RESUMEN
INTRODUCTION: The management of 10 cases of penile inflammatory granulomas following a subcutaneous injection of non-absorbable substance for the purpose of penile augmentation is presented. We subsequently used the bilateral scrotal flaps to cover the post-excision skin defect. A simple decision aid chart outlining the management of penile foreign body injections is proposed. METHODS: A total of 10 patients were included in this study. All required surgical management by penile degloving, followed by complete excision of the inflammatory granuloma and overlying skin. The dissection of 14 cadavers was carried out to study the blood supply to the anterior scrotal flap. Penile reconstruction was then performed using a bilateral scrotal flap in all but two cases. Post-operatively, the patients were followed up for a 1 year period. RESULTS: We obtained good results in terms of the aesthetic outcome with all of our ten patients with the area covered having similar color to penile skin. There were no major post-operative complications. There were two minor complications involving wound healing. Sensory function was maintained and no penile shortening or curvatures were noted, in addition all patients were satisfied with both the shape and function of the penis. CONCLUSION: Although much rarer, penile augmentation related complications are still seen in western countries. The treating doctor should be aware of its management. We had achieved acceptable outcomes in our experience with the bilateral scrotal flap. We believe it is a good and simple option for soft tissue coverage of the penis in cases following the complete inflammatory granuloma excision. It can achieve satisfactory aesthetic and functional results for this group of patients.
Asunto(s)
Procedimientos de Cirugía Plástica , Granuloma/etiología , Granuloma/cirugía , Humanos , Inyecciones Subcutáneas , Masculino , Pene/cirugía , Colgajos QuirúrgicosRESUMEN
A case of Fournier's gangrene secondary to a self-administered penile augmentation is reported. A 45 year old man from the South pacific islands was successfully treated with surgical debridement, intensive care unit admission and antibiotics after presenting to hospital with Fournier's gangrene. Two years prior, he had self-administered Vaseline to the shaft of the penis in order to augment penile size. The presentation and management are discussed and a brief literature review has been conducted.
RESUMEN
OBJECTIVE: Penile implants and injection of foreign materials have been described in texts like Kama Sutra for more than 1500 years, and are still being practiced around the world. The extent of this practice is unknown, and the documentation available today only scratches the surface. This study investigates and documents the complications after penile self-injections at the Mae Tao Clinic. To our knowledge, this study represents the largest series of patients representing complications to penile self-injections. STUDY DESIGN: Retrospective study. METHODS: We investigated data on 680 patients admitted with penile self-injections during a 5-year period. Data were studied for general patient data, symptoms, time of injection, and treatment. RESULTS: Age at admittance ranged from 17 to 68 with a mean age of 32 years. Time between injection and presentation was registered with a mean of 36.7 months, over half presented with complications within 1 year. Most frequent complications were penile pain (84%), swelling (82.5%), induration (42.9%), purulent secretion (21.8%), and ulceration (12.8%). Of the 680 patients, 507 (74.6%) underwent surgical treatment (503 excision and 4 circumcision), while 173 (25.4%) were treated conservatively. CONCLUSION: Our data suggest that penile self-injections with mineral oil are more prevalent in certain areas than previously acknowledged. In 5 years, more than 680 patients presented with complications to penile self-injections, of which 75% needed surgical intervention, mainly in the form of radical excision of the lesions followed by skin grafting. Preventive measures to this physically and psychologically devastating problem are highly warranted.