Penile paraffinoma after subcutaneous injection of paraffin. Treatment with a two step cutaneous plasty of the penile  shaft with scrotal skin.
OBJECTIVE
To report a rare case of penile paraffinoma caused by the subcutaneous or intra-urethral injection of foreign substances containing long-chain saturated hydrocarbons. These were injected in order to increase the penis size which generated a chronic granulomatous inflammatory reaction. This is a rare practice in the western world.


METHODS
We present the case of a 32-year-old Bulgarian male who presented with a two-year history of elastic, slightly painful penis swelling after subcutaneous liquid paraffin injection. The proposed treatment was excision of the affected tissue and penile reconstruction in a two-stage procedure.


RESULTS
The operative procedure was successful and the patient had good aesthetic and functional results. Paraffin and other materials injected into the penis can produce many complications. Foreign body granuloma, skin necrosis, penile deformity, chronic and unhealed ulcer, painful erection, and the inability to achieve a satisfactory sexual relationship are some of the resulting complications. Intralesional or systemic steroids have been used in primary sclerosing lipogranuloma resulting in the disappearance of the granuloma, but in our opinion the treatment of choice should be radical excision, and, if necessary, secondary reconstruction of the penis.


CONCLUSIONS
The injection of foreign substances to enhance penis size is currently an unjustifiable practice. However, it is still carried out, especially in Eastern Europe and Asia. In most cases surgical treatment is needed to treat the complications and the best modality seems to be radical excision together with follow-up.
Urology Department, Reina Sofia University Hospital, Murcia, Spain. jonateceldran@gmail.com
Julián
J
Oñate Celdrán
Carlos
C
Sanchez Rodríguez
Mariano
M
Tomás Ros
Francisco Miguel
FM
González Valverde
Juan Pedro
JP
Morga Egea
Miguel
M
Ruiz Marín
Pedro
P
Valdelvira Nadal
José Miguel
JM
Jiménez López
Luis Oscar
LO
Fontana Compiano
D000328:Adult; D003357:Cosmetic Techniques / Q000009:adverse effects*; D006099:Granuloma / Q000139:chemically induced* / Q000601:surgery; D006801:Humans; D007279:Injections, Subcutaneous / Q000009:adverse effects; D008297:Male; D008899:Mineral Oil / Q000008:administration & dosage / Q000009:adverse effects*; D010409:Penile Diseases / Q000139:chemically induced* / Q000601:surgery; D010413:Penis / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012611:Scrotum / Q000601:surgery; D014521:Urethra
D008899:Mineral Oil