The first reported case of suprapubic migration of the Penuma penile implant as a post-operative complication: A case report

Abstract

The Penuma implant was approved by the U.S. Food and Drug Administration for use in cosmetic procedures of the penis. Therefore, we present the first reported case of post-operative Penuma implant migration. A patient who underwent Penuma implant surgery presented to us with complaints of penile deformity. Physical examination revealed a swelling extending from the dorsal region of the penis to the mons pubis. Due to the patient’s stable condition, surgery was scheduled for the first day following his presentation to our clinic. Implant migration should be discussed with the patient before the operation and considered a potential risk.

Highlights

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Key findings .
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This case marks the first suprapubic migration of the Penuma penile implant as a post-operative complication.
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What is known, and what is new?
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The Penuma implant was approved by the FDA in 2004 for cosmetic correction of penile soft tissue deformities and has since been widely used in penile enlargement surgeries. The limited literature on Penuma implants documents post-operative complications such as seroma, infection, and scar formation.
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While existing literature does not cover implant migration, this case introduces migration as a potential complication, particularly following improper use of traction devices.
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What is the implication, and what should change now?
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The case introduces a previously unreported complication, highlighting the need for surgeons and patients to be aware of this potential risk. Although implant migration is rare, it can lead to significant physical and psychological consequences for the patient.

1 Introduction

The Penuma implant, made from medical-grade silicone, was approved by the U.S. Food and Drug Administration (FDA) in 2004 for use in cosmetic procedures aimed at enhancing the appearance of the penis and correcting deformities in its soft tissue. However, since receiving FDA approval, the Penuma implant has increasingly been used in penile enlargement surgeries.

Although the Penuma implant demonstrates high patient satisfaction in penile cosmetic procedures, the potential for post-operative complications can be significant and, in some cases, devastating. Although there are studies and case reports discussing complications related to Penuma, we did not come across any reports of Penuma implants migrating. Therefore, we have decided to present the first reported case of post-operative Penuma implant migration as a complication. We present the following case following the CARE reporting checklist.

2 Case presentation

A 37-year-old male patient who underwent Penuma implant surgery five years ago presented to us with complaints of penile deformity and abnormal angulation during erections. The patient stated that the surgery performed five years ago went well and that he did not experience any post-operative complications. The patient reported that he had been using a penile traction device intermittently for the past five years. He mentioned that three months before applying to us, he had fallen asleep with the traction device still attached to his penis. Upon waking the following day, he noticed the onset of his symptoms. In the following weeks, his symptoms gradually worsened. Physical examination revealed a swelling extending from the dorsal region of the penis to the mons pubis. ( Fig. 1 ). The laboratory results were nonspecific, with no findings suggestive of an infection. Due to the patient’s stable condition, surgery was scheduled for the first day following his presentation to our clinic. The Penuma implant and surrounding fibrotic tissues were removed using an infrapubic V-Y incision ( Fig. 2 ). The penis was exteriorized through the infrapubic area for inspection ( Fig. 2 ). A Jackson-Pratt drain was then placed, and the procedure was completed. The drain was removed on post-operative day 3, and the patient was discharged. The patient was scheduled for a follow-up visit two weeks post-operatively. No penile curvature or plaque was detected, and there was no issue with the patient’s voiding or tumescence ( Fig. 3 ).