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Penile Girth Enlargement: do not try it at home

International Journal of Impotence Research volume 34, pages 108–110 (2022)Cite this article

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While larger penile size has historically been associated with sexual performance, power and even social status, small penile size has been a source of obsession and reduced self-esteem [1]. The literature over penile augmentation backs as early as the 19th century [2]. People sought either medical help, allowed help from nonmedical laypersons or even performed penile injections themselves. Common materials injected under the skin of the penis include paraffin, mineral oil, metallic mercury, and silicon [3,4,5,6]. This procedure is not without risk and has a wide spectrum of complications varying from typical foreign body reaction, phimosis, scaring, deformity, ulceration, abscess formation, sexual dysfunction to more severe complications such as Fournier’s gangrene [3,4,5,6]. Paraffinoma, also known as sclerosing lipogranulomatosis, occurs following the injection of materials containing straight-chain hydrocarbons, such as paraffin or mineral oil [7]. The exogenous oil cannot be metabolized and hence replaces in time the normal subcutaneous fat forming small areas of oil surrounded by fibrosis and granulomatous chronic inflammatory reaction [7, 8]. US and MRI features of this condition have rarely been reported in the literature.

These findings are consistent with a “penile paraffinoma” (sclerosing lipogranulomatosis), secondary to the injection of foreign material type mineral oils/paraffin. The low signal intensity on MRI and the absence of oedema on ultrasound is due to the relative late presentation of our patient and represents chronic inflammation and fibrosis as a result of the foreign body reaction. Treatment is done by oral corticosteroids [9] or by radical surgical removal of the foreign body material and granuloma, only possible if the Buck’s fascia is not involved or scarred. Given the high risk of complication, this practice should be strictly discouraged, and the recognition of associated complications should be promulgated through publication of similar cases.

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Fig. 1: Ultrasound findings of penile paraffinoma.
Fig. 2: MRI findings of penile paraffinoma.

References

  1. Francoeur R, Perper T, Scherzer NA. Descriptive dictionary and atlas of sexology. 1st ed. New York: Greenwood; 1991.

  2. Silberstein J, Tracy D, Irwin G. Penile injection with silicone: case report and review of the literature. J Sex Med. 2008;5:2231–7.

    Article  Google Scholar 

  3. Lee T, Choi HR, Lee YT, Lee YH. Paraffinoma of the penis. Yonsei Med J. 1994;35:344–8.

    Article  CAS  Google Scholar 

  4. Cohen JL, Keoleian CM, Krull EA. Penile paraffinoma: self-injection with mineral oil. J Am Acad Dermatol. 2001;45:S222–4.

    Article  CAS  Google Scholar 

  5. Oh KJ, Park K, Kang TW, Kwon DD, Ryu SB. Subcutaneous metallic mercury injection for penile augmentation. Urology. 2007;69:185.e3–4.

    Article  Google Scholar 

  6. Arthaud JB. Silicone-induced penile sclerosing lipogranuloma. J Urol. 1973;110:210.

    Article  CAS  Google Scholar 

  7. Del Rosario RN, Barr RJ, Graham BS, Kaneshiro S. Exogenous and endogenous cutaneous anomalies and curiosities. Am J Dermatopathol. 2005;27:259–67.

    Article  Google Scholar 

  8. Hohaus K, Bley B, Köstler E, Schonlebe J, Wollina U. Mineral oil granuloma of the penis. J Eur Acad Dermatol Venereol. 2003;17:585–7.

    Article  CAS  Google Scholar 

  9. Lawrentschuk N, Angus D, Bolton DM. Sclerosing lipogranuloma of the genitalia treated with corticosteroids. Int Urol Nephrol. 2006;38:97–9.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, AZ Delta campus Rumbeke, Roeselare, Belgium

    Mesut Mutluoglu, Jesse Marrannes & Kristof De Smet

  2. Department of Urology, AZ Delta campus Rumbeke, Roeselare, Belgium

    Kristien Boel

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  1. Mesut Mutluoglu
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  2. Jesse Marrannes
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  3. Kristien Boel
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  4. Kristof De Smet
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Correspondence to Mesut Mutluoglu.

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Mutluoglu, M., Marrannes, J., Boel, K. et al. Penile Girth Enlargement: do not try it at home. Int J Impot Res 34, 108–110 (2022). https://doi.org/10.1038/s41443-021-00433-8

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