Glanuloplasty with Oral Mucosa Graft following Total Glans Penis Amputation.

Kwaku Appiah,Kwaku Otu-Boateng,Douglas Arthur,Edwin Yenli,Issac Opoku Antwi,George Amoah,Patrick Maison,Baah Nyamekye,Kofi Gyasi-Sarpong,Benjamin Twumasi-Frimpong,Roland Azorliade,Ken Aboah

doi:10.1155/2014/671303

Kwaku Appiah, Kwaku Otu-Boateng + Show 10 more

Open Access

https://doi.org/10.1155/2014/671303

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Abstract

This is a report on the technique of neoglans reconstruction in a patient with amputated glans penis following guillotine neonatal circumcision. A 4 cm long and 2 cm wide lower lip oral mucosa graft was harvested and used to graft the distal 2 cm of the corporal bodies after 2 cm of the distal penile skin had been excised. One edge of the lower lip oral mucosa graft was anastomosed to the urethral margins distally and proximally to the skin. At six months of followup, patient had both satisfactory cosmetic and functional outcomes.

Highlights

Circumcision is the commonest operation performed on young boys [1]
In Ghana, circumcision is regarded as a customary ritual and is mostly done by nurses, the traditional circumcisionist (Wanzam) with medical doctors being involved less often
In our center, unpublished data on 72 cases of circumcision injuries over a two-year period reveals that urethrocutaneous fistula accounts for 77.8% with penile amputation accounting for 6.9% of all injuries

Summary

Introduction

Circumcision is the commonest operation performed on young boys [1]. Like any other operation, it is not without complications and that can range from trivial to the most tragic [2]. In Ghana, circumcision is regarded as a customary ritual and is mostly done by nurses, the traditional circumcisionist (Wanzam) with medical doctors being involved less often. This is probably due to the high patient to doctor ratio making the doctors shirk this responsibility to untrained personnel. We present a case report of the use of oral mucosa graft in neoglans reconstruction in a boy with total glans penis amputation following circumcision which can guarantee long term urethral opening and acceptable cosmesis and prevent further shortening of the penis. Oral mucosa grafts have been used in urethral reconstruction In recent times, it has been used for resurfacing of the glans penis or reconstructing a neoglans penis after partial or total glansectomy for penile cancers [11]. Utilized in the management of traumatic glans penis amputations following circumcision in late presentations as has been done in cancer associated glansectomies

Case Report

Description of the Surgical Procedure

Results

Discussion

Conclusion

Conflict of Interests