title: Severe penile injuries in children and adolescents: reconstruction modalities and outcomes.
abstract: OBJECTIVE
  To review our experience with severe penile trauma, mechanism of injury, and their treatment modalities in 16 children younger than 18 years. Management of penile trauma poses diverse challenges to the reconstructive urologist, as injuries vary from abrasions to total emasculation.
  
  
  METHODS
  Analysis of 16 patients with severe penile injuries referred to us between 2002 and 2011 was undertaken. The median age at surgery was 13 years (range, 5-17). Etiology of penile trauma and choice of treatment were evaluated. The management included a wide variety of surgical techniques that were tailored to the individual patient. Results were analyzed to define etiology, that is, mechanism of penile injury and to estimate modalities of surgical management and postoperative outcomes. Also, postoperative questionnaire was used, which included questions on functioning and esthetical appearance of participating patients and overall satisfaction.
  
  
  RESULTS
  The causes of penile injury in these series were traffic accidents (2), iatrogenic trauma (5), self-amputation (1), electrocution (1), burns (3), dog bite (2), zipper injury (1), and mother's hair strangulation (1). The mean follow-up was 46 months (range, 14-122), and examinations were uneventful, except for 2 fistulae formation after neophallic urethral reconstruction.
  
  
  CONCLUSIONS
  The main goal of reconstructive surgery is to have a penis with normal appearance and functions. Severe penile injuries should be treated on a case-by-case basis using the most propitious techniques.
authors.affiliation: Belgrade University, School of Medicine, Belgrade, Serbia. Electronic address: djordjevic@uromiros.com.
authors.forename: Miroslav L
authors.initials: ML
authors.lastname: Djordjevic
authors.affiliation: Belgrade University, School of Medicine, Belgrade, Serbia.
authors.forename: Marko Z
authors.initials: MZ
authors.lastname: Bumbasirevic
authors.affiliation: Belgrade University, School of Medicine, Belgrade, Serbia.
authors.forename: Zoran
authors.initials: Z
authors.lastname: Krstic
authors.affiliation: Belgrade University, School of Medicine, Belgrade, Serbia.
authors.forename: Marta R
authors.initials: MR
authors.lastname: Bizic
authors.affiliation: Belgrade University, School of Medicine, Belgrade, Serbia.
authors.forename: Borko Z
authors.initials: BZ
authors.lastname: Stojanovic
authors.affiliation: Detroit Medical Center, Detroit, MI.
authors.forename: Ranko
authors.initials: R
authors.lastname: Miocinovic
authors.affiliation: Detroit Medical Center, Detroit, MI.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Santucci
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D010413:Penis / Q000293:injuries* / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000379:methods