title: Implantation of artificial penile nodules--a review of literature.
abstract: BACKGROUND
  The implantation of penile nodules under the foreskin is unusual in Western society. This practice is known in Slavic and Asian cultures and occasionally appears in the western world. We review the historical and medical evidence found in world literature to this date.
  
  
  OBJECTIVE
  We discuss case reports and other literature on penile nodules and evaluate their medical significance.
  
  
  METHODS
  Literature search for MEDLINE publications and additional references from non-Medline indexed publications concerning the implantation of foreign bodies under the foreskin.
  
  
  METHODS
  Literature search for MEDLINE-indexed papers followed by a manual bibliographic review of cross-references. We extended the search to non-MEDLINE references using an Internet-based search engine. More information was retrieved by contacting different experts. A statistical analysis was applied to the data collected.
  
  
  RESULTS
  There seems to be a predominance of penile bead implantation in Asian countries. The average age of a patient was 25.47 years. The average number of beads implanted was 2.71. There is a higher risk of becoming a sexually transmitted disease.
  
  
  CONCLUSIONS
  The prevalence of complications seems to be low. The incidence and severity of early or delayed complications are unknown but are probably underreported. Complications associated with this procedure should be known, especially partner complications. These nodules will possibly be encountered more often in western countries.
authors.affiliation: Department of Urology, University of Bonn, Bonn, Germany. simplissimus@gmx.de
authors.forename: Nicolas
authors.initials: N
authors.lastname: Fischer
authors.forename: Stefan
authors.initials: S
authors.lastname: Hauser
authors.forename: Olivier
authors.initials: O
authors.lastname: Brede
authors.forename: Christian
authors.initials: C
authors.lastname: Fisang
authors.forename: Stefan
authors.initials: S
authors.lastname: Müller
mesh_terms: D000293:Adolescent; D000328:Adult; D046289:Body Modification, Non-Therapeutic / Q000009:adverse effects*; D003469:Culture; D062109:Dermatologic Surgical Procedures; D005547:Foreign Bodies / Q000150:complications* / Q000601:surgery; D052816:Foreskin / Q000601:surgery; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D010413:Penis / Q000601:surgery*; D012307:Risk Factors; D012725:Sexual Behavior / Q000208:ethnology*; D012749:Sexually Transmitted Diseases; D012867:Skin / Q000293:injuries / Q000473:pathology*; D012938:Social Perception; D012959:Socioeconomic Factors; D055815:Young Adult