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Self-Mutilation of the External Genitalia in Psychiatric Patients in Souro Sanou University Teaching Hospital: Two Cases Report and Literature Review

Received: 15 August 2023     Accepted: 31 August 2023     Published: 13 September 2023
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Abstract

Over a period of three years, two cases of self-amputation of the external genitalia were recorded and managed in our urology division in Souro Sanou University Teaching Hospital. These were male patients and aged 18 years and 32 years respectively. They were irregularly followed up for psychiatric disorders. One was suffering from schizophrenia, the other from paranoid schizophrenia. The first patient self-mutilated with complete sectioning of the penis with a kitchen knife, while the second patient self-mutilated with partial amputation of the penis with exposure of the corpus cavernosa and the left testicle. Managed as an emergency from the onset, the reimplantation of the penile stump could not be carried out due to the lack of an efficient technical expertise with the availability of microsurgery. Hemostasis and refashioning of the amputation stump were performed with definitive urethrostomy for one and penile reconstruction on urethral catheter and directed healing for the other. Postoperatively the two patients were able to urinate through the urethrostomy but the cosmetic appearance of the external genitalia was unsatisfactory. Although rare, self-mutilations are dramatic and serious accidents that can be life-threatening and functionally disabling for patients. Their management must be multidisciplinary, involving urological surgeons, intensive care physicians, emergency physicians and psychiatrists with the treatment of the underlying psychiatric disorder.

Published in International Journal of Clinical Urology (Volume 7, Issue 2)
DOI 10.11648/j.ijcu.20230702.15
Page(s) 48-52
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2023. Published by Science Publishing Group

Keywords

Self-Injury, External Genitalia, Psychiatric, Emergency

References
[1] Ilgi M, Kutsal C, Abdullayev E, Aykanl E, Kirecci SL. A case of genital self-harm in a person with a high level of education. Urology Case Reports. 2017; 10: 19-22.
[2] Sunell H, Power RE, Floyd M, Quinlan DM. Genital self-harm. Int J Urol 2006; 13 (10): 1358-1360.
[3] Moufid K., Joual A., Debbagh A., Bennani S., El Mrini M: Genital self-mutilation: about 3 cases. Prog Urol, 2004; 14: 540-543.
[4] Eke N. Genital self-mutilation: there is no method in this madness. BJU Int. 2000; 85: 295-298.
[5] Veeder TA, Leo RJ. Male genital self-mutilation: A Systematic Review of Psychiatric Disorders and Psychosocial Factors. Gen Hosp Psychiatry. 2017; 44: 43-50.
[6] Waterhouse K, Gross M. Trauma to the genitourinary system: a 5-year experience with 251 cases. J Urol 1969; 101 (03): 241-246.
[7] Schwerkoske JP, Caplan JP, Benford DM. Self-Mutilation and Biblical Delusions: A Review. Psychosomatics. 2012; 53: 327–333.
[8] Schweitzer, I. Genital self-amputation and Klingsor syndrome. Australian and New Zealand Journal of Psychiatry. 1990; 24: 566-569.
[9] Bart S, Culty T, Pizzoferrato AC, Thibault F, Girault N, Chartier-Kastler E. Complete necrosis of the penis and testicles by strangulation in a psychotic context. Prog Urol, 2008, 18: 483-485.
[10] Greilsheimer H, Groves JE. Male genital self-mutilation. Arch Gen Psychiatry. 1979; 36 (4): 441-6.
[11] Kabore FA, Fall PA, Diao B, Fall B, Odzebe A, Tfeil YO, et al. Recurrent penile self-amputation in a schizophrenic background: a case report. Andrology 2008; 18 (3): 224-6.
[12] A. W. S. Odzébé, P. A. Bouya. Auto-amputation of the penis treated by repair from the start: about a case and review of the literature. Prog Urol 2015, 25: 1173-77.
[13] Gahr M, Plener PL, Kölle MA, Freudenmann RW, Schönfeldt-Lecuona C. Substance-induced self-mutilation: A systematic review. Psychiatry Res. 2012, 30; 200 (2-3): 977-83.
[14] Faustin Félicien Mouafo Tambo. Accidents of circumcision in Yaoundé, Cameroon: about five clinical observations. Prog Urol 2012, 22: 63-66.
[15] Jakhar K, Beniwal RP, Bhatia T, and Deshpande SN. Self-harm and suicide attempts in schizophrenia. Asian J Psychiatry. 2017; 30: 102-106.
[16] Tiftikcioglu YO, Erenoglu CM, Lineaweaver WC. A systematic review of penile replantations: can it guide us in penile allotransplantation? Turk J Plast Surg. 2018; 26: 97-102.
[17] El harrech Y, Abaka N, Ghoundale O, Touiti D. Genital auto-amputation or Klingsor syndrome: Successful non-microsurgical penile replantation. Annals of Urology. 2013; 5 (4): 305-308.
Cite This Article
  • APA Style

