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Management of penile amputation injuries.
J R Jezior1, J D Brady, S M Schlossberg
1Department of Urology, Eastern Virginia Medical School, The Devine Center for Genitourinary Reconstruction, Norfolk 23510, USA.
World Journal of Surgery
|January 5, 2002
Summary
Penile amputation management involves patient stabilization and tissue preservation for microsurgical replantation. Surgical reconstruction offers acceptable functional and aesthetic outcomes, with successful options for pediatric cases.
Area of Science:
- Urology
- Microsurgery
- Trauma Surgery
Background:
- Penile amputation is a rare but severe injury from various causes, including trauma and self-mutilation.
- Management necessitates immediate patient resuscitation, stabilization, and psychiatric evaluation.
- Preservation of amputated penile tissue under hypothermia is crucial for potential surgical replantation.
Purpose of the Study:
- To review the management strategies for penile amputation.
- To discuss current techniques in penile replantation and reconstruction.
- To highlight outcomes and considerations for pediatric penile amputation.
Main Methods:
- Review of current literature on penile amputation management and surgical techniques.
- Discussion of microsurgical approaches for arterial and venous anastomosis.
- Evaluation of phalloplasty techniques, including free forearm flap reconstruction.
- Analysis of outcomes in adult and pediatric populations.
Main Results:
- Microsurgical replantation of the penis demonstrates uniformly good results when performed promptly.
- Free forearm flap phalloplasty is effective for penile replacement when the native tissue is unsalvageable.
- Urethral complications can occur but are generally manageable, with acceptable functional and aesthetic results.
- Both replantation and reconstruction are successful in children, offering alternatives to gender reassignment.
Conclusions:
- Effective management of penile amputation requires a multidisciplinary approach, including resuscitation, psychiatric care, and specialized surgical intervention.
- Microsurgical techniques have significantly improved outcomes for penile replantation and reconstruction.
- Pediatric penile amputation presents unique challenges and opportunities for reconstructive surgery, with successful outcomes reported for both replantation and phallic construction.