“Parrilla urethra”: A sequalae of electric shock torture to genitals in men. A 40 case series in Kashmir (India)

Abstract

Introduction: Since the 20th century, electric shock torture has become one of the most prevalent methods of torture partly because it produces sequelae that are more challenging to visibly detect, particularly when administered using high voltage and low current. In sexual torture, a wire is wrapped around the head of the penis and a wire electrode is inserted into the urethra. This produces unbearable pain and can lead to urethral strictures with devastating physical and psychological consequences. Objective: To document electric shock torture to genitals as an etiologic agent in urethral stricture and erectile dysfunction amongst survivors of electric torture introduc-ing the term “parrilla urethra” for the electric shock torture urethral stricture. Materials and methods: The study included 40 patients who attended the Department of Urology, Directorate of Health services, Sri-nagar, Kashmir, India with obstructive lower urinary tract symptoms (LUTS) / obstructive uroflowmetry between March 2010 and No-vember 2014. All cases had an antecedent of electric shock torture to genitals six months to one year prior to examination. Pre-post psychological impact and well-being was used through Global Assessment of Functioning (GAF) scores. Results: The mean age of patients was 35.6 years. Most of the urethral strictures were located in the anterior urethra. Some degree of erectile dysfunction was present in all (100%) of patients. Psychological sequelae including depression, anxiety, acute stress disorder and symptoms of post-traumatic stress disorder were observed. Patients were treated with standard urethroplasty procedures after address-ing the urethral stricture. This improved both physical and psychological sequelae of torture.