Oleogranuloma of the penis - Causes, symptoms and treatment. MF.
The oleogranuloma of the penis is a pathological change in the skin and fascia of the penis, which develops due to the introduction of oily substances into the tissues of this organ.
Causes of penile osseous granulomas
The immediate cause of the oleogranuloma of the penis is the introduction under the skin of the penis of a variety of substances that have the ability to solidify. Typically, this is done with the goal of creating a solid education for the prolongation of sexual intercourse or even the implementation of the latter outside the state of erection. Most often, as such substances use vaseline oil, borate petrolatum, tetracycline ointment or usual sterile paraffin. Soon after the introduction of the substance under the skin at this place begins to develop productive inflammation, the result of which is a dense connective tissue formation. Over time, the granuloma grows and penetrates into the deep balls of the body of the penis, which leads to the appearance of erectile dysfunction.
Most often, these diseases are registered in closed same-sex groups, such as army departments or places of detention. The reason for the widespread spread of this disease is the ease of performing manipulation for subcutaneous administration of oily substances.
Symptoms of the gland penile gland
In the initial stages of the disease, the granuloma has the form of a small dense formation on the body of the penis, which does not cause any painful sensations. Over time, this education begins to increase in size, which is accompanied, first of all, by a violation of the man's sexual life. In place of the formation itself, a violation of the blood and lymph flow develops, which causes necrotic changes on the skin of the penis.
Oleogranuloma
In a situation where the oleogranuloma of the penis extends to the skin of the pubis, scrotum or perineum, the disease is called oleogranuloma of the external genitalia.
Therefore, if an unsuccessful attempt to carry out a plastic surgery with your own hand is already done, you should immediately seek help from a urologist.
Diagnosis of penile osteogranuloma
The main difficulty in diagnosing the oleogranuloma of the penis is a differential diagnosis of this disease with a hard chancre that develops with syphilis. The simplest method of excluding syphilis is considered to be the Wasserman reaction, which requires a small amount of venous blood.
After excluding syphilis, the main task remains confirmation of the diagnosis of olegralelema. For this, it is necessary to find out all the details of the anamnesis, which is not always possible, as often patients carefully conceal the act of injecting vaseline under the skin of the penis. Help in diagnosis can information about the service in the army or staying in places of detention.
If even after finding out an anamnesis there are questions about the origin of education, a biopsy of the neoplasm can be performed. Using a thin needle, a small area of the tissue is taken, followed by a histological examination. The results of histology indicate the presence of pathological protein hyaline and a large number of proliferative tissue. For more accurate diagnosis it is necessary to take a biopsy at once from several sites, as a single tissue intake may not give accurate results.
If the biopsy provides an opportunity to confirm the diagnosis of oleogranuloma, then ultrasound is necessary to determine the boundaries of education, which is important in the surgical treatment of the disease.
Treatment of oleogranuloma of the penis
In urology, only one radical method of treating oleogranuloma is recognized - it is an operative intervention. In this case, the Sapozhkov-Reich operation is performed. It is carried out in two stages. At the first stage, all resected and granulomatous tissues of the penis are resected. Very often patients enter the hospital already after the formation of purulent-necrotic complications on the skin of the penis. Therefore, it is extremely important to perform a complete resection of all altered tissues in order to avoid recurrence of the disease.
After the penis is actually "bared", it is immersed under the skin of the scrotum or pubis. For this, a course is made in the subcutaneous tissue, into which the penis is pierced, and its head is removed through a small incision. On this first stage of the operation can be considered complete.
View after skin plasty
The next time the patient enters the hospital after the postoperative wound has fully healed. The second operative stage of treatment consists in the excision of the penis together with the skin flaps, which then the penis is enveloped and stitched. Thus, in fact, a new skin is formed on the penis. The final step of the operation is to eliminate the skin defect on the scrotum or pubis.
In the postoperative period, patients are prescribed antibiotic tablets to prevent infection of the wound surface. You can use ceftriaxone or ampicillin, which are sold at the pharmacy even without a doctor's prescription.
