Radicality and plasticity
The key to success is complete removal of foreign material and granulomas to healthy fascia: the remaining areas continue to become inflamed and deformed. The surgeon circumferentially excises the affected skin and tissue, preserving the neurovascular bundle, urethra and head, then closes the defect: if less than half the circumference is affected, mobilized healthy skin; if it is total, use the Sapozhkov method with immersion of the trunk into the scrotum or a free skin flap. After healing, the skin of the penis is elastic, sensitivity and erection are maintained. Patients are warned against repeated administrations.
What is oleogranuloma
Oleogranuloma is a chronic inflammation with scars and granulomas after the introduction of Vaseline, paraffin, silicone or oils under the skin of the penis for the purpose of enlargement. Over time, deformation, hardening, pain, ulcerations, fistulas, swelling of the foreskin, erectile dysfunction and sexual activity develop. The only treatment is surgical removal of all altered tissues with skin grafting.
One-stage or two-stage surgery
If the lesion is limited, the granuloma is excised and the defect is closed with local skin in one operation. In case of total damage to the trunk, the Sapozhkov operation is used in two stages: after excision, the trunk is immersed in the skin of the scrotum, and after 2–3 months it is isolated to form the skin from the scrotal skin; an alternative is a free split-thickness skin graft from the thigh. The result is restoration of form and function in most patients, and sensitivity of the head is preserved.
