DOCSLIB.ORG

Penile and Genital Injuries

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Penile and Genital Injuries Urol Clin N Am 33 (2006) 117–126 Penile and Genital Injuries Hunter Wessells, MD, FACS*, Layron Long, MD Department of Urology, University of Washington School of Medicine and Harborview Medical Center, 325 Ninth Avenue, Seattle, WA 98104, USA Genital injuries are significant because of their Mechanisms association with injuries to major pelvic and vas- The male genitalia have a tremendous capacity cular organs that result from both blunt and pen- to resist injury. The flaccidity of the pendulous etrating mechanisms, and the chronic disability portion of the penis limits the transfer of kinetic resulting from penile, scrotal, and vaginal trauma. energy during trauma. In contrast, the fixed Because trauma is predominantly a disease of portion of the genitalia (eg, the crura of the penis young persons, genital injuries may profoundly in relation to the pubic rami, and the female affect health-related quality of life and contribute external genitalia in their similar relationships to the burden of disease related to trauma. Inju- with these bony structures) are prone to blunt ries to the female genitalia have additional conse- trauma from pelvic fracture or straddle injury. quences because of the association with sexual Similarly, the erect penis becomes more prone to assault and interpersonal violence [1]. Although injury because increases in pressure within the the existing literature has many gaps, a recent penis during bending rise exponentially when the Consensus Group on Genitourinary Trauma pro- penis is rigid (up to 1500 mm Hg) as opposed to vided an overview and reference point on the sub- flaccid [6]. Injury caused by missed intromission ject [2]. This article reviews the mechanism, initial or manual attempts at detumescence can cause pe- evaluation, and operative management of injuries nile fracture [7]. Less severe bending injuries may to the male and female external genitalia including still lead to long-term disability related to tunica the penis, scrotal skin, and vaginal structures. albuginea disruption (Peyronie’s disease) or arte- rial insufficiency. Firearms and missiles have an Prevalence excess of kinetic energy, which overcomes the pro- tective mechanisms of flaccidity. The incidence of genital injuries has not been Another characteristic of the male genitalia determined, but in civilian centers is likely to be particularly pertinent to injury mechanisms is the low, given that most case series span many years looseness and laxity of genital skin. Although this and include relatively small numbers of patients generally has a protective role, allowing the skin [3]. In the battlefield, the massive destruction to deform and slide away from a potential point caused by fragmentation devices, combined with of contact, in the case of machinery injury, the use of protective torso armor, has led to sur- rotating or suction devices can grab hold of vival of soldiers with increasingly severe pelvic a portion of the genital skin [8]. Laxity of skin be- and genital organ injury [4]. Penile fracture is comes a liability because the entire penile and the most commonly described blunt injury to the scrotal skin can be trapped and avulsed. penis, and over 1300 cases have been reported in The vascular supply of the genitalia also predicts the literature [5]. outcomes of other forms of injury, such as chem- ical, radiant, and infectious injury. Deep structures * Corresponding author. have multiple sources of arterial inflow. The penis E-mail address: [email protected] derives a triple blood flow from the dorsal, cav- (H. Wessells). ernosal, and bulbourethral arteries. Ischemic loss 0094-0143/06/$ - see front matter Ó 2005 Elsevier Inc. All rights reserved. doi:10.1016/j.ucl.2005.11.003 urologic.theclinics.com 118 WESSELLS & LONG of this organ because of injury is only seen with Table 1 complete amputation or prolonged constriction Organ injury scale for penile injury injury. Likewise, the testis derives blood supply AAST AIS-90 from the cremasteric, testicular, and vasal arteries. grade Penile injury score In cases of Fournier’s gangrene neither of these I Cutaneous laceration or 1 organs is lost. Conversely the skin, although richly contusion vascularized through multiple sources, receives its II Laceration of Buck’s fascia 1 arterial perfusion from deeper fascial layers, and (cavernosum) without