Leeches and Caudal Analgesia After Replantation for Glans Amputation During Neonatal Circumcision
Mousa A, Keefe DT, Wong K, Davidge K, Lorenzo AJ, Dos Santos J (2022) · Urology · n=1
RCT-EvidenzdetailsStudienreferenz
Studienprofil
- Design
- single-patient case report (28-day-old neonate, Hospital for Sick Children, Toronto)
- Stichprobengröße (n)
- 1
- Intervention
- Microvascular replantation of complete penile midshaft amputation with postoperative leech therapy, topical heparin, and caudal analgesia
- Komparator
- No control - case report
- Primärer Endpunkt
- Penile survival, replantation success, neonatal pain control
- Primäres Ergebnis
- Successful microvascular replantation with multimodal postoperative management; leech therapy combined with topical heparin and caudal analgesia for neonatal pain control
- Follow-up-Dauer
- Postoperative hospitalization with outpatient follow-up
- PMID
- 35263644
Wichtigste Ergebnisse
- Successful penile midshaft replantation in 28-day-old neonate
- Combined leech therapy + topical heparin + caudal analgesia protocol
- Multimodal anticoagulant strategy
- Pain control optimized for neonatal tolerability
- Builds on Banihani 2014 (7-day-old penopubic replant)
Einschränkungen
- Single case - no generalizable conclusions
- Cannot attribute success to specific component of multimodal protocol
- Limited long-term functional follow-up
- Selection bias toward salvageable cases
- Subjective pain assessment in neonate
Klinische Implikationen
Mousa 2022 advances neonatal penile replantation by integrating caudal analgesia for pain control alongside leech therapy and topical heparin. For US clinicians under K040187, the case illustrates how leech therapy fits into broader perioperative protocols for pediatric replantation. The multimodal approach is consistent with contemporary regional anesthesia practice in pediatrics.
Verwandte Studien
Successful Microsurgical Replantation of Amputated Penis: A Case Report and Review of Literature
Akhoondinasab MR, Farahmand HR, Zahedi A, Saraee A (2023)
Complete penile amputation during ritual neonatal circumcision and successful replantation using postoperative leech therapy
Banihani OI, Fox JA, Gander BH, Grunwaldt LJ, Cannon GM (2014)
Penile Replantation: A Review of Microsurgical Techniques, Patient Outcomes, and Solutions to Complex Reconstructive Challenges
Arbel EJ, Reese AD, Richards R, Singh S, O'Shea AW, Hennig F, Abramowitz D (2024)
Medicinal Leech Therapy in Urology: A PRISMA-Compliant Systematic Review
Battin AO, Hobeika N, Zdilla MJ (2023)