Self-inflicted gunshot injury to the external genitalia: a case report and review of literature

Abstract

Background Gunshot wounds of the external genitalia are rare. Rarer still are civilian self-inflicted gunshot wounds of the external genitalia. The protocol for the management of gunshot wounds of the penis especially with respect to urethral injuries is not fully established. Case presentation We present a 27-year-old male undergraduate student, who accidentally shot himself in the penis. He sustained American Association for the Surgery of Trauma (AAST) grades IV to V injuries to the penis, scrotum and left testes. He was managed in a multistage, multi-disciplinary fashion including staged buccal mucosal graft repair of 4 cm proximal penile urethral defect with satisfactory cosmetic and functional outcome. Conclusions Excellent functional and cosmetic results may be obtained after severe penetrating trauma to the external genitalia even in low resource centres in the hands of non-reconstructive urologists. Buccal mucosal graft is a viable option for two stage reconstruction of the urethra.

Scrotal self-inflicted gunshot injuries: report of two consecutive cases and literature review

“…Patient 1 in this report sustained unilateral grade V, while patient 2 sustained bilateral grade IV injuries. The grade V injury involved the left testis similar to that recorded by Obi et al [12]. Bilateral testicular injuries are rare [6,17].…”

“…Associated extragenital injuries should be noted and given attention, as injury to major vessels can result in fatality [8]. The commonest associated injury as demonstrated in this report and by most authors is injury to the lower extremity [5,8,10,12,14,22]. Our index patients had associated injuries to the left thigh.…”

“…The external genitalia constitute 1% of the total body surface area and receives relative protective shield from the thighs against external gunshots. When the guns are stored in trouser pockets or waist band, the genitalia become exposed and vulnerable to accidental discharges and such are said to be self-inflicted [5,6,12]. This has been attributed to improper handling and use of guns [5].…”