case_images: PMC6394109_01
case_images: Showing an amputated penis. Distal amputated penis, 7.5 cm in length, was transected 2 cm from the base of the penis.
case_images: eplasty19e02_fig1.jpg
case_images: PMC6394109_01_eplasty19e02_fig1.jpg
case_images: F1
case_images: The transection was 2 cm from the base of the penile shaft, and the distal amputated part was preserved appropriately. (Figure 1 shows the length of amputated penis.) After HBOT and Cialis, physical examination still yielded no answers but repeat SPY angiography showed increased tissue perfusion at the distal tip of the glans which prompted continuation of the Cialis and HBOT. (Figure 1 and 3 show SPY angiography prior to HBOT and Cialis treatment, after HBOT and Cialis treatment, and after debridement).
case_images: Figure after completed surgery. Following repair of 2 dorsal veins and no artery anastomosis, the replanted penis showed excellent perfusion with bright red bleeding and no venous congestion.
case_images: eplasty19e02_fig2.jpg
case_images: PMC6394109_01_eplasty19e02_fig2.jpg
case_images: F2
case_images: At the completion of the procedure, there was bright red bleeding noted from the glans penis, and no evidence of venous congestion. (Figure 2 shows bright red bleeding after the surgery.)
case_images: Figure of SPY angiography imaging and standard photos of the replanted penis. Standard clinical evaluation is not sufficient to adequately judge the level of perfusion at the distal penis. (a) Prior to HBOT and Cialis treatment, clinical evaluation was extremely difficult. (b) SPY angiography during initial clinical evaluation showed poor perfusion. (c) After initial treatment with HBOT and Cialis, it was difficult to clinically appreciate any difference. (d) With SPY angiography, perfusion at the distal tip of the penis, after initial treatment with HBOT and Cialis, is appreciated. (e) Standard photography after debridement of tissue showing healthy tissue and good perfusion. (f) SPY angiography image of the penis after debridement shows excellent perfusion to the tip.
case_images: eplasty19e02_fig3.jpg
case_images: PMC6394109_01_eplasty19e02_fig3.jpg
case_images: F3
case_images: After HBOT and Cialis, physical examination still yielded no answers but repeat SPY angiography showed increased tissue perfusion at the distal tip of the glans which prompted continuation of the Cialis and HBOT. (Figure 1 and 3 show SPY angiography prior to HBOT and Cialis treatment, after HBOT and Cialis treatment, and after debridement).