One-stage Reconstruction of Penile Paraffinoma Using Spiral Stitches FTSG and Evaluation of Sexual Function

Abstract

Summary: Paraffinoma of the penis is rare and caused by paraffin liquid injection. This condition can cause significant penile deformity, ulceration, pain, and sexual dysfunction. However, it can be managed with surgical procedures to obtain normal aesthetic and functional results. Herein, we reported a 42-year-old male with penile paraffinoma who underwent excessive surgical excision of the fibrotic tissue and one-stage reconstruction using a spiral stitch full-thickness skin graft. At one year of follow-up it showed a good aesthetic outcome with no hypertrophic scars, skin contractures, penile curvature, or penile shortening. The sexual evaluation using the International Index of Erectile Function instrument also showed a good result with normal erectile function and satisfaction with sexual sensation. This case is interesting because we used the spiral stitch full-thickness skin graft technique to cover the degloving area and long-term follow-up to evaluate the aesthetic and functional results.

Two-Stage Penile Reconstruction after Paraffin Injection: A Case Report and a Systematic Review of the Literature

“…The first and most used technique was the bilateral scrotal flap described in 11 studies and performed in 94 patients (61.8%) [ 4 , 18 , 21 , 23 , 24 , 26 , 27 , 28 , 32 , 33 ] Thirty-five out of 94 underwent a concomitant scrotoplasty [ 23 , 32 ].…”

“…Two-stage scrotum skin flap was only described in 2 studies with a total of 2 patients involved (1.32%) [ 21 , 33 ]. Finally, a medial prepuce-soprapubic advancement flap technique was described in one patient (0.66%) as well as a full thickness skin graft (FTSG) in another one(0.66%) [ 31 ].…”

“…The two-stage technique has only been described in a few patients (2 studies) [ 21 , 33 ]. In our case report, we performed this technique, despite the vast majority of the authors prefer a single stage technique.…”

Smile Incision-Modified Technique for Better Scrotal Outcome in Surgical Management of Penile Paraffinoma

“…One patient who needed reclosure treatment due to wound disruption did so after surgery. Patients with wound disruption were given 7 days of antibiotic therapy before the reclosure following moist dressing [7][8][9]18].…”

“…In reconstructive surgery penile paraffinoma patients, the paraffinoma mass is immediately distinguishable from the normal tissue. It must be removed with sharp edges to prevent a mass recurrence [11, 18]. When a complete penile excision has been performed, many techniques can be performed to return near-normal penile shape.…”