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Surgeons at Kenyatta National Hospital have successfully reattached a teenager’s severed manhood after a seven-hour operation.

Led by Prof Stanely Khainga, the team of urologists and plastic surgeons worked to reattach the teenager’s organ which was severed after an attack at his home.

The 16 year old teenager, only known as A.M. for reasons of protecting his privacy, was assaulted by unknown people at around 1 a.m. on the night of December 18, 2018.

During the horrifying night attack that took place at the Form Three student’s home, the assailants severed his male reproductive organ or penis.

“We received the case as a referral from one of the county hospitals at around 9 a.m. on December 19, 2018. His penis had been amputated at the base using a kitchen knife,” said Prof Khainga.

“Upon arrival, the patient was sick looking, confused and slightly pale but stable. He was received by a team of urologists and plastic surgeons,” the medic said.

“After initial examination and resuscitation, we immediately prepared him for theatre where we began the process of re-implantation of the penis,” said Prof Khainga.

CUT OFF 

The team, which included University of Nairobi lecturer and blood vessel or microvascular surgeon Dr Ferdinand Nangole, Dr Jujo and Dr Were, first examined the stump left behind when the organ was cut off.

“On examining the stump, we noticed it had been dressed to stop the bleeding that occurred immediately after the incident. It also had minimal soiling, with the blood vessels around the base and urethra, which passes urine, exposed,” he said.

The surgeon said the knife had sliced clean through the base of the penis, in an act he termed as “a guillotine-like amputation through the organ’s base”.

A guillotine is a device consisting of a large knife blade that fell on the victim’s neck that was invented during the French Revolution to cut off the heads of condemned prisoners.

Such as an occurrence is known as a total penile amputation in medical terms.

In the surgical procedures carried out to manage total penile amputations, patients are managed by re-suturing or restoring the penile structures while repairing the vessels.

The US National Library of Medicine reports that there have been some few cases of failure of the organ to recover sensory abilities, despite the penile shaft surviving the operation.

FIRST TIME 

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This is the first time an operation of this kind was successfully carried out on Kenyan soil.

Prof Khainga said the goal of the procedure was to achieve normal function.

“Our management goal was to restore normal function, which consists of urination, or passing urine, sexual gratification, improved self or body image and reproduction. We also sought to achieve adequate aesthetic appearance or normal appearance of the organ, including length,” he said.

During the seven hour procedure, the surgical team inserted a catheter into the severed organ to act as a support or stent during re-implantation.

They then proceeded to carry out the delicate process of repairing the urethra or passage used to pass urine and semen out of the penis, known as urethroplasty.

Urethroplasty is an open surgical reconstruction or replacement of the urethra that has been narrowed by scar tissue. The procedure is done to increase the size of the urine channel to improve urine flow.

Doctors also carried out debridement of the penis and the stump. This is the removal of necrotic tissue to promote the healing of a wound. This is because the affected area can sometimes end up getting covered with dead or necrotic tissue. This can be harmful to the body’s ability to recover and develop new skin, making debridement a necessary to remove all that dead material.

Another procedure that doctors successfully completed was the repair of the corpus spongiosum, which contains spongy erectile tissue.

Still working on the affected organ, medics surgically repaired the corpus cavernosus, which is a band of tissue that helps to facilitates penile erections.

BLOOD FLOW 

The repair of the penile shaft included the restoration of normal blood flow and function in the blood vessels known as cavernosal arteries that run along the middle of each corpus cavernosa.

Prof Khainga said the patient was now stable and doing well on the road to recovery.

“” He has done well and is reporting erections with adequate length. His wounds have also healed, he said.

The surgeon said the patient is due for discharge in a fortnight.

“A.M. is due for a discharge in the next two weeks after the removal of the urethral catheter, which was placed in the urethra to facilitate the passage of urine as he recovers,” said the medic.

The referral facility has so far refused to reveal details of the teenager’s identity and the circumstances of the attack, citing the need to protect the patient’s privacy and confidentiality.

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