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Penile self-harm: a case report and concise clinical review
Mutie Raslan1, James Donaldson, Justine Royle
1Department of Urology, Aberdeen Royal Infirmary , Aberdeen , UK.
Abstract:
Male genital self-mutilation is extremely rare and may be associated with severe psychopathology. This study reports the case of a 26-year-old man who presented after incising his prepuce with a knife and placing a rubber band around his foreskin. A plastic ring was also found underneath the prepuce. Clinical examination revealed a lateral preputial laceration with gross preputial oedema and dark red discoloration with a clear demarcation where the elastic band had been placed. A pelvic X-ray revealed no other foreign bodies. Following 72 h of observation he developed signs of preputial necrosis, which prompted urgent circumcision; this revealed a healthy underlying glans. In conclusion, male genital self-harm requires urgent urological and psychiatric assessments to prevent surgical and psychiatric sequelae including necrotizing fasciitis and suicide.
Insights
Male genital self-harm is rare and linked to severe psychopathology. This case highlights the need for prompt urological and psychiatric evaluation to prevent serious complications.
Area of Science:
- Urology
- Psychiatry
- Forensic Medicine
Background:
- Male genital self-mutilation is an exceedingly rare clinical presentation.
- It is often associated with significant underlying psychopathology, necessitating a dual approach to management.
Observation:
- A 26-year-old male presented with penile self-inflicted trauma, including laceration and constriction of the prepuce with a rubber band and plastic ring.
- Clinical examination revealed significant edema and discoloration, indicative of compromised blood flow.
- Pelvic X-ray excluded additional foreign bodies.
Findings:
- The patient developed signs of preputial necrosis within 72 hours, necessitating urgent circumcision.
- Histological examination confirmed necrosis of the foreskin, with the underlying glans remaining healthy.
- No other internal injuries or foreign bodies were identified.
Implications:
- Male genital self-harm demands immediate urological and psychiatric assessment.
- Timely intervention is crucial to mitigate surgical complications, such as necrotizing fasciitis, and psychiatric sequelae, including suicide risk.