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Journal articles on the topic 'Penile amputation'

Author: Grafiati

Published: 5 June 2025

Last updated: 8 July 2025

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1

Manganiello, Marc, William Knaus, Justin Cohen, and Bernard Lee. "Penile Self-amputation." Journal of Reconstructive Microsurgery Open 02, no. 01 (2017): e58-e62. http://dx.doi.org/10.1055/s-0037-1602792.

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Background A 24-year-old man was urgently transferred from an outside institution after self-amputating his penis. Methods The patient was suffering from a paranoid schizophrenic delusional episode. Voices told him to amputate his own penis with a utility knife. He was taken emergently to the operating room by urology and plastic surgery. Cystoscopy was performed and a 14F percutaneous suprapubic catheter was placed. The amputated distal penis and the proximal stump were debrided. The urethra, dorsal artery, and neurovascular bundles were mobilized. The distal urethra was spatulated dorsally and the proximal urethra was spatulated ventrally. The urethra was reanastomosed over a 16F Foley catheter with interrupted, 4–0 absorbable, monofilament suture. The corpora were reanastomosed with interrupted, 2–0 and 3–0, absorbable, monofilament suture. The arteries and nerve were reanastomosed. Total ischemia time was between 4 and 5 hours. Results The patient initially developed edema, ecchymosis, and mild incisional skin necrosis from the resulting reperfusion injury. However, the penile graft successfully maintained perfusion. He was discharged 2 weeks after his injury in stable psychiatric condition. His Foley catheter and suprapubic tube remained in place for 10 weeks. A voiding cystourethrogram (VCUG) demonstrated a patent urethra without evidence of urinary leakage or stricture. At the time of his VCUG, he experienced return of distal penile sensation and partial erections. Conclusion Penile reimplantation after self-amputation is successful if ischemic time is minimized and a multidisciplinary approach with plastic surgery and microvascular anastomosis is performed.

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2

Mumoli, Nicola, Matteo Giorgi-Pierfranceschi, Cesare Porta, Guendalina Manzionna, and Marianna Barberio. "Penile self-amputation." Internal and Emergency Medicine 13, no. 7 (2018): 1133. http://dx.doi.org/10.1007/s11739-018-1899-6.

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3

Abdurakhmanov, A. K., and V. A. Kopylov. "Traumatic amputation of penis." Kazan medical journal 95, no. 1 (2014): 116–17. http://dx.doi.org/10.17816/kmj1470.

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7 patients with penile traumas (4 - with penile fracture, 2 - degloving penile injury, 1 - traumatic amputation of the penis) were observed in the department of urology of the Municipal Hospital №5, Naberezhnye Chelny, Russia from 2009 to 2013. The penile trauma, regardless of its cause, is the major physical and mental trauma for the patient. It causes psychological distress, and impacts the subsequent quality of life in males. In domestic and foreign literature, there are few reports about the traumatic amputation of the penis as suicidal attempt in mental patients. At the presented case, patient himself performed the traumatic amputation to remove the strangulating ring. The patient used a metal ring to increase erection, after the coitus it caused the pathologic erection, and patient could not remove it. To decrease the edema, the patient cut the penile skin, but did not reckon the knife sharpness and the force, and performed the traumatic amputation of penis; the stump was thrown away by the patient. The described case can be distinguished because of the rare trauma mechanism in mentally healthy patient.

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4

Fazi, Julian, David Adkins, Jennifer Knight, and Adam Luchey. "Unusual Mechanisms of Penile Amputation." Case Reports in Urology 2019 (December 28, 2019): 1–4. http://dx.doi.org/10.1155/2019/1582047.

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Penile amputation is an uncommon and highly morbid injury. Many mechanisms have been reported ranging from self-mutilation and domestic violence to traumatic circumcisions. We present two unusual cases of traumatic penile amputation. An older gentleman endured extensive perineal trauma after being trapped underneath an industrial-sized lawnmower, and a young adolescent was bitten by an English bulldog and suffered amputation of the glans of his penis. These unique and very different cases of penile amputation highlight differences in operative managements, complications, and reconstructive possibilities.

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5

Kenneth, Aluora, Khainga Stanley, Nang’ole Ferdinand, et al. "Microsurgical Penile Replantation: Case Report." Annals of African Surgery 19, no. 2 (2022): 130–34. http://dx.doi.org/10.4314/aas.v19i2.12.

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Penile replantation is uncommon, with most data being case reports or case series. In our setting, replantation is fairly new despite penile amputations being common as a result of marital disputes and assault. Replantation remains the most ideal option for managing these cases. We present a case of penile replantation in a 17-year-old male after traumatic amputation following an assault. Some of the challenges we encountered included loss of skin and the glans with formation of a hypospadias. Nevertheless, the outcome was satisfactory with return of sensation and erection.

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6

Putra, Donny Eka, Theddyon Bhenlie Apry Kusbin, Paksi Satyagraha, and Stephanie Taneysa Widodo. "Case Report: Non-microscopic surgical management of incomplete penile amputation." F1000Research 9 (July 7, 2020): 681. http://dx.doi.org/10.12688/f1000research.23775.1.

