Male genital mutilation: 'whodunnit'?

Area of Science:

• Forensic Medicine
• Urology
• Psychiatry

Background:

• A 26-year-old male presented with traumatic amputation of the penis, scrotum, and testes.
• The patient alleged his 'master' inflicted the injury, but this was denied.
• The circumstances surrounding the genital mutilation were unclear, with no established motive.

Purpose of the Study:

• To report a complex case of genital amputation with unclear etiology.
• To discuss the forensic, psychological, and urological implications.
• To highlight the challenges in corroborating patient testimony in such cases.

Main Methods:

• Clinical case presentation.
• Surgical repair of the remaining penile stump and scrotum for urinary function.
• Review of patient's statement, police investigation, and subsequent patient behavior.

Main Results:

• The patient's testes were recovered, but the penile shaft was not found.
• Surgical reconstruction allowed for urination.
• Lack of corroborating evidence and the patient's subsequent behavior cast doubt on his initial accusation, suggesting possible self-infliction.

Conclusions:

• The case highlights a potential instance of self-inflicted genital mutilation.
• The patient requires extensive long-term psychological, endocrinological, and urological management.
• Forensic investigation and patient cooperation are crucial in determining the cause of such severe injuries.