American Society of Hirudotherapy

Leech therapy in penile replantation: a case of recurrent penile self-amputation

Research article published in Urology (2004)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportClinical TrialsMineo M, Jolley T, Rodriguez G · Urology, 2004

Abstract

Penile amputation is a rare urologic trauma for which immediate surgical replantation is indicated. Microsurgical techniques can reduce skin and graft loss complications; nonetheless, such complications are still highly prevalent. We report a case of self-inflicted penile amputation and describe a nonmicrosurgical technique for replantation. To improve postoperative edema due to venous congestion, we applied medicinal leeches to the penis. The edema quickly resolved, but overlying skin loss occurred, which required superficial debridement. At follow-up the patient had glans re-epithelialization with normal voiding, sensation, and erections. To our knowledge, this is the first reported case of nonmicrosurgical penile replantation with leech therapy.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeCase ReportsJournal ArticleReview
Indexed MeSH termsAdultDebridementEatingEdemaHumansLeechingMalePenile DiseasesPenisPostoperative ComplicationsRecurrenceReplantation

Summary

Penile amputation is a rare urologic trauma for which immediate surgical replantation is indicated. Microsurgical techniques can reduce skin and graft loss complications; nonetheless, such complications are still highly prevalent.

Why This Matters for Hirudotherapy

This case report describes a single instance of self-inflicted penile amputation managed with nonmicrosurgical replantation, in which medicinal leeches were applied to the penis to address postoperative edema caused by venous congestion. The abstract reports that edema quickly resolved following leech application, although overlying skin loss required superficial debridement; at follow-up, the patient showed glans re-epithelialization with normal voiding, sensation, and erections. For hirudotherapy, the case provides a direct clinical example of leech application in the setting of tissue replantation complicated by venous congestion, a context in which leech-mediated bleeding is a physiologically plausible mechanism for temporary venous drainage. However, as a single case report that the authors identify as the first of its kind, it offers only one clinical observation with no comparative data, and it cannot establish the efficacy, safety, or generalizability of leech therapy for penile or other replantation outcomes.

Citation

Leech therapy in penile replantation: a case of recurrent penile self-amputation.

Mineo M, Jolley T, Rodriguez G · Urology, 2004

Added to ASH library: March 18, 2026 · Site last updated: June 18, 2026

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.