when these are affected by synergistic bacterial tissue loss infection during Fournier’s gangrene, total skin III Cutaneous avulsion, 3 loss is inevitable. Because burns start superficially laceration through glans and progressively spread their damage down into or meatus, or cavernosal ! deeper tissues in the opposite fashion from Four- or urethral defect 2cm IV Partial penectomy or 3 nier’s gangrene, preservation of some portion of the cavernosal or urethral vascular integrity of the skin is likely in most defect ¼ 2cm chemical and thermal burns. V Total penectomy 3 A particularly unusual cause of penile injury is Abbreviations: AAST, American Association for the amputation, which is discussed separately because Surgery of Trauma; AIS, Abbreviated Injury Scale. of its unique considerations [9,10]. When assault is From Moore EE, Malangoni MA, Cogbill TH, et al. the cause, appropriate police reporting is required. Organ injury scaling VII: cervical vascular, peripheral Other cases require special input from psychiatric vascular, adrenal, penis, testis, and scrotum. J Trauma and psychologic experts. Penile amputation may 1996;41:523; with permission. be a manifestation of depressive and psychotic be- havior, either caused by schizophrenia or illicit drug abuse. Others amputate the penis to initiate likelihood of associated injuries to the spermatic the process of gender conversion. Finally, con- cord and testis, urinary bladder and urethra, striction rings can cause loss of superficial skin, rectum, and vascular structures of the iliac and deep urethral necrosis, or complete penile loss. femoral region. Blood at the urethral meatus Blunt injuries cause much less damage to the implies injury, whereas its absence can be mis- phallus than firearm and stab injuries. The laxity leading. Urethral injury occurs in 10% to 38% of of the genital skin usually protects the deep penile penile fractures and up to 22% of penile gunshot structures from avulsion, so that after car crashes wounds [12,13]. superficial lacerations of the skin are more com- A delayed presentation is not uncommon after mon. Pelvic fractures with symphyseal or pubic penile fracture and constriction ring use, usually ramus displacement can cause severe injury to the caused by patient embarrassment. The constella- deep structures of the penis, including avulsion of tion of missed intromission, acute bending, and the crus of the corpus cavernosum from its vascular and neural supply [11]. Less severe crush Table 2 injuries may also occur. The long-term conse- AAST organ injury scale for scrotal injury quences of these injuries are more significant AIS-90 than their initial presentation suggests. Although AAST grade Scrotal injury score extensive bleeding may occur, angioembolization of the internal pudendal arterial tree can control I Contusion 1 ! such hemorrhage. More importantly, the delayed II Laceration 25% of 1 scrotal diameter consequences of arterial injury are erectile dys- III Laceration ¼ 25% of 2 function or penile ischemia. Tables 1 and 2 show scrotal diameter the characteristics of injuries to the penis and IV Avulsion !50% 2 scrotum, and corresponding AIS scores. V Avulsion ¼ 50% 2 Abbreviations: AAST, American Association for the Surgery of Trauma; AIS, Abbreviated Injury Scale. Presentation From Moore EE, Malangoni MA, Cogbill TH, et al. Organ injury scaling VII: cervical vascular, peripheral Penetrating injuries to the external genitalia vascular, adrenal, penis, testis, and scrotum. J Trauma require special consideration because of the high 1996;41:523; with permission. PENILE AND GENITAL INJURIES 119 a popping sound followed by immediate detumes- orientation when structures are distorted by he- cence of the penis and acute pain are characteristic matoma. The presence of hematuria should alert of this entity. In the Middle East and other the trauma team to the possibility of a bladder regions, penile fracture may occur as a result of or upper urinary tract injury in cases of penetrat- excessive bending of the shaft in an attempt to ing firearm injuries. Finally, rectal injuries must be achieve rapid detumescence of an embarrass- sought out if complications, such as fistulae and ing penile erection [7]. Penile swelling is usually Fournier’s gangrene, are to be avoided. limited to the attachments of Buck’s fascia and Bleeding from the penis can usually be con- only the shaft of the penis is ecchymotic; a local- trolled in the emergency department