A penectomy, or amputation of the penis, is an operation to partially or completely remove the penis. It is considered the most severe genital injury. The frequency of surgical intervention is very small - no more than five percent among all types of injuries of the genitourinary organs of men. From a technical point of view, this procedure is very simple and much easier than a resection of limbs or internal organs. The most difficult thing is to maintain the psychological health of a man who has lost a penis.
Indications for removal
There are many indications for amputation of the penis. Conventionally, they can be distinguished into those that were caused by diseases (tumors, tissue necrosis, etc.), as well as injuries. This can be penetrating wounds with various objects, an injury to an organ in production, a gunshot wound, injuries associated with bites of wild or domestic animals. Amputation of the penis can be a result of burns or frostbite.
After examining the nature of the damage, the doctor decides what type of surgery will be performed: partial resection or complete removal.
Partial resection
A complete penectomy is performed only in case of severe pathologies or if the patient wants to change the gender. Partial amputation of the penis is necessary when a cancer is detected. During the operation, the doctor removes the tumor lesion with mandatory excision of the lymph nodes. In severe forms of cancer, removal of the affected pelvic bones is sometimes necessary.
With superficial wounds of the penis that do not affect the protein membrane, tissue suturing is performed while maintaining integrity.
After mechanical damage, as a result of which not only the skin is injured, but also the urethra, the cavernous body, it is necessary to provide medical assistance as soon as possible. Otherwise, due to circulatory disorders, tissue necrosis occurs. In such situations, a partial penectomy operation may be performed. If it is impossible to restore the function of the organ as a result of injuries or illness, it is removed.
The penis may be partially removed as a result of frostbite or burns. The doctor excises the affected tissue.
Penile abruption
In cases of scalping of the penis, at its separation, on the first day it is possible to maintain the viability of the organ. To do this, the torn off part of the body is treated with an antiseptic solution, placed in a sterile container and placed in the cold. Organ can be delivered to a medical facility by packing in an ice pack.
Ideally, upon separation, consult a doctor as soon as possible. Surgeons perform organ suturing operations. After rehabilitation, he partially or fully restores his function.
Surgery
Partial or complete removal of the penis is carried out in various ways. These include:
- Surgical removal by emasculation. This type of operation is applicable if a fourth stage cancer with metastases in the scrotum is diagnosed. At this stage, the testicles and the entire penis are also removed. Ectomy is performed under general anesthesia. First, surgeons excise the skin in the inguinal zone, followed by the intersection of the spermatic cord. After this, the affected lymph nodes and, in fact, the penis, are removed, with further suturing of the urethra.
- For cancer located on the glans penis, the scalping method is used.
- In case of damage to the foreskin, the skin is first excised at the base of the penis. After this, it is scalped to the borders of the coronary sulcus, and then the tissues are cut off. Next, the doctor prepares a tunnel in front of the scrotum and places the penis there. To do this, a transverse incision is made on the skin of the scrotum, into which the head of the penis is inserted, then the tissues are sutured. After some time, repeated surgical intervention is indicated, aimed at releasing the penis from the scrotum with further suturing of the renewed skin.
- Total amputation with urethrostomy. It is performed before the onset of the protein coat. During this type of operation, cavernous bodies intersect with the imposition of nodal sutures on them. Then, the urethra is sutured in the perineal skin. At the end of the operation, a catheter is inserted into the urine, which will be there permanently.
Penectomy technique
If a tumor of the penis is detected and with other pathologies, if surgery is indicated, the doctor will decide how the surgery will be performed. He can leave a stump of 2-3 centimeters or completely remove the organ.
If possible, the surgeon leaves the stump: he outlines the boundary for the cutoff of the organ. With complete defeat, its complete amputation is indicated.
Any intervention is carried out under general anesthesia. During surgery, a condom or finger from a medical glove is put on the affected areas. This procedure is necessary so that cancer cells do not infect healthy tissue.
To reduce blood loss, a tourniquet is applied to the base of the penis. After preparation, the doctor makes an incision at an angle, allowing you to save as much skin as possible. Subsequently, the stump is closed with it. The excision of the organ is carried out gradually: starting with the surface tissues and with a gradual advance in depth.
Amputation of the penis ends with suturing of the skin. A hood is pulled over the stump, the ends of which are sutured so as to leave a hole for the urethra. If there is no skin left, then it is taken from another part of the body.
Other penis surgery
In some cultures, for religious reasons, the foreskin is removed in men and boys. This operation is called circumcision - circular removal of the skin of the foreskin.
The reasons for removing the foreskin of a man are very different. In some countries, this procedure is performed in boys, after which they are considered men. Also, removal is carried out to increase the duration of sexual intercourse.
From a medical point of view, the open head of the penis is less susceptible to inflammation, so this procedure is applicable in hot countries, where sand and other contaminants can get under the foreskin. Surgery is also indicated for congenital malformations of the penis.
Amputation of the penis during sex change
Penis removal is performed with sex correction. After this operation, patients experience only psychological satisfaction.
Sex change has its drawbacks. During intercourse, the vagina will always be dry. So that the genital gap does not close, and the tissues of which it is made are not reduced, you have to almost always wear a glass or other shape.
The disadvantages of sex change include the lack of sensations from sexual intercourse, not counting prostate massage and exposure to other erogenous zones. And with too violent sex, bleeding, fistulas may develop, damage to the bladder, rectum is not excluded. And these are far from all the negative consequences of gender correction.