Management of total penile amputation following circumcision in a resource-limited setting: A case report
Introduction: Total penile amputation following circumcision is a rare complication. This case highlights the challenges associated with managing such a catastrophic injury in a resource-limited setting. Case presentation: A 46-day-old male was brought to our hospital with a five-day history of diff...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-02-01
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| Series: | Journal of Pediatric Surgery Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213576624001672 |
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| author | Suleiman Ayalew Michael A. Negussie Helina K. Teklehaimanot Nahom Getachew Mulatu Yishak Abdulsemed Mesfin Tesera Wassie |
| author_facet | Suleiman Ayalew Michael A. Negussie Helina K. Teklehaimanot Nahom Getachew Mulatu Yishak Abdulsemed Mesfin Tesera Wassie |
| author_sort | Suleiman Ayalew |
| collection | DOAJ |
| description | Introduction: Total penile amputation following circumcision is a rare complication. This case highlights the challenges associated with managing such a catastrophic injury in a resource-limited setting. Case presentation: A 46-day-old male was brought to our hospital with a five-day history of difficulty voiding, irritability, and bleeding from a circumcision done two weeks earlier by a traditional healer under suboptimal conditions. The mother reported a proper initial recovery but stated that the penis became followed by penile discolored and detached five days prior to presentation. Despite the severe injury, the patient had no fever or systemic symptoms. On admission, he was afebrile and pale. The perineal exam revealed a total penile amputation, and a nasogastric tube placed in the urethra at the referring hospital. Blood tests showed anemia (hemoglobin 8.2 g/dL) but normal renal function. The urinalysis was normal. An abdominal ultrasound (US) ruled out hydronephrosis. The patient received a blood transfusion, intravenous ceftriaxone, and pain medications. He was taken to the operating room for an exam under anesthesia. We did a debridement of the necrotic tissue and reconstructed the urethral opening with skin flaps. We left an 8 French nasogastric tube in the urethra. The postoperative recovery was uneventful. At three months of follow up, he has healed properly and has a patent neourethral meatus. Conclusion: Reconstruction of the urethral opening using locally mobilized skin flaps and urinary drainage via catheter placement can achieve satisfactory outcomes in infants with total penile amputation when advanced surgical resources are unavailable. |
| format | Article |
| id | doaj-art-e15b69f16fa14c8c941d19c3af5038c9 |
| institution | Kabale University |
| issn | 2213-5766 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Pediatric Surgery Case Reports |
| spelling | doaj-art-e15b69f16fa14c8c941d19c3af5038c92024-12-06T05:13:31ZengElsevierJournal of Pediatric Surgery Case Reports2213-57662025-02-01113102939Management of total penile amputation following circumcision in a resource-limited setting: A case reportSuleiman Ayalew0Michael A. Negussie1Helina K. Teklehaimanot2Nahom Getachew Mulatu3Yishak Abdulsemed4Mesfin Tesera Wassie5School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaSchool of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; Corresponding author.School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, EthiopiaSchool of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaSchool of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaDepartment of Pediatric Surgery, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaIntroduction: Total penile amputation following circumcision is a rare complication. This case highlights the challenges associated with managing such a catastrophic injury in a resource-limited setting. Case presentation: A 46-day-old male was brought to our hospital with a five-day history of difficulty voiding, irritability, and bleeding from a circumcision done two weeks earlier by a traditional healer under suboptimal conditions. The mother reported a proper initial recovery but stated that the penis became followed by penile discolored and detached five days prior to presentation. Despite the severe injury, the patient had no fever or systemic symptoms. On admission, he was afebrile and pale. The perineal exam revealed a total penile amputation, and a nasogastric tube placed in the urethra at the referring hospital. Blood tests showed anemia (hemoglobin 8.2 g/dL) but normal renal function. The urinalysis was normal. An abdominal ultrasound (US) ruled out hydronephrosis. The patient received a blood transfusion, intravenous ceftriaxone, and pain medications. He was taken to the operating room for an exam under anesthesia. We did a debridement of the necrotic tissue and reconstructed the urethral opening with skin flaps. We left an 8 French nasogastric tube in the urethra. The postoperative recovery was uneventful. At three months of follow up, he has healed properly and has a patent neourethral meatus. Conclusion: Reconstruction of the urethral opening using locally mobilized skin flaps and urinary drainage via catheter placement can achieve satisfactory outcomes in infants with total penile amputation when advanced surgical resources are unavailable.http://www.sciencedirect.com/science/article/pii/S2213576624001672CircumcisionPenile amputationPenile reconstructionResource-limited settingCase report |
| spellingShingle | Suleiman Ayalew Michael A. Negussie Helina K. Teklehaimanot Nahom Getachew Mulatu Yishak Abdulsemed Mesfin Tesera Wassie Management of total penile amputation following circumcision in a resource-limited setting: A case report Journal of Pediatric Surgery Case Reports Circumcision Penile amputation Penile reconstruction Resource-limited setting Case report |
| title | Management of total penile amputation following circumcision in a resource-limited setting: A case report |
| title_full | Management of total penile amputation following circumcision in a resource-limited setting: A case report |
| title_fullStr | Management of total penile amputation following circumcision in a resource-limited setting: A case report |
| title_full_unstemmed | Management of total penile amputation following circumcision in a resource-limited setting: A case report |
| title_short | Management of total penile amputation following circumcision in a resource-limited setting: A case report |
| title_sort | management of total penile amputation following circumcision in a resource limited setting a case report |
| topic | Circumcision Penile amputation Penile reconstruction Resource-limited setting Case report |
| url | http://www.sciencedirect.com/science/article/pii/S2213576624001672 |
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