with gauze ized hematoma is evident in such cases and has wraps to tamponade any bleeding. Excessively been termed an ‘‘eggplant deformity’’ [2]. When tight compressive dressings that compromise the deep investing fascia of the penis has been rup- blood supply to the distal penis must be avoided. tured by penetrating or blunt trauma, a perineal The mechanism of injury is important. Burns butterfly hematoma or scrotal bleeding can occur. should be covered with appropriate dressings Entrapment of the genitalia by industrial machin- depending on the mechanism. For thermal injury, ery including augers, power takeoff from farm 1% silver sulfadiazine cream is appropriate. tractors, and suction devices can lead to avulsion Chemical
Load more

Recommended publications
  • Clinical Practice Guideline for Limb Salvage Or Early Amputation
    Limb Salvage or Early Amputation Evidence-Based Clinical Practice Guideline Adopted by: The American Academy of Orthopaedic Surgeons Board of Directors December 6, 2019 Endorsed by: Please cite this guideline as: American Academy of Orthopaedic Surgeons. Limb Salvage or Early Amputation Evidence-Based Clinical Practice Guideline. https://www.aaos.org/globalassets/quality-and-practice-resources/dod/ lsa-cpg-final-draft-12-10-19.pdf Published December 6, 2019 View background material via the LSA CPG eAppendix Disclaimer This clinical practice guideline was developed by a physician volunteer clinical practice guideline development group based on a formal systematic review of the available scientific and clinical information and accepted approaches to treatment and/or diagnosis. This clinical practice guideline is not intended to be a fixed protocol, as some patients may require more or less treatment or different means of diagnosis. Clinical patients may not necessarily be the same as those found in a clinical trial. Patient care and treatment should always be based on a clinician’s independent medical judgment, given the individual patient’s specific clinical circumstances. Disclosure Requirement In accordance with AAOS policy, all individuals whose names appear as authors or contributors to this clinical practice guideline filed a disclosure statement as part of the submission process. All panel members provided full disclosure of potential conflicts of interest prior to voting on the recommendations contained within this clinical practice guideline. Funding Source This clinical practice guideline was funded exclusively through a research grant provided by the United States Department of Defense with no funding from outside commercial sources to support the development of this document.
    [Show full text]
  • Studies of Human Physique and Sexual Attractiveness: Sexual Preferences of Men and Women in China
    AMERICAN JOURNAL OF HUMAN BIOLOGY 19:88–95 (2007) Original Research Article Studies of Human Physique and Sexual Attractiveness: Sexual Preferences of Men and Women in China 1 2 3 1 BARNABY J. DIXSON, ALAN F. DIXSON, * BAOGUO LI, AND M.J. ANDERSON 1Department of Conservation and Research for Endangered Species, Zoological Society of San Diego, San Diego, California 2School of Biological Sciences, Victoria University of Wellington, Wellington, New Zealand 3College of Life Sciences, and Key Laboratory Resource Biology and Biotechnology in Western China, Ministry of Education, Northwest University, Xi’an, China ABSTRACT Men and women at Northwest University (n ¼ 631), Xi’an, China, were asked to rate the attractiveness of male or female figures manipulated to vary somatotype, waist-to- hip ratio (WHR), secondary sexual traits, and other features. In study 1, women rated the aver- age masculine somatotype as most attractive, followed by the mesomorphic (muscular), ecto- morphic (slim), and endomorphic (heavily built) somatotypes, in descending order of preference. In study 2, the amount and distribution of masculine trunk (chest and abdominal) hair were altered progressively in a series of front-posed figures. Women rated figures with no or little trunk hair as most attractive. Study 3 assessed the attractiveness of front-posed male figures which varied only in length of their nonerect penis. Numerical ratings for this trait were low, but moderate lengthening of the penis (22% or 33% above average) resulted in a significant increase in scores for attractiveness. In study 4, Chinese men rated the attractiveness of back- posed female images varying in waist-to-hip ratio (WHR from 0.5–1.0).
