ABSTRACT
Self-castration and penile amputation are rare life-threatening types of genital self-mutilation. The microsurgical technique of penile replantation is the gold standard; however, there are conflicting reports of successful macrosurgical penile replantations. Being rare, this condition may even be mistaken as criminal genital mutilation. The surgical management of penile amputation evolves over a few case reports and case series; therefore, it is prudent to publish such rare phenomena to make more awareness among the clinicians to initiate prompt and effective treatment. We report a case of self-multiple penile amputations and castration in a 70-year-old man suffering from bipolar disorder who also had failed macrosurgical penile replantation. To the best of our knowledge, this is the first case of self-multiple penile amputation with castration reported in the literature. Although ours is a single case experience, yet the macrosurgical replantation in multiple penile amputations is likely to be unsuccessful
ABSTRACT
Vesicouterine fistula (VUF) is a rare urogenital fistula that is even rarer during pregnancy. Even if pregnancy occurs, the outcomes appear to be very poor. The most of the cases are related to iatrogenic bladder injury during cesarean section. There is very limited literature on the pregnancy with VUF associated with herniation of fetus or fetal part(s) into the bladder cavity. Here, we report a case of pregnancy in a known case of untreated VUF. She presented at 23 weeks of gestation with features of premature rupture of membrane and herniation of fetal left lower limb inside the bladder cavity. Her pregnancy ended up with hysterotomy and the removal of a non-viable fetus along with the repair of the fistula. Hence, regardless of the severity of the signs and symptoms associated with VUF, clinicians should convince the patients for the repair of the fistula especially if the future pregnancy is contemplated