Comment & Debate
Rosemary Romberg. “Circumcision – The Painful Dilemma. Chapter Eleven: Complications of Circumcision (Condensed)”. Bergin & Garvey Publishers, Massachusetts. 1985 – “Loss of Penis: I have purposely saved the most dramatic and devastating complication for last. There have been cases in which the penis has been lost due to circumcision, caused by mishandling of the operation, as a result of an infection, or by a burn from electrocautery technique. In some cases enough penile shaft remained so that after extensive operations a functional penis could be reconstructed. In other cases the child has been surgically made into a girl.
Hamm and Kanthak describe two infants who underwent penile reconstruction:
Two cases of gangrene of the penis in newborn infants occurred following circumcision for which a high frequency cutting current was utilized. In each instance the procedure was done by the physician in this way for the first time and had been utilized in the hope that a simple, hemostatic method of circumcision would result. Each of these cases was attended by more or less complete sloughing of the external portion of the penis resulting, on spontaneous healing, in a flat, smooth area of skin continuous with the scrotum on which no evidence of penile projection was present. In each of these cases a satisfactory penis was reconstructed.
…The penis has been reconstructed utilizing the remains of the corpora cavernosa penis and the corpus cavernosum urethrae with its enclosed urethra….
Repair of the penis utilizing the remains of the penile stump by exteriorizing the deep portions of the corpora cavernosa and covering the newly formed shaft with a free skin graft provides a direct approach and a penis composed of more physiologically normal elements than is otherwise possible. 61.