Genital Self-Mutilation

Abstract

We report a series of 14 patients with 19 self-inflicted genital injuries during a period of 10 years. Of the patients 65% were psychotic and 35% were not psychotic. Repeated attempts at genital self-mutilation occurred in 31% of the cases, mainly in the psychotic group. A history of alcohol and/or drug abuse was present in 55% of the cases. Injuries varied from simple laceration of penile or scrotal skin to actual amputation of the penis or testis. The degree of injury did not differ between the psychotic and nonpsychotic patients. Surgical management and outcome varied according to the severity of the injury, the delay in presentation for treatment, and the degree of alteration in the mental status and behavior. Followup of 9 patients showed good cosmetic results with no immediate or delayed complications related to the injury. The functional results in patients with penile replantation were satisfactory. In 1 patient a urethral stricture developed that was successfully managed endoscopically. Erectile function was difficult to assess because of the marked diversity of sexual behavior in this group.

Genital Self-Mutilation and Psychotic Disorder: Case Report

“…Motivations for GSM are multifactorial. 13 In a case of male auto-castration who had recovered from a psychotic attack with probable sexual guilt, religious personality and hostility against women are rare one of antecedents of GSM behaviors, and a careful search for a probable post-psychotic depression may be beneficial in preventing this self-destructive behavior.…”

Traumatic Penile Amputation: A Case Report and Acute Management

“…During the secondary survey, it is important to look for any additional injuries, especially in the case of self-inflicted amputation by a psychotic patient. The possibility of drugs and/or alcohol intoxication or overdose should also be considered during initial stabilization [1]. A subsequent thorough history is essential to determine the nature of the injury.…”

“…Frequently, the injury is self-inflicted by patients suffering from an acute psychotic episode [1]. However, the injury has also been described secondary to domestic violence, other criminal assaults, and accidental trauma [2][3][4].…”

Successful penile replantation following autoamputation: twice!

“…1 These patients show a high tendency to repeating self-aggressive actions, especially when their pharmacotherapy is discontinued. 2,3 The literature shows at least 23 cases of penile autoamputation with successful microsurgical replantation since 1970. In many of these cases a restored erectile function and sensibility of the glans is stated within 1 y following the replantation.…”