Lupu Sorin, Bratu Ovidiu Gabriel, Tit Delia Mirela, Bungau Simona, Maghiar Octavian, Maghiar Teodor Andrei, Scarneciu Camelia C, Scarneciu Ioan
Clinic of Urology, Brasov Emergency Clinical County Hospital, Brasov 500326, Romania.
Clinical Department 3, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Exp Ther Med. 2021 Oct;22(4):1130. doi: 10.3892/etm.2021.10564. Epub 2021 Aug 5.
Genital self-mutilation is a pathology that leads to numerous and important discussions, rarely presented in the medical literature. There have been many attempts to explain the reasons behind these medical phenomena, but single cases have been generally reported, making it extremely difficult to draw valid conclusions. It is acknowledged that there are psychotic and non-psychotic causes, from psychiatric problems and sexual identity disorders to cultural or religious reasons, alcohol or recreational drug consumption, unconventional types of sexual satisfaction or self-satisfaction. Recent theories consider self-mutilation as a phenomenon of reducing distress or tension, as an expression of feelings of anger or sorrow. It is believed that 55-85% of those who have resorted to self-mutilation have at least once in their life tried to commit suicide. There is evidence that early discovery and intervention as well as proper treatment in regards to psychosis can significantly reduce the number of self-mutilation episodes, with a protective role of these individuals. Cases of genital self-mutilation may be considered real medical emergencies, sometimes extremely challenging and accompanied by severe complications. Injury of the genital area is usually accompanied by numerous early or long-term complications due to the marked vascular area and to the microbial flora present in this part of the body. The degree of mutilation is an unforeseen aspect that the medical staff may have to encounter during the intervention, sometimes testing their imagination and surgical skills when dealing with such a case. Understanding the causes of these self-aggressive behaviors, which may be life-threatening, is critical and multidisciplinary mobilization is needed after treatment of the acute phases. The outcome of these patients depends on integrated collaborative work. These cases represent a serious reason for frustration for the physicians involved in solving them, and knowledge of these issues is valuable to urologists, psychiatrists and other health professionals.
生殖器自残是一种引发众多重要讨论的病理学现象，在医学文献中鲜有呈现。人们曾多次尝试解释这些医学现象背后的原因，但通常报道的都是个别案例，因此极难得出有效的结论。人们公认，其原因既有精神性的，也有非精神性的，涵盖从精神问题、性身份障碍到文化或宗教原因、酒精或消遣性药物使用、非常规类型的性满足或自我满足等。近期的理论将自残视为减轻痛苦或紧张的一种现象，是愤怒或悲伤情绪的一种表达。据信，实施过自残行为的人中有55%至85%在其一生中至少有过一次自杀企图。有证据表明，早期发现与干预以及针对精神病的恰当治疗能够显著减少自残事件的发生次数，对这些人起到保护作用。生殖器自残案例可被视为真正的医疗急症，有时极具挑战性且会伴有严重并发症。由于生殖器区域血管丰富且该身体部位存在微生物菌群，生殖器部位受伤通常会伴有众多早期或长期并发症。自残程度是医护人员在干预过程中可能不得不面对的一个不可预见的方面，在处理此类病例时，有时会考验他们的想象力和手术技能。了解这些可能危及生命的自我攻击行为的原因至关重要，急性期治疗后需要多学科协作。这些患者的预后取决于综合协作。这些案例对于参与解决问题的医生来说是严重的挫折根源，了解这些问题对泌尿科医生、精神科医生和其他健康专业人员来说很有价值。
