Assessments and Treatment of Gunshot Injuries to the Penis

Background: Gunshot wound injuries to penile are relatively infrequent. Objectives: This study aimed at reviewing the patterns of gunshot injuries to the penile and their treatments. Methods: In November 2019, PubMed (MEDLINE), Scopus, Embase, ISI web of sciences and Google Scholar databases were searched for finding relevant studies. For this reason, various meshes and keywords were used to search including wound/injury, genitalia/genitourinary, Gunshot/war/explosion/firearm/military, penile/penis, scrotum, and urethral. Results: Of the five included studies, three studies were related to civilian gunshot injuries and two studies were related to war-injury. The average age of patients was in the range of 28-31 years old. The major gunshot penile injuries were Corporotomy, Corpus cavernosum, superficial penile wounds, and urethral injury. The most frequent concomitant damages were injuries to adjacent anatomies, including thigh injury, scrotal/testicular, abdominal organs, bladder, and rectum. There are several surgical procedures depending on the degree of gunshot penile injuries such as surgical exploration, closing the residual penile stump of a partly amputated penis, penile degloving, penoscrotal approach, simple suturing, hemostatic suturing of Buck’s fascia and skin, and surgical re-anastomosis or total replacement with phallic reconstruction. Conclusion: Penile gunshot injuries often are concomitant with other severe injuries in adjacent anatomies, which have a negative impact on the mortality of victims. For the management of these cases, it is essential to evaluate the length and size of and type of weapons.