    [Show full text]
  • Chapter 14. Anthropometry and Biomechanics
    Table of contents 14 Anthropometry and biomechanics........................................................................................ 14-1 14.1 General application of anthropometric and biomechanic data .....................................14-2 14.1.1 User population......................................................................................................14-2 14.1.2 Using design limits ................................................................................................14-4 14.1.3 Avoiding pitfalls in applying anthropometric data ................................................14-6 14.1.4 Solving a complex sequence of design problems ..................................................14-7 14.1.5 Use of distribution and correlation data...............................................................14-11 14.2 Anthropometric variability factors..............................................................................14-13 14.3 Anthropometric and biomechanics data......................................................................14-13 14.3.1 Data usage............................................................................................................14-13 14.3.2 Static body characteristics....................................................................................14-14 14.3.3 Dynamic (mobile) body characteristics ...............................................................14-28 14.3.3.1 Range of whole body motion........................................................................14-28
    [Show full text]
  • From Circumcision Injury to Penile Amputation
    Hindawi Publishing Corporation BioMed Research International Volume 2014, Article ID 375285, 6 pages http://dx.doi.org/10.1155/2014/375285 Review Article Traumatic Penile Injury: From Circumcision Injury to Penile Amputation Jae Heon Kim,1 Jae Young Park,2 and Yun Seob Song1 1 Department of Urology, Soonchunyang University Hospital, College of Medicine, Soonchunhyang University, Seoul, Republic of Korea 2 Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea Correspondence should be addressed to Jae Young Park; [email protected] and Yun Seob Song; [email protected] Received 24 April 2014; Revised 16 August 2014; Accepted 16 August 2014; Published 28 August 2014 Academic Editor: Ralf Herwig Copyright © 2014 Jae Heon Kim et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The treatment of external genitalia trauma is diverse according to the nature of trauma and injured anatomic site. The classification of trauma is important to establish a strategy of treatment; however, to date there has been less effort to make a classification for trauma of external genitalia. The classification of external trauma in male could be established by the nature of injury mechanism or anatomic site: accidental versus self-mutilation injury and penis versus penis plus scrotum or perineum. Accidental injury covers large portion of external genitalia trauma because of high prevalence and severity of this disease. The aim of this study is to summarize the mechanism and treatment of the traumatic injury of penis.
    [Show full text]
  • MR Imaging of Vaginal Morphology, Paravaginal Attachments and Ligaments
    MR imaging of vaginal morph:ingynious 05/06/15 10:09 Pagina 53 Original article MR imaging of vaginal morphology, paravaginal attachments and ligaments. Normal features VITTORIO PILONI Iniziativa Medica, Diagnostic Imaging Centre, Monselice (Padova), Italy Abstract: Aim: To define the MR appearance of the intact vaginal and paravaginal anatomy. Method: the pelvic MR examinations achieved with external coil of 25 nulliparous women (group A), mean age 31.3 range 28-35 years without pelvic floor dysfunctions, were compared with those of 8 women who had cesarean delivery (group B), mean age 34.1 range 31-40 years, for evidence of (a) vaginal morphology, length and axis inclination; (b) perineal body’s position with respect to the hymen plane; and (c) visibility of paravaginal attachments and lig- aments. Results: in both groups, axial MR images showed that the upper vagina had an horizontal, linear shape in over 91%; the middle vagi- na an H-shape or W-shape in 74% and 26%, respectively; and the lower vagina a U-shape in 82% of cases. Vaginal length, axis inclination and distance of perineal body to the hymen were not significantly different between the two groups (mean ± SD 77.3 ± 3.2 mm vs 74.3 ± 5.2 mm; 70.1 ± 4.8 degrees vs 74.04 ± 1.6 degrees; and +3.2 ± 2.4 mm vs + 2.4 ± 1.8 mm, in group A and B, respectively, P > 0.05). Overall, the lower third vaginal morphology was the less easily identifiable structure (visibility score, 2); the uterosacral ligaments and the parau- rethral ligaments were the most frequently depicted attachments (visibility score, 3 and 4, respectively); the distance of the perineal body to the hymen was the most consistent reference landmark (mean +3 mm, range -2 to + 5 mm, visibility score 4).
