Penile Self-Injections for Girth Augmentation: Treatment of Complications

Penis size has been long regarded as a symbol of strength and sexuality. Attempts to make the penis bigger have been recorded since antiquity. Penile augmentation by injecting mineral oil has been practiced for a long time. The debilitating effect has been long known, and the procedure has been abandoned by most medical practitioners. Still in some places, the practice of penile injection with mineral oil is performed by non-medical persons. 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. The affected areas are not only localized in the injected site. It can also migrate to the scrotum and suprapubic area. This migration makes treating this disorder more difficult. 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.