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Background: Penile amputation is an emergency urologic condition requiring immediate attention in order to maximize functional outcomes. Unfortunately, there is limited experience and publication of case reports describing the successful replantation of penis after incomplete amputation, especially in facilities without adequate microsurgical tools and means. We hereby present a case of penile amputation caused by a mechanical grass cutter and a discussion of its surgical management. Case description: A 33-year-old Indonesian male presented to the emergency department with incomplete penile amputation six hours post injury. The patient has no prior medical history and presented with penile amputation due to a mechanical grass cutter trauma. He underwent immediate non-microsurgery reconstructive replantation of the penis, reattaching all visible vascular, corporal, and fascia layers. After replantation, the patient recovered well and showed preserved normal appearance and sensitivity of the penis. Subsequent Doppler ultrasound investigation revealed adequate arterial flow at the distal end of the anastomosis. The patient was discharged five days after surgery. Conclusion: In the absence of microsurgical tools and means, the use of non-microsurgical replantation should be the choice of treatment in the case of incomplete penile amputation. The technique showed good outcomes involving adequate functional and cosmetic restoration.

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7

Putra, Donny Eka, Theddyon Bhenlie Apry Kusbin, Paksi Satyagraha, and Stephanie Taneysa Widodo. "Case Report: Non-microscopic surgical management of incomplete penile amputation." F1000Research 9 (September 22, 2020): 681. http://dx.doi.org/10.12688/f1000research.23775.2.

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Background: Penile amputation is an emergency urologic condition requiring immediate attention in order to maximize functional outcomes. Unfortunately, there is limited experience and publication of case reports describing the successful replantation of penis after incomplete amputation, especially in facilities without adequate microsurgical tools and means. We hereby present a case of penile amputation caused by a mechanical grass cutter and a discussion of its surgical management. Case description: A 33-year-old Indonesian male presented to the emergency department with incomplete penile amputation six hours post injury. The patient has no prior medical history and presented with penile amputation due to a mechanical grass cutter trauma. He underwent immediate non-microsurgery reconstructive replantation of the penis, reattaching all visible vascular, corporal, and fascia layers. After replantation, the patient recovered well and showed preserved normal appearance and sensitivity of the penis. Subsequent Doppler ultrasound investigation revealed adequate arterial flow at the distal end of the anastomosis. The patient was discharged five days after surgery. Conclusion: In the absence of microsurgical tools and means, the use of non-microsurgical replantation with an at least 2.5x loupe magnification should be the choice of treatment in the case of incomplete penile amputation. The technique showed good outcomes involving adequate functional and cosmetic restoration.

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8

Roth, Kirk, Jason Izard, and Darren Beiko. "Self-performed glansectomy and surgical repair by a nonpsychotic patient on androgen replacement therapy." Canadian Urological Association Journal 3, no. 4 (2013): 25. http://dx.doi.org/10.5489/cuaj.1135.

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Genital self-amputation in men is a rare condition. We report aninteresting case of penile self-amputation that was performed andsurgically repaired by a nonpsychotic patient who was enrolledin a clinical trial for androgen replacement therapy. Using steriletechnique for amputation of the glans penis and using cotton threadto suture the wound, the patient was able to avoid hemorrhageand infection. This is the first reported case of androgen therapy–induced penile self-amputation with patient-performed surgicalreconstruction using primitive instruments.

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9

Henry, Nader, Henry Bergman, Deborah Foong, and George Filobbos. "Successful penile replantation after complete amputation and 23 hours ischaemia time: the first in reported literature." BMJ Case Reports 13, no. 6 (2020): e234964. http://dx.doi.org/10.1136/bcr-2020-234964.

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Complete penile amputation is a rare and poorly documented injury with severe physical and psychosocial implications. Our institution presents a case of successful penile replantation following 23 hours of ischaemia time in a 34-year-old man with a history of paranoid schizophrenia who sustained a complete penile amputation during an act of deliberate self-harm. To the best of our knowledge, this is the longest documented ischaemia time for a successful penile replant in literature. The patient was able to achieve a full erection as early as 6 weeks postoperatively. Skin necrosis was noted as a common complication and this was successfully managed with debridement and skin grafting. Penile amputation injuries should be managed in a specialist centre with urological and plastic surgeons with expertise in microsurgical reconstruction. Penile replantation should be attempted, even if ischaemia time is prolonged, despite lower success rates given the significance of the injury to an individual.

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10

Kulkarni, S., S. Bhadranwar, A. Rawal, A. Mousa, and P. M. Joshi. "Penile skin flap neourethra after radical penile amputation." European Urology Supplements 18, no. 1 (2019): e2294. http://dx.doi.org/10.1016/s1569-9056(19)31674-4.

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11

Patel, Keval. "Organ Preserving Surgeries in Management of Penile Cancer: When and How." UroCancer Clinics of India 2, no. 3 (2024): 119–25. https://doi.org/10.4103/ucci.ucci_2_25.