    [Show full text]
  • Study Guide Medical Terminology by Thea Liza Batan About the Author
    Study Guide Medical Terminology By Thea Liza Batan About the Author Thea Liza Batan earned a Master of Science in Nursing Administration in 2007 from Xavier University in Cincinnati, Ohio. She has worked as a staff nurse, nurse instructor, and level department head. She currently works as a simulation coordinator and a free- lance writer specializing in nursing and healthcare. All terms mentioned in this text that are known to be trademarks or service marks have been appropriately capitalized. Use of a term in this text shouldn’t be regarded as affecting the validity of any trademark or service mark. Copyright © 2017 by Penn Foster, Inc. All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner. Requests for permission to make copies of any part of the work should be mailed to Copyright Permissions, Penn Foster, 925 Oak Street, Scranton, Pennsylvania 18515. Printed in the United States of America CONTENTS INSTRUCTIONS 1 READING ASSIGNMENTS 3 LESSON 1: THE FUNDAMENTALS OF MEDICAL TERMINOLOGY 5 LESSON 2: DIAGNOSIS, INTERVENTION, AND HUMAN BODY TERMS 28 LESSON 3: MUSCULOSKELETAL, CIRCULATORY, AND RESPIRATORY SYSTEM TERMS 44 LESSON 4: DIGESTIVE, URINARY, AND REPRODUCTIVE SYSTEM TERMS 69 LESSON 5: INTEGUMENTARY, NERVOUS, AND ENDOCRINE S YSTEM TERMS 96 SELF-CHECK ANSWERS 134 © PENN FOSTER, INC. 2017 MEDICAL TERMINOLOGY PAGE III Contents INSTRUCTIONS INTRODUCTION Welcome to your course on medical terminology. You’re taking this course because you’re most likely interested in pursuing a health and science career, which entails ­proficiency­in­communicating­with­healthcare­professionals­such­as­physicians,­nurses,­ or dentists.
    [Show full text]
  • Review Article Penile Fracture-Report of Two Cases and Review of Current Literatures
    ............ REVIEW ARTICLE PENILE FRACTURE-REPORT OF TWO CASES AND REVIEW OF CURRENT LITERATURES ASHRAF UDDIN MALLIK1, MD TAREQUE HASAN2, HOROBILASH HALDER3 1Department of Urology, Gonoshasthaya Samajvittik Medical College (GSMC), Nalam, Savar, Dhaka, 2Department of Surgery, GSMC, Nalam, Savar, Dhaka, 3Department of Anaesthesiology, GSMC, Savar, Dhaka Abstract Penile fracture is an uncommon urological emergency especially in Bangladesh. The other name is traumatic rupture of the tunica albugenia and corpora cavernosa in erect penis. It occurs when an erect penis face to buckle under the pressure of a blunt sexual trauma. Patient gives the typical history of immediate detumescence, severe pain, swelling and eggplant deformity of the penile shaft due to penile injury. Immediate surgical exploration and repair of corpora Cavernosa with tunica albugenia is the most effective treatment modality. In normal cases diagnosis is made from history, physical examination alone. In some special cases ultrasonogram, radiological images, including retrograde urethrography or cavernosography are mandatory for proper diagnosis.Herein, we report 2 cases of penile fracture with review of current literature regarding treatment options. Key words: Cavernosography, Penile fracture, Tunica Albugenia rupture, Urethrography. Bangladesh J. Urol. 2016; 19(2): 98-102 Introduction: discoloration of penile skin and swelling penis after Penile fracture is rupture of one or both of the tunica cracking sound during forceful bending of penile shaft albuginea, the fibrous coverings that envelop the penis’s followed by severe pain at the time of fracture. The corpora cavernosa. During vaginal or anal intercourse, main aim of this study was to describe treatment option or aggressive masturbation it is caused by rapid blunt of 2 patients with fracture penis in our urology department force to an erect penis[1].
