Subscribe to RSS
DOI: 10.1055/s-0034-1383427
Microvascular Penile Replantation Utilizing the Deep Inferior Epigastric Vessels
Publication History
10 March 2014
22 April 2014
Publication Date:
04 July 2014 (online)
![](https://www.thieme-connect.de/media/jrm/201408/lookinside/thumbnails/10.1055-s-0034-1383427-1.jpg)
Traumatic penile amputation is an uncommon occurrence described in psychiatric patients with acute psychosis, but can also be a consequence of accidents, circumcision, assault or domestic violence.[1] [2] [3] [4] It is likely that most plastic surgeons will not treat this problem during their careers.[5] The majority of amputations are secondary to self-mutilation with 87% of cases related to psychosis.[6] The desire to keep the penis is usually present once the acute psychotic episode resolves.[1]
The goals of penile replantation are to restore urinary and sexual functions[1] [2] and minimize psychological sequela.[2] Over the decades the paradigm in treatment of these injuries has shifted from simple reattachment to using microsurgery. A variety of techniques have been described,[3] however, it is widely accepted that microsurgery is required to maximize tissue preservation and decrease complications.[1] [2] [3] [7] [8] Composite grafts frequently result in skin necrosis, urethral stricture, impotence or total-graft failure.[2]
We present a case of successful penile microvascular replantation with the utility of the deep inferior epigastric vessels after a self-inflicted amputation. This novel technique has not previously been reported in literature.
Note
None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this article.
-
References
- 1 Roche NA, Vermeulen BT, Blondeel PN, Stillaert FB. Technical recommendations for penile replantation based on lessons learned from penile reconstruction. J Reconstr Microsurg 2012; 28 (4) 247-250
- 2 Chou E-K, Tai YT, Wu CI, Lin MS, Chen HH, Chang SC. Penile replantation, complication management, and technique refinement. Microsurgery 2008; 28 (3) 153-156
- 3 Babaei AR, Safarinejad MR. Penile replantation, science or myth? A systematic review. Urol J 2007; 4 (2) 62-65
- 4 Guizhong L, Feng H, Guangling H, Libo M, Kun L, Yuming S. Management of penile defects: a review. J Reconstr Microsurg 2012; 28 (5) 293-296
- 5 Zenn MR, Carson III CC, Patel MP. Replantation of the penis: a patient report. Ann Plast Surg 2000; 44 (2) 214-220
- 6 Salehipour M, Ariafar A. Successful replantation of amputated penile shaft following industrial injury. Int J Occup Environ Med 2010; 1 (4) 198-200
- 7 Razzaghi MR, Rezaei A, Mazloomfard MM, Javanmard B, Mohammadhosseini M, Rezaei I. Successful macrosurgical reimplantation of an amputated penis. Urol J 2009; 6 (4) 306-308
- 8 Salem HK, Mostafa T. Primary anastomosis of the traumatically amputated penis. Andrologia 2009; 41 (4) 264-267
- 9 Naraynsingh V, Harnarayan P, Hariharan S. Successful penile replantation using loupe magnification. Int Urol Nephrol 2011; 43 (2) 437-439