title: Leech therapy in penile replantation: a case of recurrent penile self-amputation.
abstract: Penile amputation is a rare urologic trauma for which immediate surgical replantation is indicated. Microsurgical techniques can reduce skin and graft loss complications; nonetheless, such complications are still highly prevalent. We report a case of self-inflicted penile amputation and describe a nonmicrosurgical technique for replantation. To improve postoperative edema due to venous congestion, we applied medicinal leeches to the penis. The edema quickly resolved, but overlying skin loss occurred, which required superficial debridement. At follow-up the patient had glans re-epithelialization with normal voiding, sensation, and erections. To our knowledge, this is the first reported case of nonmicrosurgical penile replantation with leech therapy.
authors.affiliation: Division of Urology, Department of Surgery, University of Texas Medical Branch at Galveston, Galveston, Texas 77550-0540, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Mineo
authors.forename: Tracie
authors.initials: T
authors.lastname: Jolley
authors.forename: Gabriel
authors.initials: G
authors.lastname: Rodriguez
mesh_terms: D000328:Adult; D003646:Debridement; D004435:Eating; D004487:Edema / Q000628:therapy*; D006801:Humans; D024763:Leeching / Q000379:methods*; D008297:Male; D010409:Penile Diseases / Q000628:therapy*; D010413:Penis / Q000293:injuries / Q000601:surgery*; D011183:Postoperative Complications / Q000628:therapy*; D012008:Recurrence; D012092:Replantation / Q000379:methods; D012557:Schizoid Personality Disorder / Q000523:psychology; D012652:Self Mutilation / Q000523:psychology / Q000601:surgery*