D'Alterio Dr. Carlo, Cirigliano Dr. Lorenzo, di Giovanni Dr. Angelo, Giordano Dr. Alessandro, Marino Dr. Claudio, Napolitano Dr. Luigi, Mirone Dr. Claudia, La Rocca Dr. Roberto, Creta Dr. Massimiliano, Palmieri Prof. Alessandro, Imbimbo Prof. Ciro, Capece Dr. Marco

(226) SCLEROSING GRANULOMA AFTER PARAFFIN INJECTION FOR PENILE AUGMENTATION: A COMPARISON BETWEEN TWO SURGICAL TECHNIQUES

  • Urology
  • Reproductive Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Psychiatry and Mental health
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Abstract Objectives Our aim is to compare two different surgical techniques for the treatment of penile paraffinoma in order to identify the most suitable technique for the characteristics of each patient. Methods We described two different surgical techniques for the correction of penile paraffinoma performed in our Urological Unit. In this video we report two cases. The first patient was a 23 years-old Bulgarian male admitted to our hospital in 2020 with penile swelling and sexual discomfort due to paraffin injected 1 year before to increase penile girth. The patient underwent a 2-stages surgical technique: during the first stage the paraffinoma was excised. The penis was buried into the scrotum. Three months later a scrotoplasty was performed. The second patient a 40 years-old Serbian men presented to our hospital in 2019 with a severe penile deformity due to multiple paraffine self-injection resulting in pain and sexual discomfort. The patient underwent a paraffinoma excision and split-thickness skin graft in one stage. Two different questionnaires, the international index of erectile function (IIEF-5) and a 6-items questionnaire on the satisfaction of genital aesthetics, were delivered to the paients by email at 3, 6 and 12 months. Results Erectile dysfunction was not reported and the scores of the IIEF-5 were comparable during the follow up. Both patients were satisfied with the aesthetic of their genitalia, however the first patient scored better in the 6-items questionnaire. No intra/post-operative complications were observed in both techniques. Conclusions In our experience patients with no scrotal involvement and suitable scrotal size benefit a dual stage technique with scrotoplasty in terms of better aesthetic outcome rather than a split-thickness skin graft. Otherwise patients with small scrotum size or scrotal involvement might undergo split thickness skin graft which provides good aesthetic outcome and a comparable sexual function. From our experice the surgeon should be skilled in both technique and a careful evaluation of patient's charactheristics should suggest wich technique fits the patient. Conflicts of Interest The Authors declair no conflict of interest.

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