Surgical Solutions for the Complications of the Vaseline Self-Injection of the Penis

Abstract

Introduction Penile girth enhancement by the injection of Vaseline is an existing practice. Many cases develop severe complications that need surgery. Aim To report on the reconstructive surgical solutions of the complications of Vaseline self-injection and the outcomes. To develop a modification of a one-step reconstruction method involving the use of pedicled scrotal flaps. Main Outcome Measures The complications and their surgical solutions were classified as regards severity and difficulty. The outcomes were observed and a newly introduced one-step surgical method was investigated. Methods Seventy-eight consecutive patients (87.2% of them with a history of imprisonment) were divided into three groups. In group A, aesthetic penile defects or phimosis caused by the Vaseline necessitated circumcision or local excision. In group B, the whole penile skin was involved, and total skin removal and two- or (a newly modified) one-step reconstructive surgery were performed. In group C, both the whole penile skin and the scrotum were involved: complete skin removal and skin grafting or skin pedicled flap transplantation were carried out. Results In five cases in group B, postoperative skin necrosis made a second operation necessary. There was one intraoperative urethral injury, where a urethral fistula developed and a second urethral reconstruction was performed. There was no major complication with the newly developed one-stage pedicled flap procedure. At the end of the therapy, all the cases were healed. All of the patients reported successful sexual intercourse after the operations and 91% were satisfied with the result. Conclusions The complications depend mainly on the amount of Vaseline injected, the hygienic circumstances, and the personal tolerability. In the worst cases, only radical skin removal and skin transplantation can solve the problem. The newly developed one-step arterial branch-preserving scrotal skin flap reconstruction appears to be a suitable and cost-effective solution for these patients.

Complications after Self-injection of Chemical Substances into the Penis

“…Penile reconstructive surger y is in continuous development, but remains an anatomic, functional and aesthetic challenge especially in cases with severe complications after illicit, self-injection [9]. The most used self-injected chemical substances are mineral oils, vaseline, paraffin oils and kanamycin [5,6]. In these abovementioned cases, reconstruction with scrotal flap technique seems a good choice, if it's not possible, skin grafts may be used from other parts of the body [9].…”

“…Consequences following injection are devastating, affecting the sexual and cosmetic function of the penis [2]. Complications can vary depending on the amount of substance that has been administered, personal tolerance, and hygiene conditions [6].…”

“…Improving the circumference of the penis after the selfinjection of Vaseline is a clandestine practice even today [6]. After the self-injection of this substance, the complications that occur are similar to other chemical substances injected and require surgical reconstruction to solve them.…”

Letter to the editor re: Penile paraffinoma: A rare but important presentation. A Gaukroger et al. J Clin Urol 2018; DOI: 10.1177/2051415818806064

“…Specific complications included phimosis, Vaseline granulomas, ulceration and necrosis, and that following surgical intervention 91% reported satisfactory sexual function. 8 Aside from genital disfiguration that occurs following Vaseline self-injection, skin necrosis, embolisation, blindness and death have also been reported. 9 Moon et al have studied the psychological impact of penile paraffinoma and reported (a) the majority of procedures were performed by non-medical personnel, (b) a higher incidence among incarcerated persons, and (c) peer recommendation prior to imprisonment was commonplace.…”

Vaseline injection, an inadequate method for penile augmentation

“…The main motivation for the intervention is the fellow prisoners' bad example, so the information of these subpopulations about the harmfulness and ineffective nature of vaseline self-injection is of essential importance. Our study of demonstrating the high incidence of complications of the petroleum jelly injection emphasizes the importance of prevention and education programs in order to improve the health and social status of the affected sub-population (Rosecker et al, 2011(Rosecker et al, , 2012Bajory et al, 2010Bajory et al, , 2013). …”