Multilobular osteochondrosarcoma of the os penis in a dog

PubMed Central

Webb, Jinelle A.; Liptak, Julius M.; Hewitt, Saundra A.; Vince, Andrew R.

2009-01-01

Multilobular osteochondrosarcoma (MLO) of the os penis was diagnosed in a dysuric dog. Recurrence was confirmed or suspected twice over a 22-month period. This is the first reported case of MLO occurring in the os penis, and the 5th reported case of neoplasia of the os penis in the dog. PMID:19337619

Explosive eversion and functional morphology of the duck penis supports sexual conflict in waterfowl genitalia

PubMed Central

Brennan, Patricia L. R.; Clark, Christopher J.; Prum, Richard O.

2010-01-01

Coevolution of male and female genitalia in waterfowl has been hypothesized to occur through sexual conflict. This hypothesis raises questions about the functional morphology of the waterfowl penis and the mechanics of copulation in waterfowl, which are poorly understood. We used high-speed video of phallus eversion and histology to describe for the first time the functional morphology of the avian penis. Eversion of the 20 cm muscovy duck penis is explosive, taking an average of 0.36 s, and achieving a maximum velocity of 1.6 m s−1. The collagen matrix of the penis is very thin and not arranged in an axial-orthogonal array, resulting in a penis that is flexible when erect. To test the hypothesis that female genital novelties make intromission difficult during forced copulations, we investigated penile eversion into glass tubes that presented different mechanical challenges to eversion. Eversion occurred successfully in a straight tube and a counterclockwise spiral tube that matched the chirality of the waterfowl penis, but eversion was significantly less successful into glass tubes with a clockwise spiral or a 135° bend, which mimicked female vaginal geometry. Our results support the hypothesis that duck vaginal complexity functions to exclude the penis during forced copulations, and coevolved with the waterfowl penis via antagonistic sexual conflict. PMID:20031991

The value of shear wave elastography in the quantification of corpus cavernosum penis rigidity and its alteration with age.

PubMed

Inci, Ercan; Turkay, Rustu; Nalbant, Mustafa Orhan; Yenice, Mustafa Gurkan; Tugcu, Volkan

2017-04-01

The goal of this study was to measure corpus cavernosum (CC) penis rigidity with shear wave elastography (SWE) in healthy volunteers and to evaluate the change of rigidity with age. SWE was performed in 60 healthy volunteers (age range 20-71, mean 47±12,83 years). Volunteers were divided into 2 groups by age (Group 1 age <50, group 2 age ≥50). We assessed SWE in 3 parts of penis (proximal, middle and glans penis) on both sides of CC. All values of SWE (in kilo Pascal) were noted along with volunteers' ages. The measurements were done both with transverse (T) and longitudinal (L) sections. We compared all SW values of penis parts and their alterations with age. The shear wave elastography values of CC penis increased with increasing age (p<0,01). There was no significant difference between both sides of CC penis (p<0,05). We calculated no significant difference between T and L sections of all parts of penis (p<0,05). SWE can provide noninvasive quantitative data of CC penis rigidity and its alteration with age. These data may create a new approach in the evaluation process and treatment options for penile pathologies. Copyright © 2017 Elsevier B.V. All rights reserved.

Penis size interacts with body shape and height to influence male attractiveness.

PubMed

Mautz, Brian S; Wong, Bob B M; Peters, Richard A; Jennions, Michael D

2013-04-23

Compelling evidence from many animal taxa indicates that male genitalia are often under postcopulatory sexual selection for characteristics that increase a male's relative fertilization success. There could, however, also be direct precopulatory female mate choice based on male genital traits. Before clothing, the nonretractable human penis would have been conspicuous to potential mates. This observation has generated suggestions that human penis size partly evolved because of female choice. Here we show, based upon female assessment of digitally projected life-size, computer-generated images, that penis size interacts with body shape and height to determine male sexual attractiveness. Positive linear selection was detected for penis size, but the marginal increase in attractiveness eventually declined with greater penis size (i.e., quadratic selection). Penis size had a stronger effect on attractiveness in taller men than in shorter men. There was a similar increase in the positive effect of penis size on attractiveness with a more masculine body shape (i.e., greater shoulder-to-hip ratio). Surprisingly, larger penis size and greater height had almost equivalent positive effects on male attractiveness. Our results support the hypothesis that female mate choice could have driven the evolution of larger penises in humans. More broadly, our results show that precopulatory sexual selection can play a role in the evolution of genital traits.

Penis size interacts with body shape and height to influence male attractiveness

PubMed Central

Mautz, Brian S.; Wong, Bob B. M.; Peters, Richard A.; Jennions, Michael D.

