Successful Microsurgical Replantation of Amputated Penis: A Case Report and Review of Literature
Akhoondinasab MR, Farahmand HR, Zahedi A, Saraee A (2023) · World Journal of Plastic Surgery · n=1
Study Profile
- Design
- case report of microsurgical penile replantation with postoperative leech therapy (Iran University of Medical Sciences, Tehran)
- Sample size (n)
- 1
- Intervention
- Microsurgical replantation of completely amputated penis after 9 hours ischemia; postoperative leech therapy 3 sessions (30 minutes each, leeches detached spontaneously) for venous congestion
- Comparator
- No control - case report
- Primary endpoint
- Penile survival, restoration of vascular and sensory function, limb-equivalent functional preservation
- Primary result
- Successful replantation with limited and predictable necrosis at penoscrotal junction (debrided and skin grafted); complete vascular and sensory restoration; psychiatric follow-up arranged for self-mutilation patient
- Follow-up duration
- Postoperative hospitalization + outpatient follow-up
- PMID
- 38226201
Key Findings
- Successful penile replantation after 9-hour ischemia
- Three sessions of leech therapy for venous congestion control
- Complete vascular and sensory recovery
- Predictable, limited necrosis only at penoscrotal junction
- Integrated psychiatric care for self-mutilation patient
Limitations
- Single case - hypothesis-generating only
- Cannot generalize from psychiatric self-mutilation context
- 9-hour ischemia uniquely long
- No long-term functional outcomes assessed
- Standard practice does not differ from non-leech penile replants
Clinical Implications
Akhoondinasab 2023 confirms leech therapy utility in penile microsurgical replantation - a rare but high-stakes K040187 indication. For US clinicians, the case reinforces that the device's primary US indication (venous congestion in flap-based reconstruction) extends to atypical genitourinary trauma. Early leech initiation (postoperative day 2) and self-detachment endpoint (30 minutes) align with standard protocols.
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