Department of Urology and Institute of Andrology, University College London Hospitals NHS Foundation Trust, London, UK.
Division of Surgery and Interventional Science, University College London, London, UK.
Int J Impot Res. 2024 Aug;36(5):498-508. doi: 10.1038/s41443-023-00675-8. Epub 2023 Mar 1.
Injection of exogenous material into the penis and scrotum has been performed for augmentation purposes. Complications include cosmetic dissatisfaction, penile necrosis and lymphoedema. We report the complications and outcomes from a single centre with an updated systematic review of the literature. A retrospective review of all cases presenting with foreign substance injection into the genitalia, over a 10-year period was performed. Thirty-five patients with a mean (standard deviation (SD); range) age of 36.9 (±9.1; 22-61) years at presentation were included. The mean (SD; range) time between injection and presentation was 7.8 (±5.8; 1 day-20 years) years. The most common injected substance was silicone (n = 16, 45.7%) and liquid paraffin (n = 8, 22.9%). The penile shaft (94.3%) was the most injected site. The most common presentations were cosmetic dissatisfaction (57.1%) and pain and/or swelling (45.7%). Surgery was required in 32 (91.4%) cases. Primary procedures included local excision and primary closure (n = 19, 59.4%), circumcision (n = 5, 15.6%), excision with a split skin graft or a scrotal flap reconstruction (n = 5, 15.6%). Three (8.6%) patients presented with necrosis and required acute debridement. Overall, 18 patients had more than 1 procedure, and 8 patients required 3 or more procedures. A systematic search of the literature identified 887 articles of which 68 studies were included for analysis. The most common substance injected was paraffin (47.7%), followed by silicone (15.8%). The majority of patients (77.9%) presented with pain, swelling or penile deformity. 78.8% of the patients underwent surgical treatment, which included excision and primary closure with or without the use of skin grafts (85.1% of all procedures), the use of flaps (12.3%) and penile amputation (n = 2). Complications of foreign body injection into the male genitalia can be serious resulting in necrosis and autoamputation. Surgical intervention is often required to excise abnormal tissue to manage pain and improve cosmesis.
将外源性物质注入阴茎和阴囊以达到增大的目的。并发症包括美容不满意、阴茎坏死和淋巴水肿。我们报告了一个中心的并发症和结果，并对文献进行了系统回顾更新。对 10 年来所有因生殖器注射异物而就诊的病例进行了回顾性分析。共纳入 35 例患者，平均年龄（标准差；范围）为 36.9（±9.1；22-61）岁。注射到就诊的平均（标准差；范围）时间为 7.8（±5.8；1 天-20 年）年。最常见的注射物质是硅胶（n=16，45.7%）和液体石蜡（n=8，22.9%）。阴茎干（94.3%）是最常注射的部位。最常见的表现是美容不满意（57.1%）和疼痛和/或肿胀（45.7%）。32 例（91.4%）需要手术。主要手术包括局部切除和一期缝合（n=19，59.4%）、包皮环切术（n=5，15.6%）、切除后用皮片或阴囊皮瓣重建（n=5，15.6%）。3 例（8.6%）患者出现坏死，需要急性清创。总体而言，18 例患者进行了 1 次以上手术，8 例患者进行了 3 次以上手术。对文献进行系统搜索，共检索到 887 篇文章，其中 68 项研究纳入分析。最常见的注射物质是石蜡（47.7%），其次是硅胶（15.8%）。大多数患者（77.9%）出现疼痛、肿胀或阴茎畸形。78.8%的患者接受了手术治疗，包括切除和一期缝合，可使用或不使用皮片（所有手术的 85.1%）、使用皮瓣（12.3%）和阴茎截断术（n=2）。男性生殖器异物注射的并发症可能很严重，导致坏死和自动截肢。为了切除异常组织以缓解疼痛和改善美容效果，通常需要手术干预。