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Summary Penile carcinoma has a high incidence in India, with 27% of the patients being under 50 years old and sexually active. There is growing interest in penile-preserving strategies owing to disadvantages of penile amputation. Penile amputation leads to both poor sexual performance and deteriorated quality of life. Again, the traditional 2 cm margin criteria are no longer considered important for better oncological outcomes. The main advantages of all penile-preserving surgeries are maintained sexual function and ability of voiding in standing position. The indications for performing penile-preserving surgeries are small tumors, located at the glans and distal shaft and carcinoma in situ or ≤T1 stage with no lymph node metastasis. The main disadvantage of penile-preserving surgeries is increased local recurrence; however, it does not lead to decrease survival.

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12

Wihono, Frendy, and Yacobda Sigumonrong. "Surgical Management (Microsurgery) of Traumatic Penile Amputation: A Case Report." Open Access Macedonian Journal of Medical Sciences 7, no. 8 (2019): 1350–52. http://dx.doi.org/10.3889/oamjms.2019.115.

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BACKGROUND: Traumatic penile amputation is an uncommon surgical emergency with various etiologies, carrying major functional and psychological consequences concerning the patient’s overall quality of life. Regardless of the aetiology, penile amputation represents a surgical emergency that must be addressed quickly and efficiently to maximise functional outcomes. CASE PRESENTATION: We herein describe a case of psychiatric disorder that resulted in a complete self-amputation of the patient’s penis. The author presents a case of a 20-year-old single Indonesian male with no significant past medical or psychiatric history, who was presented to our Regional Referral Hospital with traumatic penile self-amputation. Immediately, the patients were taken to the operating room, and careful examination under anaesthesia revealed fully and transversally transected urethra as well as corporal bodies at the level of penis base. Viable artery and vein were then searched using a microscope after suturing through the tunica albuginea of the corporal bodies on the ventral aspect and snapped them for future tying. After microvascular re-anastomosis of the left dorsal artery and only one dorsal vein done. We attached the urethra and placed a 16 Fr silicon catheter. The result was an excellent tension-free, widely spatulated urethra anastomosis, which was then reattached to the corporal bodies. The penis had significant oedema and swelling in the distal penile shaft; however, pain sensation was gradually returning. CONCLUSION: The authors noted that microsurgical reimplantation is the treatment of choice for penile amputation, with a minimum one of the penile vascular was successfully anastomosis.

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13

Rigamonti, Waifro, Cesare Tiengo, and Marco Castagnetti. "Surgical Management of Penile Amputation." Journal of Pediatric Urology 3 (April 2007): S30. http://dx.doi.org/10.1016/j.jpurol.2007.01.036.

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14

Rigamonti, Waifro, Cesare Tiengo, and Marco Castagnetti. "Surgical management of penile amputation." Journal of Pediatric Urology 3 (April 2007): S89—S90. http://dx.doi.org/10.1016/j.jpurol.2007.01.168.

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15

Jezior, James R., Jeffrey D. Brady, and Steven M. Schlossberg. "Management of Penile Amputation Injuries." World Journal of Surgery 25, no. 12 (2001): 1602–9. http://dx.doi.org/10.1007/s00268-001-0157-6.

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16

Martinez, M., and R. R. Buban. "A case of penile amputation." European Urology Open Science 57 (November 2023): S481. http://dx.doi.org/10.1016/s2666-1683(23)02406-0.

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17

Shamsher, Muhammad Asaad, Sajjad Muhammad Khan Shinwari, and Tariq Ijaz. "SUCCESSFUL MACROVASCULAR PENILE REIMPLANTATION AFTER TRAUMATIC AMPUTATION IN A YOUNG MALE." Khyber Journal of Medical Sciences 17, no. 3 (2024): 216–19. https://doi.org/10.70520/kjms.v17i3.555.

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Penile amputation is an uncommon occurrence that arises from acts of self-mutilation, unintentional trauma, or deliberate assault. In recent advances, multiple reconstructive techniques provide excellent outcomes for penile re-plantation. Here, we present a case of successful penile re-plantation and urethroplasty following 24 hours of ischemia in a 22-year-old male with complete urethral injury and a partially amputated penis. As far we know , this is one among the longest documented ischemia time for successful macrosurgical penile re-plantation. After 6 weeks of penile re-plantation, the patient recovered well and showed normal urination, erectile function, return of sensations, and satisfactory cosmetic outcome. Penile amputation injuries should be managed in a specialist center with expert urological and plastic surgeons of micro/macrosurgical reconstruction. The main aim of this study is to evaluate the treatment regimen and prognosis of macrosurgical re-plantation of penile stump.

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18

Nair, Anushka, Dyan Dsouza, and A. R. Prasanna Kumar. "Danger Down Under: A Pediatric Case of Penile Trauma with a Saw." Journal of Indian Association of Pediatric Surgeons 29, no. 1 (2024): 62–63. http://dx.doi.org/10.4103/jiaps.jiaps_137_23.

