背景技术包皮环切术通常在男性中进行,尤其是在犹太和穆斯林文化中,并且被认为是一种安全的外科手术,并发症发生率低。主要并发症,如部分和全部阴茎截肢,可能发生,但这些都是罕见的并发症.然而,已经报道并审查了高再植成功率。案例报告我们描述了一个8岁男孩的案例,该男孩在医院外的外行人进行的仪式割礼期间经历了完全的阴茎截肢。在16小时43分钟的缺血期后进行显微外科阴茎再植,结果成功,没有任何重大并发症。在我们的技术中,我们修复了背侧和深海绵体血管。术后1年,两点判别试验结果为4mm,7毫米,背侧为7毫米,腹侧部分,和龟头,分别。经过4年的随访,没有阴茎畸形等晚期并发症,尿道瘘,尿道狭窄,没有阴茎的感觉,或勃起功能障碍。两点判别试验结果为3mm,5mm,背部5毫米,腹侧部分,和龟头,分别。患者还经历了良好的阴茎感觉,早晨勃起,对美容结果的满意度,和21mL/s的峰值尿液流速,具有一致的强空隙流和20mL的低空隙残余尿液体积。结论我们的经验表明,缺血时间短,及时手术矫正,显微再植技术,和强化术后护理可以导致良好的功能结果。
BACKGROUND Circumcision is commonly performed in males, especially in Jewish and Muslim cultures, and is considered a safe surgical procedure with a low complication rate. Major complications, such as partial and total penile amputation, can occur, but those are rare complications. However, high replantation success rates have been reported and reviewed.
CASE REPORT We describe the
case of an 8-year-old boy who experienced total penile amputation during ritual circumcision performed by a layperson outside the hospital setting. Microsurgical penile replantation was performed after an ischemic period of 16 hours 43 minutes, with successful outcomes and without any major complications. In our technique, we repaired both dorsal and deep cavernosal vessels. At 1-year postoperative period, the results of two-point discrimination test were 4 mm, 7 mm, and 7 mm on the dorsal part, ventral part, and glans, respectively. After a follow-up period of 4 years, there were no late complications such as penile deformity, urethral fistula, urethral stenosis, absence of penile sensation, or erectile dysfunction. The results of two-point discrimination test were 3 mm, 5 mm, and 5 mm on the dorsal part, ventral part, and glans, respectively. The patient also experienced good penile sensation, morning erection, satisfaction with the cosmetic outcome, and a peak urine flow rate of 21 mL/s with a consistently strong void stream and a low postvoid residual urine volume of 20 mL. CONCLUSIONS Our experience suggests that a short ischemic time, prompt surgical correction, microscopic technique of replantation, and intensive postoperative care can result in good functional outcomes.