Microvascular Penile Replantation Utilizing the Deep Inferior Epigastric Vessels

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

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