AB026. Penile amputation and replantation: from etiology to management

Background and Objective: Although penile amputation is a rare urologic emergency, it carries major functional and psychological consequences in regard to the overall quality of patients life. Due to the complexity of the male genitalia, penile reconstructive surgery always poses a challenge to the urologists. Lots of developments in the management of penile fracture and penile reconstruction have been made in recent years. Herein, we analyze the aspects, managements and outcomes of this urological injury. To analysize the managements of penile amputation and microsurgical replantation.

Methods and Main Outcome Measures: Three patients, who were presented in our university-affiliated urological department and were with penis amputations as a result of felonious assault, accidental trauma, or circumcision, were included in the current study. They immediately underwent extensive reconstructive replantation of the penis performed jointly by plastics and urological teams reattaching all visible neurovascular bundles, urethra, and corporal and fascial layers. The anatomical form and sexual and urologic functions of the penis was evaluated independently following operations. Meanwhile, we reviewed the most significant literatures published in the past 10 years based on a non-structured PubMed search. To review the current published literatures and case reports on the management of penile amputation, with particular emphasis on its etiology, surgical repairs, potential complications and functional outcomes.

Results: The three patients with penile amputation had successful outcomes of microscopic replantation. We reviewed the corresponding literatures and discussed the possible reasons, with particular comments on surgical managements.

Conclusions: Even with some defects, the microsurgical replantation for penile amputation is currently useful based on both our experiences and other reports. We suggest that every attempt should be made to take microsurgical penile replantation into consideration at the first medical reception, if possible.

Keywords: Penis amputation; microsurgical; reconstructive replantation; medical management