Management of self-inflicted orchiectomy in psychiatric patient. Case report and non-systematic review of the literature

Abstract

Introduction: Self-inflicted orchidectomy and auto-castration, also known as “Eshmun complex” is a rare phenomenon. The aim of our study it to present the management of a patient who performed a self orchiectomy and propose a non-systematic review of literature about self-orchiectomy. Material and method: A 27-years old male Patient with psychiatric disorder was admitted to our ward to have been cutted his scrotum with scissors and cut away his left testicle causing active bleeding from the left spermatic artery. The patient underwent emergency surgery with clamping of the spermatic cord and hemostasis of the wound. Results: After surgery the clinical condition of the patient remained good during whole hospitalization. Urgent psychiatric evaluation was performed in order to administer proper therapy for acute management. To best of our knowledge, only 11 cases of self-orchidectomy are reported in literature and all of them except 1 case, underwent surgical exploration. Conclusions: Self-orchidectomy is an extremely rare phenomenon, often associated with psychiatric disorders, compounded by the use of drugs. In our opinion, emergency surgery should be the first choice of treatment, offering diagnostic and hemostatic purpose in a single act, aimed to prevent acute and postacute complications.

A Case Report of Self-Inflicted Surgical Castration

“…In particular, most self-inflicted testicular injuries involve the self-injection of poisons. Self-inflicted surgical castration without local anesthesia, as in this case, is very rare [1].…”

“…Genital self-mutilation is extremely rare [1]. The majority of cases of self-mutilation involve a slit on the wrist, primarily carried out for attention during puberty.…”

Szemikasztráció önkezűleg = Self-semicastration

“…Az ókori mitológia alapján az önkezűleg, saját magán elvégzett (auto) szemikasztráció jelenségét Eshmun-komplexusként is jelölik (1). A mitológia szerint Eshmun isten, hogy véget…”

Male genital self-mutilation due to tomophobia – case report and review of literature

“…Self-inflicted orchidectomy and auto-castration (also known as Eshmun complex) is a type of major self-mutilation that are usually common among younger individuals with psychiatric illness. 1 Throughout history there have been numerous reports of self-mutilation which usually involves mutilation of eyes, ears and genitals. 2 It is estimated that the incidence of genital self-mutilation between the ages of 18–35 is 1800 individuals per 100,000.…”