[Mutilations and dental deformities].
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The three main penile emergency situations have been examined so as to better define the clinical and therapeutic aspects. In the present study, a fracture of the penis (n = 12) occurred following a coital accident in 8 cases. In general, a clinical diagnosis was made and emergency surgical treatment appeared to be the most efficient means of preventing possible erectile malfunction. Mutilation of the penis was observed (n = 12) following traditional circumcision or circumcision performed by paramedical staff; or was due to self-inflicted mutilation and pyschiatric disorder (n = 6), and in one case to sexual deviation (n = 1) This category of accidents could be more adequately managed by the psychiatric treatment of certain patients and by better training of the personnel carrying out the circumcision. Priapism (n = 42) was due to sickle cell disease in 50% of cases, and relapse was noted in 10% of patients.
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Bilateral sperm granuloma with diffuse spermatocele was found to be the cause of infertility in a young Golden Retriever. Anamnesis indicated that the dog had intermittent episodes of self-inflicted ulcerative scrotal dermatitis, beginning when it was 4 to 5 months old and regardless of season or environment. A complete breeding soundness examination produced consistently azoospermic ejaculates in the presence of bilaterally firm, distinct swellings of the epididymides. Because of the poor reproductive prognosis, the owner requested castration and scrotal ablation. Although scrotal trauma was initially thought to be associated with the onset of sperm granuloma formation, evaluation of the history and physical examination and laboratory findings indicated that a bilateral congenital anomaly was the most likely cause of infertility.
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Two patients are reported with repeated, nonhealing wounds due to auto-mutilation. The diagnostic and psychiatric problems involved are discussed.
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A case is presented of a 49-year-old man who amputated his penis following instructions that he had obtained from the Internet. The patient had a long-standing amputee fetish, which evolved into eroticized genital mutilation. The transformation of the preferred fetish occurred in a setting of depression due to environmental stressors. The literature about amputee fetishism, also called "apotemnophilia," is reviewed, and possible connections with the genital mutilation are discussed.
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