American Society of Hirudotherapy

Leeches and Caudal Analgesia After Replantation for Glans Amputation During Neonatal Circumcision

Research article published in Urology (2022)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportClinical TrialsMousa et al. · Urology, 2022

Abstract

Neonatal circumcision is one of the most commonly performed surgical procedures in the world. As with all surgeries, it carries risks, including rare, but devastating complications, such as glans, and/or penile shaft amputation. Complete glans amputation with successful replantation has been previously reported. Herein we report a case of complete amputation at the penile midshaft in a 28-day-old neonate with a unique approach to postoperative care including the use of leech therapy, topical heparin, and caudal analgesia following successful microvascular replantation.

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

Publication typeCase ReportsJournal Article
Indexed MeSH termsAmputation, SurgicalAmputation, TraumaticAnalgesiaAnimalsCircumcision, MaleHumansInfant, NewbornLeechesMalePenisReplantation

Summary

Peer-reviewed clinical and outcomes research relevant to medicinal leech therapy and its biology. Indexed in PubMed and verified against the NCBI record.

Why This Matters for Hirudotherapy

This case report describes complete penile midshaft amputation during neonatal circumcision in a 28-day-old infant, managed with successful microvascular replantation followed by a postoperative regimen that included leech therapy, topical heparin, and caudal analgesia. It is directly relevant to hirudotherapy as a documented adjunct for relieving venous congestion and supporting flap/replant survival, here in an exceptionally delicate neonatal genital reconstruction. Caveat: this is a single case report describing a rare complication and a combined treatment approach, so it illustrates feasibility in one patient and cannot, on its own, establish the independent efficacy or safety of leech therapy in this setting.

Citation

Leeches and Caudal Analgesia After Replantation for Glans Amputation During Neonatal Circumcision.

Mousa et al. · Urology, 2022

Added to ASH library: May 28, 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.