3. český a mezinárodní andrologický kongres

Zamecnik L., Macek P., Roubickova J., Pavlik I.
Department of Urology, 1st Medical School, Charles University, Prague, Czech Republic

Introduction:
Authors present 3 cases of self-injection of foreign materialunder penile skin with the aim to increasing the diameter of penis.
Materials and methods:
Patient 1, age 35. Three weeks before presentation he self-injected a paraffin under the skin of the whole penis from several punctures. He presented due to difficult voiding, swelling and mauve colour of a foreskin, pain and fever up to 38 degrees. Ultrasonography showed no obvious fluid collection, thickened subcutaneous tissues only, erectile bodies intact. Patient was admitted, broad spectrum ATB administered and suprapubic tube inserted. As no clear improvement was noted within 24 hours complete circumcision was performed. Patient went well post-operatively, voided spontaneously. Histology showed acute tissue inflammatory reaction. Patient 2, age 25. He self-injected warmed Framykoin® ointment under the penile skin in 2002 without acute complications. He was complication free in 2006, but requested a removal of a subcutaneous granuloma due to unattractive appearance. Twofold surgical removal was carried out using a degloving technique and uncomplicated post-operative course. Patient 3, age 42. After change of spouse he self-injected liquid paraffin under the skin of the whole penis. Total amount was unknown. He was complication free but surgical removal of giant paraffinomas was on patient´s request. He was not satisfied with the colour and size effect of this application.
Results:
All of patients required surgical management following a selfinjection of a foreign material under penile skin due to a complication or patient's request. Postoperative course was uncomplicated in all cases.
Conclusions:
Self-injection of foreign material under the penile skin is usually followed by complications arising from a tissue inflammatory reaction or a granulomatous reaction to foreign material. These complications often lead to immediate or delayed surgical intervention.

Author email: libor.zamecnik@lf1.cuni.cz