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Genital self-mutilation in a schizophrenic patient: A case report
Salim Ouskri1, Adam El Aboudi1, Idriss Ziani1
1Ibn Sina Hospital, Morocco.
International Journal of Surgery Case Reports
|July 5, 2025
Summary
Genital self-mutilation in schizophrenia is rare but severe. Microsurgical penile glans reimplantation is possible, but vascular complications and psychiatric stabilization are critical for successful outcomes and preventing recurrence.
Area of Science:
- Urology
- Psychiatry
- Microsurgery
Background:
- Genital self-mutilation is a rare, severe self-inflicted injury.
- It is most commonly linked to psychiatric disorders, especially schizophrenia.
- Management requires urgent urological intervention and psychiatric stabilization.
Observation:
- A 38-year-old male with schizophrenia underwent penile glans amputation during a psychotic episode.
- He was hemodynamically stable with a viable amputated glans.
- Microsurgical reimplantation included arterial/venous anastomoses, urethral reconstruction, and soft tissue repair.
Findings:
- Despite initial success, progressive ischemia led to glans necrosis by postoperative day 4, requiring debridement.
- Microsurgical replantation can achieve functional recovery but carries risks of vascular complications.
- Psychiatric stabilization is paramount to prevent recurrent self-harm.
Implications:
- Genital self-mutilation in schizophrenia necessitates a multidisciplinary approach.
- Effective management combines emergency surgery with critical psychiatric intervention.
- Further research is needed for optimal treatment protocols and long-term psychiatric care.
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