Penile bead (pearling) removal in Taichung: assessment and recovery

In short

• Reasons to remove: ongoing pain, a hard lump, thin or broken skin, repeated redness and pus, or a bead coming through the skin. With no symptoms, for example if your partner has pain, removal is also possible.
• Method: laser incision, which usually means less bleeding. Depending on number, depth and position: a small cut over each bead, a circular cut below the head of the penis, or that cut plus folding back the penile skin.
• Anaesthesia and pain: a few shallow beads with no infection: usually local anaesthesia. Many beads: sedation (you sleep) is an option. Pain is worst in the first few days and usually eases in 1–2 weeks.
• Infection: removal, cleaning, drainage and a pus culture in the same session, not antibiotics and waiting.
• Recovery: wound care takes weeks. Sex usually after about 2 weeks; the doctor decides based on healing.
• Doctor and cost: Dr. Chao-An Chen (board-certified in urology and in surgery) or Dr. Kai-Wu Yang; you can choose. Self-paid. Costs are explained at the consultation. You can also ask about costs on LINE before you come.

Do not wait for a clinic appointment

See a doctor the same day, or go to an emergency department, if you have a fever, pain that gets worse quickly, redness spreading fast to the scrotum or perineum (the area between the scrotum and anus), a bad-smelling discharge, or skin turning dark or black. Severe necrotising (tissue-destroying) infections needing several operations have been reported in Taiwan and abroad.

Do not pick, dig or squeeze a bead out yourself, and do not let anyone without medical training remove it.

Why implanted beads cause problems

Reported materials include glass, marble, plastic, wood, metal and silicone, none of them medical implant materials. Often the material is unknown. The body forms a foreign-body granuloma around the object: a very hard lump under the skin that usually moves and is often not tender. It may cause no symptoms for years, but no symptoms does not mean it is safe.

Infection and skin breakdown with an exposed bead (erosion) are the most often reported complications. Most beads are put in outside a sterile setting with makeshift tools, the main source of infection and of injury to nearby nerves and blood vessels. An abscess can also form while the skin looks intact.

Infection can start years later. In one published report, it began about 48 hours after sex, with no fever and a normal white blood cell count, yet there was already pus. The true rate of long-term complications is not known and is probably underestimated, so this page gives no percentages.

When to have it checked

Have it assessed soon if:

• there is ongoing pain or tenderness around a bead;
• the area is red, swollen or warm, or feels soft and fluid-filled (pus may have formed);
• there is pus or a bad smell, or the same spot keeps getting inflamed;
• a bead has come through the skin, or the skin over it is thin, shiny or about to break;
• erections hurt, or the penis has a new bend;
• your urine stream is thinner or slower (beads on the underside can injure the urethra, the tube that carries urine);
• swelling or pain gets clearly worse after sex.

A fever with a painful lump in the penis or scrotum needs a doctor the same day.

Watching can be reasonable, but the doctor decides. If a doctor finds no infection, the lump moves and is not tender, and the skin is intact, follow-up can be arranged. Come back if the lump grows, the skin thins or new tenderness appears. Before any future MRI scan, say you have an implant; an unknown material may affect the scan.

Is it a bead, or Peyronie’s disease?

They are different. A bead lump is under the skin. In Peyronie’s disease, the hard area is deeper, in the tunica albuginea, and does not move apart from the shaft. Once infected or scarred, a bead may also hurt and stop moving. There is no evidence that pearling causes Peyronie’s disease. More: Peyronie’s disease and penile curvature (Chinese).

Assessment before removal

The doctor needs to know how many beads there are, which layer they are in, where they sit in relation to the erection tissue and the urethra, and whether there is infection now. Most people have one or two; some have dozens.

Bring these answers: about how many years ago, about how many beads, the material if you know it, and whether it has hurt recently. Tell us if you take blood thinners or bleed easily.

Imaging is not needed for everyone. The clinic adds an ultrasound scan when position or depth is unclear. With sudden swelling, ultrasound first rules out other emergencies, such as an injury to the erection tissue.

How removal is done

The approach depends on the number, depth and position of the beads, and on inflammation. These also decide the anaesthesia, setting and cost, so they cannot be chosen at booking.

Laser incision. The laser seals small vessels while it cuts, so bleeding is usually less and the doctor sees more clearly. This does not mean no bleeding: bruising and a blood collection (haematoma) can still happen.

1. A few shallow beads on the upper side, no infection: a small cut over each bead, in the clinic’s procedure room.
2. Many beads, or circumcision at the same time: a circular cut about 1 cm from the groove below the head of the penis. Circumcision and removal are done through this cut.
3. A very large number: the circular cut plus degloving, which means folding back the skin of the penis to reach all beads at once. If you are already circumcised, degloving is used.

All three are available at this clinic. No agreed number of beads decides the approach. “Not removing for now” is also an option.

Anaesthesia. Local anaesthesia is a nerve block at the base of the penis, not into the inflamed area. Anaesthetic with adrenaline is not used on the penis. It takes about 10–15 minutes to work fully, and an extra injection on the underside is often needed. If you still feel something, say so. Sedation can be assessed for many beads, a circular cut or degloving.

