A 50 yr depressed person self injured his penoscrotal region .Both carpora cavernosa and spongiosum almost cut.Left spermatic cord along with testicular artery also cut.Hb was 6.5 gm%.Treatment?



Partial penectomy and orchictomy on left repair urethra well

It is good that patient has been catheterised .It becomes the core around which primary repair can be done of corpora cavernosa and spongiosum .and lastly skin . Good parenteral antibiotics like Ceftriaxone 1gm + sulbactum 500mg B.D for 7 days followed by oral antibiotics. Tab chymoral forte 6 hourly for 10 days. Inj Tetglob 250 IU. Follow up of patient will tell whether primary repair is successful. If not later on perineal urethrostomy may be required

Primary repair and reconstruction. Repair Urethra over Foley, Repair of corpora followed by skin. Testicular artery if possible anastomosis could be done otherwise testis have other collateral supply too.. just repair primarily under antibiotic cover.

Yes I have repaired it .result is awaited.Atleast after 3rd post op day still there is no sign of ischemic necrosis.good sign.thanks

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Good control on bleeding vessels. Whatever gone is gone. Primary repair around Foley Later, urination causes soiling and softening of scrotum then perineal urethrostomy,not now

Primary repair is recommended. If a vascular surgeon or plastic surgeon is available then vascular reanastomosis should be planned. Else assess existing vascularity and plan Orchiectomy if needed

Primary articular repair by micro vascular surgoen

I agree with Dr.A.Kumar.

Hb status correction Surgical repair Cath drainage to continue Antibiotic

Partial penectomy & Lt. Orchidectomy...

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