Department of Urology, University of Szeged, 6724 Szeged Kálvária sgt. 57, Szeged, Hungary.
J Sex Med. 2013 Apr;10(4):1170-7. doi: 10.1111/jsm.12054. Epub 2013 Jan 24.
Penile girth enhancement by the injection of Vaseline is an existing practice. Many cases develop severe complications that need surgery.
To report on the reconstructive surgical solutions of the complications of Vaseline self-injection and the outcomes. To develop a modification of a one-step reconstruction method involving the use of pedicled scrotal flaps.
The complications and their surgical solutions were classified as regards severity and difficulty. The outcomes were observed and a newly introduced one-step surgical method was investigated.
Seventy-eight consecutive patients (87.2% of them with a history of imprisonment) were divided into three groups. In group A, aesthetic penile defects or phimosis caused by the Vaseline necessitated circumcision or local excision. In group B, the whole penile skin was involved, and total skin removal and two- or (a newly modified) one-step reconstructive surgery were performed. In group C, both the whole penile skin and the scrotum were involved: complete skin removal and skin grafting or skin pedicled flap transplantation were carried out.
In five cases in group B, postoperative skin necrosis made a second operation necessary. There was one intraoperative urethral injury, where a urethral fistula developed and a second urethral reconstruction was performed. There was no major complication with the newly developed one-stage pedicled flap procedure. At the end of the therapy, all the cases were healed. All of the patients reported successful sexual intercourse after the operations and 91% were satisfied with the result.
The complications depend mainly on the amount of Vaseline injected, the hygienic circumstances, and the personal tolerability. In the worst cases, only radical skin removal and skin transplantation can solve the problem. The newly developed one-step arterial branch-preserving scrotal skin flap reconstruction appears to be a suitable and cost-effective solution for these patients.
通过注射凡士林来增加阴茎周长是一种现有的做法。许多病例会出现严重的并发症，需要手术治疗。
报告凡士林自注射引起的并发症的重建手术解决方案及其结果。提出一种涉及使用带蒂阴囊皮瓣的一步法重建方法的改良。
根据严重程度和难度对并发症及其手术解决方案进行分类。观察结果并研究一种新引入的一步手术方法。
78 例连续患者（其中 87.2%有监禁史）分为三组。在 A 组中，凡士林引起的美学性阴茎缺陷或包茎需要进行包皮环切术或局部切除术。在 B 组中，整个阴茎皮肤均受累，行全层皮肤切除和双（或新改良的）一步重建手术。在 C 组中，整个阴茎皮肤和阴囊均受累：行全层皮肤切除和植皮或带蒂皮瓣移植。
在 B 组的 5 例中，术后皮肤坏死需要进行第二次手术。有 1 例术中尿道损伤，导致尿道瘘形成，并进行了第二次尿道重建。新开发的一期带蒂皮瓣手术没有出现重大并发症。治疗结束时，所有病例均已愈合。所有患者术后均能成功进行性行为，91%的患者对结果满意。
并发症主要取决于注射的凡士林量、卫生条件和个人耐受性。在最坏的情况下，只有彻底切除皮肤和植皮才能解决问题。新开发的一步动脉分支保留阴囊皮瓣重建术似乎是这些患者的一种合适且具有成本效益的解决方案。
