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created from English and partly translated
{{NYT en}}
'''Complete penile amputation''' is perhaps the most tragic of all of the many complications of non-therapeutic infant [[circumcision]]. It refers to the total, complete ablation<ref>{{REFweb
|url=https://medical-dictionary.thefreedictionary.com/ablation
|title=Ablation
|publisher=The Free Dictionary
|website=
|date=2012
|accessdate=2022-02-14
}}</ref> or destruction of the [[penis]] by a surgical mishap. Penile ablation is said to be an extremely rare condition in advanced nations where circumcision is performed by trained medical doctors, but it is more common in developing nations where traditional circumcision is the usual practice.<ref>{{REFjournal
|last=Appiah
|first=
|init=KAA
|author-link=
|last2=Gyasi-Sarpong
|first2=
|init2=CK
|author2-link=
|last3=Azorliade
|first3=
|init3=R
|author3-link=
|etal=yes
|title=Circumcision-related tragedies seen in children at the Komfo Anokye Teaching Hospital, Kumasi, Ghana
|journal=BMC Urol
|location=
|date=2016-11-08
|volume=16
|issue=
|article=
|page=65
|pages=
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5101822/
|quote=
|pubmedID=5101822
|pubmedCID=27825332
|DOI=10.1186/s12894-016-0183-1
|accessdate=2022-02-14
}}</ref>
The former practice was to do "feminizing genitoplasty" or in other words, a sex-change operation on an infant boy,<ref>{{REFjournal
|last=Gearhart
|first=
|init=JP
|author-link=
|last2=Rock
|first2=
|init2=JA
|author2-link=
|etal=no
|title=Total ablation of the penis after circumcision with electrocautery: a method of management and long-term followup
|journal=J Urol
|location=
|date=1989-09
|volume=142
|issue=3
|article=
|page=
|pages=799-801
|url=http://www.cirp.org/library/complications/gearhart1/
|pubmedID=2769863
|pubmedCID=
|DOI=10.1016/s0022-5347(17)38893-6
|accessdate=2022-02-14
}}</ref> however this was found to be unsatisfactory.<ref>{{REFjournal
|last=Diamond
|first=Milton
|init=M
|author-link=
|last2=Sigmundson
|first2=
|init2=HK
|author2-link=
|etal=no
|title=Sex reassignment at birth. Long-term review and clinical implications
|journal=Arch Pediatr Adolesc Med
|location=
|date=1997-03
|volume=151
|issue=3
|article=
|page=
|pages=298-304
|url=http://www.cirp.org/library/psych/diamond1/
|archived=
|quote=
|pubmedID=9080940
|pubmedCID=
|DOI=10.1001/archpedi.1997.02170400084015
|accessdate=2022-02-14
}}</ref>
Bradley et al. (1998) presented two cases of ablatio penis and discuss various ways of managing the condition. The first case presented is the same one later publicized by [[John Colapinto]].<ref name="bradley1998">{{REFjournal
|last=Bradley
|first=Susan J.
|init=SJ
|author-link=
|last2=Oliver
|first2=Gillian D.
|init2=GD
|author2-link=
|last3=Chernick
|first3=Avinoam B.
|init3=AB
|author3-link=
|last4=Zucker
|first4=Kenneth J.
|init4=KJ
|author4-link=
|etal=no
|title=Experiment of nurture: ablatio penis at 2 months, sex reassignment at 7 months, and a psychosexual follow-up in young adulthood
|journal=Pediatrics
|location=
|date=1998-07
|volume=102
|issue=1
|article=
|page=
|pages=e9
|url=http://www.cirp.org/library/complications/bradley/
|archived=
|quote=
|pubmedID= 9651461
|pubmedCID=
|DOI=10.1542/peds.102.1.e9
|accessdate=2022-02-14
}}</ref>
More recently, penile re-implantation using leech therapy has been described.<ref>{{REFjournal
|last=Banihani
|first=Omaya I
|init=OI
|author-link=
|last2=Fox
|first2=Janelle A.
|init2=JA
|author2-link=
|last3=Gander
|first3=Brian H.
