Microsurgical Replantation of the Amputated Penis and Scrotum in a 29-Year-Old Man

Darewicz, J; Gatek, L; Malczyk, Eugeniusz; Darewicz, Barbara; Rogowski, Karol; Kudelski, Jacek

doi:10.1159/000282912

Cited by 12 publications

(4 citation statements)

References 5 publications

(10 reference statements)

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“…Utilizing HBO could have altered the outcome of the microsurgical replant of the penis reported by Darewicz et al that had 65% necrosis of the penile replant, although ischemic time may have been a factor in that case. 30 Although this case report focused on the surgical management of penile replantation, the psychiatric aspect of these cases must not be underestimated. The majority of these cases are due to a psychotic disorder and less frequently to assault, with the nonpsychotic group usually under the influence of alcohol or illicit drugs during the time of injury.…”

Section: Discussionmentioning

confidence: 98%

Microsurgical penile replantation facilitated by postoperative HBO treatment

2004

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Successful microsurgical replantation of a penis amputated at the level of the pubis is a rare occurrence worldwide. Moreover, the use of hyperbaric oxygen (HBO) for a postoperative replant Pseudomonas wound infection has not been reported. There is also disagreement regarding the importance of microsurgical repair of only the dorsal arteries or only the profundi arteries of the penis. A case is reported of penile replantation with a postoperative Pseudomonas wound infection treated with HBO to prevent potential replant loss, with a worldwide literature review. At 1-year postoperative follow-up, the patient has normal urinary flow and reports spontaneous erection, with the ability for intromission and a sensate glans. HBO facilitated the success of a penile replantation complicated by postoperative Pseudomonas wound infection. In addition, a literature review supports the microsurgical repair of at least a single isolated dorsal penile artery, but not a single or multiple profundi arteries.

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Section: Discussionmentioning

confidence: 98%

Microsurgical penile replantation facilitated by postoperative HBO treatment

2004

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“…3,6 Favourable factors for successful reimplantation in this case included clean incision, relatively short ischaemia time, microsurgery availability, patient age and comorbidities, and smoking cessation without need of nicotine replacement. [7][8][9][10] In this case, although the dorsal nerve was not formally repaired, the patient had full improvement in sensation at 14 months perhaps suggesting ability for dorsal nerve regeneration. Therefore, inability to anastomose dorsal nerve should not preclude a patient from attempted reimplantation.…”

Section: Author Contributionsmentioning

confidence: 80%

“…Common complications include penile deformation, urethral fistulas, urethral strictures and ED 3,6 . Favourable factors for successful reimplantation in this case included clean incision, relatively short ischaemia time, microsurgery availability, patient age and comorbidities, and smoking cessation without need of nicotine replacement 7–10 . In this case, although the dorsal nerve was not formally repaired, the patient had full improvement in sensation at 14 months perhaps suggesting ability for dorsal nerve regeneration.…”

Section: Figmentioning

confidence: 83%

Penile reimplantation following traumatic complete amputation: an Australian first

Cooper,

Parkin,

Cole‐Clark

et al. 2023

ANZ Journal of Surgery

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“…The patency of the cavernosal artery is the most important for erectile function. In instances where the cavernosal artery was incompletely repaired, results were poor, possibly owing to technical difficulties 9 . Cavernosal arteries of both patients here were completely repaired, restoring normal erectile function.…”

Section: Discussionmentioning

confidence: 99%

Replantation of the Completely Amputated Adult Penis: Two Case Reports Using Microsurgical Technique

Lee

Hong

Kim

2019

Arch Hand Microsurg

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Penile amputation is an extremely rare traumatic event. The majority of cases involve adult self-mutilation due to psychological problems or surgical mishaps during circumcision of infants 1,2 . Prior to the advent of microsurgery, survival of the replanted penis depended on the adequacy of sinusoidal blood flow to re-approximated penile tissues 1 . Consequently, tissue necrosis, urethral stricture, loss of sensation, erectile dysfunction was often occurred.Microsurgical replantation has the potential to reduce such complications, but most of the reported successes (approximately 30 cases) have focused on survival, rather than meticulous technique, and were not free of postoperative complications. To restore baseline penile function, the intrinsic anatomy of the penis must be maintained.We have achieved complete anatomic restoration of a severed adult penis using a microsurgical technique that eliminates complications. The details are described here in two case reports. Normal function and aesthetics resulted in each case.

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Microsurgical Replantation of the Amputated Penis and Scrotum in a 29-Year-Old Man

Cited by 12 publications

References 5 publications

Microsurgical penile replantation facilitated by postoperative HBO treatment

Microsurgical penile replantation facilitated by postoperative HBO treatment

Penile reimplantation following traumatic complete amputation: an Australian first

Replantation of the Completely Amputated Adult Penis: Two Case Reports Using Microsurgical Technique

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