Surgical Management (Microsurgery) of Traumatic Penile Amputation: A Case Report

Traumatic penile amputation is an uncommon surgical emergency with various etiologies, carrying major functional and psychological consequences concerning the patient's overall quality of life. Regardless of the aetiology, penile amputation represents a surgical emergency that must be addressed quickly and efficiently to maximise functional outcomes.

We herein describe a case of psychiatric disorder that resulted in a complete self-amputation of the patient's penis. The author presents a case of a 20-year-old single Indonesian male with no significant past medical or psychiatric history, who was presented to our Regional Referral Hospital with traumatic penile self-amputation. Immediately, the patients were taken to the operating room, and careful examination under anaesthesia revealed fully and transversally transected urethra as well as corporal bodies at the level of penis base. Viable artery and vein were then searched using a microscope after suturing through the tunica albuginea of the corporal bodies on the ventral aspect and snapped them for future tying. After microvascular re-anastomosis of the left dorsal artery and only one dorsal vein done. We attached the urethra and placed a 16 Fr silicon catheter. The result was an excellent tension-free, widely spatulated urethra anastomosis, which was then reattached to the corporal bodies. The penis had significant oedema and swelling in the distal penile shaft; however, pain sensation was gradually returning.

The authors noted that microsurgical reimplantation is the treatment of choice for penile amputation, with a minimum one of the penile vascular was successfully anastomosis.