[SavageGlow]

Following institutional ethics review board approval and haven obtained written informed consent of the patient, we present a 27-year-old male undergraduate student of one of our tertiary institutions who presented with 12 h history of self-inflicted gunshot injuries to the external genitalia and right upper medial thigh. Patient was alleged to be a cultist and in illegal possession of firearms. He was said to have accidently shot himself in the external genitalia while trying to bring out his gun from his trouser pocket. He had no known pre-trauma co-morbidities. He was initially treated at a peripheral hospital where initial resuscitation and suturing of the right thigh injury was done before referral to our facility for expert care. The patient had no contributory past medical or surgical history.

Examination revealed a patient with stable vital signs with injuries to the external genitalia and upper medial aspect of the right thigh (Fig. 1). The external genitalia showed degloving penile shaft injury extending from the base of the penis to coronal sulcus with devitalization and loss of about 4 cm segment of the proximal penile urethra and its corpus spongiosum (Fig. 2a, b). The extensive skin loss may be secondary to thermal injury considering the closeness of the shot.

[kellyhound]

Dumb student cultists.

Patient was discharged after eight weeks of treatment on his first admission but spent an extra eight weeks in hospital before he could settle his bills.

Patient was re-admitted at 6 months post injury and underwent first stage buccal mucosal graft (BMG) urethroplasty. Buccal mucosal graft was quilted onto the corpora carvenosa between the proximal and distal urethral openings with suturing of the BMG to the edges of the urethra to form a new urethral plate. He was discharged home on the 14th post-operative day.

Assessment of the penis at 10 months post injury showed good take of BMG to form a supple neo-urethral plate. At 16 months post injury patient underwent 2nd stage urethroplasty and penile skin cover.

The BMG neo-urethral plate was tubularized using vicryl 3/0 suture in Thiersch-Duplay fashion over size 22Fr catheter to create a 22Fr urethra.

A size 16F silicone urethral catheter was left in place as a stent. Orthoplasty was also done in collaboration with the plastic surgery team. Penile scar tissue release and excision was done.

At the same sitting the penis was covered with split-thickness skin graft (STSG) harvested from the patients right thigh. The urethral stenting catheter was removed on the 28th post-operative day. Adequate urine flow and Qmax of 25 ml/s was noted.

A retrograde urethrogram was requested for the purpose of documenting the urethral repair. Patient could not afford the investigation.

He was discharged home the next day and has been on 2 monthly follow-up at the out-patient clinic. He had a satisfactory cosmetic outcome and had subjective adequate erection.

Objective assessment of erectile function using the international index of erectile function questionnaire was not done on this patient and this is a major limitation of this case report. Patient was last seen at 8 months post discharge.

[Xploit Machine]

his dick died

[ride]

Photo (shot) #5 looks to me like some had tattooed a nebula on his wang. Perhaps it was the Crab Nebula.