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Comment on “Complications and outcomes following injection of foreign material into the male external genitalia for augmentation: a single centre experience and systematic review”

International Journal of Impotence Research (2023)Cite this article

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The Original Article was published on 01 March 2023

In an article recently published on International Journal of Impotence Research, Pang et al. reported their experience on the management of complications related to the injection of foreign substances for male genital augmentation. Moreover, the authors performed a systematic review of the literature on the topic [1]. Overall, 35 patients with a mean age of 36.9 years were identified in their single-center retrospective study, covering a period of 10 years. The most common site of injection was the penis (94.3%). Silicone, paraffin, and vaseline constituted 80% of the substances injected, silicone being the most represented (45.7%). The mean time between injection and presentation to the unit was 7.8 years. Cosmetic dissatisfaction for visible lumps and penile deformity was the most frequent clinical presentation (57.1%). Pain and swelling were other common symptoms (45.7%), while necrosis was detected only in a minority of patients (8.8%). The vast majority of subjects required surgical management (91.4%) which consisted of multiple procedures in 51.4% of cases. Excision with primary closure was the most common surgery as both primary (59.4%) and secondary (65.5%) procedure, while excision with skin graft or scrotal flap accounted for 18% of all surgical procedures. Cases of necrosis required immediate debridement. Retrospective design, relatively small sample size, inclusion of a single center in north-western Europe, the non-use of validated questionnaires to evaluate outcomes were the main limitations of the original series by Peng et al. The authors included 68 studies evaluating 918 patients in their systematic review. Most of the articles (91.3%) were case reports or case series with up to 11 patients. Thailand-Myannmar was the country by far with the most complications reported (71.4%), however, this was due to the fact that the largest study on the topic (n = 680) was published in this area. The data obtained from the systematic review were quite consistent with those of the authors’ series.

This article allows for a variety of insights, many of which have already been highlighted in the Special Issue “Aesthetic Genital Surgery” recently published on International Journal of Impotence Research [2, 3].

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References

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Authors and Affiliations

  1. ROC Clinic, 28010, Madrid, Spain

    Javier Romero-Otero

  2. Department of Urology, HM Hospitals (Montepríncipe, Puerta del Sur, Sanchinarro), 28660, Madrid, Spain

    Javier Romero-Otero

  3. Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131, Naples, Italy

    Celeste Manfredi

Authors
  1. Javier Romero-Otero
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  2. Celeste Manfredi
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All authors contributed equally to the paper. CM analyzed the original article, wrote the draft commentary, and chose the references. JRO supervised the writing and revised the final version.

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Correspondence to Javier Romero-Otero.

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Romero-Otero, J., Manfredi, C. Comment on “Complications and outcomes following injection of foreign material into the male external genitalia for augmentation: a single centre experience and systematic review”. Int J Impot Res (2023). https://doi.org/10.1038/s41443-023-00701-9

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  • DOI: https://doi.org/10.1038/s41443-023-00701-9

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