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L’automutilation génitale : intérêt d’un avis psychiatrique dans la prise en charge urologique

Genital self-mutilation: Importance of psychiatric advice in urological management

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Resume

Les automutilations sont des conduites fréquentes, souvent associées à une morbidité psychiatrique. Les auteurs rapportent trois observations de sujets admis dans le service d’urologie du CHU de Cocody d’Abidjan, pour des automutilations génitales. Au cours de la prise en charge chirurgicale, l’avis psychiatrique demandé chez ces patients a conclu au diagnostic de schizophrénie paranoïde. Les frustrations survenues dans l’accomplissement de leur sexualité ont constitué les motifs évoqués par les patients pour réaliser l’automutilation génitale. La blessure auto-infligée a eu pour fonctions de communiquer à l’entourage la souffrance psychique, exprimer la dissociation psychique caractéristique de la schizophrénie. Le traitement chirurgical débuté avant la prise en charge psychiatrique ou de façon concomitante, a consisté en une suture des corps caverneux chez le 3ème patient; suture des corps caverneux et urétrorraphie chez le 2ème, puis à une urétrostomie définitive chez le premier. Ces observations soulignent l’intérêt de la collaboration entre chirurgiens et psychiatres dans la prise en charge des automutilations.

Abstract

Self-mutilation is a frequent behavior, often associated with psychiatric morbidity. The authors report the cases of three patients admitted to the Department of Urology of Cocody University Hospital for self-inflicted genital injuries. Psychiatric advice was sought during surgical treatment and led to the diagnosis of paranoid schizophrenia. The patients reported that the reason for their genital self-mutilation was frustration related to the fulfillment of their sexuality. The purpose of self-mutilation was to draw their environment’s attention to their psychological suffering and to express their psychic dissociation, characteristic of schizophrenia. Surgical treatment initiated before or at the same time as psychiatric management consisted of suturing the corpora cavernosa in the third, urethrorraphy and suturing of the corpora cavernosa in the second, and final urethrostomy in the first patient. Our report underlines the importance of a cooperation of surgeons and psychiatrists in the management of self-mutilations.

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Authors and Affiliations

  1. Service d’urologie, CHU Cocody, Abidjan, Côte-d’Ivoire

    Angoran Dékou, A. Koffi, P. G. Konan, B. Kouamé, C. Vodi & K. Manzan

  2. Service d’urologie et chirurgie de la transplantation, Hôpital Edouard Herriot, Lyon, France

    L. Badet & X. Martin

  3. Hôpital psychiatrique de Bingerville, Bingerville, Côte d’Ivoire

    D. Vé

  4. Service d’urologie du CHU de Cocody, BPV 13, Abidjan, Côte d’Ivoire

    Angoran Dékou

Authors
  1. Angoran Dékou
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  2. D. Vé
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  3. A. Koffi
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  4. P. G. Konan
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  6. L. Badet
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  7. C. Vodi
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  8. K. Manzan
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  9. X. Martin
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Correspondence to Angoran Dékou.

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Dékou, A., Vé, D., Koffi, A. et al. L’automutilation génitale : intérêt d’un avis psychiatrique dans la prise en charge urologique. Afr J Urol 15, 227–232 (2009). https://doi.org/10.1007/s12301-009-0041-4

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  • DOI: https://doi.org/10.1007/s12301-009-0041-4

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