UroToday Int J. 2009 In Press. doi:10.3834/uij.1944-5784.2009.12.08
Successfully Performed Reanastomosis of a Completely Amputated Penis: Surgical Technique
Complete penile amputation is a rare condition that requires immediate and complex surgical treatment. There are few descriptions of successful operative techniques using microsurgical methods in the literature.
The authors present the rare case of 30-year-old man who amputated his penis at its base using an ax. Nine hours after the injury, the patient underwent microsurgical anastomosis of the arteries, veins, corpora cavernosa, and urethra. The authors describe the steps in their surgical procedure and provide illustrative figures. They also explain their perioperative and postoperative support therapy.
Approximately 20% of the distal spongy body and skin of the penis became necrotic beginning on the 6th postoperative day. On the 18th day, necrectomy of the penile skin flap was performed and the phallus was buried in the scrotum. Exteriorization of the penis that was partially covered by scrotal skin was completed 2 months after reanastomosis. The distal necrotic part of the urethra was reconstructed using buccal mucosa graft transplantation. A split-thickness skin graft from a lower limb was used to cover the rest of the phallus. The patient achieved return of physiologic micturition with no urethral structures. He also experienced incomplete erectile function.
KEYWORDS: Penile amputation; Penile replantation; Surgical techniques
CORRESPONDENCE: Marek Wyczółkowski MD, PhD, Department of Urology, Rydygier Memorial Hospital, Złotej Jesieni 1 Str., 31-826 Cracow, Poland (kajus13@poczta.onet.pl).
CITATION: Urotoday Int J. 2009 Oct;2(5). doi:10.3834/uij.1944-5784.2009.12.08
|
UroToday, 1802 Fifth Street, Berkeley CA 94710 Privacy Policy | © 2009 UroToday ® All Rights Reserved |
