Penile self-harm: a case report and concise clinical review

Abstract

Male genital self-mutilation is extremely rare and may be associated with severe psychopathology. This study reports the case of a 26-year-old man who presented after incising his prepuce with a knife and placing a rubber band around his foreskin. A plastic ring was also found underneath the prepuce. Clinical examination revealed a lateral preputial laceration with gross preputial oedema and dark red discoloration with a clear demarcation where the elastic band had been placed. A pelvic X-ray revealed no other foreign bodies. Following 72 h of observation he developed signs of preputial necrosis, which prompted urgent circumcision; this revealed a healthy underlying glans. In conclusion, male genital self-harm requires urgent urological and psychiatric assessments to prevent surgical and psychiatric sequelae including necrotizing fasciitis and suicide.

Wire to the Heart: A Unique Case of Psychosis

“…Reports of non-suicidal gestures largely detail acts such as genital mutilation or self-enucleation of the eyes. Raslan et al, [5] published a case of penile self-mutilation in the context of psychopathology. Ciorba et al, [6] performed an analysis of facial self-mutilation, reporting the prevalence in populations with psychiatric disorders to be as high as 20%.…”

Implications of Genital Mutilation at Autopsy

“…Self‐mutilation has been defined as the deliberate destruction of body tissues with no conscious suicidal intent , or repetitive direct physical self‐harm that is evidently not life‐threatening . Cutting injuries are usually not found in sensitive areas such as the eyelids, nipples, or genitalia, unless there is severe psychopathology present.…”

“…There is an association with substance abuse, schizophrenia, borderline personality disorder, sexual conflict associated with guilt, and depression. Such injuries may also be found in individuals who have had previous suicide attempts or who subsequently go on to commit suicide (14,17,23,24). Autoamputation of the penis has been reported in a 35-year-old male related to cannabisinduced psychosis (25), and methamphetamine use has been associated with testicular self-mutilation (26).…”

Evaluation and management of urethral foreign bodies and description of a novel ultrasound‐guided catheter‐based extraction technique

“…Nearly all cases have been reported in men, with the majority of cases being attributed to underlying psychiatric disorders, autoerotic stimulation, intoxication, and rarely self-mutilation. [1][2][3][4][5][6] Appropriate and accurate physical examination with a thorough history of present illness (HPI) in the Supervising Editor: Lara N. Goldstein, MD, PhD.…”