American Society of Hirudotherapy

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
GRADE Very LowInsufficient evidenceCondition: Microsurgical Replantation (Digit / Ear / Scalp) →
Sample size of this trial compared with other Microsurgical Replantation (Digit / Ear / Scalp) trialsArbel EJ 202446Battin AO 202312Hong Ha N 20254van Alphen NA 20142Banihani OI 20141Akhoondinasab MR 20231Mousa A 20221Mendenhall SD 20161Momeni A 20141Senchenkov A 20131
This trial (highlighted) by sample size alongside other indexed Microsurgical Replantation (Digit / Ear / Scalp) trials. Larger trials generally carry more statistical weight.

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.

Related Trials

Successful Microsurgical Replantation of Amputated Penis: A Case Report and Review of Literature

Akhoondinasab MR, Farahmand HR, Zahedi A, Saraee A (2023)

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)

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)

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This website provides educational information and does not constitute medical advice, diagnosis, or treatment recommendations. Medicinal leech therapy carries clinically meaningful risks and should be performed only by qualified clinicians under institutionally approved protocols. FDA 510(k) clearance for medicinal leeches is limited to specific indications; investigational and off-label discussions are labeled accordingly. For patient-specific guidance, consult a qualified healthcare provider.