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ABSTRACT Partial penile amputation in the pediatric age group is an emergency and occurs mainly due to iatrogenic trauma or road traffic accidents. Such lesions are incapacitating and have a devastating psychological impact. We present the case of a 16-year-old boy who presented with an accidental, near-total penile amputation, and highlight our management plan as a favorable one.

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19

Kim, Jae Heon, Jae Young Park, and Yun Seob Song. "Traumatic Penile Injury: From Circumcision Injury to Penile Amputation." BioMed Research International 2014 (2014): 1–6. http://dx.doi.org/10.1155/2014/375285.

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The treatment of external genitalia trauma is diverse according to the nature of trauma and injured anatomic site. The classification of trauma is important to establish a strategy of treatment; however, to date there has been less effort to make a classification for trauma of external genitalia. The classification of external trauma in male could be established by the nature of injury mechanism or anatomic site: accidental versus self-mutilation injury and penis versus penis plus scrotum or perineum. Accidental injury covers large portion of external genitalia trauma because of high prevalence and severity of this disease. The aim of this study is to summarize the mechanism and treatment of the traumatic injury of penis. This study is the first review describing the issue.

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20

Kouka, Saint C. N., Tonleu L. Bentefouet, Ngor M. Thiam, et al. "Penile Cancer in the Region of Thies: Epidemiological, Diagnostic and Therapeutic Aspects." Urology and Andrology – Open Journal 7, no. 1 (2024): 12–17. http://dx.doi.org/10.17140/uaoj-7-145.

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Aim This study aimed to determine the epidemiological, clinical, histopathological, and therapeutic characteristics of patients with penile cancer in hospitals in the Thiès region. Patients and Methods We conducted a retrospective descriptive study collecting all cases of penile cancer in the different urology departments in the Thies region from January 1st, 2015, to December 31st, 2020. Results We recorded 14 cases of penile cancer during the study period. The average age of the patients was 42.93-years (range: 26 to 82-years). The average consultation time was 18-months. All patients were circumcised during childhood. The circumstances of discovery were penile pain (64.3%), ulceration of the penis (26.6%), and hematuria (14.3%). Squamous cell carcinoma was found in 100% of patients. The cancer was locally advanced or metastatic in 64.3% of cases. Partial amputation of the penis was carried out in 50% of patients, and total amputation of the penis was carried out in 42.85% of patients. One patient refused a total penile amputation. After a 6-month follow-up, 35.7% of patients had died. Conclusion The presentation of penile cancers is often late in the Thiès region. Improving the technical platform will make it possible to better manage these cancers.

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21

Alhasani, Salam. "Successful Macro-surgical Replantation of an amputated Penis." American Journal of BioMedicine 2, no. 2 (2014): 69–72. http://dx.doi.org/10.18081/2333-5106-014-04/69-72.

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Total penile amputation is an uncommon injury; 87% of the patients reported had psychiatric problems. Self-amputation of external genitals is known as Klingsor syndrome. A few patients had poor gender identity feeling themselves inadequate as males. Some cases arise from felonious assault by jealous homosexual lovers. In 1970 in Thailand, an epidemic was seen, of penile amputation as punishment for philandering by humiliated wives. Although replantation of the amputated penis has a high success rate, there may be some remaining squeals such as skin necrosis and urethral stricture or fistula. We report a case of a macroscopic replantation of an amputated penis.

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22

D’Assumpcao, Carlos, Rupam Sharma, Addie Bugas, Arash Heidari, Rick A. McPheeters, and Shahab Hillyer. "A Fatal Case of Penile Calciphylaxis." Journal of Investigative Medicine High Impact Case Reports 10 (January 2022): 232470962210762. http://dx.doi.org/10.1177/23247096221076275.

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Calciphylaxis is a rare and serious complication of chronic renal failure characterized by vascular calcium overload. It has a high mortality rate. Penile calciphylaxis is an extremely rare condition of penile necrosis due to calciphylaxis of the penile arterioles. Presented here is a severe case of systemic calciphylaxis initially presented as penile necrosis treated with sodium thiosulfate and amputation.

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23

Austoni, E., A. Guarneri, F. Colombo, A. Cazzaniga, and J. Goumas Kartalas. "Reconstructive Technique for Partial Penile Amputation." Urologia Journal 72, no. 1 (2005): 21–26. http://dx.doi.org/10.1177/039156030507200107.

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24

Trigui, Dalel, Mohamed Jallouli, and Riadh Mhiri. "Penile amputation neuroma after a circumcision." Journal of Pediatric Surgery 43, no. 9 (2008): 1764. http://dx.doi.org/10.1016/j.jpedsurg.2008.05.033.

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25

Sanger, James R., Hani S. Matloub, N. John Yousif, and Frank P. Begun. "Penile Replantation after Self-inflicted Amputation." Annals of Plastic Surgery 29, no. 6 (1992): 579–84. http://dx.doi.org/10.1097/00000637-199212000-00017.

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26

Virasoro, Ramón, Jeremy B. Tonkin, Kurt A. McCammon, and Gerald H. Jordan. "Penile Amputation: Cosmetic and Functional Results." Sexual Medicine Reviews 3, no. 3 (2015): 214–22. http://dx.doi.org/10.1002/smrj.50.

