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Review
. 2023 Mar 30;12(7):2604.
doi: 10.3390/jcm12072604.

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

Luigi Napolitano  1 , Claudio Marino  1 , Angelo Di Giovanni  1 , Assunta Zimarra  1 , Alessandro Giordano  1 , Carlo D'Alterio  1 , Gianluigi Califano  1 , Massimiliano Creta  1 , Giuseppe Celentano  1 , Roberto La Rocca  1 , Claudia Mirone  2 , Gianluca Spena  1 , Alessandro Palmieri  1 , Nicola Longo  1 , Ciro Imbimbo  1 , Marco Capece  1
Affiliations
Review

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

Luigi Napolitano et al. J Clin Med. .

Abstract

Background: Penile injection of foreign materials is an obsolete practice often performed by non-medical personnel in order to enlarge penile size.

Methods: A systematic review of the literature from 1956 to 2022 was conducted in accordance with the general guidelines recommended by the Primary Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. We included full papers published from 1956 to 2022. We also described a case report of a 23 year old Bulgarian male affected by penile paraffinoma who underwent a 2-stages surgical technique.

Results: A total of 152 cases have been reported, with a median age of 37.9 ranging from 18 to 64 years. Six different techniques have been described in the whole literature: bilateral scrotal flap, simple excision of the paraffinoma with primary closure, two-stage scrotum skin flap, medial prepuce-soprapubic advancement flap technique and penile reconstruction using split thickness skin graft (STSG) or full thickness skin graft (FTSG). An analysis of the distribution among early and late complications was then carried out.

Conclusion: In our experience, among the variety of surgical techniques described, a two-stage penile reconstruction using scrotal skin results in excellent cosmetic and functional outcomes, with a low rate of complications.

Keywords: paraffin; penile injection; penile paraffinoma; penile size; two-stage penile reconstruction.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Swollen and phimotic penis.
Figure 2
Figure 2
The paraffinoma was heterogeneous in T1 (on the left) and T2 (on the right).
Figure 3
Figure 3
Excision of infiltrated tissues.
Figure 4
Figure 4
The defect was measured in length and girth.
Figure 5
Figure 5
The subfascial scrotal tunnel was created and the penis was scrotalized.
Figure 6
Figure 6
The scrotal access.
Figure 7
Figure 7
A V-Y scrotoplasty was performed.
Figure 8
Figure 8
Final result at 6 month follow up.
Figure 9
Figure 9
PRISMA statement.
Figure 10
Figure 10
Distribution of early complications.
Figure 11
Figure 11
Distribution of late complications.
See this image and copyright information in PMC

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