2013-01-01

Compelling evidence from many animal taxa indicates that male genitalia are often under postcopulatory sexual selection for characteristics that increase a male’s relative fertilization success. There could, however, also be direct precopulatory female mate choice based on male genital traits. Before clothing, the nonretractable human penis would have been conspicuous to potential mates. This observation has generated suggestions that human penis size partly evolved because of female choice. Here we show, based upon female assessment of digitally projected life-size, computer-generated images, that penis size interacts with body shape and height to determine male sexual attractiveness. Positive linear selection was detected for penis size, but the marginal increase in attractiveness eventually declined with greater penis size (i.e., quadratic selection). Penis size had a stronger effect on attractiveness in taller men than in shorter men. There was a similar increase in the positive effect of penis size on attractiveness with a more masculine body shape (i.e., greater shoulder-to-hip ratio). Surprisingly, larger penis size and greater height had almost equivalent positive effects on male attractiveness. Our results support the hypothesis that female mate choice could have driven the evolution of larger penises in humans. More broadly, our results show that precopulatory sexual selection can play a role in the evolution of genital traits. PMID:23569234

Paraffin Granuloma Associated with Buried Glans Penis-Induced Sexual and Voiding Dysfunction

PubMed Central

Chon, Wonhee; Koo, Ja Yun; Park, Min Jung; Choi, Kyung-Un; Park, Hyun Jun

2017-01-01

A paraffinoma is a type of inflammatory lipogranuloma that develops after the injection of an artificial mineral oil, such as paraffin or silicon, into the foreskin or the subcutaneous tissue of the penis for the purpose of penis enlargement, cosmetics, or prosthesis. The authors experienced a case of macro-paraffinoma associated with sexual dysfunction, voiding dysfunction, and pain caused by a buried glans penis after a paraffin injection for penis enlargement that had been performed 35 years previously. Herein, this case is presented with a literature review. PMID:28868821

[Strangulation of the penis with a rubber band : a case report].

PubMed

Sekii, Yosuke; Katayama, Kinzou; Hayashi, Takuji; Kamoto, Akihito; Kakuta, Youiti; Mori, Naoki; Yoshioka, Toshiaki

2013-06-01

We report a case of strangulation of the penis with a rubber band. A 68-year-old man visited our hospital for treatment of a markedly swollen penis. Physical examination revealed one rubber band tightly coiled around the penis. The rubeer band was soon removed, gangrene of the penis continued. A high fever, chills and hypotension were recognized. Sepsis was presumed, and administration of antibiotics was started. Microbiologic cultures revealed streptococcus agalactiae in blood. Since his general condition did not improve, we performed partial penectomy. After the surgery, he showed complete recovery.

[A case of complete self-mutilation of penis].

PubMed

Tomita, Masayuki; Maeda, Shigetaka; Kimura, Takahiro; Ikemoto, Isao; Oishi, Yukihiko

2002-04-01

Self-mutilation of the penis is extremely rare. A 69-year-old man was admitted after having amputated his own penis completely from its root. He had no history of psychiatric illness, but his physical condition on admission was abnormal. We performed urethrocutaneostomy, rather than replantation of the penis, because of the danger that he would reinjure himself. The patient was treated by a psychiatrist under a diagnosis of alcoholic dementia. To our knowledge, this is the 24th case of self-mutilation of the penis reported in the Japanese literature.

Dermatoses of the Glans Penis in Korea: A 10-Year Single Center Experience

PubMed Central

You, Hyang-Suk; Kim, Gun-Wook; Kim, Won-Jeong; Mun, Je-Ho; Song, Margaret; Kim, Hoon-Soo; Ko, Hyun-Chang; Kim, Byung-Soo

2016-01-01

Background A variety of infectious, inflammatory, and neoplastic dermatoses can develop on the glans penis, and definitive diagnosis in such cases may be difficult owing to their non-specific symptoms and clinical appearance. Furthermore, data on dermatoses of the glans penis in Korea are limited. Objective In the present study, we aimed to determine the prevalence of dermatoses of the glans penis in Korea and provide clinical data to assist in making an accurate diagnosis. Methods We retrospectively reviewed the medical records, clinical photographs, and histologic slides of 65 patients with dermatoses of the glans penis that visited the Pusan National University Hospital between January 2004 and August 2013. Results Twenty-six types of dermatoses were identified: inflammatory dermatosis was the most common (38/65, 58.5%), followed by infectious (13/65, 20.0%), neoplastic (10/65, 15.4%), and other dermatoses (4/65, 6.2%). The most common dermatosis of the glans penis was seborrheic dermatitis, followed by lichen planus, herpes progenitalis, condyloma accuminatum, erythroplasia of Queyrat, Zoon's balanitis, and psoriasis. In the topographic analysis, the most common type of dermatosis was dermatoses that localized to the glans penis (39/65, 60.0%), followed by dermatoses involving the extra-genitalia and glans penis (22/65, 33.9%), and the genitalia (glans penis plus other genital areas) (4/65, 6.2%). Conclusion This study shows the usefulness of a topographic approach in the diagnosis of dermatoses of the glans penis in Korea. The findings could be used as baseline data for establishing an accurate diagnosis in Koreans. PMID:26848217

[Concealed penis and its surgical correction: a report of 63 cases].

