Technical Aspects in Penile Replantation: Our Experience in two Cases

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Author(s): Krishna Kumar KS, Amrita Mandal , AjitPati, Saju Narayanan, Ravi Kumar Karunakaran, Surdas R, Sumit More

Pages: 13-19 |

Penis is not only an organ of function but also an organ of masculine identity. Penile amputation may be accidental but is more often intentional and in 87% cases it is self- inflicted.1There are reports of macroscopic penile replantation with variable success in the literature.2 Currently, microsurgical replantation is the accepted standard of treatment although there is still controversy on the structures that should be repaired.3 Objectives: To assess the outcome of microsurgical penile replantation done in two cases of near total amputation of penis, attached by a small skin tag and review the literature. Patients: Two cases of near total amputation penis, attached only by a small skin tag came to our emergency. Penile replantation was done by microsurgical repair of the dorsal arteries, vein and nerves in both the cases and cavernosalarteries in the first case. Result: The postoperative recovery of the first case was uneventful. The second case had complication of minor proximal skin necrosis which needed to be skin grafted. The first patient was followed up for 3 years and the second for 8 months. Both had normal micturition and acceptable appearance. Morning erection occurred in both patients and the second patient reported successful intromission at 4 months postoperatively. Conclusion: Microsurgical penile replantation is the standard of care and timely meticulous repair can give near normal function and appearance. Repair of cavernosal arteries does not necessarily have a bearing on erection and sexual function at least in distal amputations. When amputation is at a proximal level and technically feasible, caver nosa larteries’ anastomosis should be attempted