Discussing sexual and reproductive health is not an easy task in indigenous Papua New Guinea (PNG) societies and families. Such conversations are often considered culturally sensitive and taboo. Consequently, the lack of open dialogue has severely hindered males’ sexual health, and health-seeking behaviour disparagingly. Those who do seek medical treatment are either exceptionally courageous or driven by unbearable discomfort and symptoms that force them out of their silence.
Prevalence of Penile Fibroma in PNG
Penile Fibroma is a growing problem affecting an increasing number of males in our communities. Anecdotal evidence suggests it is prevalent throughout PNG societies. Surgeons categorize penile fibroma as a trauma case because the condition is a direct result of injury or trauma to the penis caused by the injection of oils into the penis.
Over a span of two years, 500 patients were seen and treated by the surgical team at Port Moresby General Hospital as reported by Lyon, The Guardian (2019). The problem is not only unique to metropolitan Port Moresby. There have been reported cases in other parts of PNG like Lae, Vanimo, Madang, Tabubil and Eastern Highlands Province. In 2022, penile fibroma accounted for 39.7% of trauma cases managed at Wewak Hospital (Auka-Salmang,Post Courier, 2023).
Men of all social classes are affected among those who seek help – politicians, lawyers, mine workers, clergymen, etc. It affects highly educated men to the simple villagers. The median age group of men affected is 18 – 45 years old. However, there have been few cases younger than 18 years and older than 55 years (Lyons, The Guardian,2019).
Aetiology of Penile Fibroma in PNG and Presentation
Penile fibroma is a condition characterized by the growth of fibrous plaque in the penile soft tissue following the injection of oils into the penis.
The common oils used for injection are cooking oil, baby oil, noni oil, and moringa oil. The affected men reported getting the injection once or several times up to a maximum of 4 injections at different times (UNFPA Papua New Guinea, 2023).
The injected oil causes inflammatory tissue reactions and the growth of fibrous plaques in the penile soft tissue. At first, this may appear as penile enlargement but with further progression of the inflammatory response, problems set in.
Most men present with induration (hardening) of the penile skin. In some cases, the hardening extended to the scrotum and groin area. Others have abnormal lumpy mass growth over the penis or scrotum. The penis gets hidden or wrapped up in the fibrous tissues. Few have presented with ulcers, others had challenges with passing urine and suffer from various intensities of pain (UNFPA Papua New Guinea, 2023; Lyons, The Guardian,2019).
Factors Influencing the Decision for Penile Injections
The primary reason men in Papua New Guinea engage in this unsafe and dangerous practice is due to feelings of insecurity and dissatisfaction with their genital size and sexual performance. This false perception is often fuelled by exposure to explicit sexual content on the internet. Men undergo these injections with the hope that they will increase the length and girth of their penis and improve their sexual experience with their partners.
However, Kolma,Post Courier (2019) reported Professor Glen Mola stating that it is only natural for boys and men to have insecurities about their size and that this was a universal psychological phenomenon to the gender. In spite of what is said on the internet, girls are not interested in the size of male genitals. And as for the sex thing, it is much more about technique and doing what your partner wants than what size it is.
Impact of Penile Fibroma
After a few years, men may begin to experience unexpected consequences from receiving the injection, affecting them both physically and psychologically. These impacts include:
– Pain and discomfort
– Disfigurement and dysfunction of the penis
– Decreased sexual performance
– Relationship breakdowns with spouses and partners
– Increased stress and depression
Treatment of Penile Fibroma
Penile fibroma can be effectively treated through surgical intervention performed by surgeons with specialized skills and experience in penile reconstruction. The procedure is typically conducted in two stages. The first stage involves the excision of the fibrotic tissue and the attachment of the penis to the scrotum to ensure adequate blood supply. The second stage involves the detachment of the penis from the scrotum, completing the repair process.
Prevention of Penile Fibroma
- Each of us can disseminate this information within our network of friends, family members, colleagues, youth groups, and other communities to help prevent participation in this unsafe and destructive practice.
- If you become aware of any healthcare worker involved in administering these injections, please report them to the PNG Medical Board or the PNG Nursing Council for deregistration in accordance with the Medical Registration Act 1980 following the call from Dr Liko, Health Secretary. The contact details are as follows:
- PNG Nursing Council: Email: nursing_council@health.gov.pg, Phone: 3013799
- PNG Medical Board: Email: florie.kaupueina@health.gov.pg, Phone: 3013813
References
1. Auka-Salmang/Post Courier, G. (2023, June 26). Penile Injection on the Rise. Post Courier. https://www.postcourier.com.pg/penile-injection-on-the-rise/
2. Isimeli/PNG Haus Bung, T. (2023, July 10). Report Harmful Practices. https://pnghausbung.com/liko-report-harmful-practices-by-health-workers/
3. Kolma/Post Courier, F. (2019, April 4). Size does not matter, says leading gynecologist. Post Courier. https://www.postcourier.com.pg/size-not-matter-says-leading-gynaecologist/
4. Lyons/The Guardian, K. (2019, April 12). Botched penis enlargements: Papua New Guinea doctors warn of nationwide problem. The Guardian. https://www.theguardian.com/world/2019/apr/12/botched-penis-enlargements-papua-new-guinea-doctors-warn-of-nationwide-problem
5. UNFPA Papua New Guinea. (2023, July 17). “This is silently destroying lives”: Exposing the cobra head phenomenon in Papua New Guinea. https://png.unfpa.org/en/news/%E2%80%9C-silently-destroying-lives%E2%80%9D-exposing-cobra-head-phenomenon-papua-new-guinea