GENITAL AMPUTATION weight and decreased sexual interest The degree of the scrotum in the left side.After recovering from of depression was considered severe.There was the depressive episode two months later patient no indication of delirium or post-ictal confusional was repentant about the act. He expressed that state. he should not have acted in that manner by an The patient had attempted suicide by idea within the spur of a moment. jumping into the well in one of his previous episodes. Besides this he never had any self DISCUSSION injurious behaviour. Hisrighttestis was removed because of a complication during inguinal hernia Self-multilation has been defined as an operation at the age of 29 years. His sexual desire individual's intentionally damaging a part of his or and activities were described as satisfactory. her own body apparently without a conscious There was no sexual dysfunction beside the lack intent to die. Various risk factors have been of desire during depressive episodes. He had no identified in the previous case reports of genital extramarital sexual relationship. The frequency of self-mutilation. Guilt feeling associated with sexual sexual intercourse was once or twice a month in conflicts (Nakaya, 1996) or sexual offences (Martin the last one year. The last time he had sexual & Gattaz, 1991) have been reported in most intercourse was before the onset of the ongoing studies. Disturbance of sexual identity depression around two months back. (Nakaya, 1996), conflict over masturbation There was no substance abuse,impulse (Shimizu & Mizuta,1995),homosexual or control disorder or any personality disorder.No transsexual tendencies, repudiation of male other comorbid psychiatric disorders were present genitals,absence of a competent male for The patient had no history of seizure disorder.There identification in childhood (Martin & Gattaz, 1991), was no family history of suicide,self-injurious forced early sexual activity, profound ambivalence behaviour or any psychiatric illness. towards adult sexuality have been described (Krasucki et al.,1995). Religious psychotic experiences (Nakaya,1996; Schweitzer, 1990), schizophrenia (Martin, & Gattaz ,1991; Feldman,1988), affective psychoses,alcohol intoxication (Martin & Gattaz, 1991),personality disorders (Krasucki et al., 1995; Wise et al., 1989),especially borderline personality disorder (Feldman, 1988) have been associated with genital self-mutilation. Genital self-mutilation have been observed as a possible method of suicide attempt (Becker & Hartmann,1997;Conacher et al.,1991;Yang & Bollard ,1993 ; Schweitzer, 1990). Body image preoccupation ( Krasucki et al.,1995) and distortion (Wise et al.,1989) have also been Flg.1-Perineum after reconstruction: a portion of reported as the associated conditions in genital scrotal skin on left side is seen sellf-mutilatran. The organs could not be replanted because The index case was undergoing depression of altered state of the severed organs.After heafng and had death wishes and suicidal ideas. of the wound the urination was occurring in a However.according to him he intended to poor stream through the stenosed meatus at the amputate his genitals to get rid of urinary problems residual penile stump which was embedded in the of incontinence secondary to benign hypertrophy skin.There were about two inches of perineal skin of prostate. The facts that the act was potentially 343