PubMed

Cheng, Fan; Zhang, Xiaobin; Liu, Xiuheng; Zhou, Jiangqiao; Xia, Yue; Ge, Minghuan

2004-02-01

To evaluate the basic principles of surgical correction of concealed penis. From Jan. 1999 to Dec. 2002, 63 cases of concealed penis, aged from 1 year and 6 months to 19 years with a mean age of 7 years and 2 months, were corrected with two different approaches: 37 cases of group A with obesity were corrected by anchoring micrus tissue onto the pubis at the base of the penis, and 26 cases of group B by fixing the subcutateous tissues at both sides of the penile shaft to the deep tunica albuginea at the penile root. Then prepuce plasty was carried out. Six-month postoperative follow-up found adequate exposure of the penis in all of group A, prepuce oedema in 7 cases, abdomen fat liquidization in 3 cases, unsatisfactory recovery of incision hollow in 3 cases and patchy numbness of the glans in 1 case. The 25 cases of group B had satisfactory exposure of the penis, with no obvious prepuce oedema, 1 case with retraction of the penis 7 days after operation. Various surgical procedures could be adopted for concealed penis, and the key to the satisfactory appearance is the restoration of penile tunicae and the fixation at the base of the penis. Further study is needed to determine the natural history of these disorders as well as which conditions and what age will benefit most from surgical intervention.

[Half-gloving cordectomy: a modified procedure for concealed penis].

PubMed

Sun, Wei-Gui; Zheng, Qi-Chuan; Jiang, Kun

2012-06-01

To search for a simple surgical procedure for the treatment of concealed penis that may have better effect and less complications. We used a modified surgical method in the treatment of 58 patients with concealed penis aged from 3 to 15 (mean 6.8) years. The operation was simplified and involved the following steps: wholly unveiling the penis glans, half-degloving the foreskins, cutting off all the adhesive fibers up to the penile suspensory ligaments, and liberating the external penis. The operation was successful in all the patients, with the operative time of 15 -45 (mean 33) minutes, hospital stay of 2 - 5 (mean 3.5) days, but no complications except mild foreskin edema in 5 cases. The external penis was prolonged from 0.5 - 2.8 (mean 1.4) cm preoperatively to 3.2 - 8.5 (mean 3.9) cm postoperatively. The patients were followed up for 1 -3 years, all satisfied with the length and appearance of the penis, and their sexual and reproductive functions were normal. The modified surgical procedure for concealed penis is simple and effective, with desirable outcomes, few postoperative complications and no damage to sexual and reproductive functions.

Smooth muscle cells of penis in the rat: noninvasive quantification with shear wave elastography.

PubMed

Zhang, Jia-Jie; Qiao, Xiao-Hui; Gao, Feng; Bai, Ming; Li, Fan; Du, Lian-Fang; Xing, Jin-Fang

2015-01-01

Smooth muscle cells (SMCs) of cavernosum play an important role in erection. It is of great significance to quantitatively analyze the level of SMCs in penis. In this study, we investigated the feasibility of shear wave elastography (SWE) on evaluating the level of SMCs in penis quantitatively. Twenty healthy male rats were selected. The SWE imaging of penis was carried out and then immunohistochemistry analysis of penis was performed to analyze the expression of alpha smooth muscle actin in penis. The measurement index of SWE examination was tissue stiffness (TS). The measurement index of immunohistochemistry analysis was positive area percentage of alpha smooth muscle actin (AP). Sixty sets of data of TS and AP were obtained. The results showed that TS was significantly correlated with AP and the correlation coefficient was -0.618 (p < 0.001). The result of TS had been plotted against the AP measurements. The relation between the two results has been fitted with quadric curve; the goodness-of-fit index was 0.364 (p < 0.001). The level of SMCs in penis was successfully quantified in vivo with SWE. SWE can be used clinically for evaluating the level of SMCs in penis quantitatively.

[The penis prolongation and augmentation combined with autologous granular fat injection and silicone implantation].

