Experience in non-microscopic surgical management of complete penile amputation in a resource-limited setting: a case report.

[INTRODUCTION AND IMPORTANCE] Penile amputation is a urologic emergency requiring prompt treatment to optimize outcomes. This report focuses on a case of self-inflicted penile amputation, its surgical management, and a review of current literature.

[CASE PRESENTATION] A 40-year-old Ethiopian male with a known psychiatric illness arrived at the emergency department eight hours after a complete penile amputation. He underwent non-microsurgical replantation, reconnecting the corporal, fascial layers, and skin. Post-surgery, he recovered well with good erectile function, preserved sensation, and an acceptable appearance. He was discharged six weeks later.

[CLINICAL DISCUSSION] While microsurgical replantation is considered the gold standard, emerging evidence suggests that non-microsurgical techniques can achieve favorable outcomes, particularly when performed within a critical ischemia window. This case supports previous findings that penile replantation without microvascular anastomosis can still restore organ viability, adequate urinary function, and satisfactory sexual outcomes. The report underscores the potential role of corporal blood supply in maintaining penile perfusion even without vascular re-anastomosis.

[CONCLUSION] In cases of complete penile amputation without microsurgical tools, gross replantation is the preferred treatment, offering good functional and cosmetic outcomes.