    [Show full text]
  • Reducing Amputation Rates After Severe Frostbite JENNIFER TAVES, MD, and THOMAS SATRE, MD, University of Minnesota/St
    FPIN’s Help Desk Answers Reducing Amputation Rates After Severe Frostbite JENNIFER TAVES, MD, and THOMAS SATRE, MD, University of Minnesota/St. Cloud Hospital Family Medicine Resi- dency Program, St. Cloud, Minnesota Help Desk Answers pro- Clinical Question in the tPA plus iloprost group with severe vides answers to questions submitted by practicing Is tissue plasminogen activator (tPA) effec- disease and only three and nine digits in the family physicians to the tive in reducing digital amputation rates in other treatment arms. Thus, no conclusions Family Physicians Inquiries patients with severe frostbite? can be reached about the effect of tPA plus Network (FPIN). Members iloprost compared with iloprost alone. of the network select Evidence-Based Answer questions based on their A 2007 retrospective cohort trial evalu- relevance to family medi- In patients with severe frostbite, tPA plus a ated the use of tPA in six patients with severe cine. Answers are drawn prostacyclin may be used to decrease the risk of frostbite.2 After rapid rewarming, patients from an approved set of digital amputation. (Strength of Recommen- underwent digital angiography, and those evidence-based resources and undergo peer review. dation [SOR]: B, based on a single randomized with significant perfusion defects received controlled trial [RCT].) tPA can be used alone intraarterial tPA (0.5 to 1 mg per hour IV The complete database of evidence-based ques- and is associated with lower amputation rates infusion) and heparin (500 units per hour tions and answers is compared with local wound care. (SOR: C, IV infusion) for up to 48 hours. Patients who copyrighted by FPIN.
    [Show full text]
  • Department of Veterans Affairs 8320-01
    This document is scheduled to be published in the Federal Register on 02/22/2013 and available online at http://federalregister.gov/a/2013-04134, and on FDsys.gov DEPARTMENT OF VETERANS AFFAIRS 8320-01 38 CFR Part 17 RIN 2900-AO21 Criteria for a Catastrophically Disabled Determination for Purposes of Enrollment AGENCY: Department of Veterans Affairs. ACTION: Proposed rule. SUMMARY: The Department of Veterans Affairs (VA) proposes to amend its regulation concerning the manner in which VA determines that a veteran is catastrophically disabled for purposes of enrollment in priority group 4 for VA health care. The current regulation relies on specific codes from the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and Current Procedural Terminology (CPT®). We propose to state the descriptions that would identify an individual as catastrophically disabled, instead of using the corresponding ICD-9-CM and CPT® codes. The revisions would ensure that our regulation is not out of date when new versions of those codes are published. The revisions would also broaden some of the descriptions for a finding of catastrophic disability. Additionally, we would eliminate the Folstein Mini Mental State Examination (MMSE) as a criterion for determining whether a veteran meets the definition of catastrophically disabled, because we have determined that the MMSE is no longer a necessary clinical assessment tool. DATES: Comments on the proposed rule must be received by VA on or before [Insert date 60 days after date of publication in the FEDERAL REGISTER]. ADDRESSES: Written comments may be submitted through http://www.regulations.gov; by mail or hand-delivery to the Director, Regulations Management (02REG), Department of Veterans Affairs, 810 Vermont Avenue, NW, Room 1068, Washington, DC 20420; or by fax to (202) 273-9026.
