BENGALURU: A 12-year-old Nigerian boy’s genital organs were successfully reconstructed at Fortis Hospital, Bannerghatta Road, in a rare and complex surgery. “The boy had lost his external genitalia in a major road accident six years ago. He was a victim of multiple body injuries and had undergone amputation of his entire penis and right testes, owing to the accident. Since then, he was unable to pass urine normally and has been living with a catheter. He was going to school with the plastic bag hanging,” said the Fortis Hospital spokesperson.
A multi-disciplinary team of doctors at the hospital, comprising paediatrician, endocrinologist, plastic surgeon, surgical gastroenterologist and paediatric intensive care unit (ICU) team led by Dr Mohan Keshavamurthy, successfully reconstructed his genital organs. The patient was discharged 10 days after the surgery. Dr Keshavamurthy is director, Urology, Uro-oncology, Uro-gynaecology, Andrology, Transplant & Robotic Surgery at Fortis Hospitals, Bengaluru, and chairman, Renal Sciences Specialty Council at Fortis Hospitals, India.
According to the hospital spokesperson, the boy was on a urethral catheter, had a weak bladder with less urine holding capacity which resulted in incontinence between routine catheterizations. He also had a history of two hemorrhages from damaged femoral blood vessels.
“While doctors at his hometown managed the hemorrhages non-operatively, they could not conduct surgical reconstruction of the external genitalia, due to unavailability of the medical facilities/ infrastructure, post which he was referred to Fortis Hospital, Bannerghatta Road,” the spokesperson stated. Calling it a very “rare and complex procedure”, Dr Keshavamurthy said that they had to do a cystoscopy to look inside the bladder using a thin camera, followed by a robot-assisted laparoscopic ileal augmentation of the bladder wherein the bladder was enlarged using a section of small intestine to protect the upper urinary tract and re-establish continence.
It was done under general anaesthesia. The patient was then moved to the paediatric ICU for observation. Post successful completion of the first stage, hormonal replacement procedure was done. During the second stage, penile reconstruction was carried out,” he explained. “The boy’s urethral catheter was removed after the reconstructive surgery. He is currently doing well and has returned to his country. He will be returning after six months for the third stage of surgery,” the hospital stated.