Research Article: Prevalence and predictors of penile nodules in French Guiana’s sole prison facility

Date Published: September 27, 2018

Publisher: Public Library of Science

Author(s): Mathieu Nacher, Gulen Ayhan, Romain Arnal, Florence Huber, Celia Basurko, Agathe Pastre, Bruno Falissard, Vincent About, Scott Decker.

http://doi.org/10.1371/journal.pone.0204808

Abstract

Penile implants or nodules are objects inserted beneath the skin of the penis mostly for erotic purposes. The procedure is painful and there may be complications. It is often associated with prison. Our objectives were to describe the prevalence of penile nodules among inmates in French Guiana, and to study factors associated with this practice, notably psychiatric diagnoses.

The study was cross-sectional. All consenting new adult prisoners incarcerated between 01/01/2014 and 31/12/2014 at the penitentiary centre of French Guiana were included. The Mini International Neuropsychiatric Interview (MINI) was used to screen for psychiatric diagnoses.

Of 492, 29.6% declared having penile nodules. The median number was 4 (IQR = 2–7). The number of nodules correlated with age. There was no statistical link between the presence of penile nodules and the reasonforincarceration. Multivariate analysis showed that persons <45years with prior incarcerations, with substance addiction, and those with a history of death in the family were more likely to have penile nodules. Those with psychosis and those with suicidal risk were less likely to have penile nodules. Prisoners speaking English or Maroon languages seemed more likely to have penile implants in the multivariate model. Overall, 29.6% of arriving inmates had penile nodules. The practice was linked to drug addiction and was less frequent among those with psychosis and suicidal risk. Given the high HIV prevalence in prison, penile nodule may be an obstacle to condom-based prevention.

Partial Text

Penile implants or nodules are objects inserted beneath the skin of the penis.[1] Although the literature on the subject is rare, the practice has been described for a long time.[2] Thus, the Kama Sutra reported it and scientific paper was dedicated to it the first time in the 19th century in Sumatra.[3]

The study was cross-sectional. All consenting new adult prisoners incarcerated between 01/01/2014 and 31/12/2014 at the penitentiary centre of French Guiana were included. Inmates with legal guardianship were excluded so not to compromise the procedures for our study.

Overall 29.6% of the respondents in the Remire-Montjoly Penitentiary declared having penile nodules. The practice seemed more frequent in those who had a history of prior incarceration, who were younger than 45 years, those with a history of drug addiction variables which are in accordance with the published literature[1,2]. It is noteworthy that each of these variables was independently associated with penile nodules. Penile nodules are frequently inserted during imprisonment but they are also commonly inserted outside of prison too, for a fee, by persons that are not health professionals and have no legal authorization to conduct these invasive procedures. Hence 16% of the surveyed population who had never been imprisoned before had penile nodules. There was also an independent statistically significant association between the presence of penile nodules anda history of death in the family. To our knowledge this had never been reported in the literature. The intended “erotic” function of penile nodules, in the context of frequent sexual deprivation of inmates is a frequent explanation, the ritual display of courage and belonging to a group is another frequent interpretation.However, we have no straightforward explanation for the association with death of a family member, perhaps further anthropological studies may enlighten us on some of the motivations for inserting penile nodules in our region. Finally, there was a negative association between penile nodules, and psychosis and suicide risk.Perhaps these mental states change the salience of the sexual and/or social motivations for inserting penile nodules. Again this would require qualitative analyzes to better understand these statistical associations.

 

Source:

http://doi.org/10.1371/journal.pone.0204808

 

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