Self-inflicted traumatic penile amputation: A case report

Abstract text (incl. references and figure legends)

Penile and testicular amputations are very rare and are mainly caused by self-mutilation, assault, or accidental trauma. Penile injuries can be extremely disturbing to the physical and mental state of the patient. Management requires resuscitation and stabilization of the patient with particular attention to underlying psychiatric illness.

We present the case of a 22-year-old man with history of psychiatric disorder that presented to the emergency department with a self-inflicted traumatic complete penile and scrotal amputation with a "katana". The patient also had an extensive right leg wound with loss of skin. At admission, he was hemodynamically stable, calm, with no signs of distress or pain. A Foley catheter was immediately inserted to prevent further contamination. With the collaboration of the police force, the amputated tissue was found at the patient"s home and preserved under hypothermic conditions in preparation for surgical replantation. He was immediately transferred to a tertiary care center with Plastic Surgery and Urology, where he was submitted to primary surgical reconstruction with penile replantation and subsequently skin graft to the leg wound. He was discharged after 6 weeks. At the 2 months follow-up visit, he showed a satisfactory cosmetic outcome, well-healed penile graft, and normal voiding.

Genital reconstruction is challenging. We present the case of a young male with a self-mutilation lesion. The patient was submitted to a reconstructive procedure within 12 hours of the lesion occurrence. The work of the health professionals in coordination with the police was determinant to the success of this case. Self-mutilation is not considered to be an absolute contraindication to replantation.

Jezior JR et al. Management of penile amputation injuries. World J Surg. 2001

Sanger JR et al. Penile replantation after self-inflicted amputation. Ann Plast Surg. 1992

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