If there is infection. Antibiotics alone usually cannot control it while the object is still there. The clinic removes the beads, cleans (debridement) and drains the area, and sends pus for culture in the same session, then adjusts antibiotics to the result.

Not always all of them. The extent depends on what the doctor finds during the procedure. Some beads can be left if you wish, but infected beads, beads through the skin and beads close to the urethra usually cannot. With many deep beads or thin skin, removal may be done in stages. This is agreed before the procedure. Complete removal in one session cannot be guaranteed.

When the clinic refers you to a hospital

Some situations need hospital admission, imaging, anaesthesia support or reconstruction. The clinic then recommends a hospital with these resources and passes on the tests already done:

• bleeding that does not stop with pressure;
• numbness in the penis not caused by anaesthesia (possible nerve damage);
• sudden swelling of the penis, which may be a penile fracture needing emergency surgery: go straight to an emergency department;
• a deep abscess, dead skin, or suspected necrotising fasciitis (infection spreading along tissue layers);
• beads on the underside if the urethra may be affected;
• large tissue loss needing a skin flap or graft;
• fever or a raised white blood cell count;
• inflammation reaching the base of the penis, because infection at the injection site rules out a nerve block. Shallow redness and pus on the shaft can be treated at the clinic.

Risks, side effects and limits

• Deep tissue injury. Implanting and removing can both injure the erection tissue, arteries and nerves of the penis. Numbness or reduced feeling of the skin is a possible risk. Beads on the underside carry a risk to the urethra. Damage to the tunica albuginea can cause long-term problems similar to a penile fracture.
• Lasting problems with function and appearance may remain after removal.
• Bleeding and haematoma can happen with local anaesthesia of the penis; most are treated with pressure and dressings. The risk is higher with many or deep beads, a bleeding tendency, or blood thinners.
• Infection. The antibiotic is chosen from the culture result. One reported case grew Pseudomonas aeruginosa and was treated for 14 days.
• Night-time erections stretch the penile skin and may pull on the wound and stitches for a while.
• Hardness and scars. The tissue around the bead takes time to change, so some hardness may remain for a while. If the skin was already broken or repeatedly infected, care takes longer and the scar may differ in colour.
• Appearance. Recovery of the skin depends on the number of beads, how long they were there and the skin. A return to the original appearance cannot be guaranteed, and no study gives figures for it.
• The evidence on this page is case reports, small case series and professional articles. It cannot predict success or complication rates.

Recovery

• Pain is worst in the first few days and usually eases in 1–2 weeks. You receive oral painkillers; a self-paid painkiller injection can be added.
• Healing takes weeks, not days. Stitches and follow-up visits depend on the extent and are explained before surgery.
• Sex is usually possible after about 2 weeks; the doctor decides based on healing. It takes longer after wide removal, thin skin, or bruising and haematoma. Sex before full healing can make the wound open, bleed or become infected.
• If your partner has had pain or mucosal injury, wait until neither of you has symptoms.

Blood tests and your partner

If the beads were put in outside a medical setting by someone without medical training, one blood test for hepatitis B (surface antigen and antibody), hepatitis C and HIV is advised, even with no symptoms.

• Exposure in the last three months: an antibody test may still be in the window period. Ask about a nucleic acid test: HIV RT-PCR and the window period.
• Syphilis, gonorrhoea and chlamydia testing depends on your sexual risk: STI screening: tests and timing.
• If hepatitis B surface antigen and antibody are both negative, you can discuss vaccination.
• To check without a medical record: anonymous screening in Taichung.

Partner pain after sex is a common reason for removal. Reported effects in partners include vaginal bleeding, ulcers and injury to the vagina and cervix, and damaged mucosa raises the chance of passing on infections. If your partner has had repeated pain or bleeding, a check for your partner is advised too.

Frequently asked questions

Appointments and access

Consultations are conducted in Mandarin, and can also be conducted in English.

On LINE, describe roughly how many beads, how long they have been there, and any redness or discharge now. The doctor then assesses you in person. You do not need to explain why you are here in the waiting area; the clinic has private consulting rooms.

昭安泌尿科診所 (Morning Urology Clinic)
No. 98, Boguan 2nd St., West District, Taichung City 403, Taiwan（403 臺中市西區博館二街98號）
Consulting hours: Monday to Saturday (closed Sunday). Online booking is open 24 hours.

This page was produced by 昭安泌尿科診所 (Morning Urology Clinic). Medical content last updated: September 2026 (same as the Traditional Chinese version). English version published: 5 November 2026. Medically reviewed by Dr. Chao-An Chen, urologist.

Sources: Kirkham CL, et al. Int J Emerg Med. 2019;12:22 / Xu R, et al. Cureus. 2023;15(6):e40700 / Murfi MR, Adi K. Urol Case Rep. 2026;66:103436 / Elyaguov J, et al. Urol Case Rep. 2020;32:101268 / McPhee AS, McKay AC. Dorsal Penile Nerve Block. StatPearls / Jimie J, Lyttle M. Urology News. 2019;23(5).

This page provides general medical information and does not replace an individual diagnosis or treatment plan.