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) · Urology · n=1
RCT evidence detailTrial reference
Study Profile
- Design
- single-patient case report (7-day-old neonate, Children's Hospital of Pittsburgh of UPMC)
- Sample size (n)
- 1
- Intervention
- Microvascular replantation of completely amputated penis at penopubic junction (Mogen clamp injury during circumcision) with postoperative leech therapy
- Comparator
- No control - single case report
- Primary endpoint
- Penile salvage and functional restoration
- Primary result
- First reported neonatal penile amputation replantation with postoperative leech therapy; successful tissue survival with leech-mediated venous decongestion
- Follow-up duration
- Postoperative hospitalization with subsequent outpatient follow-up
- PMID
- 24928459
Key Findings
- First reported neonatal penile leech therapy for replantation
- Mogen clamp circumcision complication context
- Successful tissue survival with leech-mediated venous decongestion
- Penopubic junction amputation level
- Documents US K040187 application in 7-day-old patient
Limitations
- Single case - no generalizable conclusions
- Limited long-term follow-up reporting
- Functional outcomes uncertain at age 7 days
- Cannot quantify leech vs surgical contribution
- Extreme age limits protocol transfer
Clinical Implications
Banihani 2014 documents the youngest reported leech therapy patient in penile replantation literature. For US clinicians under K040187, the case demonstrates feasibility of the device indication in neonates but raises proportional dose/duration questions. The Mogen clamp circumcision complication context highlights leech therapy's role in iatrogenic injury salvage.
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