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27

Zumbo, G., and D. Saraceno. "Penile Carcinoma." Urologia Journal 73, no. 2 (2006): 242–43. http://dx.doi.org/10.1177/039156030607300206.

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The carcinoma of the penis is a rare neoplasia which tends to remain localized for long because of the patient's embarrassment; thus the diagnosis is often late. The treatment modality is a critical issue due to the controversies existing with regard to the role of linfoadenectomy. However, in cases of no lymphonodal involvement, the surgical treatment with the penis amputation proves certainly to be curative and leads to a favourable outcome.

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Junaidi, Mustafa V., Nasrudin Haris, and Handini Annisya. "Late management of traumatic complete penile amputation: A Case Report." Brawijaya Journal of Urology 4, no. 02 (2024): 23–27. http://dx.doi.org/10.11594/bjurology.2024.004.02.1.

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Traumatic complete penile amputation is a rare condition. Despite the implementation and success of known repair strategies, rural hospitals nevertheless face limitations. Furthermore, the amputation of the penis is accompanied by significant challenges and complications in the later stages. We present a case of a 43-year-old man who had previously undergone complete amputation of his penis and is now experiencing urine retention. A suprapubic cystostomy procedure was performed on the patient to divert urine. The patient planned to have a reconstructive operation by seeking treatment at a specialized tertiary referral hospital with expertise in reconstructive urology. However, the patient displayed a hesitancy to interact with healthcare practitioners. The purpose of this case report is to illustrate the complexities of traumatic total penile amputation and the early care of a rare urology case that may arise in peripheral hospitals without urologists.

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29

Sheikh, Omar Adam, Shukri Said Mohamed, and Ahmet Sarac. "Penile amputation after neonatal circumcision: a case report." Annals of Medicine & Surgery 85, no. 8 (2023): 4083–86. http://dx.doi.org/10.1097/ms9.0000000000000996.

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Introduction and Importance: In children, one of the most common surgical procedures worldwide is circumcision, which has strong religious implications and is frequently performed for nontherapeutic reasons. Circumcision is typically associated with old customs. Complete penile amputation is extremely uncommon, and the prognosis is little understood. Case Presentation: A 7-day-old male term baby was circumcised with a cauter by an unexperienced practitioner, and the patient was admitted to the department of pediatric surgery. Both the glans and the body had become discolored and necrotic. The patient was taken into the theater and given general anesthesia. The authors removed the debridement and inserted a catheter into the urethra to prevent urethral stenosis. Discussion: The procedure of circumcision has several medical benefits and is widely performed for religious, cultural, and medical reasons. It is generally agreed that circumcision prevents against sexually transmitted diseases, penile and cervical cancer in adults, as well as urinary tract infections in children. Partial or complete penile amputation injuries are rare and frequently the result of psychotic self-harm. Operators must correctly conduct the circumcision in order to prevent the potential complications that can happen when the procedure is performed out by untrained hands. The most common cause of penile amputation injuries, whether partial or total, is psychotic self-harm. Operators must carry out the procedure carefully to prevent the potential complications that can happen when circumcision is performed by untrained hands. Conclusion: The authors present here a case of a 7-day-old boy who had ritual circumcision with a cauter complicated by an entire penile amputation, which was treated with the insertion of a catheter to prevent the closure of the urethra. The patient reported his penis was circumcised with cautery one day later the glans and the entire penis became discolored and necrosis, unfortunately, the entire penis was lost with the overlying skin.

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30

Ballo, Bréhima, Amadou Berthé, Ousmane Koné, et al. "Penile Cancer at the Urology Department of Koutiala Reference Health Center. About Three Cases and Literature Review." EAS Journal of Medicine and Surgery 6, no. 02 (2024): 44–53. http://dx.doi.org/10.36349/easjms.2024.v06i02.007.

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Goal: Raise awareness among the population to be consulted early in the event of penile cancer and to accept the treatment proposed by the clinician, based on three observations of penile cancer treated in the urology department of the center of reference health Koutiala. Material and methods: This was a prospective review of three cases of penile cancer diagnosed and treated in the urology department of the Koutiala reference health center over a period of two years from January 1, 2021. As of December 31, 2022. The first case was a squamous cell carcinoma of the penile in a 67-year-old patient who suffered amputation of the glans during circumcision, having undergone an adenomectomy in December 2020. The second patient was 63 years old and circumcised; having had urinary bilharzia in childhood and also presenting squamous cell carcinoma. The third case was a 74-year-old circumcised patient with ulcerated swelling of the glans. A review of the literature made it possible to identify the frequency and risk factors and/or precancerous lesions of this cancer on both sides in the world in general and more particularly in Africa. Results: Over a period of two years, three cases of penile cancer were recorded and treated in the urology department of the Koutiala reference health center. The three patients were aged 67, 63 and 74 years respectively. They were all farmers, circumcised and one had his glans amputated during the circumcision. A cystotomy was performed in one patient but all refused amputation of the penis. No patient received radiotherapy or chemotherapy because they were all lost to follow-up. The histological type encountered in our patients was squamous cell carcinoma. Conclusion: Penile cancer remains the least common urological cancer in our practice, behind testicular cancer. Patients are seen late, at stages requiring penile amputation, which few patients accept.

