title: [Penile necrosis resulting from post-circumcision microwave diathermy: A report of 9 cases].
abstract: OBJECTIVE
  To investigate the pathogenesis and treatment of penile necrosis resulting from microwave diathermy following circumcision.
  
  
  METHODS
  We retrospectively analyzed the clinical data about 9 cases of penile necrosis resulting from postoperative microwave diathermy following circumcision. The 9 males, aged 20 - 39 (mean 26) years, underwent traditional circumcision for redundant prepuce or phimosis in other hospitals, followed by microwave diathermy for 30 - 60 minutes daily, which resulted in penile necrosis. With no response to conservative therapy, the patients were referred to our hospital at 3 -30 days postoperatively. Of the 9 patients, 5 presented with dry gangrene and 4 with moist gangrene. Six of the patients underwent partial penectomy, including 1 that received penis lengthening.3 months later, while the other 3 underwent total penectomy for total penile necrosis followed by penile reconstruction 3 months later, with deep inferior epigastric perforator (DIEP) flaps and by implantation of the 12th costal cartilage in 2 cases and with epigastric groin island flaps and by urethroplasty in the other.
  
  
  RESULTS
  The patients were followed up for 2 - 8 years, and all could urinate smoothly in the standing position. Of the 6 men treated by partial penectomy, 1 received penis lengthening and achieved a penile length of 7 cm and 5 had the remaining penile length of 3 -5 cm, 4 with erectile function and the other 2 capable of sexual intercourse. The 3 men treated by total penectomy achieved nearly normal external appearance of the penis, with a finalized length of (11.7 ± 1.3) cm, a circumference of (11.4 ± 2.1) cm, and a normal feel of the skin. Of the 3 cases of penile reconstruction, 2 achieved sufficient erectile hardness of the penis (grade 3) for sexual intercourse, while the other 1 remained impotent.
  
  
  CONCLUSIONS
  Post-circumcision microwave diathermy may result in penile necrosis, for the management of which, early debridement is necessitated and penile lengthening or reconstruction can be performed according to the severity of the lesion and needs of the patient.
authors.forename: Dan-bo
authors.initials: DB
authors.lastname: Fang
authors.forename: Yue-hong
authors.initials: YH
authors.lastname: Shen
authors.forename: Xuan-wen
authors.initials: XW
authors.lastname: Zhu
authors.forename: Jia-jie
authors.initials: JJ
authors.lastname: Fang
authors.forename: Qi-qi
authors.initials: QQ
authors.lastname: Mao
authors.lastname: Wang Chao-jun
authors.forename: Fu-qing
authors.initials: FQ
authors.lastname: Tan
authors.forename: Qing-wei
authors.initials: QW
authors.lastname: He
authors.forename: Bo-hua
authors.initials: BH
authors.lastname: Shen
authors.forename: Li-ping
authors.initials: LP
authors.lastname: Xie
mesh_terms: D000328:Adult; D002944:Circumcision, Male / Q000379:methods*; D003075:Coitus; D066186:Costal Cartilage / Q000637:transplantation; D003972:Diathermy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D008872:Microwaves / Q000009:adverse effects*; D010413:Penis / Q000002:abnormalities / Q000601:surgery; D010688:Phimosis / Q000601:surgery; D011184:Postoperative Period; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D055815:Young Adult