Treatment with folk remedies
. However funny this may look, but olegoranumema, which, strictly speaking, is a consequence of folk methods of improving the human body, does not have the same kind of folk methods of treatment. All the various ointments and creams that are designed to dissolve the granuloma formed are not only ineffective, but they sometimes even lead to erosion and ulceration on the trunk of the penis. Therefore, once having committed the stupidity that led to the formation of oleogranuloma, it is important not to be mistaken for the second time and in time to seek help from a specialist.
Features of nutrition and lifestyle
Patients should adhere to a special regime after the first phase of surgery, in order to approach the second stage of treatment in optimal condition. For this, it is necessary to carry out the toilet of the external genital organs after each act of urination, and also to regularly change the bandages. If the purulent processes begin in the area of the postoperative wound, then a Levomekoi ointment should be used to resolve them, which contributes to the removal of pus and the early formation of granulations.
In cases where the plasty of the penis is performed under the skin of the pubis, the act of urinating becomes extremely uncomfortable, since the urine stream is directed upwards. In such situations, patients in the postoperative period are recommended to have a urethral catheter, up to the second stage of surgical treatment.
Rehabilitation after
As a rule, all patients who have undergone two stages of a complicated operation suffer from erectile dysfunction. Therefore, they are recommended psychotherapy courses for professional psychologists before the second stage. As practice shows, carrying out such rehabilitation is not always effective, since patients with oleogranuloma in most cases are asocial or immoral citizens.
The second direction in the rehabilitation of patients with olngranulemoma is the depilation of the skin of the penis. Since the plastic of the penis is performed by the skin of the scrotum or pubis, where hair growth is actively occurring, after the second stage of Sapozhkov's operation, the hair growth continues on the trunk of the penis. This brings great aesthetic and hygienic discomfort. After normal shaving, hair growth is activated even more, so patients are advised to perform laser hair removal, after which no bristles form.
Complications of the oleogranuloma of the penis
The most common complication of the olegoranumas of the penis are ulcerative skin defects with suppuration. They are formed due to inadequate blood supply of this anatomical site. Due to poor lymphatic drainage from the body of the penis, ulcers have a very sluggish tendency to healing. Even if the process of scarring occurs on the background of oleogranuloma, the scars have an irregular shape and deform the penis.
In addition, the curvature of the penis may occur and because of the active growth of granulation tissue. In such a situation, it is very important to address the urologist in time, since the cavernous bodies of the penis can atrophy, which will not allow the latter to even even after the operative intervention.
The consequence of the surgery for the removal of granulomatous tissue and plasty of the penis is erectile dysfunction, which develops due to a violation of the innervation of the organ. As practice shows, units of patients after such surgical intervention, retain the ability to have sex. Quite often against the background of erectile dysfunction, people develop psychological disorders and complexes. In the literature, even cases where erectile dysfunction and deformation of the penis became the cause of suicide are described.
Prevention of oleogranuloma of the penis
This disease can be completely prevented by simply not injecting any substances under the skin of the penis. Naturally, people with normal upbringing and education will not even have a thought to carry out such procedures. To exclude such a disease among uneducated citizens, it is very important to conduct educational work, which should be carried out, first of all, in orphanages, places of deprivation of liberty and army departments. It is also very important to conduct appropriate lessons in ordinary general education schools, since adolescence is very vulnerable to such hobbies.
Prognosis for treatment of oleogranuloma of the penis
Prognosis for life - favorable. To date, there is no known direct complication of this disease, which would have a lethal outcome.
Forecast for working capacity - favorable. No degree of illness can be considered a reason for transferring a person to a disability pension.
The prognosis for recovery is relatively favorable. Despite the fact that getting rid of the cause of the disease and its consequences in most cases is possible, no one can guarantee the restoration of sexual function after treatment. Even if patients still have the opportunity to perform sexual acts, they bring the patient huge inconveniences because of the growth of hair directly on the body of the penis.
Rev.doctor urologist Astashin Е.Е.