Ramirez Juan C, Wickremasinghe Praveen D, Mayol-Velez Luis X, Izquierdo-Pretel Guillermo
Internal Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, USA.
Cureus. 2023 Apr 5;15(4):e37155. doi: 10.7759/cureus.37155. eCollection 2023 Apr.
The purpose of this report is to alert and inform the medical community about the presence and practice of subcutaneous penile implants (SPIs), which are used with the intent of increasing sexual pleasure. This case aspires to deflect plausible misconceptions in the specific populations who use the SPIs. This case study was performed in January 2023 at a tertiary care center in Miami, Florida. A 61-year-old Cuban male admitted for a routine hernia repair with an incidental finding of a benign SPI was interviewed and examined; an extended collection of historical information regarding the patient's penile implant was ascertained. The patient stated that there was a tradition among the men and adolescent individuals living along coastal cities/towns of Cuba such as Havana and Matanzas who would elect to have pieces of stones or gems or any solid objects shaped and molded into round objects that are used for the intent of increasing sexual pleasure. The patient referred to the implant as "La Perla Del Mar," which translates directly into "Pearl of the Sea." Upon visualization of the nodule on examination, a differential diagnosis may include infection (such as syphilis), granulomas, sarcoidosis, dermatofibroma, epithelial inclusion cyst, or malignancy. However, an appropriate workup informed us about the penile implant. Clinicians should employ caution in investigating a penile nodule by taking a detailed social and sexual history and physical exam from the patient if possible. This case and the literature review cited to bolster the notion of a lack of chronic symptoms due to the inserted objects. Several provocations for the implantation of an artificial penile nodule, in this case, maybe extrapolated, such as the desire for a prospective partner's pleasure/displeasure, group identification, or masculine embodiment. The main takeaways from this case report are the considerations that should be taken in the older Caribbean population for patients with the "Perla Del Mar" implantation and bolstering the notion of complete sexual education for clinicians regarding specific populations to enhance patient care.
本报告的目的是提醒并告知医学界有关皮下阴茎植入物（SPI）的存在及使用情况，其使用目的是增加性快感。本案例旨在消除使用SPI的特定人群中可能存在的误解。本案例研究于2023年1月在佛罗里达州迈阿密的一家三级医疗中心进行。一名因常规疝气修补入院的61岁古巴男性，偶然发现了一个良性SPI，对其进行了访谈和检查；确定了关于该患者阴茎植入物的详细历史信息。患者表示，在古巴沿海城市如哈瓦那和马坦萨斯生活的男性和青少年中，存在一种传统，即选择将石头、宝石或任何固体物体塑形为圆形物体，用于增加性快感。患者将该植入物称为“La Perla Del Mar”，直译为“海之珠”。检查时看到结节，鉴别诊断可能包括感染（如梅毒）、肉芽肿、结节病、皮肤纤维瘤、上皮包涵囊肿或恶性肿瘤。然而，适当的检查让我们了解到这是阴茎植入物。临床医生在调查阴茎结节时应谨慎，尽可能从患者那里获取详细的社会和性病史以及体格检查。本案例及引用的文献综述支持了因植入物体而缺乏慢性症状的观点。在这种情况下，植入人造阴茎结节的一些诱因可以推断出来，比如对潜在伴侣的愉悦/不愉悦的渴望、群体认同或男性气质的体现。本病例报告的主要要点是，对于植入“海之珠”的老年加勒比人群患者应考虑的因素，以及加强临床医生针对特定人群的全面性教育以提高患者护理水平。
