TITLE:
Complex Traumatic Abdominoperineal Degloving Injury with Bilateral Testicular Avulsion and Complete Penile Urethral Transection: Successful Multidisciplinary Reconstruction and Functional Recovery
AUTHORS:
Muhammad Mahajna, Husein Hijazi, Wesal Akariya, Gabi Shokaier, Ran Katz, Alexander Braslavsky, Kasis Shoukry, Tarek Taha
KEYWORDS:
Degloving Injury, Genital Trauma, Bilateral Testicular Avulsion, Penile Urethral Transection, Negative Pressure Wound Therapy, Split-Thickness Skin Grafting, Reconstructive Urology
JOURNAL NAME:
Open Journal of Urology,
Vol.16 No.8,
August
18,
2026
ABSTRACT: Traumatic degloving and high-energy avulsion injuries of the lower abdomen and male genitalia are rare, severe industrial emergencies. These complex abdo-perineal disruptions present immense reconstructive challenges, requiring a strategic balance of acute lower urinary tract stabilization and staged tissue reconstruction. A 40-year-old male industrial worker sustained heavy machine-induced trauma, resulting in a large lower abdominal defect with high-friction thermal margins, complete scrotal skin avulsion, total traumatic amputation of both testes, and complete distal penile urethral disconnection. Emergency management included radical debridement, bilateral spermatic cord ligation, and primary end-to-end urethral anastomosis over a catheter. Postoperative negative pressure wound therapy promoted granulation tissue, preparing the defect for a split-thickness skin graft from the thigh. At a two-month follow-up, cystoscopy confirmed excellent urethral patency, and the patient achieved uninhibited spontaneous voiding after catheter removal. Prompt anatomical realignment combined with staged vacuum-assisted closure and autologous skin resurfacing optimizes outcomes in devastating urogenital trauma.