Simple Penile Amputation
The amputation of the penis due to trauma is an uncommon surgical emergency. The state of the stump and the severed segment determines whether or not the penis may be replanted. Debridement and stump closure, followed by secondary reconstruction, are preferred if wound conditions at the amputation site are not favorable.
The fundamentals of successful replantation include debris removal, necrotic tissue debridement, anastomosis of the severed urethra, repair of the corporal bodies and tunica, and microsurgical restoration of the dorsal neurovascular plexus. There is a higher rate of erectile dysfunction and urethral strictures when the repair is done without the use of a microscope.
Before considering repair, all patients who have been assaulted should be resuscitated and stabilized. To rule out other ailments, a second survey should be required. Penile deformation, erectile dysfunction, hematoma formation, abscess, urethral fistula, urethral stenosis, delayed/ missing penile sensation, and replantation failure are all common consequences of penile replantation.
