Abstract
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.
Highlights
Penile amputation can present as an isolated injury or as part of an extensive perineal trauma requiring intensive care unit admission
The original approach for penile replantation, which was first described in the late 1920’s by Ehrich, was a macrosurgical technique that focused on aligning the major structures of the penis including the urethra, corpora spongiosa, corpora cavernosa, and glandular epithelium [4, 5]
The macrosurgical technique has higher rates of complications including skin necrosis, sensation deficits, erectile dysfunction, urethral strictures, and fistula formation when compared with the microsurgical approach [2,3,4]
Summary
Penile amputation can present as an isolated injury or as part of an extensive perineal trauma requiring intensive care unit admission. The original approach for penile replantation, which was first described in the late 1920’s by Ehrich, was a macrosurgical technique that focused on aligning the major structures of the penis including the urethra, corpora spongiosa, corpora cavernosa, and glandular epithelium [4, 5]. This approach is dependent on the corporal sinusoidal blood flow [4]. The second case is a 12-year-old boy who had his glans bitten off by a dog These rare and unusual mechanisms of penile amputation highlight differences in the management, complications, and reconstructive possibilities
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