Download PDF
Semin Plast Surg 2013; 27(04): 205-210
DOI: 10.1055/s-0033-1360588
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Technical Considerations and Outcomes in Penile Replantation

Gautam Biswas
1   Department of Plastic and Reconstructive Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
› Author Affiliations
Further Information

Publication History

Publication Date:
27 November 2013 (online)

    Permissions and Reprints

Abstract

Penile amputations are uncommon injuries, therefore, the management and outcome of these patients have been compiled from solitary case studies or short reviews. Accidental trauma during circumcision, injury inflicted by a partner following marital discord, and genital self-mutilation observed in patients with deep psychosis, account for a majority of the presentations. Initially, patients with total penile amputations were managed by resuturing the penile structures without repairing the vessels. A high incidence of skin and glans necrosis, urethral strictures, and a failure of sensory recovery were observed, though the penile shaft sometimes survived. Presently, microsurgical replantation has markedly improved the results, though issues of skin loss and urethral stricture still persist. A series of three patients with penile amputation is presented (complete = 2, partial = 1); the technical considerations and outcomes are discussed.

Keywords

penile replantation - genital - self-mutilation
 

  • 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 (5) 775-776
    PubMedGoogle Scholar
  • 2 Romilly CS, Isaac MT. Male genital self-mutilation. Br J Hosp Med 1996; 55 (7) 427-431
    PubMedGoogle Scholar
  • 3 Bhatt YC, Vyas KA, Srivastava RK, Panse NS. Microneurovascular reimplantation in a case of total penile amputation. Indian J Plast Surg 2008; 41 (2) 206-210
    CrossrefPubMedGoogle Scholar
  • 4 Thatte RL, Wagh MS, Kulkarni ND. Identical unusual subtotal penile amputation in children: a report of four cases. Br J Plast Surg 1993; 46 (6) 535-537
    CrossrefPubMedGoogle Scholar
  • 5 Stewart DE, Lowrey MR. Replantations surgery following self-inflicted amputation. Can J Psychiatry 1980; 25 (2) 143-150
    PubMedGoogle Scholar
  • 6 Ehrich WS. Two unusual penile injuries. J Urol 1929; 21: 239-243
    PubMedGoogle Scholar
  • 7 Landström JT, Schuyler RW, Macris GP. Microsurgical penile replantation facilitated by postoperative HBO treatment. Microsurgery 2004; 24 (1) 49-55
    CrossrefPubMedGoogle Scholar
  • 8 Jezior JR, Brady JD, Schlossberg SM. Management of penile amputation injuries. World J Surg 2001; 25 (12) 1602-1609
    CrossrefPubMedGoogle Scholar
  • 9 Mora W, Drach GW. Self-emasculation and self-castration: immediate surgical management and ultimate psychological adjustment. J Urol 1980; 124 (2) 208-209
    PubMedGoogle Scholar
  • 10 Sanger JR, Matloub HS, Yousif NJ, Begun FP. Penile replantation after self-inflicted amputation. Ann Plast Surg 1992; 29 (6) 579-584
    CrossrefPubMedGoogle Scholar
  • 11 Wei FC, McKee NH, Huerta FJ, Robinette MA. Microsurgical replantation of a completely amputated penis. Ann Plast Surg 1983; 10 (4) 317-321
    CrossrefPubMedGoogle Scholar
  • 12 Zenn MR, Carson III CC, Patel MP. Replantation of the penis: a patient report. Ann Plast Surg 2000; 44 (2) 214-220
    CrossrefPubMedGoogle Scholar
  • 13 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 (3) 325-328
    CrossrefPubMedGoogle Scholar
  • 14 Aydin A, Aslan A, Tuncer S. Penile amputation due to circumcision and replantation. Plast Reconstr Surg 2002; 110 (2) 707-708
    PubMedGoogle Scholar
  • 15 Hashem FK, Ahmed S, al-Malaq AA, AbuDaia JM. Successful replantation of penile amputation (post circumcision), complicated by prolonged ischemia. Br J Plast Surg 1999; 52 (4) 308-310
