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Med J Bakirkoy. 2009; 5(3): 123-126


Microsurgical reimplantantion of a self-amputated penis with anastomosis of a single deep dorsal penile artery: Case report

Necati Gürbüz, Bedi Özbay, Nadir Kalfazade, Serdar Karadağ, Eray Kemahlı, Muzaffer Baş, Ali İhsan Taşçı.

Abstract
Microsurgical penile reimplantation was performed in a 24 years old man with chronic schizophrenia after a complete penile self-amputation. Urethra, corpora cavernosa and right deep dorsal penile artery were anastomosed microsurgically 6 hours after trauma. Skin necrosis on postoperative day 4 and distal urethral defect at the end of the first week developed. Necrotic tissues were debrided and a free skin graft was laid on the defect. During long-term follow-up, there was a distal urethral defect which was 1.5 cm in length, the sensation was decreased on distal penile shaft and glans and penile length was also shortened. The patient had morning erections, but he has not attempted sexual intercourse. We have observed rigid erection continuing for 10 minutes with combined injection stimulation test.

Key words: Penile amputation, penile reimplantation, microsurgical reimplantation



Otoampüte bir penisin tek derin dorsal arterin mikrocerrahi anastomozu ile reimplantasyonu: Olgu sunumu

Özet
Kronik şizofrenik 24 yaşında bir hastada komplet penis otoamputasyonu sonrası mikrocerrahi ile penil reimplantasyon yapıldı. Travmadan 6 saat sonra mikrocerrahi onarımla üretra, korpus kavernosumlar ve sağ derin dorsal arterin anastomozu yapıldı. Postoperatif 4. gün cilt nekrozu ve 2. haftanın sonunda distal üretral defekt gelişti. Nekrotik dokular serbest cilt grefti ile onarıldı. İzlemde 1.5 cm uzunluğunda distal üretral defekt vardı, distal penil şaftta ve glansta duyum azalmıştı ve penisin uzunluğu kısalmıştı. Hastanın sabah ereksiyonları vardı, ama cinsel ilişkiyi denememişti. Kombine enjeksiyon stimülasyon testinde 10 dakika süren rijid ereksiyon gözlendi.

Anahtar Kelimeler: Penil amputasyon, penil reimplantasyon, mikrocerrahi reimplantasyon



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