title: Subcutaneous penile insertion of domino fragments by incarcerated males in southwest United States prisons: a report of three cases.
abstract: BACKGROUND
  Self-insertion of penile foreign bodies is performed worldwide, largely due to a perception that it will enhance sexual performance and virility. There are relatively few cases reported in the United States.
  
  
  OBJECTIVE
  We report three cases of Hispanic men incarcerated in separate southwest United States prisons who utilized a similar technique to insert foreign bodies fabricated out of dominos into the subcutaneous tissues of the penis.
  
  
  METHODS
  Details of the three cases were retrospectively reviewed.
  
  
  METHODS
  Resolution of the case.
  
  
  RESULTS
  In each case, an incarcerated Hispanic male or fellow inmate filed a domino into a unique shape for placement under the penile skin. Utilizing the tip of a ballpoint pen or a sharpened shard of plastic to create a puncture wound, each man inserted the domino fragment into the subcutaneous tissue of the penis. All three men presented with infection requiring operative removal.
  
  
  CONCLUSIONS
  Incarcerated males put themselves at risk for injury and infection when attempting penile enhancement with improvised equipment.
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9110, USA. Steven.Hudak@utsouthwestern.edu
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Hudak
authors.forename: James
authors.initials: J
authors.lastname: McGeady
authors.forename: Alan W
authors.initials: AW
authors.lastname: Shindel
authors.forename: Benjamin N
authors.initials: BN
authors.lastname: Breyer
mesh_terms: D000328:Adult; D046289:Body Modification, Non-Therapeutic / Q000009:adverse effects*; D005547:Foreign Bodies / Q000150:complications; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D010413:Penis; D011329:Prisoners; D012189:Retrospective Studies; D012725:Sexual Behavior; D015206:Southwestern United States; D014481:United States
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