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Penile Pearls

Penile pearls (also called penile beads, Yakuza beads, or cultural variants) are non-medical foreign bodies implanted beneath the skin of the penis — typically small plastic, metal, or stone beads inserted through a skin incision into the subcutaneous tissue. The practice originates in several cultural and incarcerated-populations contexts and is not a medical procedure.

Why It's in the Biomaterials Reference​

The reconstructive urologist is not the implanter — but is routinely called to manage the complications:[1]

  • Infection and abscess
  • Erosion through the skin (exposed bead) or into the urethra
  • Urethral injury — beads adjacent to the urethra may erode into the lumen
  • Partner injury — dyspareunia, vaginal laceration during intercourse
  • Necrotizing infections — non-sterile implantation in unsanitary settings can progress to Fournier's gangrene
  • Removal requests when the patient reconsiders the modification

Management​

  • Identification on physical exam and imaging — beads are typically radiopaque; ultrasound or CT localizes them within the subcutaneous tissue
  • Elective explantation through small overlying skin incisions; relatively straightforward when not infected
  • Urgent explantation with debridement for infected or eroded beads
  • Reconstruction of any urethral or urethrocutaneous fistula that has developed — see Urethrocutaneous Fistula

Counseling​

Removal consultations are a documentation opportunity rather than a lecture — the clinical priority is clean removal without recrimination. Patients may need referral for reconstruction of shaft skin defects after multiple-bead removal.

References​

1. Chung AD, Aswani Y, Tsai LL. Imaging Review of Male Genitourinary Devices and Augmentations. European Journal of Radiology. 2026;199:112829. doi:10.1016/j.ejrad.2026.112829

See also: Free Silicone Injection, Urethrocutaneous Fistula, Fournier's Gangrene.