Machado Prof Bruno, Tran Aimee, Scherzer Dr. Nickolas, Bailey Scott, Hellstrom Prof. Wayne

(222) THE NEW PENIS SCORING CRITERIA AND PACKAGE CHECKLIST: RESULTS OF A LITERATURE SYSTEMATIC REVIEW OF PENILE AMPUTATION AND REPLANTATION

  • Urology
  • Reproductive Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Psychiatry and Mental health
Save to CiteDrive Show PDF

Abstract Objectives This study has 3 aims: 1) Produce an updated systematic review of penile replantation 2) Appraise the comparative value of the PENIS Score and propose the PACKAGE Checklist for penile amputation case reports and reviews 3) Identify confusing terminology and recommend standardizing vocabulary to describe penile amputation and replantation. Methods We assessed 432 full-text case reports in 20 languages identifying 122 microsurgical and 40 surgical cases of penile replantation that qualified for our review. The cases were stratified using the PENIS Score for penile amputations using five criteria: position, extension, neurovascular repair, ischemia time and type, and severed edges and contamination. Four outcomes: postoperative complications, erection, urination, and sensation, were evaluated using Kendall’s tau coefficient for each of the PENIS criteria. Results The viability of microsurgical and surgical replantation was equivalent at 92% and 94%, respectively. A statistical correlation was found between microsurgical repair and the return of sensation, though this did not correlate with nerve repair. The return of sensation with nerve repair was 51%, comparable to microsurgical replantation without nerve repair at 42%, both were significantly higher than the 14% found in surgical replantation. A significant correlation was noted between the extension of the amputation and the severity of postoperative complications in microsurgical replantations, (τ = .2649, p = .0126), not observed with surgical replantation. the presence of a skin bridge was associated with a 40% reduction in severe postoperative complications compared to complete amputations, regardless of surgical method. Conclusions Microsurgical replantation is superior in the return of sensation, with or without nerve repair. In the absence of microsurgical skills, surgical replantation is an appropriate alternative. The lack of standardization in penile replantation case reports makes the comparison between case-reports difficult. Implementing the PACKAGE Checklist and PENIS Score will help future case reports and systematic reviews, allowing for more robust conclusions. Conflicts of Interest Authors do not have conflict of interest.

Need a simple solution for managing your BibTeX entries? Explore CiteDrive!

  • Web-based, modern reference management
  • Collaborate and share with fellow researchers
  • Integration with Overleaf
  • Comprehensive BibTeX/BibLaTeX support
  • Save articles and websites directly from your browser
  • Search for new articles from a database of tens of millions of references
Try out CiteDrive

More from our Archive