PubMed

Xie, Yang-chun; Zhang, Yang; Fan, Jin-cai; Liu, Yuan-bo; Liu, Li-qiang; Wang, Qian

2007-07-01

To prevent the retraction of the penis after prolongation and augmentation. After all the superficial and part of the deep suspensory ligament amputation, we implanted the silicon sheet (the length 2.3-3.6 cm, the width 1.5-2.5 cm, the thickness 2-3 mm) and injected autologous granular fat (30-48 ml) into penis. 16 patients (age 22-63 years, averagely 38 years) underwent this kind operation, the prolongation length is 1.8-5.1 cm, the average was 2.91 cm, the increased diameter of penis was 0.6-1 cm, the average is 0.85 cm, the following period is 3 months to 2 years. The results are satisfactory with the penis retraction less than 8%, and less than 10% decrease in diameter. This method is an ideal way of the penis prolongation and augmentation, the implantation of the silicon sheet is effective way to prevent the retraction of the penis.

Penis Allotransplantation in Beagle Dog

PubMed Central

2016-01-01

This is an original research of penis allotransplantation. The paper presents an experiment allogenic penis transplantation model in Beagles, with a focus on recovery of blood supply and changes in tissue architecture. Twenty adult Beagles were allocated to 10 pairs for penile transplantation. After operation, the skin and glans were observed. If adverse symptoms occurred, the transplanted penis was resected and pathologically examined. Frequency of urination, urinary stream, and patency level were recorded 7 days after transplantation. Cystourethrography was performed on Day 10. The transplanted penises were resected on Day 14 for pathological examination. The research showed that transplanted penises survived after allotransplantation, and the dogs regained urination ability. Penis autotransplantation in Beagles is feasible. This preliminary study shows a potential for application of this new procedure for penis transplantation in humans. PMID:26977412

Penis Allotransplantation in Beagle Dog.

PubMed

Zhao, Yongbin; Hu, Weilie; Zhang, Lichao; Guo, Fei; Wang, Wei; Wang, Bangqi; Zhang, Changzheng

2016-01-01

This is an original research of penis allotransplantation. The paper presents an experiment allogenic penis transplantation model in Beagles, with a focus on recovery of blood supply and changes in tissue architecture. Twenty adult Beagles were allocated to 10 pairs for penile transplantation. After operation, the skin and glans were observed. If adverse symptoms occurred, the transplanted penis was resected and pathologically examined. Frequency of urination, urinary stream, and patency level were recorded 7 days after transplantation. Cystourethrography was performed on Day 10. The transplanted penises were resected on Day 14 for pathological examination. The research showed that transplanted penises survived after allotransplantation, and the dogs regained urination ability. Penis autotransplantation in Beagles is feasible. This preliminary study shows a potential for application of this new procedure for penis transplantation in humans.

[Repair and functional reconstruction of the penis (a report of 62 cases)].

PubMed

Wang, Zhong; Cai, Zhi-Kang; Cheng, Kai-Xiang; Da, Jun; Jiang, Yue-Qing; Lu, Mu-Jun; Ren, Xiao-Min; Zhang, Ke; Xu, Ming-Xi; Yao, Hai-Jun; Chen, Qi; Wang, Hao; Dong, Guo-Qin

2009-08-01

To investigate the effects of surgery treatment on serious penile lesions and malformation. Sixty-two patients, aged from 19 to 63 years old (mean 35 ys), were included in the study. Among them, 4 patients suffered from penis partial defection were respectively treated with restoring defective penis, penis lengthening and urethroplasty; three patients with penis completely missing were treated with penis reconstruction surgery; 22 cases with serious penile curvature were treated with the 16-dot plication technique (Lue's procedure); 15 cases with penile fracture were treated with conservative treatment for 1 case and with patch penis, corpus spongiosum, and deep penile dorsal vein ligation for 14 cases; 5 cases with post-operative complications of 3-pieces of penile prosthesis, including the prosthesis perforating to the urethra, water pump failure, broken connection tube, erection angle < 60 degrees and failure to expansion the corpus cavernosum, were treated by taking out prostheses, urethral repair cracks, replacement of the prostheses, excision of fibrosis scar and re-implantation prostheses respectively. Four cases with penis complete amputation were treated with the penis replantation; three cases of avulsion injury were treated with the replantation and free flap skin; 6 with Paget's disease of penises were treated with the lesion free skin buried in the scrotum and penis. All these patients were followed up for 3 months to 4 years, with the average of 9 months. Among the 4 cases of penis partial defection, 2 patients were satisfied with the penile appearance and sexual function; 1 got some satisfactory and 1 was unsatisfied. Three cases with the loss of the penis completely were satisfied with both the postoperative appearance and urination, and 1 was not satisfied. Twenty-two cases of penile curvature deformities were corrected, and one case was recurrence. Fourteen of the 15 patients with penile fracture were followed, and all got the restoration of sexual function. Among them, 5 cases with post-operative complications, including mild bending, algopareunia, subcutaneous induration, poor hardness and poor sexual pleasure, were not further treated, and another case lost; Five cases with post-operative complications of three-pieces penile prosthesis were treated successfully, and 4 of their spouses were satisfied with their sexual function after operation, only 1 of their spouse not satisfied. Among four cases with complete amputation of penis, two cases of penis were replanted successfully while two necrosis. Three cases with avulsion were treated with skin grafting successfully. All 6 cases with penile Paget's disease were followed for 2 -4 years, and free skin grafts were all survival. One patient died of brain metastases 18 months after operation and five cases were disease-free survival. The patients should be treated based on the procedure of andrological and urological surgery, together with microsurgical, flap or skin graft technique. The urologist should design personalized surgical procedure. Most of the patient's penis shape and erectile dysfunction can be reconstructed by our procedures, but some patients can not achieve the desired appearance or function of penis. New approaches of the treatment ought to be developed to restore both of the shape and function for those severe injury of the penis.

