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Functional penile replantation after traumatic avulsion amputation below the pubis: A case report
Author(s) -
Elmaraghi Shady,
Chen Tzujane Jenny,
Heckman Jennifer E.,
Shiau Jonathan M.,
Williams Daniel H.,
Abel E. Jason,
Afifi Ahmed M.
Publication year - 2020
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.30425
Subject(s) - medicine , avulsion , replantation , surgery , avulsion injury , degloving , penis , amputation , crush injury , microsurgery
Penile amputation is a rare injury with significant posttraumatic ramifications. We present a case of successful immediate replantation after traumatic penile avulsion in a 52‐year‐old male patient. The patient reported his penis was caught in machinery during a boating accident, and avulsed at the level of the pubis. Immediate replantation of this proximal avulsion injury with no suitable proximal arterial stumps required transfer of the superficial inferior epigastric artery for arterial inflow. One artery and two veins were repaired. The urethral injury was found to be immediately distal to the urethral sphincter in the membranous portion, and repaired primarily. Urinary diversion was performed with a suprapubic catheter until the repair had healed. The postoperative course was complicated by less than 10% skin necrosis requiring skin grafting. At three years follow up, the patient has a penis with normal urinary function and is able to obtain erections with pharmacologic aids. Avulsion should not preclude penile replantation, which may have acceptable functional and esthetic results.