Korean J Urol.  2014 Dec;55(12):841-843. 10.4111/kju.2014.55.12.841.

Reconstruction of an Amputated Glans Penis With a Buccal Mucosal Graft: Case Report of a Novel Technique

• Aboutaleb

• KMID: 2070100
• DOI: http://doi.org/10.4111/kju.2014.55.12.841

Abstract

Penile amputation is a rare catastrophe and a serious complication of circumcision. Reconstruction of the glans penis may be indicated following amputation. Our report discusses a novel technique for reconfiguration of an amputated glans penis 1 year after a complicated circumcision. A 2-year-old male infant presented to us with glans penis amputation that had occurred during circumcision 1 year previously. The parents complained of severe meatal stenosis with disfigurement of the penis. Penis length was 3 cm. Complete penile degloving was performed. The distal part of the remaining penis was prepared by removing fibrous tissue. A buccal mucosal graft was applied to the distal part of the penis associated with meatotomy. The use of a buccal mucosal graft is a successful and simple procedure with acceptable cosmetic and functional results for late reconfiguration of the glans penis after amputation when penile size is suitable.

Keyword

Amputation; Mouth mucosa; Penis

MeSH Terms

Amputation, Traumatic/*surgery
Child, Preschool
Circumcision, Male/adverse effects
Humans
Male
Mouth Mucosa/*transplantation
Penis/*injuries/*surgery
Reconstructive Surgical Procedures/*methods

Figure

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  FIG. 1 The amputated glans penis 1 year after circumcision. The penis is disfigured and with severe meatal stenosis.

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  FIG. 2 Operative technique images. (A) Penis after penile degloving, removal of scar tissue, and meatotomy. (B) Use of the buccal mucosal graft to cover the distal part of the remaining penis to simulate the glans.

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  FIG. 3 Postoperative follow-up. (A) Penis at 1-week follow-up postoperatively with a silicone catheter and healthy-appearing buccal mucosa, which appropriately simulated the glans penis. (B) Photograph at the 3-month follow-up showing a good-looking glans penis with wide external urethral meatus.

Reference

1. Harrison NW, Eshleman JL, Ngugi PM. Ethical issues in the developing world. Br J Urol. 1995; 76:Suppl 2. 93–96.

2. Strimling BS. Partial amputation of glans penis during Mogen clamp circumcision. Pediatrics. 1996; 97(6 Pt 1):906–907.

3. Ozkan S, Gurpinar T. A serious circumcision complication: penile shaft amputation and a new reattachment technique with a successful outcome. J Urol. 1997; 158:1946–1947.

4. Sanger JR, Matloub HS, Yousif NJ, Begun FP. Penile replantation after self-inflicted amputation. Ann Plast Surg. 1992; 29:579–584.

5. Greenberger ML, Lowe BA. Penile stump advancement as an alternative to perineal urethrostomy after penile amputation. J Urol. 1999; 161:893–894.

6. Sahin C, Toraman AR, Kalkan M. Complications of circumcision: our experiences over the last 15 years. Eur J Gen Med. 2011; 8:176–181.

7. Jezior JR, Brady JD, Schlossberg SM. Management of penile amputation injuries. World J Surg. 2001; 25:1602–1609.

8. Pippi Salle JL, Jesus LE, Lorenzo AJ, Romao RL, Figueroa VH, Bagli DJ, et al. Glans amputation during routine neonatal circumcision: mechanism of injury and strategy for prevention. J Pediatr Urol. 2013; 9(6 Pt A):763–768.

9. Ince B, Gundeslioglu AO. A salvage operation for total penis amputation due to circumcision. Arch Plast Surg. 2013; 40:247–250.

10. Cook A, Khoury AE, Bagli DJ, Farhat WA, Pippi Salle JL. Use of buccal mucosa to simulate the coronal sulcus after traumatic penile amputation. Urology. 2005; 66:1109.