Paraffin Granuloma Associated with Buried Glans Penis-Induced Sexual and Voiding Dysfunction.

PubMed

Chon, Wonhee; Koo, Ja Yun; Park, Min Jung; Choi, Kyung Un; Park, Hyun Jun; Park, Nam Cheol

2017-08-01

A paraffinoma is a type of inflammatory lipogranuloma that develops after the injection of an artificial mineral oil, such as paraffin or silicon, into the foreskin or the subcutaneous tissue of the penis for the purpose of penis enlargement, cosmetics, or prosthesis. The authors experienced a case of macro-paraffinoma associated with sexual dysfunction, voiding dysfunction, and pain caused by a buried glans penis after a paraffin injection for penis enlargement that had been performed 35 years previously. Herein, this case is presented with a literature review. Copyright © 2017 Korean Society for Sexual Medicine and Andrology.

Hypospadias repair - series (image)

MedlinePlus

... penis. Hypospadias is usually associated with an abnormal curvature of the penis, called "chordee". Hypospadias is one ... of the surgery are to repair the abnormal curvature of the penis, and to create a new ...

Transnitrosylation: A Factor in Nitric Oxide-Mediated Penile Erection

PubMed Central

Goetz, Tabitha; La Favor, Justin D.; Burnett, Arthur L.

2016-01-01

Introduction Nitric oxide (NO) signaling can be mediated not only through classical cGMP, but also through S-nitrosylation. The impact of S-nitrosylation on erectile function and in NO regulation and oxidative stress in the penis, however, remains poorly understood. Aims To characterize the role of GSNOR, a major regulator of S-nitrosylation homeostasis, on erection physiology and on eNOS function and oxidative/nitrosative stress in the penis. Materials and Methods Adult GSNOR-deficient and WT mice were used. Erectile function was assessed in response to electrical stimulation of the cavernous nerve. Total NO in penile homogenates was measured by Griess reaction. Protein S-nitrosylation, endothelial NO synthase (eNOS) phosphorylation on Ser-1177 (positive regulatory site), eNOS uncoupling, and markers of oxidative stress (4-hydroxy-2-nonenal [4-HNE], malondialdehyde, and nitrotyrosine) in the penis were measured by Western blot. Main outcome measures Erectile function, eNOS function and oxidative stress in the penis of GSNOR-deficient mice. Results Erectile function was intact in GSNOR-deficient mice. Total S-nitrosylated proteins were increased (p<0.05) in the GSNOR−/− compared to WT mouse penis. While eNOS phosphorylation on Ser-1177 did not differ between the GSNOR−/− and WT mouse penis at baseline, electrical stimulation of the cavernous nerve increased (p<0.05) P-eNOS in the WT mouse penis, but failed to increase P-eNOS in the GSNOR−/− mouse penis. Total NO production was decreased (p<0.05), while eNOS uncoupling, 4-HNE, malondialdehyde, and nitrotyrosine were increased (p<0.05) in the GSNOR-deficient mouse penis compared to that of WT mice. Conclusion Transnitrosylation mechanisms play an important role in regulating NO bioactivity in the penis. Deficiency of GSNOR leads to eNOS dysfunction and increased oxidative damage, suggesting that homeostatic eNOS function in the penis is governed by transnitrosylation. PMID:27114194

Posttranslational inactivation of endothelial nitric oxide synthase in the transgenic sickle cell mouse penis

PubMed Central

Musicki, Biljana; Champion, Hunter C.; Hsu, Lewis L.; Bivalacqua, Trinity J.; Burnett, Arthur L.

