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
Характеристика исследования
- Дизайн
- case report of microsurgical penile replantation with postoperative leech therapy (Iran University of Medical Sciences, Tehran)
- Размер выборки (n)
- 1
- Вмешательство
- Microsurgical replantation of completely amputated penis after 9 hours ischemia; postoperative leech therapy 3 sessions (30 minutes each, leeches detached spontaneously) for venous congestion
- Компаратор
- No control - case report
- Первичная конечная точка
- Penile survival, restoration of vascular and sensory function, limb-equivalent functional preservation
- Основной результат
- 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
- Длительность наблюдения
- Postoperative hospitalization + outpatient follow-up
- PMID
- 38226201
Ключевые выводы
- 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
Ограничения
- 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
Клиническое значение
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.
Связанные исследования
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)
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)