Self-emasculation: review of the literature, report of a case and outline of the objectives of management.

Self-emasculation is the end result of an unusual psychiatric disorder, which initially requires surgical treatment. Only 51 cases have been reported in the English literature since 1900. No previous attempt to preserve testicular androgen function by reimplantation or grafting has been reported. We describe an unsuccessful attempt to graft the testicles in subcutaneous thigh pockets. Microscopically, the biopsied autografts showed no viable interstitial or germinal testicular tissue. The objectives of the treatment of self-emasculation injury are restoration of anatomical and functional continuity of the urethra as a urinary channel, preservation of the capacity for sustained penile erection, preservation of testicular androgen activity, prompt psychiatric evaluation and treatment of the underlying illness, and restoration of the normal appearance of the scrotum.