|init3=BH
|author3-link=
|last4=Grunwaldt
|first4=Lorelei J.
|init4=LJ
|author4-link=
|last5=Cannon
|first5=Glenn M.
|init5=GM
|author5-link=
|etal=no
|title=Complete penile amputation during ritual neonatal circumcision and successful replantation using postoperative leech therapy
|journal=Urology
|location=
|date=2014-06-11
|volume=84
|issue=2
|article=
|page=
|pages=472-4
|url=https://www.goldjournal.net/article/S0090-4295(14)00390-2/fulltext
|archived=
|quote=
|pubmedID=24928459
|pubmedCID=
|DOI=10.1016/j.urology.2014.04.021
|accessdate=2022-02-14
}}</ref>
== Xhosa-Beschneidung ==
The Eastern Cape Province of South Africa is the home of the Xhosa people. The culture of the Xhosa includes many traditional practices, including a rite of passage to manhood called ''Ulwaluko''. Ulwaluko includes a circumcision by a traditional practitioner. The circumcisions are not performed in accordance with modern medical practice. They are notorious for loss of penile skin, infection, gangrene, '''total loss of the penis''', and even death.<ref>{{REFweb
|url=http://www.cirp.org/news/1996-07-19SouthAfrica/
|title=Initiation horror as four dead
|last=
|first=
|date=1996-07-19
|accessdate=2022-02-16
}}</ref> <ref>{{REFnews
|title=Circumcision leaves 24 dead, 100 in hospital
|url=http://www.cirp.org/news/thestar07-16-02/
|last=
|first=
|init=
|author-link=
|last2=
|init2=
|author2-link=
|publisher=The Star
|website=
|date=2002-07-17
|accessdate=2022-02-15
|quote=
}}</ref> Ulwaluko is viewed as an important part of Xhosa culture, so there is little interest on the part of governmental authorities on regulating the practice.<ref>{{REFweb
|url=https://www.ulwaluko.co.za/Home.html
|title=Ulwaluko
|last=
|first=
|date=
|accessdate=2022-02-16
|quote=The incompetence and indifference of the traditional leaders is astounding.
}}</ref>
=== Leben ohne Penis ===
Mia Malan (2013) discussed the difficulties of life without a penis.<ref name="malan2013">{{REFnews
|title=The boys who lost their manhood
|url=https://mg.co.za/article/2013-08-16-00-the-boys-who-lost-their-manhood/
|last=Malan
|first=Mia
|init=
|author-link=
|last2=
|init2=
|author2-link=
|publisher=Mail & Guardian
|website=
|date=2013-08-16
|accessdate=2022-02-16
|quote=
}}</ref>
=== Penis-Transplantation ===
The first succesful penile transplant<ref>{{REFjournal
|last=van der Merwe
|first=
|init=A
|author-link=
|last2=Graewe
|first2=Frank
|init2=F
|author2-link=
|last3=Zühlke
|first3=Alexander
|init3=A
|author3-link=
|etal=yes
|title=Penile allotransplantation for penis amputation following ritual circumcision: a case report with 24 months of follow-up
|journal=Lancet
|location=
|date=2017-09-09
|volume=390
|issue=10099
|article=
|page=
|pages=1038-47
|url=https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31807-X/fulltext
|archived=
|quote=
|pubmedID=28823494
|pubmedCID=
|DOI=10.1016/S0140-6736(17)31807-X
|accessdate=2022-02-15
}}</ref> was the result of a loss of a boy's penis during the ulwaluko initation.<ref>{{REFweb
|url=https://www.bbc.com/news/health-31876219
|title=South Africans perform first 'successful' penis transplant
|last=Gallagher
|first=James
|init=J
|author-link=
|publisher=BBC News
|website=
|date=2015-03-13
|accessdate=2022-02-15
|format=
|quote=
}}</ref>
{{SEEALSO}}
* [[Amputation]]
* [[David Reimer]]
* [[Ulwaluko]]
{{REF}}
[[Kategorie:Beschneidungskomplikation]]
[[Kategorie:Begriff]]
[[Kategorie:Kanada]]
[[Kategorie:Südafrika]]
[[en:Complete penile amputation]]
