• Archives of Reconstructive Microsurgery
• /
• v.10 no.1
• /
• pp.23-27
• /
• 2001

Penile amputation results primarily from attempts at self-emasculation in the psychotic individual or from felonious assault. Because of the complex nature of patients whom perform self-emasculation and low incidence of felonious assault, large series of these individuals do not exist, and experience with amputation injuries of the genitals is confined to individual case reports. Fortunately, complete amputation of penis is quite rare but potentially devastating occurrence. The repels of the treatment of penile amputation by coporal reapproximation that have been published since 1977 indicate that microreplantation techniques are propably superior to the technically simpler nonmicroscopic coporal reapproximation techniques. As microsurgical techniques have been demonstrated to superior, the preferred method of replantation involves this routine whenever possible. We have experience of a case of successful replantation of completely amputated penis by using microneurovascular repair, with the good result of cosmetic and functional concern. Herein, we report this case with the review of the literatures.

• Archives of Reconstructive Microsurgery
• /
• v.11 no.2
• /
• pp.146-152
• /
• 2002

As the defects of the penis caused by trauma, surgical amputation, or congenital abnormality give the patients both psychological trauma and functional impairment, reconstruction of the penis is mandatory. Radial forearm free flap is reliable one-stage procedure, which can reconstruct both the phallus and the urethra. Chang and Whang's adaptation of the "tube-in-a-tube" concept and its incorporation into a free flap design represented a major advance in microsurgical phallic construction. Biemer described a modification of the radial forearm flap design in which the neourethra was centered over the radial artery, but the phallic shaft was separated into two paraurethral swatches. The authors have performed one-stage penile reconstruction in two patients since 1998, using a radial forearm free flap. Our present design incorporates the original Biemer triple skin island and includes a fourth distal island for neoglans. One case was the amputation of the penis from felonious assault and the other case was the iatrogenic penile amputation from repetitive urologic surgery for congenital hypospadia. All patients showed aesthetically acceptable results and good tactile sensory recovery. Severe complications such as necrosis, fistula, or urethral stricture were not occurred. Biemer's method modified by the authors is reliable one-stage penile reconstruction providing good aesthetic and functional results.

• Journal of Veterinary Clinics
• /
• v.17 no.2
• /
• pp.499-501
• /
• 2000

Paraphilmosis, is a condition in which the extruded penis cannot be withdrawn back into the preputial cavity. In this study, the 2 dogs that showed prolonged erection. exposed penis from the sheath and hair surrounding the prepural orifice for several days, were ana1ysis of blood and urine ard carried out surgical treatment. In urinalysis, there were struvites, spermuria and bactera (streptococci) in urine. Firstly, these dogs were treated with non-surgical method, however severe necrosis of the Penis was developed form prolonged exposure and vascular compromise. Finally, partial penile amputation and preputial lengthening were performed and resulted in successful treatment.

• Archives of Plastic Surgery
• /
• v.49 no.3
• /
• pp.448-452
• /
• 2022

Total reconstruction of the penis (TPR) represents a challenge for urologists and plastic surgeons, especially when urethral length is severely reduced. We here describe, for the first time in an oncologic scenario, a double flap phalloplasty using a pedicled anterolateral thigh (ALT) flap for penile reconstruction and a radial forearm free flap (RFFF) for complete neourethra and glans reconstruction following penile amputation. A 48-year-old patient came to our department following a total penectomy with inferior urethral derivation. The indication for a double flap phalloplasty was posed as only way to fully reconstruct the urethra on its length avoiding possible complications of single flap reconstruction using tube-into-tube technique. Both flaps healed uneventfully with no neourethral strictures or fistulas described. At 18 months follow-up, the patient was extremely satisfied with the aesthetic result and was able to void in standing position. We think that a double free tissue transfer for TPR should be considered, particularly when a urethral length > 14 cm needs to be reconstructed. While the pedicled ALT can be used to reconstruct a proper penile shaft with an easily concealed scar, the RFFF can provide adequate neourethra length with satisfactory sensory recovery at the neoglans.

• Archives of Plastic Surgery
• /
• v.40 no.3
• /
• pp.247-250
• /
• 2013

Circumcision is one of the most common rituals in Jewish and Islamic cultures. It may also be performed for phimosis correction or the treatment of recurrent balanitis. Although circumcision is considered to be a technically easy and safe surgical procedure with no significant risk, it may lead to severe complications such as necrotizing fasciitis or total penis amputation. In this report, we present a case of penis amputation at two levels occurring with third-degree burns due to electrocautery during circumcision. Although penile replantation was attempted, it was unsuccessful due to burn damage to the veins. After restoration of the functional structures, the penis was buried in the inguinal area by reepithelization to maintain blood circulation. The recovery of the penis was successful. This case is presented as a novel example of groin flap surgery to achieve a functionally and aesthetically acceptable outcome in a salvage operation for a penis with significant traumatic injury, which has not been previously reported in the literature.

• Journal of Veterinary Clinics
• /
• v.34 no.3
• /
• pp.218-221
• /
• 2017

A 14-year-old castrated Shih Tzu weighing 5.4 kg presented with painful penile erection and dysuria that had been ongoing for 2 days. Treatment with salbutamol and gabapentin was initiated, but after 24 hours, the dog had not responded, so it was decided to proceed with penile amputation. The patient went into cardiac arrest during the surgery and died, despite attempted cardiopulmonary resuscitation. During the surgery, the penis was found to have an enlarged, tortuous, purple blood vessel located dorso-caudally to the bulbus glandis. A hemi-circular fibrous mass was found inside the vessel on histopathological examination; this mass may have induced the ischemic priapism by occluding the vein. This report describes a rare case of ischemic priapism in dogs.

• Journal of Veterinary Clinics
• /
• v.24 no.4
• /
• pp.627-630
• /
• 2007

A mixed-breed hunting dog suffered penile amputation and lacerations in the femoral and inguinal areas while hunting wild boar. The penis was replanted by anastomoses of the urethra, cavernous body, and the left and right dorsal veins of the penis. The transected penis recovered anatomically and functionally. No evidence of postoperative necrosis or edema was detected at the distal portion of the penis. In addition, fistulas and stenosis were not found on urethrogram 20 days after the surgery. Aside from surgery, we performed experimental cavernosography to identify the importance of the anastomosis of the dorsal veins of the penis in three beagle dogs. The cavernosograms revealed that, the contrast medium, which was injected into the bulbus glandis, drained by the left and right dorsal veins of the penis, then converged into one vessel at the ischial arch and diverged into the left and right internal pudendal veins. Thus, reanastomosis of the left and right dorsal veins of the penis in cases of transected canine penis appears to be important for positive postoperative prognosis.