Treatment of Paraffin-Induced Lipogranuloma of the Penis by Bipedicled Scrotal Flap With Y-V incision

Kim, Sun Wook; Yoon, Byung Il; Ha, U-Syn; Kim, Sae Woong; Cho, Yong-Hyun; Sohn, Dong Wan

doi:10.1097/sap.0b013e31828637d3

Cited by 29 publications

(18 citation statements)

References 8 publications

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“…Full-thickness or split-thickness skin graft from the inguinal area or abdomen after paraffinoma excision is feasible [10]. But those grafts are not as extensible as penile skin, and also are different in color from penile skin.…”

Section: Discussionmentioning

confidence: 99%

Penile skin preservation technique for reconstruction surgery of penile paraffinoma

Kim¹,

Shin

Park

2019

Investig Clin Urol

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Purpose Penile resurfacing with various scrotal flaps is a simple, effective, and reliable reconstructive armamentarium to treat penile paraffinoma. However, scrotal flaps often result in heavy hair-bearing penile skin causing dyspareunia or shortening of penile length. We introduce a new penile skin preservation technique for reconstruction surgery of penile paraffinoma. Materials and Methods From March 2007 to April 2018, 23 patients underwent excision of paraffinoma with the penile skin preservation technique. Complete removal of the subcutaneous tissue was done, including paraffinoma. No. 10 surgical blades were used to peel off the skin as thin as possible in order to get paraffinoma-free skin. The preserved penile skin was given an end to end anastomosis to the circumferential incision site. Multiple anchoring fixation sutures of the penile skin were made on the underlying tissue. Dressing of chopped gauze soaked with antibiotic saline solution was done on the skin to help preserve it and keep it fixed on the penis. Results The skin survived completely without necrosis in 19 patients (82.6%), with the mean duration of healing being 21.9 days. The penis after the operation looked natural in color and shape. Partial necrosis after the operation was shown on 4 patients (17.4%), whom were all later treated with the scrotal skin free graft. The final results were successful without any cosmetic or functional complications, such as skin contracture. Conclusions Penile resurfacing with the penile skin preservation technique is a new effective reliable method for skin-intact paraffinoma which produces good functional and cosmetic results.

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Section: Discussionmentioning

confidence: 99%

Penile skin preservation technique for reconstruction surgery of penile paraffinoma

Kim¹,

Shin

Park

2019

Investig Clin Urol

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“…Usually a desired girth can be achieved either with invasive and expensive techniques [8] , [9] or by less invasive and certainly less costly procedures such as injecting various substances. Injecting filling substances is usually performed in the penile skin as well as in the dartos fascia, which can cause a foreign body reaction, as the human body lacks the enzymes to metabolize interstitial exogenous oils.…”

Section: Discussionmentioning

confidence: 99%

“…Compared to suggested procedures by Shin et al [9] the ‘T-style anastomosis’ technique is characterised by delayed wound healing and infection and the ‘inverted V-shape anastomosis’ technique needs extended scrotal flaps, which in our case was impossible, as the scrotum was infiltrated by paraffin in both hemi-scrotal areas. For the ‘bipedicled scrotal flap with Y-V incision’ technique suggested by Kim et al [8] , extended scrotal flaps are needed as well. Penile reconstruction in cases of failed self-augmentation procedures with injected substances should be performed with the use of healthy and well blood-supplied tissues.…”

Section: Discussionmentioning

confidence: 99%

Minimal surgical management of penile paraffinoma after subcutaneous penile paraffin injection

Dellis

Nastos

Mastorakos

et al. 2017

Arab Journal of Urology

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ObjectivesTo describe our reconstructive technique, without flap or graft use, after penile self-augmentation with injected substances, such as paraffin, which are still performed with unfortunate consequences.Patient and methodsSuccessful single-stage minimal surgical management of an already twice unsuccessfully managed ulcerative penile paraffinoma in a 38-year-old Greek man.ResultsThe patient was discharged with no postoperative complications, with a five-item version of the International Index of Erectile Function score of 23/25 (i.e. normal erectile function) and flaccid penile length of 5 cm.ConclusionsPenile paraffinoma is a serious complication that can be successfully managed with a single-stage minimal surgical procedure, with normal aesthetic and functional results.

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“…Surgery is the best therapeutic option for this disease (3,28,35). Surgery involves complex reconstructive procedures; it is time consuming and may require a staged approach involving bi-pedicled or bilateral scrotal flaps (17,24,(36)(37)(38)(39). Complete excision is critical to remove all the granuloma material, even extending to the suprapubic area, and involved regional adenopathy (28).…”

Section: Treatmentmentioning

confidence: 99%

“…For non-reconstructive surgeons, the Cecil's staged scrotal flap operation is a good choice for its relative simplicity (Figures 4,5). The bi-pedicled scrotal flap technique can still be performed even if more than half of the penile skin is involved (17,35,37,38,40).…”

Section: Category Contentmentioning

confidence: 99%

Sclerosing lipogranuloma of the penis: a narrative review of complications and treatment

Soebhali¹,

Felício²,

Oliveira³

et al. 2021

Transl Androl Urol

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Sclerosing lipogranuloma of the penis is a relatively rare disorder associated with injection of illicit foreign materials for penile augmentation. We aim to report the clinical presentation, diagnosis, treatment, and outcomes of patients with this condition, and to review the most relevant literature currently available.Background: Injection of mineral oil into the subcutaneous tissues of the penis for augmentation has been practiced since ancient times. The potential for complications has long been known, and most doctors have abandoned the procedure. However, it is still practiced in some parts of the world. The complications may be devastating including death from embolism or sepsis. The affected area may not be restricted to the injection site, potentially involving the scrotal and suprapubic areas. Surgery with complete removal of the involved tissue followed by covering the denuded area with a graft or skin flap is the best therapeutic option. Methods:The literature search involved keywords such as penis, augmentation, enlargement, sclerosing, lipogranuloma, penile injection, paraffinoma, and was obtained from computerized search of databases such as PubMed, Google Search and Scopus. Personal experience of the lead author (BS) is also described. We tried arbitrarily to limit our search to articles including ≥5 patients pertaining to the subject of our review and, therefore, excluded single case reports. However, a single systematic search of PubMed and Scopus was also found and included. Conclusions:The treatment of choice is radical excision of all the lesions followed by skin grafting.Bearing in mind that prospective, randomized, controlled studies are considered difficult to carry out, further work will continue apparently to be based on case series by individual surgeons. It is critical to advise patients to separate the myths from the facts and use preventive measures through awareness and education to best minimize the downsides of this problem.

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Treatment of Paraffin-Induced Lipogranuloma of the Penis by Bipedicled Scrotal Flap With Y-V incision

Abstract: The authors had performed a complete excision of paraffinoma in patients with penile paraffinoma with concurrent skin necrosis and obtained good outcomes of preventing the shortening of penile length by performing a bipedicled scrotal flap with Y-V incision using the scrotal skin.

Cited by 29 publications

References 8 publications

Penile skin preservation technique for reconstruction surgery of penile paraffinoma

Penile skin preservation technique for reconstruction surgery of penile paraffinoma

Minimal surgical management of penile paraffinoma after subcutaneous penile paraffin injection

Sclerosing lipogranuloma of the penis: a narrative review of complications and treatment

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