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Management of Trauma to the Penis


       
Trauma to the penis and the testicles is thought to be rare, but is far from it. For example, considering that circumcision is done to ALL Muslims and Jewish, it is done to millions of boys worldwide. And considering that every surgery has possible complications, a procedure done to millions must result in thousands of complications (at least). This is the case. Circumcision has resulted in total and partial loss of the penis in many. The consensus was either to leave this victim as is, or if the victim is less than one year old, convert him to a female, which is easy, especially considering that the gender identity (feeling of masculinity) is not yet well formed at this age. This harsh destiny motivated me to devise surgical techniques that changed the future of many:

Construction Of Neo-Glans Penis: A New Sculpturing Technique From Rectus Abdominis Myo-Fascial Flap
O.K.Z. Shaeer and A. El Sebaie
J Sex Med 2005; 2: 259–265

Shaeer O. Restoration Of The Penis Following Amputation At Circumcision: Shaeer’s A-Y Plasty. JSM-08-2007-294. In Press.


The first technique targets those with amputation of the glans (head of the penis), making it possible to restore the shape of the penis using an abdominal muscle and special sculpturing techniques.

The second technique targets those with total amputation of the penis, restoring the penis by utilizing the reserve that is normally attached to the pubic bone, with security measures that will prevent retraction of that reserve back to where it came from read more .

Circumcision is not the only cause of injury. My colleagues all over the world and myself have treated gun shot injuries, cut injuries, caustic injuries, thermal injuries and car accidents that have mutilated the genitals. Strangest of all is the “hair-coil syndrome”, where a hair strand from the mother falls to the penis of the child, spontaneously wraps around it and tightens till it causes necrosis (death) of the penis, that falls off! We have treated a lot of these rare cases with our techniques.
 

 Neo-Glans Formation

Pre and Post

Rectus flap harvested.

Rectus flap set to the recepient site.

Fashioning the flap.

Fashioning the flap.

 Shaft Restoration

Pre and Post

The penis released after cutting the ligament. The "A" has been cut. Note the cavity between the penis and pubis.

De-epithelialized caudal rectangle.

Caudal fat rectangle inside the cavity and the skin triangle attached to the base of the penis to pull it up.

Y closure

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Management of Fracture Penis


      
Fracture of the penis is a condition where excessive force applied to the long axis of the penis in the erect state results in rupture of the tunica albuginea of the corpus cavernosum. Surgical management can be confusing and time consuming due to the concealment of the tear in organized blood and edematous tissue, necessitating extensive dissection in friable traumatized tissues, especially if the tear is a small one, or if there are multiple tears.

      
I use methylene blue to aid the localization of tunical and urethral tears in such cases. Methylene blue was injected into the corpora cavernosa and through the urethral meatus to point out tears. This rendered repair easy, reliable, safe and fast, and eliminated the need for unnecessary lengthening of the surgical repair, as well as the need for more complex imaging procedures.

Methylene Blue-Guided Repair of Fractured Penis
O.K.Z. Shaeer
J Sex Med 2006;3:349–354

 

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Treatment of Mutilation of the Glans by Re-sculpturing


      
Mutilation of the glans of the penis occurs as a congenital abnormality or as a complication of surgery or injury. Replacement of the glans with other tissues deprives the patient of the unique erogenous sensation of glanular tissues. If remnants of the glans still exist, they can be reconfigured into the shape of a relatively normal glans with preservationof the erogenous sensation:

Shaeer O, El-Sebaie A, Sherif ِ ِِA, El-Sadat A. Re-Configuration of the Mutilated Glans. J sex Med. In Press
 

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