Genital self-mutilation

Abstract

We present a case report of a 22-year-old Nigerian student who presented to the accident and emergency unit of a Nigerian Teaching Hospital with a history of self-inflicted genital injury following a suicide attempt. He had background history of predisposition to depressive illness, a current diagnosis of a major depressive disorder, and had had two attempted suicidal episodes in the last 3 months prior to this event. The clinical finding shows a patient with sad affect, feeling of hopelessness, and worthlessness; however, the vital signs remained fairly stable. At examination under anesthesia, the testes were exposed and the right already self-castrated. The penis was degloved to the level of the Buck's fascia with intact corpora cavernosa and urethra. He had surgical excision of the hanging self-castrated right testis with debridement and primary closure of the genital laceration. He was promptly reviewed by the psychiatrists who co-managed appropriately.

Self Mutilation of Genitalia-Using Teeth

“…Rarely, self-mutilation has a serious nature that leads the patient to attempt to amputate his penis, castrate himself, extract his eye or amputate his hand [1]. The vast majority of reported cases have occurred among single, white males in their 20s and 30s [3,5,7]. Our patient fit into these gender and age groups.…”

“…It is often a multidisciplinary responsibility between the urologist, psychiatrist, psychologist, and primary care physician. The ultimate goal of surgical treatment includes restoration of the anatomy and function as much as possible [5]. A superficial laceration may require no more than simple suturing, which was the case for our patient.…”

“…Self-inflicted injuries range from simple lacerations of the external genitalia to complete amputation of the penis and testes. In most cases, penile mutilation is common [4,5]. In a group of 52 cases of GSM, Greilsheimer and Groves found 87% of the patients to be psychotic and 13% of the patients to be non-psychotic.…”

Genital self-mutilation in an attempt of suicide by a patient with a borderline personality

“…[16] The investigation of the risk factors of the self-mutilation behavior in borderline patients found factors counting loss of physical integrity, confusion, the feeling of guiltiness, self-underestimation, the dependence or the abusive consumption of a substance. [3171819202122] The presence of maltreatment during childhood including physical or effective negligence, sexual abuse is mostly mentioned as a predictive factor of the self-mutilation in borderline personality patients. [1]…”

“…[32022] Authors insisted on the addictive nature through deliverance of endorphin and dopamine in blood, and on the distractive function consisting of shifting patient attention from moral pain to physical pain. Subsequently, 60% of borderline patients did not report any pain feeling during the self-mutilation acts.…”