Surgical management of constrictive penile tie with urethrocutaneous and corporeal mutilation

ABSTRACT

Due to interference of non-medical personal in circumcision as well as abarrent psychosexual behavior complications in the form of constrictive penile tie with urethrocutaneous slough and variable degrees of corporeal wasting and mutilation was encountered. Since 1990-1997, 18 patients with such a condition has been surgically corrected. 14 patients presented as postcircumcision complication by traditional circumcisers while 4 patients had altered psychosexual behavior with self-induced genital mutilation. All patients had urethrocutaneous sloughing and corporeal wasting ranging from minor to severe. Seven patients had severe corporeal wasting in such a way that the distal penile segment and glans was hanging by a very narrowstrip of tissues. End to end urethral anastomosis and skin refashioning was done to all patients. Patients with severe degree of corporeal wasting were subjected to trimming and reaproximation of the corporeal bodies. Two patients developed stricture at site of anastomosis managed by endoscopic urethrotomy, one patient developed fistula that required repair and one patient had mild ventral skin chordee that required no intervention. All our patient had achieved satisfactory functional and cosmetic results: