MEDizzy
FeedLibraryLearningDiscussLeaderboardJournal
MEDizzy
Abeer Fatima
Abeer Fatimaover 2 years ago
Successful Multidisciplinary Approach Salvaged Self-Amputated Penis

Successful Multidisciplinary Approach Salvaged Self-Amputated Penis

A 24-year-old male, known case of schizophrenia, presented to ER with penile self-amputation. During an episode of paranoid schizophrenic delusion, the patient cut his penis with utility knife. The case was received by plastic surgery and urology department. Emergency procedures were carried out to reimplant the penis. Percutaneous suprapubic catheter was inserted to facilitate voiding. The proximal part of penis as well as the distal amputated part were debrided. The cut ends of urethra were spatulated and re-anastomosed on Foley’s catheter with absorbable sutures after mobilization. The neurovascular bundle and dorsal artery were also mobilized and subsequently re-anastomosed. Corpora were re-attached by absorbable sutures. After grafting, the patient developed complications as a result of reperfusion injuries; the complications included ecchymosis, edema, and mild necrosis along the incision line. However, the perfusion was maintained resulting in successful grafting. The patient was simultaneously treated for psychiatric condition. Patient was discharged after 2 weeks; however, the Foley’s catheter and suprapubic tube were left in place for 10 weeks. A voiding cystourethrogram demonstrated a patent urethra with no strictures. Partial erection and penile sensations started to develop by the time voiding cystourethrogram was performed. Despite total ischemic time of approximately 4 to 5 hours, penile grafting was successful attributed to timely intervention by multi-disciplinary approach. Reference https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0037-1602792 Image via https://indianjurol.com/article.asp?issn=0970-1591;year=2010;volume=26;issue=3;spage=434;epage=437;aulast=Gyan;type=3

SurgeryEmergencyUrologyPsychiatryAmputation
17
Top rated comment
K
K
over 2 years ago

Interesting case. Thank you for sharing!

Reply
Other commentsSign in to post comments. You don't have an account? Sign up now!
Related posts
Generalized Anxiety Disorder Generalized anxiety disorder involves persistent and excessive worry that interferes with daily activities. This ongoing worry and tension may be accompanied by physical symptoms, such as restlessness, feeling on edge or easily fatigued, difficulty concentrating, muscle tension or problems sleeping. Often the worries focus on everyday things such as job responsibilities, family health or minor matters such as chores, car repairs, or appointments.The core symptom of panic disorder is recurrent panic attacks, an overwhelming combination of physical and psychological distress. During an attack, several of these symptoms occur in combination: Panic Disorder Symptoms During an attack, several of these symptoms occur in combination Palpitations, pounding heart or rapid heart rateNumbness or tinglingSweatingChills or hot flashesTrembling or shakingNausea or abdominal painsFeeling of shortness of breath or smothering sensationsFeeling detachedChest painFear of losing controlFeeling dizzy, light-headed or faintFear of dyingFeeling of choking  Because the symptoms can be quite severe, some people who experience a panic attack may believe they are having a heart attack or some other life-threatening illness. They may go to a hospital emergency department. Panic attacks may be expected, such as a response to a feared object, or unexpected, apparently occurring for no reason. The mean age for onset of panic disorder is 20-24. Panic attacks may occur with other mental disorders such as depression or PTSD.Agoraphobia Agoraphobia is the fear of being in situations where escape may be difficult or embarrassing, or help might not be available in the event of panic symptoms. The fear is out of proportion to the actual situation and lasts generally six months or more and causes problems in functioning. A person with agoraphobia experiences this fear in two or more of the following situations: Using public transportation Being in open spaces Being in enclosed places Standing in line or being in a crowd Being outside the home alone The individual actively avoids the situation, requires a companion or endures with intense fear or anxiety. Untreated agoraphobia can become so serious that a person may be unable to leave the house. A person can only be diagnosed with agoraphobia if the fear is intensely upsetting, or if it significantly interferes with normal daily activities.Separation Anxiety Disorder A person with separation anxiety disorder is excessively fearful or anxious about separation from those with whom he or she is attached. The feeling is beyond what is appropriate for the person's age, persists (at least four weeks in children and six months in adults) and causes problems functioning. A person with separation anxiety disorder may be persistently worried about losing the person closest to him or her, may be reluctant or refuse to go out or sleep away from home or without that person, or may experience nightmares about separation. Physical symptoms of distress often develop in childhood, but symptoms can carry though adulthood.Selective Mutism Children with selective mutism do not speak in some social situations where they are expected to speak, such as school, even though they speak in other situations. They will speak in their home around immediate family members, but often will not speak even in front of others, such as close friends or grandparents. The lack of speech may interfere with social communication, although children with this disorder sometimes use non-spoken or nonverbal means (e.g., grunting, pointing, writing). The lack of speech can also have significant consequences in school, leading to academic problems and social isolation. Many children with selective mutism also experience excessive shyness, fear of social embarrassment and high social anxiety. However, they typically have normal language skills. Selective mutism usually begins before age 5, but it may not be formally identified until the child enters school. Many children will outgrow selective mutism. For children who also have social anxiety disorder, selective mutism may disappear, but symptoms of social anxiety disorder may remain.Mental and physical health are interconnected. We, as a society, need to work on emphasizing the importance of the two. This would prevent people developing physical and mental diseases at earlier and earlier ages.Post Op ComplicationsPost Op ComplicationsstomachNecrosis gangrene

Recent MCQs

‌
‌
‌
‌
‌
‌
‌
‌
‌
‌
Show more MCQs

Recent flashcard sets

‌
‌
‌
‌
‌
‌
‌
‌
‌
‌
Show more flashcards
FeedLearn
Add
Search
Discuss