2017-01-01

INTRODUCTION Sickle cell disease (SCD)-associated priapism is characterized by endothelial nitric oxide synthase (eNOS) dysfunction in the penis. However, the mechanism of decreased eNOS function/activation in the penis in association with SCD is not known. AIMS Our hypothesis in the present study was that eNOS is functionally inactivated in the SCD penis in association with impairments in eNOS posttranslational phosphorylation and the enzyme’s interactions with its regulatory proteins. METHODS Sickle cell transgenic (sickle) mice were used as an animal model of SCD. Wild type (WT) mice served as controls. Penes were excised at baseline for molecular studies. eNOS phosphorylation on Ser-1177 (positive regulatory site) and Thr-495 (negative regulatory site), total eNOS, and phosphorylated AKT (upstream mediator of eNOS phosphorylation on Ser-1177) expressions, and eNOS interactions with heat shock protein 90 (HSP90) and caveolin-1 were measured by Western blot. Constitutive NOS catalytic activity was measured by conversion of L-[14C]arginine-to-L-[14C]citrulline in the presence of calcium. MAIN OUTCOME MEASURES Molecular mechanisms of eNOS dysfunction in the sickle mouse penis. RESULTS eNOS phosphorylated on Ser-1177, an active portion of eNOS, was decreased in the sickle mouse penis compared to WT penis. eNOS interaction with its positive protein regulator HSP90, but not with its negative protein regulator caveolin-1, and phosphorylated AKT expression, as well as constitutive NOS activity, were also decreased in the sickle mouse penis compared to WT penis. eNOS phosphorylated on Thr-495, total eNOS, HSP90, and caveolin-1 protein expressions in the penis were not affected by SCD. CONCLUSION These findings provide a molecular basis for chronically reduced eNOS function in the penis by SCD, which involves decreased eNOS phosphorylation on Ser-1177 and decreased eNOS-HSP90 interaction. PMID:21143412

Efficacy and safety of newly developed cross-linked dextran gel injection for glans penis augmentation with a novel technique

PubMed Central

Yang, Dae Yul; Ko, Kyungtae; Lee, Seong Ho; Moon, Du Geon; Kim, Jong Wook; Lee, Won Ki

2018-01-01

There is no safe and effective standard method for glans penis augmentation. Furthermore, there has been scant research on glans penis augmentation due to a poor understanding of glans anatomy, technical difficulty, and a lack of suitable substances for augmentation. Cross-linked dextran gel is a newly developed filler for soft-tissue augmentation. We evaluated the efficacy and safety of using a novel technique to inject cross-linked dextran gel for glans penis augmentation during a 24-week follow-up study. This prospective, single-arm, multicenter study enrolled twenty healthy adult men who underwent glans penis augmentation between June and August 2013. Cross-linked dextran gel was injected into the glans penis using a simple and easy technique. The sizes of the glans penis and individual satisfaction were assessed. Any adverse event was also reported. A total of 18 individuals were analyzed; two of them were lost to follow-up. The mean procedure time and injected volume were about 30 min and 6.6 ± 0.9 ml, respectively. The mean surface areas of the glans at baseline and 24 weeks were 20.0 ± 3.5 cm2 and 33.6 ± 5.4 cm2, respectively, representing a mean increase of 68.7% ± 14.0% (P < 0.001). Sixteen individuals (88.9%) were satisfied with the outcomes, and none were dissatisfied. There were no serious adverse events during the study. Cross-linked dextran gel injection for glans penis augmentation was easy and showed a significant augmentative effect on the glans penis, good durability, and was well tolerated without serious adverse events. Therefore, cross-linked dextran gel injection may be an effective, new technique for glans penis augmentation. PMID:28303807

[PREPUTIAL PEDICLED FLAP PHALLOPLASTY FOR REPAIR OF SEVERE WEBBED PENIS].

PubMed

Huang, Yidong; Zeng, Li; Huang, Guizhen; Kang, Lei; Huang, Lugang

2016-11-08

To evaluate the effectiveness of preputial pedicled flap phalloplasty for repair of severe webbed penis. Between May 2011 and May 2015, 23 boys with severe webbed penis were treated. The age ranged from 2 years and 8 months to 8 years and 3 months (mean, 4 years and 8 months). According to El-Koutby & El Gohary classification, 14 cases were rated as grade 3 simple webbed penis and 9 cases as compound webbed penis (2 cases of type 1, 2 cases of type 2, and 5 cases of type 3). The penis length was 2.1-5.4 cm (mean, 3.4 cm), and the penoscrotal angle was 130-160° (mean, 144°). All the glans could not be exposed. No other urinary system diseases and no history of penile surgery were found in children. All cases underwent one stage preputial pedicled flap phalloplasty. After successful correction, the penis length was 3.6-6.4 cm (mean, 4.7 cm); the penoscrotal angle was 90-110° (mean, 97°). Clear skin boundaries were observed at penile and scrotal parts. No web skin or scrotal skin was left on the penis. Primary healing of incision was obtained, with no necrosis of the flap or infection. All cases were followed up 12 to 41 months (mean, 25 months). No penile curvature, abnormal sensation of glans, or recurrence of the penoscrotal angle occurred, and the patients had normal urination. Preputial pedicled flap phalloplasty can be used as one stage repair for severe webbed penis. The penis is close to natural state and had satisfactory appearance, avoiding the possibility of long-term edema and penile curvature.

