The challenges and complications of re-implantation of the penis following amputation

Abstract

Amputation of the penis is a rare and devastating injury. The etiologies vary from accidental, self-inflicted to attacks due to sexual jealousy and revenge. In the present era of microvascular surgery, replantation is the standard care. However, replantation of the penis comes with its own set of difficulties and complications. Knowledge of the anatomy and prior knowledge of the possible complications makes the surgeon aware of the course of events after a replantation. It helps in devising strategies to overcome these challenges methodically. We present a case of penile replant with the complications that we encountered, and the measures are taken to counter them on our way to a successful outcome.

Funding: No external funding.

Keywords: Microsurgery; Penile amputation; Replantation.

Figure 1

A 12Fr silicone catheter was passed across the urethra of the amputated part and into the urethra of the stump

Figure 2

The glans and shaft of the penis with prepuce changed to normal colour, turgor, and capillary refill

Figure 3

Debridement of all necrotic skin was done

Figure 4a

Debridement with a thin split-thickness graft was done for the raw areas. All wounds healed uneventfully.

Figure 4b

The catheter was removed at 6weeks. Follow-up at 10 weeks shows the patient has a good shaft length with stable skin coverage