Penile Self-amputation

A 24-year-old man was brought to an outside hospital emergency department by his mother after the distal three-quarters of his penis with a utility knife was completely amputated. The patient was hemodynamically stable at the time of presentation; however, he was actively bleeding from the dorsal penile arteries. Vascular clamps were placed for hemostasis, a Foley catheter was placed into the urethral stump for urinary drainage, 2 units of packed red blood cells were infused, and he was emergently transferred to our tertiary care hospital for further management. He was accompanied by his grandmother and maternal aunt. The patient reportedly suffered from a long history of depression. Additionally, he had experienced visual and auditory hallucinations, including commands to sever his own penis. He