Penile paraffinoma-Treatment strategies

Abstract

Penile paraffinomas are aconsequence of an injection of mineral oils for augmentation. As an result of the foreign body reaction local complications regularly occur, which require aplastic reconstructive intervention. So far 8 cases have been treated in our clinic over the last 20 years. Presentation of the operative treatment techniques for penile paraffinoma as well as the indications and complications. After reviewing the relevant literature, we analyzed the data of our own patient cohort. Since 1999 atotal of 8 patients with lipogranuloma underwent surgical treatment at the St. Antonius Hospital in Eschweiler. The choice of aplastic reconstructive treatment depends on the extent of the paraffinoma. If it is limited to the foreskin, aradical circumcision is sufficient but if it extends to the skin of the penile shaft, aplastic defect coverage with amesh graft, afull skin graft or ascrotal skin flap is required. In cases with additional pathologies, such as urethral fistulas, auxiliary reconstructive procedures should be performed. For optimal cosmetic and functional results, the surgeon must master abroad spectrum of plastic reconstructive techniques. In selected complex cases an interdisciplinary approach consisting of urologists and plastic surgeons can be necessary.