Successful penile reconstruction following prior arteriovenous loop thrombosis due to undiagnosed protein-S deficiency and exogenous testosterone.
Flap failure from microvascular thrombotic occlusion is a rare but significant cause for unsuccessful reconstructive surgery. We encountered thrombosis of arteriovenous loop in a patient undergoing phallus reconstruction. Further investigations revealed underlying previously asymptomatic hypercoagulable state due to protein-S deficiency in addition to long-term exogenous testosterone administration. Role of thrombophilia testing, thrombogenic potential of testosterone and the need for therapeutic perioperative anti-coagulation in such situations are described here.
Department of Hematology, Apollo Hospitals, Bengaluru, Karnataka, India.
Parameswaran
P
Anoop
Department of Plastic Surgery, Apollo Hospitals, Bengaluru, Karnataka, India.
Vithal
V
Malmande
Department of Plastic Surgery, Apollo Hospitals, Bengaluru, Karnataka, India.
M N
MN
Prakash Kumar
Department of Plastic Surgery, Apollo Hospitals, Bengaluru, Karnataka, India.
Naveen
N
Rao
Microvascular thrombosis; testosterone; thrombophilia