Case Series: Iatrogenic Penile Amputatum Paksi Satyagraha, Fusarina Mumpuni Intantyana Asri*, Kurnia Penta Seputra Department of Urology, Faculty of Medicine, Universitas Brawijaya, Saiful Anwar General Hospital Malang, East Java, Indonesia *Corresponding Author Abstract Penile amputation is the most common complications of guillotine circumcision. There are three cases of iatrogenic penile amputation due to circumcision in Saiful Anwar General Hospital Malang in last 5 years. This series contains three cases of iatrogenic penile amputation due to circumcision in Saiful Anwar General Hospital Malang within 2013-2018 and all of them taken from hospital medical record. One of them already done replantation of penile but unsuccessful due to the preserved of the cutout and the ischemic time of the wound. All of them get the injury due to Guillotine technique that perform by unexperienced person. In cases of microphallus, buried penis, hypospadias, epispadias, phimosis and penoscrotal webbing the circumcision should be performed by a surgeon. Guillotine techniques are not safe for patients under 10 years old, because increase the risk of penile injury. Keywords : Iatrogenic penile amputation, Circumcision Introduction In Penile amputation is the most common complication of Guillotine circumcision 1 . Incidents of penile amputation due to circumcision varies in different country. The incidence of penile amputation was highest among males circumcised at 10 years or older 2 . In Canada reported that 6 cases referred over a 5-year period, penile amputation during circumcision. There one case of partial amputation of glans penis in Israel at 2005, which the circumcision was performed by a ritual circumciser 3 . Although repair techniques have been well described in literature, failure of replantation and its causes are poorly understood and reported. A systematic review of 80 cases from 1996 to 2007 reported only 37.5% of cases undergoing a successful replantation 4 . This is a case series consisting of 3 total case and we collected in Saiful Anwar General Hospital Malang in last 5 years. Case 1 An 8 years old boy patient was come to emergency room with penile amputation post circumcision with Guillotine technique by an elderly in their village 8 hours before admission. The glans penis is not specially preserved when brought to Malang, only wrapped in sterile gauze in the plastic bag. Patients said already done twice spontaneous micturition after circumcision, and there some blood mixed in urine. The patient was taken immediately to the operating room and was operated on under general anesthesia, the urologist perform penile exploration and primary closure. The penile cutout seems not viable to do replantation, so for helping this patient urinating, the urologist inserted 14 Fr Foley catheter. Three days after surgery, the wound close perfectly and the patient withdraw from hospital.