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精神分裂症患者连续自切双侧睾丸再植术后的生存能力管理和评估:1 例罕见病例报告。

Rare Case of Managing and Evaluating Viability after Replantation of a Serial Self-Amputated Bilateral Testis by a Patient with Schizophrenia: A Case Report.

机构信息

Department of Plastic and Reconstructive Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea,

Department of Urology, Hyundae General Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea.

出版信息

Urol Int. 2023;107(8):827-834. doi: 10.1159/000531149. Epub 2023 Aug 4.

Abstract

Amputation of the testis is very rare in clinical situations; therefore, most surgeons have no experience with an amputated testis. In this case, a 31-year-old male with schizophrenia amputated both testes due to self-mutilation. We performed replantation surgery via microscopy. On postoperative day 1, he removed his right testis by using his hand, even though his hands were restrained. The second attack disrupted the viability of the right testis. However, after proper management, we checked the normal sex hormone level by preserving the replanted left testis. We evaluated the viability of the replanted testis by performing five examinations, namely, intraoperative indocyanine green injection, testicular scan with technetium pertechnetate, contrast-enhanced computerized tomography, Doppler ultrasonography, and serum testosterone level. In this report, we aimed to describe our rare experience about management with replantation of the amputated testes and evaluation of their viability.

摘要

睾丸切除术在临床情况下非常罕见;因此,大多数外科医生都没有切除睾丸的经验。在这种情况下,一名 31 岁的精神分裂症男性因自残而切除了双侧睾丸。我们通过显微镜进行了再植手术。术后第 1 天,尽管他的手被束缚着,他还是用手将右侧睾丸摘除。第二次攻击破坏了右侧睾丸的活力。然而,经过适当的处理,我们通过保留再植的左侧睾丸来检查正常的性激素水平。我们通过进行五项检查,即术中吲哚菁绿注射、锝 99m 放射性核素睾丸扫描、增强计算机断层扫描、多普勒超声检查和血清睾酮水平,来评估再植睾丸的活力。在本报告中,我们旨在描述我们在处理和评估切除睾丸的再植和活力方面的罕见经验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15de/10614563/b275405edb16/uin-2023-0107-0008-531149_F01.jpg

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