a crush injury to the foreskin. A month later, the
scar remained on my foreskin. Barotrauma caused by neodymium magnets
often involves damage to thin tissues, including the intestinal tract
and mucous membranes. The structures of the corpus cavernosum and the
corpus cavernosum of the urethra, which form the penis, are spongy and
soft tissues. This tissue becomes rigid as it fills with blood. For this
reason, if not only the foreskin but also the corpus cavernosum of the
penis is pinched, there is a possibility that blood flow to the corpus
cavernosum and damage to the urethra may occur. After removing the
neodymium magnet, it is necessary to observe the color of the glans and
foreskin and the state of urination.</div><div>References</div><div>1. Taylor MA, Spanos SP, Fenton SJ, Russell KW. Ball Magnets Clicked
Together on the Epiglottis. <i>Cureus</i> . 2020. 12(5): e8181. doi:
10.7759/cureus.8181</div><div>2. Yuksel C, Ankarali S, Aslan Yuksel N. The use of neodymium magnets in
healthcare and their effects on health. <i>North Clin Istanb</i> . 2018;
5(3): 268-273. doi:10.14744/nci.2017.00483</div><div>Figure 1</div><div>A　Neodymium magnet that pinches the foreskin of the penis</div><div>B　 Foreskin with a crush injury</div>