Penile Urethral Section by Firearm in an Adolescent: A Case Report at Somine Dolo Hospital, Mopti (Mali)

Abstract: Since 2012, Mali has been experiencing a security crisis, characterized by armed attacks against civilians and soldiers; in the form of terrorist attacks or ambushes using various vulnerable agents. The injuries observed are often multiple and serious and can affect all organs to varying degrees. The penis is rarely hit by firearms due to its position, its volume relative to the rest of the body, and its mobility. We report a case of penile urethral section by firearm, initially treated in a primary structure, then referred to our structure for better management. The patient was a 13-year-old boy with no known medical or surgical history. He was traveling to their field with his older brother in a cart. Along the way, they were attacked by unidentified armed individuals. They were immediately rescued and taken back to their health facility, where the older brother succumbed to his injuries. There, he underwent an open cystostomy and a penile bandage, as he had no other associated injuries. A week later, he was referred to our facility for better care. On admission, he was hemodynamically stable and had a well-draining cystostomy catheter. Lateroventral penile degeneration was present, along with a section of the penile urethra over an infected wound. There were no lesions of the corpora cavernosa. Otherwise, there were no other unusual features. We initially initiated treatment with antibiotics, anti-inflammatories, and a daily dressing. He also received antitetanus serum. Three months later, we scheduled and performed an end-to-end urethroplasty of the penile urethra under a CH14 catheter. The postoperative course was uneventful.