Microscopic Replantation of Complete Penile Amputation With Video Demonstration.

ABSTRACT

BACKGROUND: Penile amputation is an extremely rare genital injury. To the best of our knowledge, there are only about 200 cases reported in Chinese and English literature, most of them are case reports. So far, there is not any video demonstration of microscopic replantation of complete penile amputation with meticulous surgical skills. OBJECTIVE: To provide a successful example of penile replantation after complete penile amputation through video presentation of the application of meticulous microsurgical techniques and optimized procedures. MATERIALS AND METHODS: The 25-year-old patient was admitted to our hospital 3.5 hours after his penis was completely amputated due to self-mutilation. Microscopic penile replantation was immediately performed after preoperative preparation. After the surgical procedure, the patient was treated with broad-spectrum antibiotics, analgesia, antithrombotics and anxiolytic. RESULTS: The total ischemic time was about 10 hours. The duration of surgery was about 7 hours. On the 14th day post-surgery, the wound healed smoothly, the glans was ruddy in color, and the appearance returned to normal without obvious complications. The patient urinates normally with a maximal urinary flow rate of 25 ml/s after removing the catheter. Three months after surgery, the local sensation of foreskin and glans recovered significantly, which showed that slight needling could lead to obvious pain, and the penis erection hardness score was 3 during morning erection or urinary bladder distention. Six months after surgery, the patient reported that he was completely satisfied with the result, which showed that the sensation of the penis and glans surface returned to almost normal and the optimal erection hardness score was 4. CONCLUSION: Careful microsurgical anastomosis of the dorsal arteries, deep dorsal vein, superficial dorsal vein and multiple dorsal nerves could obtain ideal recovery of penile appearance and function and avoid any obvious complications.