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Penile replantation after self-inflicted amputation.
J R Sanger1, H S Matloub, N J Yousif
1Department of Plastic and Reconstruction Surgery, Medical College of Wisconsin, Milwaukee.
Annals of Plastic Surgery
|December 1, 1992
Summary
Microsurgical penile replantation successfully restored sensation and erections in four men after self-amputation. This technique is superior for penile reattachment, despite associated psychiatric challenges.
Area of Science:
- Urology
- Microsurgery
- Reconstructive Surgery
Background:
- Self-inflicted penile amputation presents a unique surgical challenge.
- Evaluating the efficacy of microsurgical techniques for penile replantation is crucial.
Observation:
- Four men underwent successful penile replantation using microsurgery.
- Postoperative complications were minimal, with good functional and sensory recovery.
- One patient required a skin graft and experienced a mild urethral stricture, successfully treated with dilation.
Findings:
- Microsurgical replantation achieved excellent return of sensation and normal erectile function in all patients.
- The technique proved superior to other penile reattachment methods, avoiding complications like necrosis, fistula, and strictures.
- A significant concern is the high incidence of recurrent self-mutilation and severe psychiatric pathology in this patient group.
Implications:
- Microsurgical penile replantation is the gold standard treatment for self-inflicted penile amputation.
- Long-term follow-up highlights the persistent psychiatric issues requiring comprehensive management.
- Further research into the psychological aspects and management of self-mutilation in these cases is warranted.