[Primitive neuroectodermal tumor/Ewing's sarcoma of the penis in children: a case report and review of the literature].

PubMed

Zhang, Da-Wei; Jin, Mei; Zhou, Chun-Ju; Song, Hong-Cheng; Ma, Xiao-Li

2012-12-01

To investigate the clinical manifestations, pathological characteristics and treatment of primitive neuroectodermal tumor/Ewing's sarcoma (PNET/EWS) of the penis in children. We analyzed the clinical data of a case of PNET/EWS and reviewed relevant literature. The patient was a 5-year-old boy, admitted for penis swelling with pain for 11 months. Biopsy showed a small round cell tumor, CD99 positive by immunohistochemical staining, with EWS translocation by fluorescence in situ hybridization on molecular biological examination. The tumor was confirmed to be PNET/EWS of the penis, and disappeared after 45 weeks of chemotherapy and local radiotherapy. PNET/EWS of the penis is an extremely rare disease, with no specific clinical symptoms except penis enlargement with pain. Immunohistochemistry and molecular biological examination contribute to its diagnosis.

Sonic hedgehog, Apoptosis and the Penis

PubMed Central

Podlasek, Carol A.

2009-01-01

Introduction Smooth muscle apoptosis in the penis is common in prostatectomy patients and animal models of erectile dysfunction (ED). A critical regulator of smooth muscle apoptosis in the penis is the secreted protein Sonic hedgehog (SHH). Since SHH protein treatment of the penis prevents cavernous nerve (CN) injury induced apoptosis, SHH has the potential to treat post-prostatectomy apoptosis. However little is known about how SHH signaling is regulated in the adult penis. Aim The goal of this review is to examine what is known about SHH signaling in the penis, to offer insight as to how SHH inhibition induces apoptosis in penile smooth muscle, and to define the role of the SHH pathway in maintaining CN integrity. Methods Information presented in this review was derived from a literature search using the National Library of Medicine PubMed Services. Search terms included SHH, apoptosis, smooth muscle, penis, ED, pelvic ganglia, corpora cavernosa, CN, regeneration, Schwann cell, neural activity and transport. Results In this review we have discussed the role of the CN in regulation of SHH abundance and apoptosis induction in the penis and have examined the function and localization of SHH signaling in the CN. Conclusion There is substantial potential to develop SHH for delivery to the penis of prostatectomy patients at the time of surgery in order to prevent apoptosis induction and long term ED development. Studies are in progress which will identify if SHH may be used as a regenerative therapy to speed CN regeneration. PMID:19267857

Kissing nevus of the penis. Report of two cases and review of the literature*

PubMed Central

Wang, Songting; Zhou, Mingshu; Qiao, Jianjun

2014-01-01

Kissing nevus is a curious type of nevus that was first described on the eyelids and rarely described on the penis. We report two cases of kissing nevus of the penis and review previously reported cases. The lesions of the kissing nevus of the penis showed characteristic mirror-image symmetry relative to the coronal sulcus. On histopathology, the lesion showed a compound nevus. PMID:24770514

Testosterone regulates keratin 33B expression in rat penis growth through androgen receptor signaling

PubMed Central

Ma, Yan-Min; Wu, Kai-Jie; Dang, Qiang; Shi, Qi; Gao, Yang; Guo, Peng; Xu, Shan; Wang, Xin-Yang; He, Da-Lin; Gong, Yong-Guang

2014-01-01

Androgen therapy is the mainstay of treatment for the hypogonadotropic hypogonadal micropenis because it obviously enhances penis growth in prepubescent microphallic patients. However, the molecular mechanisms of androgen treatment leading to penis growth are still largely unknown. To clarify this well-known phenomenon, we successfully generated a castrated male Sprague Dawley rat model at puberty followed by testosterone administration. Interestingly, compared with the control group, testosterone treatment stimulated a dose-dependent increase of penis weight, length, and width in castrated rats accompanied with a dramatic recovery of the pathological changes of the penis. Mechanistically, testosterone administration substantially increased the expression of androgen receptor (AR) protein. Increased AR protein in the penis could subsequently initiate transcription of its target genes, including keratin 33B (Krt33b). Importantly, we demonstrated that KRT33B is generally expressed in the rat penis and that most KRT33B expression is cytoplasmic. Furthermore, AR could directly modulate its expression by binding to a putative androgen response element sequence of the Krt33b promoter. Overall, this study reveals a novel mechanism facilitating penis growth after testosterone treatment in precastrated prepubescent animals, in which androgen enhances the expression of AR protein as well as its target genes, such as Krt33b. PMID:24994782

Testosterone regulates keratin 33B expression in rat penis growth through androgen receptor signaling.

