Subcutaneous Penile Insertion of Domino Fragments by Incarcerated Males in Southwest United States Prisons: A Report of Three Cases


Steven J. Hudak, MD, Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas 75390-9110, USA. Tel: 214-648-0277; Fax: 214-648-8786; E-mail:


Introduction.  Self-insertion of penile foreign bodies is performed worldwide, largely due to a perception that it will enhance sexual performance and virility. There are relatively few cases reported in the United States.

Aim.  We report three cases of Hispanic men incarcerated in separate southwest United States prisons who utilized a similar technique to insert foreign bodies fabricated out of dominos into the subcutaneous tissues of the penis.

Methods.  Details of the three cases were retrospectively reviewed.

Main Outcome Measure.  Resolution of the case.

Results.  In each case, an incarcerated Hispanic male or fellow inmate filed a domino into a unique shape for placement under the penile skin. Utilizing the tip of a ballpoint pen or a sharpened shard of plastic to create a puncture wound, each man inserted the domino fragment into the subcutaneous tissue of the penis. All three men presented with infection requiring operative removal.

Conclusions.  Incarcerated males put themselves at risk for injury and infection when attempting penile enhancement with improvised equipment. Hudak SJ, McGeady J, Shindel AW, and Breyer BN. Subcutaneous penile insertion of domino fragments by incarcerated males in southwest United States prisons: A report of three cases. J Sex Med 2012;9:632–634.