Total amputation of Penis and left testis; case report

ABSTRACT

Penile amputation is one of the rare complications of genitourinary tract injuries. Most cases of penile amputation are the result of self mutilation in patients suffering from psychiatric diseases. Penile amputation with less common causes is accidental trauma and felonious assault. In this paper we present a case with total amputation of penis and left testis who was treated by a complete team of surgery. A 44 year old man who was injured by combine farm machine and developed total penile amputation from the base and total amputation of left testis from spermatic cord in inguinal area. Patient with hypovolemic shock due to severe bleeding was admitted to emergency ward. After resuscitation of patient and stabilization of vital signs he underwent open cystostomy, perineal urethrostomy and right testis fixation based on severity of trauma, necrosis of amputated segment and nonvisualization of proximal of penis. Now, patient has complete urinary continence and is candidated for penile prosthesis or repair via radius or gracilis muscles but he refuses this procedure. However total amputation of penis and testis in accidental trauma is very rare, a complete surgical team including urologist, microsurgeon and plastic surgeon should be organized and replantation should be performed if distal part of penis is viable