Rigi10™ Malleable Penile Prosthesis
Also Known As
Penile paraffinoma, Penile siliconoma, Penile vaselinoma, Mineral oil granuloma of the penis, Liponecrosis of the penis, Penile oleogranuloma, Sclerotizing lipogranuloma, Penile foreign body granuloma.¹
Definition
Sclerosing lipogranuloma of the penis is a relatively rare chronic inflammatory condition characterized by the formation of granulomas, diffuse induration, and sclerosis of the subcutaneous tissue of the penis. This reaction is typically triggered by the injection of foreign substances, often non-medical grade oils or other materials, for the purpose of penile augmentation.¹ It is a foreign body reaction where the injected lipid material, which the body cannot metabolize, incites an inflammatory response leading to fibrosis, nodule formation, and potential disfigurement of the penis. The condition can lead to significant functional impairment and psychological distress.¹²
Clinical Context
Sclerosing lipogranuloma of the penis typically arises following the subcutaneous injection of foreign materials for penile enlargement, a practice still seen in some parts of the world despite known severe complications.¹ Symptoms can manifest from weeks to many years after the injection and include penile swelling, hardening, pain, deformity, and skin changes such as discoloration or ulceration. Patients may also experience erectile dysfunction and difficulties with intercourse.¹ The condition is diagnosed based on clinical history (history of injection) and physical examination, sometimes aided by imaging like ultrasound or MRI to assess the extent of involvement. Histopathological examination of excised tissue confirms the diagnosis by showing characteristic features of foreign body granulomatous inflammation with lipid vacuoles.¹
Patient selection for treatment depends on the severity of symptoms and the extent of tissue involvement. Conservative management with analgesics and antibiotics may be used for mild cases or to manage acute inflammation, but it is generally not curative.¹ The definitive treatment is surgical excision of all affected tissue, including the injected material and surrounding granulomatous and fibrotic tissue. This often requires complex reconstructive procedures, such as skin grafting (split-thickness or full-thickness skin grafts) or scrotal flaps, to cover the resulting defect and restore penile form and function.¹ Expected outcomes after successful surgery include removal of the foreign material, resolution of pain and inflammation, and improved cosmetic appearance and sexual function, although complications such as graft failure, infection, or recurrence can occur.¹