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Garg, Sanchit, Shivprasad V. Date, Arunesh Gupta, and Amresh S. Baliarsing. "Successful microsurgical replantation of an amputated penis." Indian Journal of Plastic Surgery 49, no. 01 (2016): 99–105. http://dx.doi.org/10.4103/0970-0358.182257.

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ABSTRACTPenile amputation is an uncommon injury for which immediate surgical replantation is warranted. Microsurgical replantation is the “standard” method for penile replantation. Early replantation yields a high success and low complication rate. We report a case of a 34-year-old male who presented with amputation at the proximal penile shaft which was successfully replanted using microsurgical techniques. Minor skin necrosis was noted post-operatively which was debrided and covered with skin graft. Follow-up at 6 months showed satisfactory cosmetic appearance, normal voiding, return of sensations and erectile function. The level of evidence was V.

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32

Baarimah, Alhareth, Latif Dar, Rayan Dashnan, Saeed Alshahrani, Mohammed Beaiti, and Khaled ALDhabaan. "Penile Hair Tourniquet Syndrome (PHTS): A Case Report of a Two-Year-Old Boy." Case Reports in Urology 2022 (August 9, 2022): 1–3. http://dx.doi.org/10.1155/2022/8030934.

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Penile hair tourniquet syndrome (PHTS) is an unusual phenomenon. A physician should have a high index of suspicion when a circumcised child presents with glans swelling and inflammation. It must be considered a surgical emergency, as early diagnosis and treatment can prevent complications (e.g., urethra-cutaneous fistula, complete urethral transection, penile gangrene, and penile amputation). We report a case of two-year-old boy to highlight the importance of early diagnosis and prompt treatment.

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33

Fuoco, Michael, Leonard Cox, and Thomas Kinahan. "Penile amputation and successful reattachment and the role of winter shunt in postoperative viability: A case report and literature review." Canadian Urological Association Journal 9, no. 5-6 (2015): 297. http://dx.doi.org/10.5489/cuaj.2522.

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Traumatic self-amputation of the penis by a psychotic patient is rare. Microvascular replantation is the favored management approach. There are no known cases of self-amputation followed by ingestion of the stump and subsequent replantation. A 51-yearold patient with paranoid schizophrenia presented 2 hours following penile amputation. He had swallowed the excised portion, which was endoscopically retrieved from the stomach in the emergency department. Successful reattachment was achieved including microvascular repair of the dorsal penile arteries without cavernosal arterial anastamoses. A Winter’s shunt was performed to improve venous circulation. The patient has been followed for 3 years from the date of repair. He has adequate erection for intercourse and good urinary function, but has experienced sensory loss over the dorsal aspect and glans and urethral stricture dilation. This is the first report of replantation following ingestion of an amputated penis.

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Aydin, Atakan, Alp Aslan, and Serdar Tuncer. "PENILE AMPUTATION DUE TO CIRCUMCISION AND REPLANTATION." Plastic and Reconstructive Surgery 110, no. 2 (2002): 707–8. http://dx.doi.org/10.1097/00006534-200208000-00067.

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Yao, H., D. C. Zheng, M. K. Xie, et al. "020 Surgical Management of Traumatic Penile Amputation." Journal of Sexual Medicine 14, no. 1 (2017): S9. http://dx.doi.org/10.1016/j.jsxm.2016.11.022.

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Morey, Allen F. "Re: Penile Amputation: Cosmetic and Functional Results." Journal of Urology 195, no. 5 (2016): 1509–10. http://dx.doi.org/10.1016/j.juro.2016.02.013.

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Shaw, Matthew B. K., A. Michael Sadove, and Richard C. Rink. "Reconstruction After Total Penile Amputation and Emasculation." Annals of Plastic Surgery 50, no. 3 (2003): 321–24. http://dx.doi.org/10.1097/01.sap.0000029629.81612.2e.

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Shenoy, Sunil P., Prashanth K. Marla, and Dinesh Kadam. "Lessons Learned From a Cryptic Penile Amputation." Urology 77, no. 1 (2011): 257–58. http://dx.doi.org/10.1016/j.urology.2010.10.004.

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Beniamin, Francesco, Marco Castagnetti, and Waifro Rigamonti. "Surgical management of penile amputation in children." Journal of Pediatric Surgery 43, no. 10 (2008): 1939–43. http://dx.doi.org/10.1016/j.jpedsurg.2008.05.028.

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Reddy, S. V. Krishna, Ahammad Basha Shaik, and Srinivas Rao K. "Penile injuries: A 10-year experience." Canadian Urological Association Journal 8, no. 9-10 (2014): 626. http://dx.doi.org/10.5489/cuaj.1821.

