title: Penile sclerosing lipogranulomas and disfigurement from use of "1Super Extenze" among Laotian immigrants.
abstract: BACKGROUND
  Subcutaneous penile injection of various oils for penile augmentation has been described among men in Laos. We have now treated three Laotian immigrants with penile disfigurement secondary to sclerosing lipogranulomas, also known as paraffinoma, induced by injection of a mineral oil compound marketed as "1Super Extenze," which they purchased in the United States.
  
  
  OBJECTIVE
  This series describes the clinical course and management of complications associated with the use of "1Super Extenze" in three Laotian men.
  
  
  METHODS
  Surgeons excised all grossly affected tissue and performed reconstruction using skin grafting, Z-plasty, and tissue advancement, respectively. Tissue from the penile shaft of each patient and a local lymph node in one patient was examined microscopically. Mass spectroscopy was performed on an aliquot of "1Super Extenze."
  
  
  METHODS
  Urinary function, sexual function, and cosmesis of the three reported cases, chemical composition of "1Super Extenze," and microscopic analysis of penile and regional lymphatic tissue.
  
  
  RESULTS
  Short-term cosmetic and functional outcomes were acceptable after surgical intervention. Histologic findings consistent with sclerosing lipogranulomas were seen in specimens from affected subcutaneous and lymphatic tissue. "1Super Extenze" proved to be composed of mineral oil with tocopherol acetate (vitamin E).
  
  
  CONCLUSIONS
  Injection of "1Super Extenze" into the penile shaft results in sclerosing lipogranulomas, which can cause severe sexual and urinary complications. Surgical resection of all grossly involved tissue with appropriate reconstruction can mitigate these problems. This series supports previous recommendations in the literature that men should avoid the use of non-medical foreign bodies and fillers as means of penile augmentation.
authors: Wake Forest University--Department of Urology, Winston-Salem, NC 27103, USA. tedmannymd@gmail.com
authors: Ted
authors: T
authors: Manny
authors: Joseph
authors: J
authors: Pettus
authors: Ashok
authors: A
authors: Hemal
authors: Malcolm
authors: M
authors: Marks
authors: Majid
authors: M
authors: Mirzazadeh
mesh_terms: D000328:Adult; D054242:Emigrants and Immigrants; D015745:Granuloma, Foreign-Body / Q000473:pathology* / Q000601:surgery; D006801:Humans; D055104:Infusions, Subcutaneous; D007812:Laos; D008297:Male; D054526:Men's Health; D008875:Middle Aged; D008899:Mineral Oil / Q000009:adverse effects*; D010413:Penis / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D019651:Plastic Surgery Procedures; D012598:Sclerosis / Q000473:pathology* / Q000601:surgery; D058428:Silica Gel / Q000009:adverse effects*
chemical_list: D058428:Silica Gel; D008899:Mineral Oil