Microsurgical reimplantation of the amputated penis : report of two unusual injuries and review of literature

Penile amputation, both complete and incomplete, is a rare component of genitourinary trauma. Successful reimplantation of the organ is still less frequent. We report 2 cases of penile amputations in which successful reimplantation was done using microsurgical technique. Both patients had a complete amputation of the penis with no arterial, venous or neural connection between the amputated part and the residual stump except for a twig of tissue in one part of the circumference. The amputated partswere reimplanted with microsurgical reanastamosis of the dorsal arteries, deep dorsal vein and the neurovascular bundle. The total time to re-establishment of circulation was 13 hours and 11 hours respectively. Both patients developed edema of penile skin postoperatively and one patient had superficial sloughing off of the skin. One patient required an internal urethrotomy 6 weeks after the injury. Both patients have altered sensation over the skin of the glans and the mid-shaft of penis. One patient masturbates with a semi-rigid erection and the other has regular sexual intercourse 3 months after surgery. A review of literature is also presented.