Limits...
An unusual delayed complication of paraffin self-injection for penile girth augmentation.

De Siati M, Selvaggio O, Di Fino G, Liuzzi G, Massenio P, Sanguedolce F, Carrieri G, Cormio L - BMC Urol (2013)

Bottom Line: The scarred tissue between dartos and Buck's fascia and a fibrotic ring occluding the urethra were removed and the penile skin reconstructed.Pathology confirmed the diagnosis of paraffinoma.The patient resumed normal voiding immediately after catheter removal on second postoperative day; he was very pleased with cosmetic, sexual and voiding results at six weeks, six months and 1 year follow-up.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Urology and Renal Transplantation, University of Foggia, Viale Pinto n° 1, 71122, Foggia, Italy. luigicormio@libero.it.

ABSTRACT

Background: Penile self-injection of various oils is still carried out among Eastern Europe people for penile girth augmentation despite the potential destructive complications of this practice are well known. Penile reactions to such foreign bodies include scarring, abscess formation, ulceration, and even Fournier's gangrene; voiding problems due to mineral oil self-injection have been reported only once. To our knowledge, we describe the first case of paraffin self-injection for penile girth augmentation presenting with acute urinary retention.

Case presentation: A 27-year-old Romanian man presented with severe penile pain and acute urinary retention five years after having practiced repeated penile self-injections of paraffin for penile girth augmentation. The penile shaft was massively enlarged, fibrotic and phymotic; urethral catheterization failed due to severe stricture of the proximal pendulum urethra. The patients refused placement of a suprapubic catheter and underwent immediate penile surgical exploration. The scarred tissue between dartos and Buck's fascia and a fibrotic ring occluding the urethra were removed and the penile skin reconstructed. Pathology confirmed the diagnosis of paraffinoma. The patient resumed normal voiding immediately after catheter removal on second postoperative day; he was very pleased with cosmetic, sexual and voiding results at six weeks, six months and 1 year follow-up.

Conclusions: The present report describes a novel complication of penile self-injection for penile girth augmentation. Because of the increasing number of patients seeking penile augmentation, physicians dealing with sexual medicine should pay more attention to such request to prevent the use of non medical treatments that can turn into medical disasters.

Show MeSH

Related in: MedlinePlus

Massively enlarged and deformed penile shaft with phymotic foreskin. Physical examination revealed a penile shaft enlarged, deformed and fibrotic, with phymotic foreskin; the scrotum was normal.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4219597&req=5

Figure 1: Massively enlarged and deformed penile shaft with phymotic foreskin. Physical examination revealed a penile shaft enlarged, deformed and fibrotic, with phymotic foreskin; the scrotum was normal.

Mentions: A 27-year-old Romanian man presented with severe penile pain and acute urinary retention. He had an unremarkable medical history. On physical examination, the penis was massively enlarged and the foreskin phymotic while the scrotum was normal (Figure 1). He reported having practiced, approximately 5 years before, five penile self-injections of paraffin for PGA and having had, following each injection, an immediate inflammatory reaction that ceased spontaneously in a few days. The four years after the injections had been uneventful, whereas in the fifth year he noticed progressive penile swelling with increasing intercourse and voiding difficulties up to the present episode of urinary retention. Urethral catheterization failed due to severe stricture of the proximal pendulum urethra. The patients refused placement of a suprapubic catheter; therefore, penile surgical exploration was immediately carried out. Following midline dorsal penile shaft incision (Figure 2), the scarred tissue between dartos and Buck’s fascia was widely excised. Then we carried out a complete subcoronal and a midline ventral penile shaft incision to free the ventral penile portion from the scarred tissue. In this phase, a fibrotic ring occluding the urethra was encountered and removed (Figure 3). The penile incisions were finally closed and a detensioning prepubic skin plasty (transverse incision and longitudinal suture) was carried out to prevent a buried penis effect.


An unusual delayed complication of paraffin self-injection for penile girth augmentation.

De Siati M, Selvaggio O, Di Fino G, Liuzzi G, Massenio P, Sanguedolce F, Carrieri G, Cormio L - BMC Urol (2013)

Massively enlarged and deformed penile shaft with phymotic foreskin. Physical examination revealed a penile shaft enlarged, deformed and fibrotic, with phymotic foreskin; the scrotum was normal.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4219597&req=5

Figure 1: Massively enlarged and deformed penile shaft with phymotic foreskin. Physical examination revealed a penile shaft enlarged, deformed and fibrotic, with phymotic foreskin; the scrotum was normal.
Mentions: A 27-year-old Romanian man presented with severe penile pain and acute urinary retention. He had an unremarkable medical history. On physical examination, the penis was massively enlarged and the foreskin phymotic while the scrotum was normal (Figure 1). He reported having practiced, approximately 5 years before, five penile self-injections of paraffin for PGA and having had, following each injection, an immediate inflammatory reaction that ceased spontaneously in a few days. The four years after the injections had been uneventful, whereas in the fifth year he noticed progressive penile swelling with increasing intercourse and voiding difficulties up to the present episode of urinary retention. Urethral catheterization failed due to severe stricture of the proximal pendulum urethra. The patients refused placement of a suprapubic catheter; therefore, penile surgical exploration was immediately carried out. Following midline dorsal penile shaft incision (Figure 2), the scarred tissue between dartos and Buck’s fascia was widely excised. Then we carried out a complete subcoronal and a midline ventral penile shaft incision to free the ventral penile portion from the scarred tissue. In this phase, a fibrotic ring occluding the urethra was encountered and removed (Figure 3). The penile incisions were finally closed and a detensioning prepubic skin plasty (transverse incision and longitudinal suture) was carried out to prevent a buried penis effect.

Bottom Line: The scarred tissue between dartos and Buck's fascia and a fibrotic ring occluding the urethra were removed and the penile skin reconstructed.Pathology confirmed the diagnosis of paraffinoma.The patient resumed normal voiding immediately after catheter removal on second postoperative day; he was very pleased with cosmetic, sexual and voiding results at six weeks, six months and 1 year follow-up.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Urology and Renal Transplantation, University of Foggia, Viale Pinto n° 1, 71122, Foggia, Italy. luigicormio@libero.it.

ABSTRACT

Background: Penile self-injection of various oils is still carried out among Eastern Europe people for penile girth augmentation despite the potential destructive complications of this practice are well known. Penile reactions to such foreign bodies include scarring, abscess formation, ulceration, and even Fournier's gangrene; voiding problems due to mineral oil self-injection have been reported only once. To our knowledge, we describe the first case of paraffin self-injection for penile girth augmentation presenting with acute urinary retention.

Case presentation: A 27-year-old Romanian man presented with severe penile pain and acute urinary retention five years after having practiced repeated penile self-injections of paraffin for penile girth augmentation. The penile shaft was massively enlarged, fibrotic and phymotic; urethral catheterization failed due to severe stricture of the proximal pendulum urethra. The patients refused placement of a suprapubic catheter and underwent immediate penile surgical exploration. The scarred tissue between dartos and Buck's fascia and a fibrotic ring occluding the urethra were removed and the penile skin reconstructed. Pathology confirmed the diagnosis of paraffinoma. The patient resumed normal voiding immediately after catheter removal on second postoperative day; he was very pleased with cosmetic, sexual and voiding results at six weeks, six months and 1 year follow-up.

Conclusions: The present report describes a novel complication of penile self-injection for penile girth augmentation. Because of the increasing number of patients seeking penile augmentation, physicians dealing with sexual medicine should pay more attention to such request to prevent the use of non medical treatments that can turn into medical disasters.

Show MeSH
Related in: MedlinePlus