ABSTRACT
We present a case report of a 22-year-old Nigerian student who presented to the accident and emergency unit of a Nigerian Teaching Hospital with a history of self-inflicted genital injury following a suicide attempt. He had background history of predisposition to depressive illness, a current diagnosis of a major depressive disorder, and had had two attempted suicidal episodes in the last 3 months prior to this event. The clinical finding shows a patient with sad affect, feeling of hopelessness, and worthlessness; however, the vital signs remained fairly stable. At examination under anesthesia, the testes were exposed and the right already self-castrated. The penis was degloved to the level of the Buck's fascia with intact corpora cavernosa and urethra. He had surgical excision of the hanging self-castrated right testis with debridement and primary closure of the genital laceration. He was promptly reviewed by the psychiatrists who co-managed appropriately.
Subject(s)
Castration/psychology , Depressive Disorder, Major/psychology , Self Mutilation/psychology , Suicide, Attempted/psychology , Castration/rehabilitation , Depressive Disorder, Major/complications , Humans , Male , Penis/injuries , Penis/surgery , Scrotum/injuries , Scrotum/surgery , Self Mutilation/complications , Testis/injuries , Testis/surgery , Treatment Outcome , Young AdultABSTRACT
Self-emasculation and self-castration most often occur in individuals with known psychiatric disease. In the 3 patients presented 2 performed self-castration apparently while suffering the effects of drugs or alcohol. In both instances apparent psychological adjustment was satisfactory after appropriate psychological care. In the third patient total self-emasculation occurred against the background of known schizophrenia. Immediate surgical management of each patient is presented.
