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Patel SR, Kanabur P, Possoit HE, Kinley A, Beatriz V, Coburn M, Sukumar S. Management of Mammalian Bites to the External Genitalia: A Scoping Review. BJU Int 2021; 130:722-729. [PMID: 34897940 DOI: 10.1111/bju.15671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/04/2021] [Accepted: 12/07/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To review the existing publications in literature in order to determine the approaches for the medical and operative management of mammalian bites to the external genitalia. METHODS AND MATERIAL The Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Review guidelines were followed. Four databases were searched. Articles were independently screened and analyzed by two reviewers. Publications were included if detailed summaries of genitalia bites and management were documented. Discrepancies were resolved by a third reviewer. Data was extracted from the final article cohort. RESULTS Forty-two articles were included in this scoping review. A total of 67 cases of mammalian bites to the genitalia were reported in the cohort. The most common injury site was the penis (44.9%). Dog and human bites were the most common type of mammalian bites (61.2% and 26.9%, respectively). 13.4% of cases were managed with medical therapy while 86.6% of cases required surgical intervention. The most common intervention was wound irrigation, debridement, and primary closure (32.8%). Though uncommon, other operative approaches included skin flaps (7.5%) and grafts (4.5%), re-implantation (4.5%), urethroplasty/repair (7.5%), penectomy (3.0%), scrotoplasty (3.0%), and perineal urethrostomy (1.5%). The reported complication rate was 19.4%. The mean follow-up time was 39.9 months. CONCLUSION Trauma related to mammalian bites is associated with high utilization of healthcare resources and cost. Though management of such bites to the genitalia is controversial, surgical intervention is often warranted ranging from simple debridement of devitalized tissue to complex reconstructive surgery. This review underscores the need for further investigation of mammalian bites to the genitalia to improve surgical options and monitor for long-term complication rates.
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Affiliation(s)
- Sagar R Patel
- Scott Department of Urology, Baylor College of Medicine, Houston, Texas, USA.,Ben Taub General Hospital, Houston, Texas, USA
| | - Pratik Kanabur
- Scott Department of Urology, Baylor College of Medicine, Houston, Texas, USA.,Ben Taub General Hospital, Houston, Texas, USA
| | - Harlee E Possoit
- Scott Department of Urology, Baylor College of Medicine, Houston, Texas, USA.,Louisiana State University Health Shreveport, School of Medicine, Shreveport, Louisiana, USA
| | - Austin Kinley
- Scott Department of Urology, Baylor College of Medicine, Houston, Texas, USA
| | | | - Michael Coburn
- Scott Department of Urology, Baylor College of Medicine, Houston, Texas, USA.,Ben Taub General Hospital, Houston, Texas, USA
| | - Shyam Sukumar
- Scott Department of Urology, Baylor College of Medicine, Houston, Texas, USA.,Ben Taub General Hospital, Houston, Texas, USA
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