Prognostic influence of the amputation level on outcomes following the reconstruction of circumcision‑related penile amputation: A systematic review

Sigumonrong,Yacobda Hamonangan; Warli,Muhammad H.; Muharia,Bayu H.R.

doi:10.3892/wasj.2025.380

Prognostic influence of the amputation level on outcomes following the reconstruction of circumcision‑related penile amputation: A systematic review

Authors:
- Yacobda Hamonangan Sigumonrong
- Muhammad H. Warli
- Bayu H.R. Muharia
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Affiliations: Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara‑Haji Adam Malik General Hospital, Medan, North Sumatera 20155, Indonesia, Department of Urology, Faculty of Medicine, Universitas Indonesia‑Haji Adam Malik General Hospital, Jakarta 10430, Indonesia
Published online on: July 29, 2025 https://doi.org/10.3892/wasj.2025.380
Article Number: 92
Copyright : © Sigumonrong et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].

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Abstract

Penile amputation is a rare, yet severe complication of circumcision, posing substantial physical, psychological and social burdens. Surgical outcomes are largely determined by the level of amputation and the timing of the intervention. The present systematic review evaluated the prognostic implications of the amputation level on functional recovery, aesthetic outcomes and post‑operative complications. Utilizing the Preferred Reporting Items for Systematic Reviews and Meta‑Analyses (PRISMA) guidelines, 28 studies comprising 102 cases were included. Amputation levels were classified as glans‑only (n=60), glans with corpora (n=3) and below corpora (n=39). Glans‑only amputations demonstrated optimal outcomes with the favorable restoration of urinary and erectile function and low complication rates. Amputations below the corpora, despite increased complexity, exhibited satisfactory results when managed promptly due to preserved vascular integrity. By contrast, injuries involving both the glans and corpora exhibited the highest complication rates, often requiring complex reconstructive procedures. On the whole, these findings indicate that the amputation level is a key prognostic factor in penile reconstruction. Future multicenter and prospective studies are warranted to standardize treatment protocols and explore advancements in reconstructive surgery.

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