Sclerosing lipogranuloma of the penis: a review of management and classification

Abstract

Enlargement of penile girth is has always long been a subject of extensive debate and controversy. Genital injection of high-viscosity fluids like paraffin and mineral oil has been performed for more than 100 years. The debilitating effect has been long known, and the procedure has been abandoned by most medical practitioners. Injection often performed by non-professional persons or by the patients themselves, in a non-standardized way. The mineral oil contains foreign lipid that cannot be metabolized by human body, thus foreign body reaction will occur. The inflamed tissue and foreign body reaction will result in sclerosing lipogranuloma. This disorder also known with the injected materials names, e.g. paraffinoma, siliconoma or vaselinoma of the penis. Complications of the injection vary from inflammation, swelling, pain, hardened penile skin, to disastrous effects like ulcers, skin necrosis, pain in erection, sexual disability caused by pain either the patient or the sexual partner, and death by embolism. After injection of the mineral oil, in many patients the symptoms will occur almost instantly. Swelling, inflammation of the penile skin, redness, oedema (that will give an impression of larger penile girth) are among the symptoms occurred. Surgery is the best viable option to treat this disorder. Complete excision of the affected area, followed by covering the healthy area either by grafts or flaps. If available, scrotal skin is a good choice to cover the affected area. A good classification system of sclerosing lipogranuloma of the penis will be helpful in reporting and treating the disease.