ONE-STAGE MODIFIED BIPEDICLED SCROTAL FLAP IN PENILE SCLEROSING LIPOGRANULOMA SURGICAL RECONSTRUCTION: A CASE SERIES
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Abstract
Introduction: Sclerosing lipogranuloma is commonly encountered by urologists and plastic surgeons. Despite potential permanent damage, increasing penile size by injecting unusual substances, usually oil-based, becomes a trend in society. The immediate result, practicality, and affordability of the procedure caused penile shaft deformity, pain, and difficulties in sexual activity. Objective: This study aims to report three cases of modified scrotal flap reconstruction techniques to reconstruct heavily deformed penile shafts with satisfying results. Case(s) Presentation: Three males presented with painful enlarged and deformed penile shaft following a penile enlargement procedure by injection of unusual substances done by non-medical practitioners. Following penile sclerosing lipogranuloma diagnosis, lipogranuloma excision and one-stage modified bipedicle scrotal flap were conducted for all patients. Discussion: A reconstructive procedure is needed to eliminate pain and restore sexual functions. Among available surgical reconstruction techniques, the bipedicled scrotal flap was more suitable in most limited healthcare setting for its less technical complexity, fewer complications, better aesthetic outcomes, and better sexual functions. All cases were reconstructed in a one-stage procedure, they were cost-efficient without losing their features. Conclusion: The one-stage modified bipedicled scrotal flap technique is a beneficial technique for penile reconstruction caused by sclerosing lipogranuloma, especially in health centers where patients reside in distant places. Keywords: Sclerosing lipogranuloma, scrotal flap, reconstruction techniques.
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sclerosing lipogranuloma, scrotal flap, reconstruction techniques
Shin YS, Zhao C, Park JK. New reconstructive surgery for penile paraffinoma to prevent necrosis of ventral penile skin. Urology. 2013 Feb;81(2):437–41.
Salauddin SA, Ghazali H. Surgical Techniques for Correction of Penile Paraffinoma. Malaysian Journal of Medical Sciences. 2019;26(6):137–42.
Symeonidis A, Symeonidis EN, Toutziaris C, Dimitriadis G. Obstructive lower urinary tract symptoms (LUTS) as the initial presentation of penile paraffinoma: a case report and literature review. Pan African Medical Journal. 2021;38.
Gutiérrez-Zurimendi G, Albisu-Tristán A, Gil-Martín AR, De Casasola-Rodríguez GG, Lozano-Ortega JL, Urresola-Olabarrieta A, et al. Granulomatous inflammation of the penis due to injection of an unknown substance. Rev Mex Urol. 2019;79(1).
McAninch JW, Lue TF. Smith & Tanagho’ s General Urology 18th ed. McGraw Hill. 2013. 613–614 p.
Downey AP, Osman NI, Mangera A, Inman RD, Reid S V., Chapple CR. Penile Paraffinoma. Eur Urol Focus. 2019 Sep;5(5):894–8.
Bettocchi C, Checchia AA, Falagario UG, Ricapito A, Busetto GM, Cormio L, et al. Male esthetic genital surgery: recommendations and gaps to be filled. Int J Impot Res. 2022 May 5;34(4):392–403.
Pehlivanov G, Kavaklieva S, Kazandjieva J, Kapnilov D, Tsankov N. Foreign‐body granuloma of the penis in sexually active individuals (penile paraffinoma). Journal of the European Academy of Dermatology and Venereology. 2008 Jul 6;22(7):845–51.
Napolitano L, Marino C, Di Giovanni A, Zimarra A, Giordano A, D’Alterio C, et al. Two-Stage Penile Reconstruction after Paraffin Injection: A Case Report and a Systematic Review of the Literature. J Clin Med. 2023 Apr 1;12(7).
Soebhali B, Felicio J, Oliveira P, Martins FE. Sclerosing lipogranuloma of the penis: a narrative review of complications and treatment. Transl Androl Urol. 2021 Jun;10(6):2705–14.
Murányi M, Varga D, Kiss Z, Flaskó T. A New Modified Bipedicle Scrotal Skin Flap Technique for the Reconstruction of Penile Skin in Patients with Paraffin-Induced Sclerosing Lipogranuloma of the Penis. Journal of Urology. 2022 Jul 1;208(1):171–8.
Dunev VR, Kolev NH, Genov PP. Late results of bilateral scrotal flap. Urol Case Rep. 2019 Nov;27:100920.
Alwaal A, McAninch JW, Harris CR, Breyer BN. Utilities of Split-Thickness Skin Grafting for Male Genital Reconstruction. Urology. 2015 Oct;86(4):835–9.
Ismy J, Amirsyah M, Palgunadi IN, Firdaus GI, Fakhrulrizal F, Khalilullah SA. One-stage Reconstruction of Penile Paraffinoma Using Spiral Stitches FTSG and Evaluation of Sexual Function. Plast Reconstr Surg Glob Open. 2022 Jan 18;10(1):E4048.
Chico Goerne MB, Khogeer A, Davison P, Carrier S, Aubé-Peterkin M. Alternative surgical management of penile siliconoma using partial degloving and resurfacing. Archivio Italiano di Urologia e Andrologia. 2023 Feb 22;
Kim SW, Yoon B Il, Ha US, Kim SW, Cho YH, Sohn DW. Treatment of paraffin-induced lipogranuloma of the penis by bipedicled scrotal flap with Y-V incision. Ann Plast Surg. 2014;73(6):692–5.
Fakin R, Zimmermann S, Jindarak S, Lindenblatt N, Giovanoli P, Suwajo P. Reconstruction of Penile Shaft Defects Following Silicone Injection by Bipedicled Anterior Scrotal Flap. Journal of Urology. 2017 Apr 1;197(4):1166–70.
Jeong JH, Shin HJ, Woo SH, Seul JH. A New Repair Technique for Penile Paraffinoma. Ann Plast Surg. 1996 Oct;37(4):386–93.
Sung Kim J, Seob Shin Y, Kwan Park J. Penile skin preservation technique for reconstruction surgery of penile paraffinoma. Investig Clin Urol. 2019 Mar 1;60(2):133–7