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Self-mutilation is intentionally injuring oneself. Generally, the most common self-inflicted wounds are burns and cuts which can be closed and open. In extreme cases it could be a suicidal attempt. In urology, genitals are usually the object of mutilation. Because of their anatomical features and topographic location, they are most commonly exposed to these procedures. There may be cuts on the penis, perineum, scrotum; scrotum avulsion, orhiectomia, castration to penile amputation. These are mental patients suffering from paranioid schizophrenia. As part of their delusions, they have bodily-cinesthetic hallucinations that manifest discomfort in the genital area. There is a delusional idea that the only solution to eliminate the hallucinations present is to self-mutilate. Because these organs are very blood-borne, they are always shocked after the ritual because of bleeding and pain. We present a 46-year-old patient with severe genital injury, scrotum avulsion, and subtotal penile amputation. Since more than 2 hours had passed since self-mutilation, the suture of the penis could not be done, so after resuscitation, a suture of the scrotum, tunica albuginae and an external urethral opening were done. After leaving the recovery room, he was transferred to a psychiatric ward and later to a higher health care facility.

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