Paraffinoma of the penis is a subtype of sclerosing lipogranuloma. The prognosis of untreated paraffinoma is poor.
What is paraffinoma of the penis?
Paraffinomas are tumors that result from the introduction of kerosene or other lipoid substances under the skin. Often, these substances cause a granulomatous reaction in the subcutaneous fat tissue. Paraffinomas can develop not only in the penile region but also in the gluteal region, female and male breast, or abdomen. However, the majority of self-induced paraffinomas are found in the genital region. In the past, kerosene injections were more common. Today, paraffinomas of the penis are very rare due to the known unpleasant side effects and granuloma formation. Kerosene for penis enlargement probably goes back to the Austrian surgeon Robert Gersuny. In 1903, he reported the use of kerosene as a testicular prosthesis. As early as 1899, he injected kerosene into a patient who had to have both testicles removed due to an infection. Since at that time there were only successes and not yet any side effects, Gersuny and numerous colleagues injected mineral oils and kerosene into various parts of the body, treating, among other things, deformities of the face. Hemorrhoids and incontinence were also treated with kerosene injections. At this time, penis enlargements with kerosene became fashionable. After about 20 years, the serious late effects of this therapy became apparent. Since 1950, kerosene has no longer been used for injections in medicine. The material has been successively replaced in therapy by other materials such as hyaluron or collagen.
Causes
Paraffinoma of the penis results from the injection of kerosenes or mineral oils under the skin of the penis. In the early 20th century, injection of kerosenes or mineral oils was a common technique to enlarge the penis. Later, after the side effects became known, the method was used extremely rarely in Northern Europe. Today, penis enlargement with kerosene is still practiced in many Eastern European countries and sporadically in Korea. Kerosene injections are mainly performed by non-medical professionals. This of course increases the risk of complications and side effects. The average age for men performing kerosene injections is just under 40 years, with ages ranging from 19 to 77. There are several reasons behind kerosene injections. Patients desire a larger penis, suffer from erectile dysfunction (erectile dysfunction), or have a desire to better satisfy their partner. The kerosene is usually injected through the urethra or fatty tissue.
Symptoms, complaints and signs
A year usually passes from the first kerosene injection until the paraffinoma develops. In individual cases, the tumor may not show up until 40 years later. Subcutaneous injection of kerosene or other mineral oils may result in a foreign body reaction. The cells of the mononuclear phagocyte system try to eliminate the foreign substance. In the process, so-called foreign body granulomas form. These are nodular neoplasms of the tissue that are not infectious. They consist of epithelioid cells, mononuclear cells or giant cells that wrap around the foreign substance and encapsulate it. In the long term, the inflammatory reactions triggered by the foreign body can lead to degeneration of the cells and thus to cancer. Especially in older patients, there is a risk that the ulcerating lesions of the penis will develop into squamous cell carcinoma. A majority of patients who have self-injected kerosene into the penis are not satisfied with the results. In fact, nearly 75 percent of all patients would like to have the injected kerosene removed. Less than 20 percent have no side effects after the injection. Most patients suffer from inflammation, skin necrosis and pain.
Diagnosis and disease progression
Paraffinoma is diagnosed based on clinical symptoms and medical history. Tumors on the penis that occurred after an injection with kerosene suggest paraffinoma. Ulcerations or other inflammations on the penis after kerosene injections are also indicative of paraffinoma.However, in order to make a correct diagnosis, the physician must rely on the patient’s honest information. If the patient conceals the kerosene injections, only a biopsy of the tumor can provide clarity.
Complications
A paraffinoma of the penis must be treated by a physician in any case. If treatment is not received, the tissue may die completely due to the cancer. Furthermore, the cancer can spread to other regions of the body and cause damage to the tissue there. The quality of life of the affected person is significantly reduced due to the paraffinoma on the penis. In most cases, patients suffer from various inflammations and infections on the penis. Necrosis of the skin can also occur with this complaint and make the patient’s daily life much more difficult. Furthermore, various skin complaints also occur in the affected person on the penis. In many cases, the injections of kerosene into the penis are concealed, so that a proper diagnosis cannot be made. This possibly reduces the life expectancy of the affected person, as proper treatment is also not carried out. Usually, surgical intervention is performed for paraffinoma of the penis. This can limit most of the symptoms. Particular complications do not occur in this case, if the diagnosis is made early and thus the treatment can also begin early.
When should you go to the doctor?