    Adama Ouattara, Abdoul Karim Paré, Mamadou T. Traoré, Delphine Yé, Aissata Ouédraogo, et al. (2023). Self-Mutilation of the External Genitalia in Psychiatric Patients in Souro Sanou University Teaching Hospital: Two Cases Report and Literature Review. International Journal of Clinical Urology, 7(2), 48-52. https://doi.org/10.11648/j.ijcu.20230702.15

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    ACS Style

    Adama Ouattara; Abdoul Karim Paré; Mamadou T. Traoré; Delphine Yé; Aissata Ouédraogo, et al. Self-Mutilation of the External Genitalia in Psychiatric Patients in Souro Sanou University Teaching Hospital: Two Cases Report and Literature Review. Int. J. Clin. Urol. 2023, 7(2), 48-52. doi: 10.11648/j.ijcu.20230702.15

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    AMA Style

    Adama Ouattara, Abdoul Karim Paré, Mamadou T. Traoré, Delphine Yé, Aissata Ouédraogo, et al. Self-Mutilation of the External Genitalia in Psychiatric Patients in Souro Sanou University Teaching Hospital: Two Cases Report and Literature Review. Int J Clin Urol. 2023;7(2):48-52. doi: 10.11648/j.ijcu.20230702.15

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  • @article{10.11648/j.ijcu.20230702.15,
      author = {Adama Ouattara and Abdoul Karim Paré and Mamadou T. Traoré and Delphine Yé and Aissata Ouédraogo and Ali Sherazi and Mohamed Simporé and Mickael Rouamba and Timothée Kambou},
      title = {Self-Mutilation of the External Genitalia in Psychiatric Patients in Souro Sanou University Teaching Hospital: Two Cases Report and Literature Review},
      journal = {International Journal of Clinical Urology},
      volume = {7},
      number = {2},
      pages = {48-52},
      doi = {10.11648/j.ijcu.20230702.15},
      url = {https://doi.org/10.11648/j.ijcu.20230702.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcu.20230702.15},
      abstract = {Over a period of three years, two cases of self-amputation of the external genitalia were recorded and managed in our urology division in Souro Sanou University Teaching Hospital. These were male patients and aged 18 years and 32 years respectively. They were irregularly followed up for psychiatric disorders. One was suffering from schizophrenia, the other from paranoid schizophrenia. The first patient self-mutilated with complete sectioning of the penis with a kitchen knife, while the second patient self-mutilated with partial amputation of the penis with exposure of the corpus cavernosa and the left testicle. Managed as an emergency from the onset, the reimplantation of the penile stump could not be carried out due to the lack of an efficient technical expertise with the availability of microsurgery. Hemostasis and refashioning of the amputation stump were performed with definitive urethrostomy for one and penile reconstruction on urethral catheter and directed healing for the other. Postoperatively the two patients were able to urinate through the urethrostomy but the cosmetic appearance of the external genitalia was unsatisfactory. Although rare, self-mutilations are dramatic and serious accidents that can be life-threatening and functionally disabling for patients. Their management must be multidisciplinary, involving urological surgeons, intensive care physicians, emergency physicians and psychiatrists with the treatment of the underlying psychiatric disorder.},
     year = {2023}
    }
    

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Author Information
  • Division of Urology, Souro Sanou University Teaching Hospital, Bobo-Dioulasso, Burkina Faso

  • Division of Urology, Souro Sanou University Teaching Hospital, Bobo-Dioulasso, Burkina Faso

  • Division of Urology, Regional University Teaching Hospital, Ouahigouya, Burkina Faso

  • Division of Urology, Souro Sanou University Teaching Hospital, Bobo-Dioulasso, Burkina Faso

  • Division of Urology, Regional University Teaching Hospital, Ouahigouya, Burkina Faso

  • Department of Medicine, Dalhousie Medicine New Brunswick, Saint John, Canada

  • Division of Urology, Souro Sanou University Teaching Hospital, Bobo-Dioulasso, Burkina Faso

  • Division of Urology, Souro Sanou University Teaching Hospital, Bobo-Dioulasso, Burkina Faso

  • Division of Urology, Souro Sanou University Teaching Hospital, Bobo-Dioulasso, Burkina Faso

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