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Iatrogenic penile glans amputation: major novel reconstructive procedure.

Nasr R, Traboulsi SL, Abou Ghaida RR, Bakhach J - Case Rep Urol (2013)

Bottom Line: Even though it is relatively safe, it is not a complication-free procedure.Postoperative followup to 90 days is illustrated.Surgical reconstruction is possible with varying satisfactory results.

View Article: PubMed Central - PubMed

Affiliation: Division of Urology, Surgery Department, American University of Beirut, P.O. Box 11-0236 Riad El Solh, Beirut 1107 2020, Lebanon.

ABSTRACT
Circumcision is a very common urological practice. Even though it is relatively safe, it is not a complication-free procedure. We describe a patient that underwent a neonatal circumcision complicated by iatrogenic complete glans amputation. Reconstructive repair of a neoglans using a modified traditional method was used. Postoperative followup to 90 days is illustrated. Despite being a simple procedure, circumcision in unprofessional hands can have major complication impacting the emotional and sexual life of patients. Surgical reconstruction is possible with varying satisfactory results.

No MeSH data available.


Related in: MedlinePlus

The rectus muscle flap with the distal penile shaft.
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fig5: The rectus muscle flap with the distal penile shaft.

Mentions: The patient was put in the supine position and the whole abdomen and genitalia till the lower thighs were scrubbed and draped. A Z-plasty incision was done dorsally and ventrally at the base of the penis (Figure 2), and dissection of the corpora cavernosa from the inferior pubic bone was done (Figure 3). The dorsal vein was ligated, the suspensory ligament was cut, the corpora were sutured to each other, and the suspensory ligament was reattached to a more proximal part of tunica taking care not to injure the neurovascular bundle. To give more length to the stump, we performed Liposuction of the mons pubis and the penile base. The scar tissue at the tip of penile stump was dissected and (as done by Shaeer et al.) a neourethra was fashioned by tubularizing the distally degloved foreskin over a 14 Fr foley catheter (Figure 4). Through a Pfannenstiel incision, a rectus abdominis flap of 4 × 12 cm was harvested with preservation of the deep epigastric neurovascular supply (Figure 5) and was tunneled under the skin of the suprapubic area and the penile shaft skin to reach the area of the neoglans (Figure 6). The flap was covered with a split thickness skin graft harvested from the hairless left anterior thigh.


Iatrogenic penile glans amputation: major novel reconstructive procedure.

Nasr R, Traboulsi SL, Abou Ghaida RR, Bakhach J - Case Rep Urol (2013)

The rectus muscle flap with the distal penile shaft.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3860129&req=5

fig5: The rectus muscle flap with the distal penile shaft.
Mentions: The patient was put in the supine position and the whole abdomen and genitalia till the lower thighs were scrubbed and draped. A Z-plasty incision was done dorsally and ventrally at the base of the penis (Figure 2), and dissection of the corpora cavernosa from the inferior pubic bone was done (Figure 3). The dorsal vein was ligated, the suspensory ligament was cut, the corpora were sutured to each other, and the suspensory ligament was reattached to a more proximal part of tunica taking care not to injure the neurovascular bundle. To give more length to the stump, we performed Liposuction of the mons pubis and the penile base. The scar tissue at the tip of penile stump was dissected and (as done by Shaeer et al.) a neourethra was fashioned by tubularizing the distally degloved foreskin over a 14 Fr foley catheter (Figure 4). Through a Pfannenstiel incision, a rectus abdominis flap of 4 × 12 cm was harvested with preservation of the deep epigastric neurovascular supply (Figure 5) and was tunneled under the skin of the suprapubic area and the penile shaft skin to reach the area of the neoglans (Figure 6). The flap was covered with a split thickness skin graft harvested from the hairless left anterior thigh.

Bottom Line: Even though it is relatively safe, it is not a complication-free procedure.Postoperative followup to 90 days is illustrated.Surgical reconstruction is possible with varying satisfactory results.

View Article: PubMed Central - PubMed

Affiliation: Division of Urology, Surgery Department, American University of Beirut, P.O. Box 11-0236 Riad El Solh, Beirut 1107 2020, Lebanon.

ABSTRACT
Circumcision is a very common urological practice. Even though it is relatively safe, it is not a complication-free procedure. We describe a patient that underwent a neonatal circumcision complicated by iatrogenic complete glans amputation. Reconstructive repair of a neoglans using a modified traditional method was used. Postoperative followup to 90 days is illustrated. Despite being a simple procedure, circumcision in unprofessional hands can have major complication impacting the emotional and sexual life of patients. Surgical reconstruction is possible with varying satisfactory results.

No MeSH data available.


Related in: MedlinePlus