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We report our 10-year experience with penile injuries. We retrospectively reviewed the records of 156 cases of male external genitalia injuries between May 2002 and December 2012. Of these, only 26 patients presented without urethral injuries and were included in this study. Patients were divided into 4 groups: Group 1 (n = 12) with patients with penile fractures injuries; Group 2 (n = 5) with patients with penile amputation injuries; Group 3 (n = 2) with patients with penile penetrating injuries; and Group 4 (n = 7) with patients with penile soft tissue injuries. Grading of injury was done using the American Association for the Surgery of Trauma (AAST)-Organ injury scale of penile injury. Penile injuries without urethral injuries are urological emergencies which require immediate attention.

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Veeramani, Anamika, Charles D. Hwang, Jason C. Gardenier, et al. "Posttraumatic Penile Replantation with Minimal Skin Necrosis." Plastic and Reconstructive Surgery - Global Open 11, no. 8 (2023): e5205. http://dx.doi.org/10.1097/gox.0000000000005205.

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Summary: Penile amputation is a surgical emergency where practical and timely perioperative management is crucial for ensuring a successful outcome. Tenuous viability of penile and scrotal skin has been well described in the literature, with a putative mechanism attributed to the transection of distal branches of the external pudendal artery. Although the perforasomes critical to penile replantation have been debated, this case report details a patient who successfully recovered sensation and function with minimal necrosis after penile replantation. Surgically, this was facilitated by intentional drain placement, aggressive debridement beyond the zone of injury, and planned redundancies with dorsal artery/vein anastomoses via interposition grafts of the dorsal penile vessels alone.

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Ayres, BE, M. Iles, L. Hounsome, et al. "Trends in incidence, mortality and treatment of penile cancer before and after centralisation of penile cancer services in England (1990–2009)." Journal of Clinical Urology 10, no. 1_suppl (2017): 19–23. http://dx.doi.org/10.1177/2051415816676740.

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Objective: Penile cancer services were centralised in England in 2002. Has this had an impact on treatments for penile cancer and survival? Patients and methods: All cases of penile cancer from 1990 to 2009 were identified from national cancer registry data. Mortality data were obtained from the Office for National Statistics and survival data were extracted from a national population-based database, the Cancer Information System. Socioeconomic deprivation was calculated using a national income deprivation score and surgical treatments were obtained from Hospital Episode Statistics (HES) data. Results: The number of penile cancer cases recorded rose from 300 to 400 per year during the early period of centralisation. There was a significant rise in the age-standardised incidence of penile cancer from 1.2 per 100,000 to 1.4 per 100,000 during this period. Mortality remained stable at 0.3 per 100,000. One-year and five-year relative survival remained stable after centralisation at 88% and 72% respectively. The incidence and mortality of penile cancer was significantly higher in the most deprived quintile of the population. Following centralisation, the number of total penile amputations was low at 11% but only 39% of men were recorded as having lymph node surgery, although this may reflect poor compliance with coding rather than true practice. Conclusions: The incidence of penile cancer in England is rising, but mortality and survival remains stable. Incidence and mortality is higher in more deprived areas, and greater public awareness of this disease and its risk factors are needed. By 2009, rates of penile amputation were low but potentially the proportion of lymph-node surgery remained low. This may change with the uptake of inguinal sentinel lymph-node sampling.

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Grandez-Urbina, J. Antonio, Elizabeth Corrales-Acosta, J. Eduardo Tejeda-Mariaca, Rafael Pichardo-Rodriguez, and Herney Garcia-Perdomo. "Case Report: Penile necrosis associated to paraphimosis with calciphylaxis due to terminal chronic kidney disease." F1000Research 8 (July 19, 2019): 1133. http://dx.doi.org/10.12688/f1000research.18834.1.

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Background: Penile necrosis is a rare condition that may present in patients with diabetes mellitus or chronic kidney disease (CKD). The recommended treatment is controversial. We report a case of penile necrosis in a diabetic patient caused by episode of paraphimosis associated with uremic arteriopathy treated with partial amputation. Clinical Case: A 53-year-old male with a background of arterial hypertension, diabetes mellitus and CKD in hemodialysis. The patient presented with paraphimosis and glans necrosis. An emergency circumcision was carried out. A doppler ultrasound found fluid collection in the left corpus cavernosum, parietal vascular calcifications and vascular insufficiency in the corpus cavernosum that suggested necrosis. A partial amputation of the penis was carried out. After three years of follow-up, the outcome has remained favorable. Conclusions: Penile necrosis is a rare but serious complication of terminal CKD. In these patients, systemic calciphylaxis is usually observed. The main take-away lesson is that a multidisciplinary approach is necessary.

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GREENBERGER, MATTHEW L., and BRUCE A. LOWE. "PENILE STUMP ADVANCEMENT AS AN ALTERNATIVE TO PERINEAL URETHROSTOMY AFTER PENILE AMPUTATION." Journal of Urology 161, no. 3 (1999): 893–94. http://dx.doi.org/10.1016/s0022-5347(01)61799-3.

