A Presentation of Penile Siliconoma in Primary Care after a Dubious Implant Injection: A Case Report

Abstract@#Cases of penile siliconoma are unusual and less commonly present to medical practitioners. The siliconoma is a subsequence of injecting high viscous solution into the penis; commonly sillicone with the aim to enhance its size and performance. This case will look at a patient who developed penile siliconoma after a dubious penile implant injection gone wrong. It will also look at what surgical options are available to the unfortunate patients to ease their suffering. Physician should have a high index of suspicion on the use of such substances to enhance sexual performances in patients presenting with atypical penile swelling.

Penile paraffinoma: A surgical challenge

OBJECTIVE: The authors share their experience on four different cases of penile paraffinoma surgically treated at the Bicol Medical Center from January 2011 - September 2014. METHODOLOGY: Four patients with subcutaneous injection of foreign body (Vaseline, petroleum jelly or Baby oil) into their penises were treated. The authors applied two kinds of technique: anterolateral thigh pedicle flap and scrotal advancement flap, depending on the skin defect after excision of the paraffinoma. Outcomes measured were immediate post-operative complications (flap necrosis, hematoma, infection) and 3 months post-operative follow-up (contracture, pain on erection, improvement in sexual function and acceptable cosmetic appearance). RESULTS: All patients had a relatively uneventful post-operative course. There were no instances of flap necrosis, bleeding, hematoma or dysuria. Morbidity was minimal and no secondary surgical intervention was done. All had acceptable cosmetic appearance based on the satisfaction of both the patients and the surgeons. All reported decrease in pain during erection, except for one, who underwent scrotal advancement flap, complaining of vague penoscrotal pain when his penis was erect. CONCLUSION: Penile paraffinoma remains a reconstructive surgical challenge requiring application of varying techniques depending on the pre-operative foreign body involvement.

The Treatment of Penile Paraffinoma Using Various Scrotal Flap

Paraffin injection for augmentation of penis is usually attempted by untrained persons. Complications such as penile deformity, skin necrosis, erectile dysfunction, and foreign body sensation usually follow. Definite treatment for the patients with those complications includes complete removal of skin and subcutaneous tissue infiltrated by the paraffin and resurfacing with skin graft and local flap. It may not be possible to remove paraffinoma completely due to infiltrated corpus cavernosum and spongiosum. The remnant paraffinoma does not permit skin graft coverage. For the patients who had these problems, we tried techniques comprised of various scrotal flaps to produce reliable and stable coverage. The scrotal skin, which has high elasticity and good texture, seems to be a good material for denuded penis coverage, despite its hairy nature. Since March 1998, 21 patients with penile paraffinoma have been treated using the various scrotal flaps. All flaps survived and the reconstructed penis had immediate postoperative tactile sensibility. The results were successful with no other major complications.

Extensive Penis Paraffinoma: Treatment by Penoplasty Using Various Scrotal Flaps and Radial Forearm Free Flap / 대한남성과학회지

PURPOSE: There is no single method of choice for penoplasty in extensive penile paraffinoma, and surgeons must choose a suitable method according to the condition of each individual patient. Herein, we present 19 cases of extensive penile paraffinoma treated with various scrotal flaps or a new method involving a radial forearm free flap. PATIENTS AND METHODS: We reviewed the 19 cases of penile paraffinoma, which affected the whole penile skin with or without involvement of the scrotal flap 5 cases, an "apron" scrotal flap in 4 cases, and a bipedicle scrotal flap in 3 cases. Because of his underdeveloped scrotum, a new technique, radial forearm free-flap penoplasty, was done in one patient with Klinefelter's syndrome. The postoperative results were satisfactory in all except six cases. One of these was managed by a secondary full-thickness skin graft for partial scrotal flap necrosis, and the others were managed by secondary simple repair for wound disruption and infection. All patients were satisfied with the cosmetic and functional results of the scrotal flap. CONCLUSIONS: Because of their great elasticity, scrotal flaps are extremely advantageous for the repair of an extensively denuded penis. A radial forearm free flap, perhaps including the subcutaneous tissue, a long vascular pedicle, and less hair, is an alternative method when a scrotal flap is not available. Its biggest drawback is the unpleasant appearance of the donor site, which is closed with a split-thickness skin graft.

Penile paraffinoma: 39 cases / 대한비뇨기과학회지

Penile paraffinoma chiefly resulting from injudicious paraffin injection into the penile tissue for the purpose or enlarging the penis and facilitating erection provokes a lot of serious undesirable effects. The only successful therapy for the complicated penile paraffinoma is adequate surgical excision of the involved tissue and repair of the denuded penis. But it is not easy to resurface the completely denuded penis after complete removal of extensive paraffinoma. Herein we present 39 eases of penile paraffinoma who underwent the surgical correction. The extent of paraffinoma was confined within the distal penile skin in 13 cases and spread to the whole penile skin with or without involvement of scrotum and prepubic soft tissue in 26 cases. The treatment modalities for covering the denuded penis after complete excision of the granulomatous tissue were bilateral pedicle scrotal flap in 23 cases. primary closure in 15 cases and Cecil`s scrotal implantation in 1 case. Bilateral pedicle scrotal flaps based on the lateral scrotal blood supply were extremely advantageous for repair of a extensively denuded penis because of their great elasticity and the cosmetic and functional results of the scrotal flap were satisfactory in all patients.