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) · Urology · n=1
Детали доказательств RCTСсылка на исследование
GRADE Очень низкаяНедостаточно доказательствСостояние: Microsurgical Replantation (Digit / Ear / Scalp) →
Характеристика исследования
- Дизайн
- single-patient case report (28-day-old neonate, Hospital for Sick Children, Toronto)
- Размер выборки (n)
- 1
- Вмешательство
- Microvascular replantation of complete penile midshaft amputation with postoperative leech therapy, topical heparin, and caudal analgesia
- Компаратор
- No control - case report
- Первичная конечная точка
- Penile survival, replantation success, neonatal pain control
- Основной результат
- Successful microvascular replantation with multimodal postoperative management; leech therapy combined with topical heparin and caudal analgesia for neonatal pain control
- Длительность наблюдения
- Postoperative hospitalization with outpatient follow-up
- PMID
- 35263644
Ключевые выводы
- Successful penile midshaft replantation in 28-day-old neonate
- Combined leech therapy + topical heparin + caudal analgesia protocol
- Multimodal anticoagulant strategy
- Pain control optimized for neonatal tolerability
- Builds on Banihani 2014 (7-day-old penopubic replant)
Ограничения
- Single case - no generalizable conclusions
- Cannot attribute success to specific component of multimodal protocol
- Limited long-term functional follow-up
- Selection bias toward salvageable cases
- Subjective pain assessment in neonate
Клиническое значение
Mousa 2022 advances neonatal penile replantation by integrating caudal analgesia for pain control alongside leech therapy and topical heparin. For US clinicians under K040187, the case illustrates how leech therapy fits into broader perioperative protocols for pediatric replantation. The multimodal approach is consistent with contemporary regional anesthesia practice in pediatrics.
Связанные исследования
Successful Microsurgical Replantation of Amputated Penis: A Case Report and Review of Literature
Akhoondinasab MR, Farahmand HR, Zahedi A, Saraee A (2023)
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)
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)