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. 2013 Nov;27(4):205-10.
doi: 10.1055/s-0033-1360588.

Technical considerations and outcomes in penile replantation

Gautam Biswas  1
Affiliations

Technical considerations and outcomes in penile replantation

Gautam Biswas. Semin Plast Surg. 2013 Nov.

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: genital; penile replantation; self-mutilation.

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Figures

Fig. 1
Fig. 1
(A,B) Genital self-mutilation in a psychiatric patient. (C) Following microsurgical replantation. (D) Follow-up 2 1/2 years following replantation. Note the incomplete erection and prominent preputial vein.
Fig. 2
Fig. 2
(A) Early postoperative view showing partial skin necrosis following replantation of a traumatically amputated penis. (B) After secondary healing. (C) Urethral stricture noted in late postoperative period managed by regular dilatation.
Fig. 3
Fig. 3
Diagram illustrating the skin, fascial layers, cross section, and vessels of the penis.
See this image and copyright information in PMC

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