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Patient had silicone injections directly into the penis about 20 years ago. No other pertinent medical history. I've tried mult types of dressings, wound gels, collagen, Santyl, but nothing heals this. Anyone have experience treating a patient with this issue?
Apr 18, 2020 by Becky Naughton, APRN
2 replies
Elaine Horibe Song
MD, PhD, MBA
Hi Becky,
Thank you for sharing this case! Ulcers resulting from silicone injections are very challenging and hard to treat indeed. Besides ulcers, literature reports other types of complications such as granulomas, fibrosis, deformities, inflammatory reactions, etc. Other colleagues may have different experiences to share...For all complications though, definitive treatment as reported in literature invariably includes radical surgical excision of granulomatous, fibrotic or ulcerative tissue (e.g., extended penile-shaft skin excision), followed by surgical reconstruction [1-3]. Even surgical excision is challenging, as injectable silicone can infiltrate fascias and deeper tissues. Incomplete silicone removal can result in fibrosis and further ulceration. Wondering if the patient has been evaluated by a plastic surgeon or urologist?

Summary of case reports on liquid injectable silicone into the penis [3]: https://woundreference.com/files/3435.png

[1] Dellis AE, Arkoumanis T, Kyprianou C, Papatsoris AG. Paraffinoma, siliconoma and Co: Disastrous consequences of failed penile augmentation-A single-centre successful surgical management of a challenging entity. Andrologia. 2018;50(10):e13109. doi:10.1111/and.13109 
[2] Shamsodini A, Al-Ansari AA, Talib RA, Alkhafaji HM, Shokeir AA, Toth C. Complications of penile augmentation by use of nonmedical industrial silicone. J Sex Med. 2012;9(12):3279–3283. doi:10.1111/j.1743-6109.2011.02563.x
[3] Silberstein J, Downs T, Goldstein I. Penile injection with silicone: case report and review of the literature. J Sex Med. 2008;5(9):2231–2237. doi:10.1111/j.1743-6109.2008.00911.x
 https://pubmed.ncbi.nlm.nih.gov/18657262/
Apr 18, 2020
Thanks for your reply... I've had the pt see a urologist who told him to cont wound care as I suggested. Next stop... plastic surgeon!

Becky
Apr 20, 2020
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