Successful Microsurgical Replantation of Amputated Penis: A Case Report and Review of Literature
Case report published in World J Plast Surg (2023)
Abstract
This study aims to explain microscopic replantation in a rare case of a wholly amputated penis after prolonged ischemia. A 36-year-old patient underwent microscopic replantation of the penis after 9 hours. The penis was completely amputated due to self-mutilation. Microvascular replantation was performed after pre-operative preparation. On the second day after surgery, congestion was observed in the penis, and three sessions of leech therapy were conducted each time the leeches were placed for 30 minutes and then detached by themselves. The patient was referred to a psychiatrist to continue treatment after discharge from the hospital. Penile amputation is a rare situation and has different causes. There are various treatments to repair the amputated penis, which are both microvascular and microvascular. The microsurgery methods have shown the best results. In the present case, due to microsurgical artery repair and the early start of leech therapy, there was limited and predictable necrosis in the area of the penoscrotal junction flap, which underwent debridement and skin graft. Complete amputation of the penis is a rare phenomenon. Efforts should be made to perform the replantation surgery as soon as possible. The venous outflow is an essential factor in the success of penile re-implantation, and completely restored vascular and sensory function in this case. Early initiation of psychological care to control underlying disease leads to further cooperation of the patient to handle complications and avoid the recurrence of self-injury.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Case of a 36-year-old patient with self-inflicted penile amputation undergoing microscopic replantation after 9 hours of ischemia. Three sessions of leech therapy applied for postoperative congestion management; complete sensory and vascular recovery achieved.
Why This Matters for Hirudotherapy
This case report describes microsurgical replantation of a completely amputated penis after 9 hours of ischemia in a 36-year-old patient. On postoperative day 2, penile congestion developed, and three sessions of medicinal leech therapy were applied (30 minutes each, with leeches detaching spontaneously). The authors attribute limited and predictable necrosis at the penoscrotal junction flap — managed with debridement and skin graft — to the combination of microsurgical arterial repair and early initiation of leech therapy, with complete restoration of vascular and sensory function. For ASH's domain, this illustrates a classic salvage indication for hirudotherapy: relief of venous congestion following microvascular replantation where venous outflow is compromised. The honest caveat is that this is a single case report with no control group; while leech therapy is described as beneficial, its contribution relative to surgical repair cannot be isolated, and no outcomes beyond this one patient are presented.
Citation
Successful Microsurgical Replantation of Amputated Penis: A Case Report and Review of Literature.
Akhoondinasab MR et al. · World journal of plastic surgery, 2023
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