Schneider Children's Hospital, Long Island Jewish Medical Center, New Hyde Park, New York, USA.Journal of Urology, Volume 170, Issue 4 Pt 2): Pages 1691-1694, October 2003.
Department of Urology, Schneider Children's Hospital, Long Island Jewish Medical Center, New Hyde Park, New York, USA.
PURPOSE: We review our experience with the management of iatrogenic penile injuries. Apart from circumcision, serious damage to the penis can occur following hypospadias repair, surgery for priapism or total loss of the penis following surgical repairof bladder exstrophy.
MATERIALS AND METHODS: A retrospective analysis of patients with iatrogenic penile amputation referred to us between 1980 and 2000 was undertaken. Causes of injury and choiceof management were reviewed.
RESULTS: Of the 13 cases treated during the 20-year period mechanism of primary injury was circumcision in 4, hypospadias repair in 6, priapism in 1, bladder exstrophy repair in 1 and penile carcinoma in 1. A variety of techniques were used for phallic reconstruction. Penile degloving, division of suspensory ligament and rotational skin flaps achieved penile augmentation and enhancement. Reasonable cosmesis and penile length were achieved in all cases. In indicated cases microsurgical phalloplasty was technically feasible. However long-term followup showed various complications including erosions from the use of a penile stiffener.
CONCLUSIONS: The ultimate goal of reconstructive surgery is to have a penis with normal function and appearance. The management of penile injury requires a wide variety of surgical techniques that are tailored to the individual patient. Expedient penile reconstruction is successful and therapeutic delay is associated with complications.
Publication Types:
PMID: 14501693 [PubMed - indexed for MEDLINE]
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