'''Complete penile amputation''' is perhaps the most tragic of all of the many complications of non-therapeutic infant [[circumcision]]. It refers to the total, complete ablation<ref>{{REFweb
|url=https://medical-dictionary.thefreedictionary.com/ablation
|title=Ablation
|publisher=The Free Dictionary
|website=
|date=2012
|accessdate=2022-02-14
}}</ref> or destruction of the [[penis]] by a surgical mishap. Penile ablation is said to be an extremely rare condition in advanced nations where circumcision is performed by trained medical doctors, but it is more common in developing nations where traditional circumcision is the usual practice.<ref>{{REFjournal
|last=Appiah
|first=
|init=KAA
|author-link=
|last2=Gyasi-Sarpong
|first2=
|init2=CK
|author2-link=
|last3=Azorliade
|first3=
|init3=R
|author3-link=
|etal=yes
|title=Circumcision-related tragedies seen in children at the Komfo Anokye Teaching Hospital, Kumasi, Ghana
|journal=BMC Urol
|location=
|date=2016-11-08
|volume=16
|issue=
|article=
|page=65
|pages=
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5101822/
|quote=
|pubmedID=5101822
|pubmedCID=27825332
|DOI=10.1186/s12894-016-0183-1
|accessdate=2022-02-14
}}</ref>
The former practice was to do "feminizing genitoplasty" or in other words, a sex-change operation on an infant boy,<ref>{{REFjournal
|last=Gearhart
|first=
|init=JP
|author-link=
|last2=Rock
|first2=
|init2=JA
|author2-link=
|etal=no
|title=Total ablation of the penis after circumcision with electrocautery: a method of management and long-term followup
|journal=J Urol
|location=
|date=1989-09
|volume=142
|issue=3
|article=
|page=
|pages=799-801
|url=http://www.cirp.org/library/complications/gearhart1/
|pubmedID=2769863
|pubmedCID=
|DOI=10.1016/s0022-5347(17)38893-6
|accessdate=2022-02-14
}}</ref> however this was found to be unsatisfactory.<ref>{{REFjournal
|last=Diamond
|first=Milton
|init=M
|author-link=
|last2=Sigmundson
|first2=
|init2=HK
|author2-link=
|etal=no
|title=Sex reassignment at birth. Long-term review and clinical implications
|journal=Arch Pediatr Adolesc Med
|location=
|date=1997-03
|volume=151
|issue=3
|article=
|page=
|pages=298-304
|url=http://www.cirp.org/library/psych/diamond1/
|archived=
|quote=
|pubmedID=9080940
|pubmedCID=
|DOI=10.1001/archpedi.1997.02170400084015
|accessdate=2022-02-14
}}</ref>
Bradley et al. (1998) presented two cases of ablatio penis and discuss various ways of managing the condition. The first case presented is the same one later publicized by [[John Colapinto]].<ref name="bradley1998">{{REFjournal
|last=Bradley
|first=Susan J.
|init=SJ
|author-link=
|last2=Oliver
|first2=Gillian D.
|init2=GD
|author2-link=
|last3=Chernick
|first3=Avinoam B.
|init3=AB
|author3-link=
|last4=Zucker
|first4=Kenneth J.
|init4=KJ
|author4-link=
|etal=no
|title=Experiment of nurture: ablatio penis at 2 months, sex reassignment at 7 months, and a psychosexual follow-up in young adulthood
|journal=Pediatrics
|location=
|date=1998-07
|volume=102
|issue=1
|article=
|page=
|pages=e9
|url=http://www.cirp.org/library/complications/bradley/
|archived=
|quote=
|pubmedID= 9651461
|pubmedCID=
|DOI=10.1542/peds.102.1.e9
|accessdate=2022-02-14
}}</ref>
More recently, penile re-implantation using leech therapy has been described.<ref>{{REFjournal
|last=Banihani
|first=Omaya I
|init=OI
|author-link=
|last2=Fox
|first2=Janelle A.
|init2=JA
|author2-link=
|last3=Gander
|first3=Brian H.
|init3=BH
|author3-link=
|last4=Grunwaldt
|first4=Lorelei J.
