Outcomes of surgical correction of penile deformities following the injection of foreign substances (penile paraffinoma)
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Abstract
Background
Penile augmentation using injectable foreign substances has gained popularity among specific populations seeking aesthetic enhancement. However, when such procedures are performed by untrained individuals or with non-medical-grade materials, they may result in serious complications. These include local inflammation, chronic ulceration, penile deformity, and severe infections. According to a public health advisory issued by the Department of Medical Services of Thailand, the penile tissue often mounts an immune response to eliminate these foreign substances, leading to tissue fibrosis, granuloma formation, and in some cases, irreversible penile deformities. In cases where the injected substances are not sterile, serious infections can occur, sometimes necessitating penile amputation. Surgical intervention is often necessary to manage such complications. Nonetheless, surgical outcomes vary, and secondary complications may occur. Therefore, a thorough evaluation of surgical results is essential for optimizing clinical management and improving patient safety.
Objective
To evaluate surgical outcomes and associated factors in patients undergoing corrective surgery for penile paraffinoma.
Materials and methods
This was a retrospective descriptive study of patients diagnosed with penile paraffinoma and treated surgically at Bhuddhasothon Hospital between October 1, 2018, and September 30, 2023. Data were collected from medical records, including demographic information, type of foreign substance, clinical presentation, operative details, and postoperative outcomes. Statistical analysis was performed to identify factors associated with complications.
Results
Out of 92 cases, 63 patients had complete data for analysis. The mean age was 40.48 ± 11.80 years, and the mean BMI was 23.31 ± 3.70 kg/m². The most commonly injected substances were liquid paraffin (33.33%) and olive oil (23.81%). The most frequent presenting symptom was penile infection or inflammation (73.02%). Most patients (96.83%) underwent two-stage surgical excision using a scrotal skin flap. The mean operative time was 38.41 ± 18.11 minutes. Postoperative complications included severe pain requiring injectable analgesics (22.22%), wound dehiscence (4.76%), and tissue necrosis (3.17%). Erectile function was preserved in 98.41% of patients. Patients with complications had significantly longer operative times and hospital stays than those without complications (p < 0.001). Other variables such as age, BMI, type of substance, and presenting symptoms were not statistically different between groups.
Conclusions
Penile paraffinoma remains a challenging public health issue. While surgical outcomes are generally favorable, longer operative times are significantly associated with an increased risk of postoperative complications. Thorough preoperative evaluation and patient education regarding the dangers of illicit penile augmentation are crucial to improving outcomes and reducing the long-term healthcare burden.
Article Details
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