@article{ref1,
title="Self-inflicted penile and testicular amputation: a very rare case report and treatment dilemma in the absence of microsurgical service",
journal="International journal of surgery case reports",
year="2024",
author="Abdella, Mejudin Kedir and Gebreselassie, Kaleab Habtemichael and Kurabachew, Henok Ababu",
volume="122",
number="",
pages="e110043-e110043",
abstract="INTRODUCTION AND IMPORTANCE: Genital self-mutilation is a rare urologic surgical emergency that is usually encountered in patients with underlying psychiatric illness. Because of shortage of published data and variance in management schemes worldwide, these conditions can present a significant management dilemma. CASE PRESENTATION: In this case report we present this rare phenomenon, where a known schizophrenic patient presented after he amputated both of his testes and penis under the influence of command hallucination. After 15 h of the incident, macroscopic replantation of the severed genitalia was done and psychiatric evaluation and management initiated simultaneously. But the replantation failed after 9th post operative day. <br><br>DISCUSSION: Initial management of patients presenting with genital amputation should be resuscitation. The severed organ has to be washed with sterile saline and placed in &quot;double bag&quot;. There are multiple factors for the success of replantation, the major ones are cooling of the amputated organ and precise microsurgical replantation. <br><br>CONCLUSION: Early intervention and microscopic replantation are crucial for the successful outcome.<p /> <p>Language: en</p>",
language="en",
issn="2210-2612",
doi="10.1016/j.ijscr.2024.110043",
url="http://dx.doi.org/10.1016/j.ijscr.2024.110043"
}