|init4=LJ
|author4-link=
|last5=Cannon
|first5=Glenn M.
|init5=GM
|author5-link=
|etal=no
|title=Complete penile amputation during ritual neonatal circumcision and successful replantation using postoperative leech therapy
|journal=Urology
|location=
|date=2014-06-11
|volume=84
|issue=2
|article=
|page=
|pages=472-4
|url=https://www.goldjournal.net/article/S0090-4295(14)00390-2/fulltext
|archived=
|quote=
|pubmedID=24928459
|pubmedCID=
|DOI=10.1016/j.urology.2014.04.021
|accessdate=2022-02-14
}}</ref>
== Xhosa-Beschneidung ==
The Eastern Cape Province of South Africa is the home of the Xhosa people. The culture of the Xhosa includes many traditional practices, including a rite of passage to manhood called ''Ulwaluko''. Ulwaluko includes a circumcision by a traditional practitioner. The circumcisions are not performed in accordance with modern medical practice. They are notorious for loss of penile skin, infection, gangrene, '''total loss of the penis''', and even death.<ref>{{REFweb
|url=http://www.cirp.org/news/1996-07-19SouthAfrica/
|title=Initiation horror as four dead
|last=
|first=
|date=1996-07-19
|accessdate=2022-02-16
}}</ref> <ref>{{REFnews
|title=Circumcision leaves 24 dead, 100 in hospital
|url=http://www.cirp.org/news/thestar07-16-02/
|last=
|first=
|init=
|author-link=
|last2=
|init2=
|author2-link=
|publisher=The Star
|website=
|date=2002-07-17
|accessdate=2022-02-15
|quote=
}}</ref> Ulwaluko is viewed as an important part of Xhosa culture, so there is little interest on the part of governmental authorities on regulating the practice.<ref>{{REFweb
|url=https://www.ulwaluko.co.za/Home.html
|title=Ulwaluko
|last=
|first=
|date=
|accessdate=2022-02-16
|quote=The incompetence and indifference of the traditional leaders is astounding.
}}</ref>
=== Leben ohne Penis ===
Mia Malan (2013) discussed the difficulties of life without a penis.<ref name="malan2013">{{REFnews
|title=The boys who lost their manhood
|url=https://mg.co.za/article/2013-08-16-00-the-boys-who-lost-their-manhood/
|last=Malan
|first=Mia
|init=
|author-link=
|last2=
|init2=
|author2-link=
|publisher=Mail & Guardian
|website=
|date=2013-08-16
|accessdate=2022-02-16
|quote=
}}</ref>
=== Penis-Transplantation ===
The first succesful penile transplant<ref>{{REFjournal
|last=van der Merwe
|first=
|init=A
|author-link=
|last2=Graewe
|first2=Frank
|init2=F
|author2-link=
|last3=Zühlke
|first3=Alexander
|init3=A
|author3-link=
|etal=yes
|title=Penile allotransplantation for penis amputation following ritual circumcision: a case report with 24 months of follow-up
|journal=Lancet
|location=
|date=2017-09-09
|volume=390
|issue=10099
|article=
|page=
|pages=1038-47
|url=https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31807-X/fulltext
|archived=
|quote=
|pubmedID=28823494
|pubmedCID=
|DOI=10.1016/S0140-6736(17)31807-X
|accessdate=2022-02-15
}}</ref> was the result of a loss of a boy's penis during the ulwaluko initation.<ref>{{REFweb
|url=https://www.bbc.com/news/health-31876219
|title=South Africans perform first 'successful' penis transplant
|last=Gallagher
|first=James
|init=J
|author-link=
|publisher=BBC News
|website=
|date=2015-03-13
|accessdate=2022-02-15
|format=
|quote=
}}</ref>
{{SEEALSO}}
* [[Amputation]]
* [[David Reimer]]
* [[Ulwaluko]]
{{REF}}
[[Kategorie:Beschneidungskomplikation]]
[[Kategorie:Begriff]]
[[Kategorie:Kanada]]
[[Kategorie:Südafrika]]
[[en:Complete penile amputation]]