Background: Penile amputation is an emergency urologic condition requiring immediate attention in order to maximize functional outcomes. Unfortunately, there is limited experience and publication of case reports describing the successful replantation of penis after incomplete amputation, especially in facilities without adequate microsurgical tools and means. We hereby present a case of penile amputation caused by a mechanical grass cutter and a discussion of its surgical management. Case description: A 33-year-old Indonesian male presented to the emergency department with incomplete penile amputation six hours post injury. The patient has no prior medical history and presented with penile amputation due to a mechanical grass cutter trauma. He underwent immediate non-microsurgery reconstructive replantation of the penis, reattaching all visible vascular, corporal, and fascia layers. After replantation, the patient recovered well and showed preserved normal appearance and sensitivity of the penis. Subsequent Doppler ultrasound investigation revealed adequate arterial flow at the distal end of the anastomosis. The patient was discharged five days after surgery.  Conclusion: In the absence of microsurgical tools and means, the use of non-microsurgical replantation with an at least 2.5x loupe magnification should be the choice of treatment in the case of incomplete penile amputation. The technique showed good outcomes involving adequate functional and cosmetic restoration.

Ikterus atau jaundice sering dijumpai pada neonatus dan bayi. Ikterus dapat bersifat fisiologis atau patologis. Pada dasarnya, ikterus merupakan manifestasi klinis peningkatan kadar bilirubin dalam darah atau hiperbilirubinemia. Peningkatan bilirubin yang berlebihan berpotensi toksik dan dapat menyebabkan kematian. Pendekatan klinis yang baik dan terarah sangat penting untuk menentukan secara cepat dan tepat perlunya evaluasi dan intervensi medis lanjutan. Icterus or jaundice is a clinical symptom often found in neonates and infants. The condition might arise from physiological or pathological causes. Jaundice is a clinical manifestation signifying an elevated blood level of bilirubin (hyperbilirubinemia). Excessive increase in bilirubin is potentially toxic and might even lead to death. A good and directed clinical approach is very important to evaluate the need for further medical intervention.

No abstract

Background: Penile amputation is an emergency urologic condition requiring immediate attention in order to maximize functional outcomes. Unfortunately, there is limited experience and publication of case reports describing the successful replantation of penis after incomplete amputation, especially in facilities without adequate microsurgical tools and means. We hereby present a case of penile amputation caused by a mechanical grass cutter and a discussion of its surgical management. Case description: A 33-year-old Indonesian male presented to the emergency department with incomplete penile amputation six hours post injury. The patient has no prior medical history and presented with penile amputation due to a mechanical grass cutter trauma. He underwent immediate non-microsurgery reconstructive replantation of the penis, reattaching all visible vascular, corporal, and fascia layers. After replantation, the patient recovered well and showed preserved normal appearance and sensitivity of the penis. Subsequent Doppler ultrasound investigation revealed adequate arterial flow at the distal end of the anastomosis. The patient was discharged five days after surgery.  Conclusion: In the absence of microsurgical tools and means, the use of non-microsurgical replantation should be the choice of treatment in the case of incomplete penile amputation. The technique showed good outcomes involving adequate functional and cosmetic restoration.