Surgical Techniques for Correction of Penile Paraffinoma

Abstract

BackgroundPenile augmentation using injection of a foreign body into penile skin was mainly performed by non-medical personnel. Majority of these patients end up with complication of an abnormal mass formation known as penile paraffinoma.MethodsWe described three different surgical techniques for correction of penile paraffinoma based on our single-centre experience. Informed consents were obtained from patients whose photographs were taken during the operation step.ResultsIn general, three patients had simple excision biopsy with primary suturing, four patients underwent single stage excision of circumferential granuloma with bilateral scrotal skin flap reconstruction and one patient experienced dual stage procedure. Three of them were injected with paraffin, one with silicone and the remaining four were unable to identify the substance used. All patients successfully underwent the surgical procedure and four of them had minor post-operative surgical site infection and wound gapping.ConclusionAll patients recovered well and the mean International Index of Erectile Function (IIEF-5) score obtained was 24.25. In our experience, excision biopsy was adequate for focal mass and reconstructive surgery using bilateral scrotal flap was suitable for circumferential mass.

Scrotal bridge flap reconstructive surgery for extensive penile paraffinoma: steps and outcomes from a single center: a case series

“…The bilateral scrotal flap is called so because it basically uses two scrotal flaps, taken lateral to the penile shaft and inferiorly toward the median raphe, and each flap is raised superiorly and wrapped around the penile shaft with two T-style anastomoses at the distal end of the penile shaft, ventrally and dorsally. We believe that in cases of extensive penile paraffinoma, especially when it involves the entire penile shaft and part of the scrotum or the suprapubic area, using our technique would provide healthier scrotal flap These 10 cases are a slightly larger series than the four cases previously described by Salauddin et al [6]. Otherwise, to the best of our knowledge, this technique had never been previously described in detail or published in any other literature.…”

A New Modified Bipedicle Scrotal Skin Flap Technique for the Reconstruction of Penile Skin in Patients with Paraffin-Induced Sclerosing Lipogranuloma of the Penis

“…1,7 Partial skin deficit following removal of a stage 1 SLP can be resolved by primary closure of the residual intact penile skin. 1,13,14 Generally, lipogranulomas involve the whole penis, which requires resurfacing with a skin graft 11,15,16 or scrotal skin flap. 1,5,6,[13][14][15] Splitthickness skin graft reconstruction results in sexual functional repair and cosmetically acceptable hairless penile skin.…”

“…1,13,14 Generally, lipogranulomas involve the whole penis, which requires resurfacing with a skin graft 11,15,16 or scrotal skin flap. 1,5,6,[13][14][15] Splitthickness skin graft reconstruction results in sexual functional repair and cosmetically acceptable hairless penile skin. It can be applied even in cases when a large part of the scrotum is also involved.…”

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

“…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).…”