    [Show full text]
  • Lower Limb Amputation Booklet
    A Resource Guide For Lower Limb Amputation Table of Contents Reasons for Amputation . 3 Emotional Adjustments to Amputation . 4 Caring for your Residual Limb . 6 Skin Care Shaping Contracture Management Pressure Relief Sound Limb Preservation Skin Problems Associated with Amputation . 8 Phantom Limb Sensation/Pain . 10 Physical Therapy Following Amputation . 12 Stretches Exercises Preparing for Prosthetic Evaluation . 18 Prosthetic Options . 19 Socket Suspension Knee Feet Caring for your Prosthetic . .. 23 Resources . 24 Websites . 26 Reasons for Amputation There are many reasons for amputations; these are some of the more common causes: Poor Circulation The most common reason for amputation is peripheral artery disease, which leads to poor circulation due to narrowing of the arteries . Without blood flowing throughout the entire limb, the tissues are deprived of oxygen and nutrients . Without oxygen and nutrients, the tissue may begin to die, and this may lead to infection . If the infection becomes too severe, there may be need for amputation . Non-healing wounds or infection People with decreased sensation in the lower extremities may develop wounds and be unaware of these wounds until the wound site has become severe and even infected . If the wound is not responding to antibiotics, the wound may become too severe and there may be need for amputation . Trauma Many types of trauma may result in limb loss, these include, but are not limited to: » Motor vehicle accident » Serious burn » Machinery Accidents » Severe fractures due to falls » Frostbite The most important aspect of many health concerns is prevention . If you have lost a limb due to complications with impaired sensation or circulation, you are at a higher risk for further injury, or new injury to your sound, or intact, limb .
    [Show full text]
  • Traumatic Amputation of the Glans Penis: Report of a Case
    Traumatic amputation of the glans penis: Report of a case ANTHONY J. CERONE, JR., D.O. JEROME R. PIETRAS, n.o. Stratford, New Jersey F. KENNETH SHOCKLEY, DD., FACOS Cherry Hill, New Jersey urologist recognize the need for these supportive Traumatic amputation of the glans discussions. In most cases, adequate sexual func- penis is an unusual injury which has tion on both a physiologic and psychologic basis occasionally been reported in the can be restored. A case of traumatic penile ampu- literature. Usually, the amputation is tation is reported in this article. The amputation the result of an accident; however, it occurred while the patient was masturbating with can be the result of unusual sexual the aid of a hand-held vacuum cleaner. While this behavior. In the case reported, the practice has become more common in recent years, patient was masturbating with a most accounts in the literature on this subject are hand-held vacuum cleaner. presented in a "letters-to-the-editor" section. Practicing urologists should be aware of this traumatic type of injury Report of case and its consequences. The following A 19-year-old white male presented to the hospital fol- operative approaches should be lowing a traumatic injury to the penis. One hour prior to considered: reanastomosis, plastic admission, the patient was engaged in masturbation. In reconstruction, or local reshaping. In search of further excitement during this activity, he uti- the case presented, reshaping was lized a hand-held vacuum cleaner. The patient claimed he learned about this so-called enhancer from advertis- utilized since only the distal glans ing in a pornographic magazine.
    [Show full text]
  • Amputation Explained Download
    2 Amputation Explained CONTENTS About Amputation 03 How Common Are Amputations? 03 General Causes Explained 04 Outlook 06 Complications of Amputation 06 Psychological Impact of Amputation 07 Lower and Upper Limb Amputations 09 How an Amputation is Performed 10 Pre-Operative Assessment 10 Surgery 11 Recovering from Amputation 12 Going Home 15 Contact Us 16 About Amputation This leaflet is part of a series produced by Blesma for your general information. It is designed for anyone scheduled for amputation or further amputations, but is useful for anyone who has had surgery to remove a limb or limbs, or part of a limb or limbs. It is hoped that this information will allow people to monitor their own health and seek early advice and intervention from an appropriate medical practitioner. Any questions brought up by this leaflet should be raised with a doctor. How Common Are Amputations? Between 5,000 and 6,000 major limb amputations are carried out in the UK every year. The most common reason for amputation is a loss of blood supply to the affected limb (critical ischemia), which accounts for 70 per cent of lower limb amputations. Trauma is the most common reason for upper limb amputations, and accounts for 57 per cent. People with either Type 1 or Type 2 diabetes are particularly at risk, and are 15 times more likely to need an amputation than the general population. This is because diabetes leads to high blood glucose levels that can damage blood vessels, leading to a restriction in blood supply. More than half of all amputations are performed in people aged 70 or over, while men are twice as likely to need an amputation as women.
    [Show full text]