Publications
- Birmingham surgeons rose to the challenge of reattaching a man's amputated penis
- This penile replantation was especially difficult considering the duration of lost blood supply to the organ
- However, the surgery was successful, and the man is reportedly able to have an erection
A 34-year-old man has been making international headlines after having his penis successfully reattached by surgeons in Birmingham, 23 hours after he had cut it off. The man is reported to have a history of paranoid schizophrenia, which led to him amputating his penis during a self-harm incident.
According to the surgeons from the University Hospitals Birmingham NHS Foundation Trust, whose case report was published in BMJ Case Reports, “complete penile amputation is a rare and poorly documented injury with severe physical and psychosocial implications”.
The surgeons also wrote that this is the longest documented time a penis has been without sufficient blood flow, and had still managed to be successfully reattached.
Previous successful case studies
Successful penile replantation, as it is known, is rare as it is often complicated by prolonged ischaemia (reduced blood flow to the tissue or organ). Other similar cases include a 1999 surgical procedure after a four-year-old Saudi Arabian boy’s circumcision – performed outside of hospital – was accidentally amputated.
In this case, the organ had been without blood supply for 18 hours and replantation was successful. The report was published in the British Journal of Plastic Surgery.
Another 2015 report from the Canadian Urological Association Journal documents a rare case where a 51-year-old paranoid schizophrenic patient showed up at the hospital two hours after he had amputated his penis and swallowed its stump.
Luckily for him, the surgeons were able to retrieve the stump from his stomach and successfully reattach it. The surgeons wrote that they had followed his progress three years after the surgery, and he had reported “adequate erection for intercourse and good urinary function”, although he had experienced sensory loss over the glans (head of the penis), among other things.
Perhaps most famous of all was the case of John Wayne Bobbitt who arrived at the emergency room in 1993, after his then wife had cut off his penis with a 30cm knife. "It was kind of an out-of-body experience,” James Sehn, MD, the urologist who treated Bobbitt said in an interview with 20/20. Bobbitt also ended up walking out of the hospital a happy man, after his surgery turned out well.
In an article in Seminars in Plastic Surgery, the authors note that penile amputation commonly occurs as a result of self-mutilation, accidental trauma during circumcision, entrapment in machinery, or trauma inflicted by a partner following marital discord.
Birmingham surgeons encourage penile replantation
In the recent case, the Birmingham surgeons explained that the man’s urethra was working six weeks post-surgery, and that sensation had returned to his penis. More than this, he was able to achieve a full erection after the team carefully reattached his arteries and veins.
Due to the success of this operation, and considering it is the longest ischaemia time reported in published case studies and reviews, the surgeons encouraged this type of replantation:
“Penile replantation should be attempted, even if ischaemia time is prolonged, despite lower success rates given the significance of the injury to an individual,” they wrote.
