Filling the Void: A Case of Sepsis Following the Injection of a Penile Bulking Agent

Many cosmetic procedures are now performed by non-medical personnel. Owing to the wide coverage of aesthetic procedures by the media, patients may be less informed of the serious complications that can be seen when impure materials are injected by less-skilled practitioners. The authors present a case of sepsis following the injection of a non-medical grade penile bulking agent. Although penile augmentation is under-reported in the literature, public interest in such procedures is increasing. The growing demand for such procedures needs to be addressed by the medical community.

Injectable dermal fillers have become an increasingly popular cosmetic procedure. However, due to their commercial potential and aesthetic popularity, these procedures are also now being performed in non-clinical settings, where regulation of the injectable materials is less stringent. The nature of cosmetic surgery has meant that non-surgical cosmetic procedures are often trivialised by the media. While many procedures are generally quite safe, even non-surgical procedures carry potential risks and problems, especially where there are uncertainties regarding the purity of the injected material. The general demedicalisation of cosmetic procedures has compromised patient safety, as these procedures are now performed at lower costs by unskilled or poorly trained practitioners who are often working in non-medical environments. It should be noted that the majority of adverse case reports, including our patient, had procedures which were performed by non-medical personnel using silicone-based fillers of unknown purity or volume…^1–3

Full article at:   http://goo.gl/nAzJym

By:  Elaine Redmond,1 James C Forde,2 and Hugh D Flood2

¹University Hospital of Limerick, Limerick, Ireland

2

²Department of Urology, University Hospital of Limerick, Limerick, Ireland

1University Hospital of Limerick, Limerick, Ireland

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Beliefs About Penis Size: Validation of a Scale for Men Ashamed About Their Penis Size

No measures are available for understanding beliefs in men who experience shame about the perceived size of their penis. Such a measure might be helpful for treatment planning, and measuring outcome after any psychological or physical intervention. Aim: Our aim was to validate a newly developed measure, called the Beliefs about Penis Size Scale (BAPS). Method: 173 male participants completed a new questionnaire consisting of 18 items to be validated and developed into the BAPS, as well as various other standardised measures. An urologist also measured actual penis size. Main outcome measures: The BAPS was validated against six psychosexual self-report questionnaires as well as penile size measurements. Results: Exploratory factor analysis reduced the number of items in the BAPS from 18 to 10, which was best explained by one factor. The 10-item BAPS had good internal consistency and correlated significantly with measures of depression, anxiety, body image quality of life, social anxiety, erectile function, overall satisfaction and the importance attached to penis size. The BAPS was not found to correlate with actual penis size. It was able to discriminate between those who had concerns or were dissatisfied about their penis size and those who were not. Conclusions: This is the first study to develop a scale for measurement of beliefs about penis size. It may be used as part of an assessment for men who experience shame about the perceived size of their penis and as an outcome measure after treatment. The BAPS measures various manifestations of masculinity and shame about their perceived penis size including internal self-evaluative beliefs; negative evaluation by others; anticipated consequences of a perceived small penis and extreme self-consciousness.

Full PDF article at: https://goo.gl/qoQYyf

By: David Veale1 , Ertimiss Eshkevari1 , Julie Read1 , Sarah Miles1 , Andrea Troglia1 , Rachael Phillips1 , Lina Carmona2 , Chiara Fiorito2 , Kevan Wylie3 , Gordon Muir2

1 NIHR Specialist Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust and The Institute of Psychiatry, Kings College London 

2 King's College Hospital, London 

3 Porterbrook Clinic, Sheffield

  

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Sexual Functioning and Behavior of Men with Body Dysmorphic Disorder Concerning Penis Size Compared with Men Anxious about Penis Size and with Controls

Little is known about the sexual functioning and behavior of men anxious about the size of their penis and the means that they might use to try to alter the size of their penis.

To compare sexual functioning and behavior in men with body dysmorphic disorder (BDD) concerning penis size and in men with small penis anxiety (SPA without BDD) and in a control group of men who do not have any concerns.

An opportunistic sample of 90 men from the community were recruited and divided into three groups: BDD (n = 26); SPA (n = 31) and controls (n = 33).

The Index of Erectile Function (IEF), sexual identity and history; and interventions to alter the size of their penis.

