RESUMEN
A 33-year-old man who self injected paraffin into his penis to facilitate an erection and increase his potency suffered from diffuse ulceration and a wide defect on the penile skin involving the proximal glans to the penopubic junction with a high fever. The compromised skin and subcutaneous tissue had to be completely removed and a sensate radial forearm free flap was performed around the penile shaft. This method gave the patient excellent satisfaction in both cosmetic and sexual function. Therefore, this method might be a good therapeutic alternative, especially for young adults indulging in active sexual activity and suffer from wide skin defects even though this operation is expensive and not easy.
Asunto(s)
Adulto , Humanos , Masculino , Adulto Joven , Fiebre , Antebrazo , Colgajos Tisulares Libres , Parafina , Pene , Conducta Sexual , Piel , Tejido Subcutáneo , ÚlceraRESUMEN
PURPOSE: The penis has been attracted to everyone associated with various diseases and sexual activity. Lots of materials and instruments has been applied to the penis for sexual arousal. Furthermore, those ar e usually made and applied in inappropriate ways by non-medical personnel. This resulted in lots of complications in various degrees. So, we investigated the real problems concerning various procedures performed on the genitalia by non-medical personnel. MATERIALS AND METHODS: We reviewed retrospectively medical records of 32 male and one female patients having complications which had been developed following some procedures on the genitalia by non-medical personnel from January 1995 to December 1999. These patients were analyzed according to characteristics of the patients, the methods, purposes, complications and treatments. RESULTS: Their age at first visit was various from 12 years to 70 years (mean, 35.8 years). At that time when procedures had been performed, their age were 12 years to 56 yeats (mean, 30.8 years) in 26 cases whose ages were identified. Among them 22cases (66.7%) were the married and 11 (33.3%) were the unmarried. Occupations were various and out-of-work were 10 (30.4%), commerce 8 (24.2%), firm worker 6(18.2%), student 5 (15.2%), and private job manager and the not-identified 2 (6.1%). according to the school career, the high school graduates were 18 (54.6%), the college graduates 7 (21.2%), middle school graduates 4 (12.1%), and 4 were under middle school. These procedures were performed for sexual satisfaction in 29 cases (87.9%) and for cheap and easy circumcision in 4 cases (12.1%), of which 26 cases (78.8%) had been performed by other person and 7 cases (21.2%) by himself. According to the materials used, 22 (66.7%) cases had been injected vaseline or paraffin in to the penis and one (3.0%) into the vulva, and one (3.0%) plicated his penile skin with rubber band using sewing needle, which 24 cases (72.7%) were for enlargement of the genitalia. 2 (6.0%) cases inserted plastic balls into the penile skin for sexual arousal of partner. 3 (9.1%) cases put a metallic ring, a ceramic ring, and a vacuum device over their penis for improving erection quality, respectively. 4(12.1%) cases had applied the commercially-maid self-circumcision devices over their prepuce, Complications were foreign body sensation, pain at erection, inflammation, skin necrosis, and septic condition, which were variable case by case. Treatments were removal of foreign materials and devices, necrotic tissue, and primary repair of defected skin, for that, in 2 (6.0%) cases, skin flap and graft were needed. CONCLUSIONS: Lots of complications, severe in some cases, had been developed on external genitalia following various procedures performed by medically unauthorized person. So, we have to strongly for their purpose and it would be rather harmful. At the same time, we have to strongly recommend the government to control strictly such materials and instruments not to be sold and used inappropriately.
Asunto(s)
Femenino , Humanos , Masculino , Nivel de Alerta , Cerámica , Circuncisión Masculina , Comercio , Cuerpos Extraños , Genitales , Inflamación , Registros Médicos , Necrosis , Agujas , Ocupaciones , Parafina , Pene , Vaselina , Plásticos , Estudios Retrospectivos , Goma , Sensación , Conducta Sexual , Persona Soltera , Piel , Trasplantes , Vacio , VulvaRESUMEN
Shock wave lithotripsy(SWL) has been considered as a contraindication in a patient with bleeding diathesis. However, appropriate pre-treatment made it possible recently. We present a case of ureteral stone patient with hemophilia A which was resolved successfully using SWL and this would be the first report concerning SWL in a hemophilia A patient in our country.