Penile Paraffinoma

Penile paraffinoma is an uncommon entity produced by penile paraffin injections for the purpose of penile enlargement by a nonmedical person. Although it is not a current method of penile enlargement procedures, in our opinion dermatologists and urology specialist should be have knowledge of this entity about diagnosis and management. It will be an aim to share our experiences and views in this paper. 1. Introduction Penile paraffinoma, or as named in old terms sclerosing lipogranuloma of male genitalia, is an uncommon entity produced by penile paraffin injections for the purpose of penile enlargement [1, 2]. Generally, penile subcutaneous and glandular paraffin injections for penile augmentation are performed by a nonmedical person, under unacceptable conditions. It usually occurs months to years after the injections. Unfortunately the injections are generally repeated a number of times in order to reach the desired enlargement and shape, which in turn causes the early complications such as infection, allergic reactions, paraphimosis (circumcised or uncircumcised), severe pain, or tenderness and inflammatory reactions. In 1899, Robert Gersuny who is an Austrian surgeon from Vienna injected mineral oil (Vaseline) to substitute the absence of testicles in a patient who had undergone bilateral orchiectomy for tuberculosis epididymitis [1, 3]. The immediate success of the operation encouraged him to use Vaseline as filling material for soft tissue defects. Human body lacks the enzymes to metabolize interstitial exogenous oils [4]. So, a foreign body reaction will inevitably cause a subcutaneous paraffin deposition. Complications of the injection of these oil substances are well known and had been reported in 1906 in two patients who had received paraffin injections for facial wrinkles and developed defacing subcutaneous nodules. The principle of the technique was the injection of a product that becomes semiliquid by heating, but it solidifies when it gets colder. It remains stable in the human body. It was used for the cure of palatal defects, as well as urinary fistulae and hernia repairs but was mainly used for cosmetic purposes: for the filling of wrinkles of face, cheeks, and frontal areas and for breast augmentation as well as penile reconstruction. Although serious complications had been reported, it remained popular for the first 20 years of the 20th century. Unfortunately, even with initial good results, secondary or late severe complications appeared due to the deposition of paraffin. There was formation of nodules called lipogranulomas, which