If men who have undergone an enlargement of their penis by kerosene injection suffer from discomfort, a doctor should be consulted. Since this procedure is nowadays performed primarily in Asian areas by non-medical practitioners, the risk group of those affected is greatly limited. If irregularities develop after about twelve months of a procedure, there is cause for concern. In some cases, the changes occur several decades after the kerosene injection. The formation of foreign body granulomas on the penis is an indication of a disorder and must be presented to a physician. If pain, swelling or changes in the skin appearance occur, a visit to the doctor is necessary. Since the disorder leads to premature death if left untreated, a doctor should be consulted at the first signs of discrepancy. Inflammations in the intimate area, a loss of libido as well as sexual dysfunctions should be examined and treated by a doctor. Problems with urination or a feeling of illness indicate a health impairment. If there is weight loss, a feeling of illness or general malaise, a doctor should be consulted to clarify the symptoms. Pus formation can lead to sepsis, which can become life-threatening, so a doctor should definitely be consulted in this case.
Treatment and therapy
Any paraffinoma in the penile region requires treatment. Untreated paraffinomas steadily worsen and have a rather poor prognosis. The paraffinomas need to be cut out. This procedure is also called radical excision. Similarly, the penile foreskin must be completely removed (circumcision). If the paraffinoma is not completely removed, there is a risk of recurrence. Depending on the size of the kerosene tumor, phalloplasty may be required. This involves reconstructing parts of the penis from the patient’s own body tissue. If the patient does not agree to surgery, or if the course is less dramatic, conservative therapy may be used. For this, glucocorticoids such as triamcinolone are repeatedly injected into the paraffinoma. Alternatively, the treating physician may administer corticosteroids. Although no long-term results are available on these forms of therapy, some physicians recommend this option as first-line therapy. In this case, surgical removal is performed only if the results of first-line therapy are not satisfactory.
Outlook and prognosis
With early medical treatment, the prognosis for paraffinoma of the penis is favorable. This health disorder is the development of tumors, which must be treated imperatively. Otherwise, in addition to disturbances of erection or general sexual act, there is a health development with a fatal course. The cancer cells can spread further in the organism through the bloodstream and lead to the development of further tumors.Without appropriate cancer therapy, the average life expectancy of the affected person is shortened to a considerable degree. If the diagnosis is made quickly in the early stages of the disease, there is a good chance of a complete recovery given the current state of scientific and medical knowledge. The tumors that have developed are completely removed in a surgical procedure. In addition, it must be checked whether a paraffinoma has also developed in other parts of the body. Under optimal conditions, the start of treatment is already before any possible spread. In these cases, the foreskin of the penis is removed, thus initiating recovery. If the tumor cannot be completely removed, a regression of the symptoms can be expected in the further course of the disease. For this reason, the patient should always participate in control examinations over the entire lifespan, to have possible changes and abnormalities diagnosed at an early stage.
Prevention
Paraffinoma is a disease that occurs exclusively after kerosene or other mineral oils are injected into the body. Thus, paraffinoma can be prevented quite easily by refraining from such dangerous injections.
Aftercare
In the case of paraffinoma of the penis, the measures of an aftercare are usually significantly limited. In many cases, they are not even available to the affected person, since in many cases the disease cannot be completely cured again. The affected person should therefore see a doctor at a very early stage to avoid further complications or other complaints in the further course of the disease. The earlier a doctor is contacted, the better is usually the further course of the disease, so that a doctor should be consulted at the first signs and symptoms of the disease. The affected persons themselves are dependent on a surgical intervention. Affected persons should rest and take it easy after such an operation. Especially the region around the penis should be spared. Regular check-ups are also necessary to examine the condition of the paraffinoma of the penis. In many cases, the use of various creams and ointments is also possible, but it is always necessary to pay attention to the correct dosage and also regular use. Paraffinoma of the penis does not usually reduce the life expectancy of the affected person.
This is what you can do yourself
Patients with this diagnosis must definitely receive medical treatment, even if surgery cannot be avoided. Here, it is quite important to educate patients and clearly inform them that they may die prematurely from their paraffinoma. This is especially true for patients who deny the praffin injections into the penis. The fact that the patients in question have used a justifiably outdated, dangerous method of penile enlargement suggests that they place an overriding importance on penile size and put their health at risk for it. This is in contrast to the fact that paraffinoma of the penis is accompanied by inflammation and pain, which stands in the way of pleasurable sexual intercourse. Patients may feel they are in a dilemma here. Therefore, they are strongly advised to undergo accompanying psychotherapy. In this therapy, the values of the mostly Asian patients should be examined more closely and corrected if necessary. The aim must be to reconcile those affected with their bodies. Since a paraffinoma of the penis weakens the entire body, patients should lead a healthy lifestyle. This includes a diet of fresh, vitamin-rich foods, adequate sleep, and abstaining from alcohol and nicotine. Detoxification and elimination procedures also support the healing process. Alternative practitioners and doctors specializing in naturopathy provide advice on this.