Penile self-mutilation preceded by bizarre delusions: two case reports

Journal of Medical Case Reports

Moulay Hassan Farih¹  Ismail Rammouz²  Mohammed Jamal El Fassi¹  Abdelhak Khallouk¹  Mohammed Fadl Tazi¹  Soufiane Mellas³  Roos E Stuurman-Wieringa⁴  Omar Riyach¹  Amine Bout²  Mustapha Ahsaini¹  Driss Amiroune¹  Youssef Kharbach¹ 

[1] Department of Urology, Hassan II University Hospital, Fez, Morocco;Department of Psychiatry, Hassan II University Hospital, Fez, Morocco;Department of Anatomy, Faculty of Medicine, Mohammed Ben Abdellah University, Fez, Morocco;Department of Urology, Reinier de Graaf Gasthuis, P.O., GA, Delft, The Netherlands

关键词: Schizophrenia;    Genital self-mutilation;    Behavior disorder;   

Others  :  1181106
DOI  :  10.1186/1752-1947-8-246

 received in 2013-12-04, accepted in 2014-05-24,  发布年份 2014

【 摘 要 】

Introduction

Genital self-mutilation is listed as a symptom of borderline personality disorder. The type of injury varies from simple skin laceration to total amputation of the penis and testicles. These injuries are urological and surgical emergencies.

Case presentation

We report two cases of penile self-mutilation precipitated by erotic and religious bizarre delusions.

Our first patient is a 24-year-old Moroccan man who visited our emergency room with a metallic ring at the root of his penis which had caused marked edema of his entire penis.

Our second patient is a 26-year-old Moroccan man evaluated in our emergency unit. A clinical examination revealed a wound at the dorsal side of his penis with complete transection of the dorsal vein and imperfect hemostasis.

The two patients were treated in our emergency unit after which a favorable clinical course was observed.

Conclusion

Cases of genital self-mutilation are urological and psychiatric emergencies, therefore it is important that surgical and psychiatric teams collaborate closely while managing cases of genital self-mutilation.

【 授权许可】

   
2014 Kharbach et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Coons PM: Self amputation of the breasts by a male with schizo-typal personality disorder. Hosp Community Psychiatry 1992, 43:175e6.
• [2]Stroch D: Self-castration. Letter to the editor. JAMA 1901, 36:270.
• [3]Klonsky ED: The functions of deliberate self-injury: a review of the evidence. Clin Psychol Rev 2007, 27(2):226-239.
• [4]Simopoulos EF, Trinidad AC: Two cases of male genital self-mutilation: an examination of liaison dynamics. Psychosomatics 2012, 53(2):178-180.
• [5]Aboseif S, Gumez R, Mc Aminch JW: Genital self-mutilation. J Urol 1993, 150:1143-1146.
• [6]Bourgeois M: Genital self-mutilation. Contracept Fertil Sex 1984, 12(4):597-601.
• [7]Greilsheimer H, Groves JE: Male genital self-mutilation. Arch Gen Psychiatr 1979, 36:441.
• [8]Favazza AR: Bodies under siege: self-mutilation and body modification. In Culture and Psychiatry. second edition. Baltimore: John Hopkins University Press; 1996.
• [9]Mental Health Foundation: Truth Hurts Report. London: England; 2006.
• [10]Large M, Babidge N, Andrews D, Storey P, Nielssen O: Major self-mutilation in the first episode of psychosis. Schizophr Bull 2009, 35(5):1012-1021.
• [11]Mitsui K, Kokubo H, Kato K, Nakamura K, Aoki S, Taki T, Yamada Y, Honda N, Fukatsu H: A case of self-mutilation of testis. HinyokikaKiyo 2002, 48:281-283.
• [12]Garaffa G, Gentile V, Antonini G, Tsafrakidis P, Raheem AA, Ralph DJ: Penile reconstruction in the male. Arab J Urol 2013, 11(3):267-271.
• [13]Allen FM, DugiIII D: Chapter 88: Genital and Lower Urinary Tract Trauma. In Campbell-Walsh Urology. Volume 3 10th edition. Edited by Kavoussi LR, Novick AC, Partin AW, Peters CA.
• [14]Schwerkoske JP, Caplan JP, Benford DM: Self-mutilation and biblical delusions: a review. Psychosomatics 2012, 53:327-333.
• [15]Aynaud O, Casanova JM: Pathologies de la Verge. Paris: Masson; 1998:316.