Successful Reconstruction of the Penile Skin Loss Using a Scrotal Flap as a Result of Complete Resection Following a Traditional Circumcision: A Case Report

Abstract

Background: Circumcision is the oldest and most common surgical procedure in the world. One out of three adult males is subjected to this procedure at some point in their lives. Circumcision is done for different reasons, most often to meet religious and/or cultural obligations. Though rare, there exist medical indications for this procedure. As in all surgical procedures, there are early or late complications or morbidities associated with circumcision ranging from mild to severe. The factors that influence the rate of occurrence of complications include: the surgical technique applied, the degree of asepsis during the procedure, and the expertise of the practitioner carrying out the procedure. Case Presentation: This is the case of a 20-year-old black male. He presented in the emergency department of the Douala Laquintinie Hospital (DLH) two hours after circumcision with persistent bleeding from the penile wound. This was performed by a traditional healer using the technique of guillotine. Examination of the external genitalia revealed a wound on the penis with loss of skin over the whole penile shaft. Under spinal anesthesia, a reconstruction intervention which involved a single step scrotal skin flap advancement over the penile shaft was done. We noted satisfactory healing process with a pleasing aesthetic appearance of the penis. He confirmed satisfactory penile erection and sexual activity two months after hospital discharge. Conclusion: Circumcision is a simple surgical procedure that can result to life threatening complications or high morbidity more often when performed by an unskilled practitioner. Education of the population on the safer sites of circumcision can help in the prevention and early management of complications.