Successful microsurgical replantation of an amputated penis

ABSTRACT

Penile amputation is an uncommon injury for which immediate surgical replantation is warranted. Microsurgical replantation is the “standard” method for penile replantation. Early replantation yields a high success and low complication rate. We report a case of a 34-year-old male who presented with amputation at the proximal penile shaft which was successfully replanted using microsurgical techniques. Minor skin necrosis was noted post-operatively which was debrided and covered with skin graft. Follow-up at 6 months showed satisfactory cosmetic appearance, normal voiding, return of sensations and erectile function. The level of evidence was V.

KEY WORDS

Microsurgical replantation - penile amputation - pharmacostimulation

• REFERENCES

• 1 Evins SC, Whittle T, Rous SN. Self-emasculation: Review of the literature, report of a case and outline of the objectives of management. J Urol 1977; 118: 775-6
• 2 Bhanganada K, Chayavatana T, Pongnumkul C, Tonmukayakul A, Sakolsatayadorn P, Komaratat K. et al. Surgical management of an epidemic of penile amputations in Siam. Am J Surg 1983; 146: 376-82
• 3 Ehrich WS. Two unusual penile injuries. J Urol 1929; 21: 239
• 4 Jordan GH, Gilbert DA. Management of amputation injuries of the male genitalia. Urol Clin North Am 1989; 16: 359-67
• 5 Cohen BE, May Jr. JW, Daly JS, Young HH. Successful clinical replantation of an amputated penis by microneurovascular repair. Case report. Plast Reconstr Surg 1977; 59: 276-80
• 6 Tamai S, Nakamura Y, Motomiya Y. Microsurgical replantation of a completely amputated penis and scrotum: Case report. Plast Reconstr Surg 1977; 60: 287-91
• 7 Wei FC, McKee NH, Huerta FJ, Robinette MA. Microsurgical replantation of a completely amputated penis. Ann Plast Surg 1983; 10: 317-21
• 8 Babaei AR, Safarinejad MR. Penile replantation, science or myth? A systematic review. Urol J 2007; 4: 62-5
• 9 Lue TF. Physiology of penile erection and pathophysiology of erectile dusfunction. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA. editors Campbell-Walsh Urology Vol. 1. 10th ed.. Philadelphia: Elsevier Saunders; 2012: p. 688-719
• 10 Quartey JK. Microcirculation of penile and scrotal skin. Atlas Urol Clin North Am 1997; 5: 1-9
• 11 Lidman D, Danielsson P, Abdiu A, Fåhraeus B. The functional result two years after a microsurgical penile replantation. Case report. Scand J Plast Reconstr Surg Hand Surg 1999; 33: 325-8
• 12 Quartey JK. Anatomy and blood supply of the urethra and penis. In: Schreiter F, Jordan GH. editors Reconstructive Urethral Surgery. Germany: Springer Medizin Verlag Heidelberg; 2006: p. 11-7
• 13 Tansatit T, Jindarak S, Sampatanukul P, Wannaprasert T. Neurovascular anatomy of the penis and pelvis in Thai males: Applications to male-to-female and pelvic surgeries. J Med Assoc Thai 2007; 90: 121-8
• 14 Bookstein JJ, Lang EV. Penile magnification pharmacoarteriography: Details of intrapenile arterial anatomy. AJR Am J Roentgenol 1987; 148: 883-8
• 15 Kochakarn W, Muangman V, Krauwit A. Traumatic penile amputation: Results with primary reattachment. J Urol 1997; 157: 857
• 16 Carroll PR, Lue TF, Schmidt RA, Trengrove-Jones G, McAninch JW. Penile replantation: Current concepts. J Urol 1985; 133: 281-5
• 17 Goldstein I, Lue TF, Padma-Nathan H, Rosen RC, Steers WD, Wicker PA. Oral sildenafil in the treatment of erectile dysfunction. Sildenafil Study Group. N Engl J Med 1998; 338: 1397-404
• 18 Meuleman EJ, Bemelmans BL, van Asten WN, Doesburg WH, Skotnicki SH, Debruyne FM. Assessment of penile blood flow by duplex ultrasonography in 44 men with normal erectile potency in different phases of erection. J Urol 1992; 147: 51-6