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Martínez-Piñeiro, L., J. Cisneros, J. López-Tello, T. Pastor, and J. J. de la Peña. "Penile squamous cell carcinoma. Partial penile amputation and inguinal and pelvic lymphadenectomy." European Urology Supplements 1, no. 1 (2002): 192. http://dx.doi.org/10.1016/s1569-9056(02)80745-x.

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Liu, Chan-Jung, Chien-Hui Ou, and Yung-Ming Lin. "Successful penile replantation followig penile self-amputation: Case report and literature review." Urological Science 26, no. 4 (2015): 307. http://dx.doi.org/10.1016/j.urols.2015.11.081.

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Mineo, Michael, Tracie Jolley, and Gabriel Rodriguez. "Leech therapy in penile replantation: a case of recurrent penile self-amputation." Urology 63, no. 5 (2004): 981–83. http://dx.doi.org/10.1016/j.urology.2004.01.019.

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Abhijith, H. M., M. M. Hussain, Mohd Shafiuddin, and Vitthal Prasad Haribhat. "Strangulation Induced Penile Gangrene in a Mentally Challenged Person." Karnataka Journal of Surgery 2 (February 14, 2025): 37–39. https://doi.org/10.25259/kjs_16_2024.

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Penile gangrene is a rare entity, seen most commonly in patients using rings at the root of the penis for erection and rarely with ischaemia from various causes like self-harm, accidents, or assaults. Penoscrotal constriction devices, utilised for sexual enhancement, employ diverse materials. Conversely, penile strangulation, a rare urological emergency, requires swift intervention to prevent severe complications like necrosis. Treatment often demands an early intervention. A mentally challenged 25-year-old boy presented with suspected penile gangrene. Examination revealed multiple rubber bands constricting the base of the penis, causing strangulation. Urgently, the bands were removed in the emergency room (ER). Imaging showed a complete lack of blood flow with gangrenous changes, resulting in urethrocuteneous fistula total penectomy with perineal urethrostomy done. The earliest publication on this condition noted rubber bands as the most common strangulation agents in paediatric cases, with a mean age of 7.5 years. Chronic strangulated partial penile amputation cases are rare, possibly making this report the first. Previously introduced a five-point grading scale for penile strangulation injuries. Penile amputation constitutes a rare urological emergency, necessitating prompt surgical intervention for restoration for cosmetic and functional recovery and erectile capability. Reconstruction efforts should be aimed at every individual case. For those who report late to the ER, it may become difficult to preserve the anatomical and physiological function of the penis. Additionally, psychological support and counselling for affected individuals are crucial aspects of clinical care.

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Srivastava, J. L., V. K. Tiwari, and Pramod Kumar. "Modified Technique of Penile Reconstruction by Gracilis Myocutaneous Flap." Indian Journal of Plastic Surgery 22, no. 01 (1989): 011–14. http://dx.doi.org/10.1055/s-0043-1774339.

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SummaryA modified technique of penile reconstruction by unilateral gracilis myocutaneous flap in three cases of amputation of penis with emphasis on improving the cosmesis of penis is being described.

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Kenenna, Obiatuegwu, Otabor Christopher, Magnus E, Awuzie Chinemezu, and Okonta Emeka. "Penile Gangrene Leading to Penile Amputation: An Unusual Complication of Diabetes in a Patient with Multiple Myeloma." International Journal of Clinical Urology 9, no. 1 (2025): 55–61. https://doi.org/10.11648/j.ijcu.20250901.19.

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&lt;i&gt;Introduction: &lt;/i&gt;Penile gangrene is rare and can pose difficulties in management. Although the penis have a rich arterial supply, they are basically end arteries and arterial occlusion will invariably cause distal necrosis similar to ischemic gangrene often noted in the digits of extremities. It is estimated that around 8–18% of cancer patients have diabetes. Diabetes and multiple myeloma are two overwhelming conditions for both patients and clinicians. In this paper we described our experience with managing penile gangrene in a diabetic patient with multiple myeloma on chemotherapy. Our patient had partial penectomy with refashioning of the penile stump and neo-meatus. &lt;i&gt;Case report&lt;/i&gt;: He is OND, a 54 year old male patient who presented to our facility with difficulty in passing urine and progressive discoloration of glans penis for a week duration. These symptoms were insidious in onset and progressed to involve the penis up to the mid penile shaft. He is a known type 2 diabetic patient with poor control and was recently managed for diabetic ketoacidosis (DKA) by our endocrinologist. He was also diagnosed of multiple myeloma 6 weeks prior to presentation and had commenced his chemotherapy protocol. External genitalia revealed penile swelling with features of gangrene. He was counseled on partial penile amputation with refashioning of penile stump and neo meatus. The immediate postoperative condition was satisfactory. The histological diagnosis was that of benign calcinosis to rule out metastatic calcifications. &lt;i&gt;Conclusion&lt;/i&gt;: Penile gangrene is a hallmark of severe systemic vascular disease. It is rare in clinical practice. Early presentation can result in penile salvage. However with late presentation partial or total penile loss becomes inevitable.

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