| Abstrakt: |
Introduction. Penile growth enhancement procedures (surgical or non-surgical) have seen an increase in recent years probably because of increased pornography consumption. The main premise that this frequent exposure might "insert" into the male psyche is that masculinity is directly linked to penis size. As the subject remains "taboo" for many individuals seeking this kind of enhancement and the fact that these interventions might come at a high cost, some men seek different solutions to obtaining the same results. Unfortunately, these modalities are inappropriate and might lead to disastrous effects. The objectives of this study are to identify: the incidence of this pathology, most frequent complications and best treatment options that would lead to normal sexual function. Material and methods. To achieve this we relied on a case series of patients that were admitted to our hospital between Oct 2013 - July 2020 with different complications after self-injection of different substances (mainly kanamycin ointment) into the penile skin to achieve girth enhancement. Our series has 28 patients, with ages between 15-46 years and all underwent different surgical procedures to excise the involved tissue and reconstruction. Hospital stay, postoperative complication rates and results were also analysed. Results. Good outcomes were obtained only after surgical treatment. In some cases, conservative treatment was initiated but with unsatisfactory results, so the patients needed complementary surgeries. Almost all cases were resolved in one surgical step, with excision and reconstruction done at the same time. We opted for several reconstructive options, depending on the gravity of the situation and, also patient preference. Most cases needed circumcision or V-Y advancement flaps, as the majority of foreign material was situated in the prepuce. Most healed without any complications (75%) and the rates are comparable with those presented in other studies. The highest complication rate was skin graft lysis (10,7%), as grafting the penis implies greater difficulty than other body areas. Mean hospital stay was 7,57 days, and it was positively influenced by existence of complications. Conclusions. The best treatment remains complete surgical excision of fibrous tissue and penis resurfacing using skin grafts or scrotal flaps. Partial or incomplete excision will seldom yield good results and will lead to further postoperative complications. In our practice we used both methods, but we started to favor flap reconstruction for its better and foreseeable postoperative results and easier management. [ABSTRACT FROM AUTHOR] |
