O 05. Penile replantation: Two case reports and review of the literature

O 05. Penile replantation: Two case reports and review of the literature

Guizhong Li1, Feng He1, Guangling Huang1, Libo Man1, Kun Liu2, Yuming Shen3

1Department of Urology, Beijing Jishuitan Hospital, China; 2Department of Hand Surgery, Beijing Jishuitan Hospital, China; 3Department of Burn Surgery, Beijing Jishuitan Hospital, Beijing, China

Objective: The aim of this article is to present our experience dealing with complete penile amputation. A review of the literature is given and current treatment options and outcomes are evaluated.

Methods: Two cases of penile complete amputation from our clinical practice are reported. We performed a computerized MEDLINE search followed by a manual bibliographic review of cross-references. These reports were analyzed and the important findings are summarized.

Results: Two cases of penile amputation from our clinical practice are presented involving different degrees of vascular insult leading to different pathogenesis, clinical presentation, and surgical approach. In the first case, a 34-year-old man, a penile amputation and successful replantation is presented. This report presents the microsurgical procedure and postoperative care that led to successful engraftment and function using bipedicled scrotal flap. At 18 months follow-up the patient had glans re-epithelialization with normal voiding, sensation, and erections. In the second case, a 25-year-old man presented to the emergency room 15 hours after distal penile amputation, which had 2 wounds occurred as a result of self-mutilation caused by psychiatric problems. The patient presented with hemorrhagic and traumatic shock. The preoperative and postoperative measures were as described for case 1, On day 14, serious infections were noted, the necrotic skin was superficially debrided, and the amputated penis was relieved. Furthermore, We noted motives, types of objects, types of amputation, symptomatolog y, trauma grades, diagnoses including psychological involvement, and possible treatment options.

Conclusions: Prompt diagnosis and early treatment are essential to avoid the potential complications of ischemic necrosis and autoamputation. Microsurgical reanastomosing of the dorsal penile vein, penile arteries, and dorsal nerves can be identified as the "standard" method for penile replantation.

Key words

Penis; amputation; trauma; replantation

DOI: 10.3978/j.issn.2223-4683.2012.s130

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