Effective Composite Grafting of Subcoronal Penile Amputation after Ritual Circumcision (Khatna) in a 3-Year-Old Child

Correspondence: Pratibha Rana (E-mail: [e-mail])

Abstract

Background Ritual circumcision (khitan or khatna) is a common practice in male children, especially in Jewish and Muslim cultures, but if it is done by unsafe local barbers, can result in minor complications like Infection and Scarring to major complications, such as partial and total penile amputation.

Case Report We describe the case of a 3-year-old boy who experienced total subcoronal penile amputation during ritual circumcision performed by a lay person (local barber). We had initially attempted replantation, but only a dorsal venous anastomosis was done. Corporal artery anastomosis is not possible in this case because of the very small lumen size (0.1 mm) of corporal arteries, so we have proceeded with composite grafting of the amputated part with dorsal venous anastomosis after 8 hours of ischemic time, with successful take of the composite graft.

Conclusion Our experience suggests that, if microsurgical penile replantation is not possible because of the small lumen of vessels (0.1 mm) at subcoronal level in children, composite grafting of the penile amputated part will give good, effective results.

Keywords: penile amputation, composite grafting, ritual circumcision, pediatric reconstruction

Publication History

Article published online:
10 November 2025