    CrossrefPubMedGoogle Scholar
  • 16 Matloub HS, Yousif NJ, Sanger JR. Temporary ectopic implantation of an amputated penis. Plast Reconstr Surg 1994; 93 (2) 408-412
    PubMedGoogle Scholar
  • 17 Bhanganada K, Chayavatana T, Pongnumkul C , et al. Surgical management of an epidemic of penile amputations in Siam. Am J Surg 1983; 146 (3) 376-382
    CrossrefPubMedGoogle Scholar
  • 18 Tamai S, Nakamura Y, Motomiya Y. Microsurgical replantation of a completely amputated penis and scrotum: case report. Plast Reconstr Surg 1977; 60 (2) 287-291
    CrossrefPubMedGoogle Scholar
  • 19 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 (2) 276-280
    CrossrefPubMedGoogle Scholar
  • 20 Darewicz B, Galek L, Darewicz J, Kudelski J, Malczyk E. Successful microsurgical replantation of an amputated penis. Int Urol Nephrol 2001; 33 (2) 385-386
    CrossrefPubMedGoogle Scholar
  • 21 Carroll PR, Lue TF, Schmidt RA, Trengrove-Jones G, McAninch JW. Penile replantation: current concepts. J Urol 1985; 133 (2) 281-285
    CrossrefPubMedGoogle Scholar
  • 22 Aboseif S, Gomez R, McAninch JW. Genital self-mutilation. J Urol 1993; 150 (4) 1143-1146
    PubMedGoogle Scholar
  • 23 Yeniyol CO, Yener H, Keçeci Y, Ayder AR. Microvascular replantation of a self amputated penis. Int Urol Nephrol 2002; 33 (1) 117-119
    CrossrefPubMedGoogle Scholar
  • 24 Ishida O, Ikuta Y, Shirane T, Nakahara M. Penile replantation after self-inflicted complete amputation: case report. J Reconstr Microsurg 1996; 12 (1) 23-26
    Article in Thieme ConnectPubMedGoogle Scholar
  • 25 Heymann AD, Bell-Thompson J, Rathod DM, Heller LE. Successful reimplantation of the penis using microvascular techniques. J Urol 1977; 118 (5) 879-880
    CrossrefPubMedGoogle Scholar
  • 26 Chou EK, Tai YT, Wu CI, Lin MS, Chen HH, Chang SC. Penile replantation, complication management, and technique refinement. Microsurgery 2008; 28 (3) 153-156
    CrossrefPubMedGoogle Scholar
  • 27 Jordan GH, Gilbert DA. Management of amputation injuries of the male genitalia. Urol Clin North Am 1989; 16 (2) 359-367
    PubMedGoogle Scholar
  • 28 Sherman J, Borer JG, Horowitz M, Glassberg KI. Circumcision: successful glanular reconstruction and survival following traumatic amputation. J Urol 1996; 156 (2 Pt 2) 842-844
    CrossrefPubMedGoogle Scholar
  • 29 Gluckman GR, Stoller ML, Jacobs MM, Kagan BA. New born penile glans amputation during circumcision and successful attachment. J Urol 1995; 153: 778-779
    CrossrefPubMedGoogle Scholar
  • 30 Jiménez-Cruz JF, Garcia-Reboll L, Alonso M, Broseta E, Sanz S. Microsurgical penis replantation after self-mutilation. Eur Urol 1995; 27 (3) 246-248
    PubMedGoogle Scholar
  • 31 Blacker KH, Wong N. Four cases of autocastration. Arch Gen Psychiatry 1963; 8: 169-176
    CrossrefPubMedGoogle Scholar
  • 32 Mosahebi A, Butterworth M, Knight R, Berger L, Kaisary A, Butler PE. Delayed penile replantation after prolonged warm ischemia. Microsurgery 2001; 21 (2) 52-54
    CrossrefPubMedGoogle Scholar
  • 33 Yamano Y, Tanaka H. Replantation of a completely amputated penis by the microsurgical technique: a case report. Microsurgery 1984; 5 (1) 40-43
    CrossrefPubMedGoogle Scholar
  • 34 Pederson WC. Replantation. Plast Reconstr Surg 2001; 107 (3) 823-841
    CrossrefPubMedGoogle Scholar
  • 35 Stunell H, Power RE, Floyd Jr M, Quinlan DM. Genital self-mutilation. Int J Urol 2006; 13 (10) 1358-1360
    CrossrefPubMedGoogle Scholar
  • 36 Greilsheimer H, Groves JE. Male genital self-mutilation. Arch Gen Psychiatry 1979; 36 (4) 441-446
    CrossrefPubMedGoogle Scholar
  • 37 Griffiths M, Britto J, Frame J. 5-year follow-up of replantation of penis and testis in a child. Lancet 2003; 361 (9353) 263
    PubMedGoogle Scholar