ROANOKE TIMES

                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: THURSDAY, June 24, 1993                   TAG: 9306240099
SECTION: VIRGINIA                    PAGE: C5   EDITION: STATE 
SOURCE: The Washington Post
DATELINE: MANASSAS                                LENGTH: Medium


PENIS REATTACHED AFTER WIFE CUTS IT OFF

A 26-year-old suburban Washington man whose wife cut off his penis with a kitchen knife while he slept Wednesday morning was reported in satisfactory condition Wednesday night after 9 1/2 hours of surgery to reattach the organ, officials said.

Authorities learned of the incident when the man showed up at a hospital about 5 a.m. Police officers were dispatched to his nearby apartment to search for the missing penis, but couldn't find it.

About the same time, the man's wife called authorities from a pay phone to say she had been raped, had fled the apartment "in a panic," unknowingly taking the penis with her, and had thrown it out the window of her car at an intersection near the city line of Manassas Park.

The penis was recovered at the intersection, packed in ice and taken by fire and rescue personnel to Prince William Hospital in Manassas, where the surgical reattachment procedure began shortly after 6 a.m., said James T. Sehn, a urologist who was one of two doctors who participated in the operation.

Prosecutor Paul B. Ebert said Wednesday night that the couple, who were not identified, "had been experiencing considerable domestic difficulty."

"Her bags were packed," Ebert said of the 24-year-old wife.

The woman told police that her husband had raped her shortly before she cut off two-thirds of his penis. "After he went to sleep, she got a kitchen knife," Ebert said.

A police spokesman said the woman was released after being treated as a rape victim at the same hospital where her husband was undergoing surgery.

Police charged the woman with aggravated malicious wounding, a felony that carries a maximum penalty of 40 years in jail. Ebert said that police had been unable to interview the man, and that no charges had been brought in connection with the woman's rape allegation.

Former neighbors of the couple said the woman had often complained of being beaten by her husband.

"He was just a kid, and she was caught in a terrible, terrible situation," said a man who asked not to be identified. "She obviously needed help," said another neighbor. The couple reportedly separated at least once, in October 1991.

Penile reattachments, although not medically difficult, are rare. "It's safe to say that fewer than 100 have ever been done," said Charles B. Cuono, a professor of surgery at Yale University School of Medicine, who could recall only three such surgeries there in 12 years.

The first penile reattachment was performed in Japan in the mid-1970s. "In those days, we defined success as survival of the part," Cuono said. "You put the penis back on; and if it didn't turn black, it was a success."

Doctors now examine urinary function, erectile ability and fertility in determining

Reattaching a penis is technically easier than operating on a severed fingertip, said Michael F. Angel, director of microsurgery at the Johns Hopkins School of Medicine. "The real challenge is to get it to function."

In that regard, the "mechanism of amputation," in Cuono's words, is an important factor. "In cases where it's a guillotine-type cut, the success rate approaches 85 to 90 percent."

Sehn, the urologist at Prince William Hospital, said his patient had experienced "a very clean amputation." During the long surgery, Sehn and David Berman, a plastic and microvascular surgeon, reconnected the man's urethra, which allows urine and semen to pass, along with four arteries, two veins and two dorsal nerves.

The arteries carry blood that contains oxygen to the penis, while veins carry oxygen-depleted blood back to the heart. Sehn said the patient was experiencing "excellent blood flow from his dorsal arteries, and we're hopeful the graft will be successful. But we're still in a wait-and-see mode" for at least 24 hours, he said.



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