Men with BDD compared with controls had reduced erectile dysfunction, orgasmic function, intercourse satisfaction and overall satisfaction on the IEF. Men with SPA compared with controls had reduced intercourse satisfaction. There were no differences in sexual desire, the frequency of intercourse or masturbation across any of the three groups. Men with BDD and SPA were more likely than the controls to attempt to alter the shape or size of their penis (for example jelqing, vacuum pumps or stretching devices) with poor reported success.

Men with BDD are more likely to have erectile dysfunction and less satisfaction with intercourse than controls but maintain their libido. Further research is required to develop and evaluate a psychological intervention for such men with adequate outcome measures.

Table 2

Sexual history of BDD, SPA, and control participants

Measure	BDD group	Small penis anxiety group	Control group	Comparison
	n = 26	n = 31	n = 33	ANCOVA/Fisher's Exact Test
Previous sexual experience, n (%)	23 (88.5)	30 (96.8)	32 (97)	Fisher's Exact Test P = 0.432
Mean age at first sexual experience (SD)	17.17 (5.80)	19.13 (5.78)	18.66 (2.77)	n/a
Mean number of previous sexual partners (SD)	22.15 (29.37)	35.90 (94.15)	36.16 (105.00)	F (2, 86) = 1.60, P = 0.209
Median number of previous sexual partners	12.50	6.00	12.50
Mean number of long-term sexual partners (SD)	3.12 (2.76)	2.13 (1.50)	2.94 (2.95)	F (2, 86) = 0.823, P = 0.443
Mean frequency of sexual intercourse per month (SD)	2.88 (4.66)	5.29 (7.78)	6.58 (6.58)	F (2, 86) = 0.700, P = 0.499
Mean frequency of pornography access per month (SD)	11.69 (11.45)	13.87 (12.94)	15.00 (12.12)	F (2, 86) = 0.219, P = 0.804
Mean age at first masturbation (SD)	14.46 (5.84)	12.58 (3.01)	12.76 (2.17)	F (2, 86) = 2.73, P = 0.071
Mean frequency of masturbation per month (SD)	14.54 (11.63)	16.68 (9.91)	20.58 (15.73)	F (2, 86) = 1.21, P = 0.304
Belief penis damaged through masturbation, n (%) (0 “not at all”—10 “convinced”)	3 (11.5)	5 (16.1)	4 (12.1)	Fisher's Exact Test P = 0.859
Sexual Orientation, n (%)
Heterosexual	19 (73.1)	22 (71.0)	26 (78.8)	Fisher's Exact Test P = 0.790
Homosexual	7 (26.9)	9 (29.0)	7 (21.2)

Table 4

Interventions tried to alter the size or appearance of the penis, and their success rates

Measure	BDD group	Small penis anxiety group	Control group	Comparison
	n = 26	n = 31	n = 33
Previous attempt to alter the shape or size of the penis, n (%)	11 (42.3)	10 (32.3)	0 (0)	Fisher's Exact Test P < 0.001
Mean number of procedures tried (SD)	1.75 (0.75),	1.36 (0.67)	n/a	t (20) = .−1.29, P = 0.211
Type of procedure n (%)
Exercises	2 (18.2)	8 (80)
Pump	2 (18.2)	0 (0)	n/a	Fisher's Exact Test P = 0.083
Elastic stretching device	1 (9)	0 (0)
Viagra	1 (9)	0 (0)
Multiple procedures	5 (45.5)	2 (20)
Mean cosmetic success of procedure (0–8) (SD)	2.67 (2.31)	5.00 (1.87)	n/a	t (20) = 1.58, P = 0.166
Mean reduced preoccupation with size concern following the procedure (0–8)(SD)	1.67 (2.08)	4.17 (2.40)	n/a	t (20) = 1.53, P = 0.170

Full article at: http://goo.gl/8HIR4D

By: David Veale,* Sarah Miles,* Julie Read,* Andrea Troglia,* Kevan Wylie,† and Gordon Muir‡

*Institute of Psychiatry, Psychology and Neurosciences, Kings College London, South London and Maudsley NHS Foundation Trust, London, UK

†Porterbrook Clinic, Sheffield Health and Social Care NHS Foundation Trust, Sheffield, UK

‡King's College Hospital, NHS Foundation Trust, London, UK

  

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