PubMed

Ma, Yan-Min; Wu, Kai-Jie; Dang, Qiang; Shi, Qi; Gao, Yang; Guo, Peng; Xu, Shan; Wang, Xin-Yang; He, Da-Lin; Gong, Yong-Guang

2014-01-01

Androgen therapy is the mainstay of treatment for the hypogonadotropic hypogonadal micropenis because it obviously enhances penis growth in prepubescent microphallic patients. However, the molecular mechanisms of androgen treatment leading to penis growth are still largely unknown. To clarify this well-known phenomenon, we successfully generated a castrated male Sprague Dawley rat model at puberty followed by testosterone administration. Interestingly, compared with the control group, testosterone treatment stimulated a dose-dependent increase of penis weight, length, and width in castrated rats accompanied with a dramatic recovery of the pathological changes of the penis. Mechanistically, testosterone administration substantially increased the expression of androgen receptor (AR) protein. Increased AR protein in the penis could subsequently initiate transcription of its target genes, including keratin 33B (Krt33b). Importantly, we demonstrated that KRT33B is generally expressed in the rat penis and that most KRT33B expression is cytoplasmic. Furthermore, AR could directly modulate its expression by binding to a putative androgen response element sequence of the Krt33b promoter. Overall, this study reveals a novel mechanism facilitating penis growth after testosterone treatment in precastrated prepubescent animals, in which androgen enhances the expression of AR protein as well as its target genes, such as Krt33b.

Surgical treatment of buried penis.

PubMed

Lipszyc, E; Pfister, C; Liard, A; Mitrofanoff, P

1997-10-01

The buried penis is a rare congenital entity, whose treatment is surgical. There are few publications concerning this matter. The authors report on their experience in 10 cases (1990-1995). In this abnormality, the tip of the glans does not project from the pubic or scrotal skin. It is due to: 1) an excessive development of the penile fascia which retracts the penis; 2) insufficient attachment of the penile skin at the base of the penis; 3) often excessive prepubic fat worsens the appearance of the abnormality but does not by itself totally explain it; 4) a tight phimosis is often present. Surgical treatment is necessary because this aspect tends to persist even after puberty. One cannot indeed count on the development at the age of puberty, neither on the diminution of the fat, nor on the simple cure of the phimosis. One must above all ban circumcision which causes the risk of eliminating the skin necessary for reconstruction. The surgical procedure will comprise: 1) a longitudinal dorsal incision extended circumferentially; 2) resection of the thickened fascia penis; 3) anchoring of the deep face of the dermis to the proximal part of the fascia penis at the base of the penis. This surgical procedure has always brought a significant improvement to the appearance of the penis.

An experimental study: evaluating the tissue structure of penis with 2D-ShearWave™ Elastography.

PubMed

Qiao, X-H; Zhang, J-J; Gao, F; Li, F; Liu, Y; Xing, L-X; Du, L-F; Xing, J-F

2017-01-01

The aim of this study was to investigate the feasibility of two-dimensional-ShearWave™ Elastography (2D-SWE) on evaluating the change of tissue structure of penis. Twenty healthy male Sprague Dawley rats were divided into penis-developed group (PDG, 52 weeks) and penis-underdeveloped group (PUDG, 5 weeks). The ultrafast ultrasound device-Aixplorer® (SuperSonic Imagine) was used for 2D-SWE imaging of the penis, the measurement index was shear wave stiffness (SWS, kPa). All rat penises were cut off immediately after ultrasonic examination. After paraffin embedding, slicing and hematoxylin-eosin staining, the tissue structure of the penis was observed under light microscope. SWS of all rat penises were measured successfully. The results showed that SWS of PDG was significantly lower than PUDG (P=0.008). At the same time, the pathological results found that there were significant differences in the tissue structures (sinusoids, smooth muscle cells and fibrocytes) of the penises between the two groups. These results suggest that there are significant differences in SWS between different tissue structures of penis. 2D-SWE is expected to be used on the etiological diagnosis of erectile dysfunction by serving as a new noninvasive method of evaluating the change of tissue structure of penis.

[Verrucous carcinoma of penis: a case report].

PubMed

Yokonishi, Tetsuhiro; Ito, Yuusuke; Matsumoto, Tatsuya; Osaka, Kimito; Umemoto, Susumu; Komiya, Atsushi; Kobayashi, Kazuki; Sakai, Naoki; Noguchi, Sumio; Kishi, Hiroichi; Tsuura, Yukio; Ikeda, Shigeru

2010-06-01

We report a case of verrucous carcinoma of the penis. A 62-year-old man, who presented with penile swelling and pain, was referred to our hospital. Although, penile tumor biopsy revealed no evidence of malignancy, the patient presented with penile swelling and discharge. The penis was surgically resected and urinary diversion was performed. The pathological examination of the resected glans revealed verrucous carcinoma of penis. Furthermore, in situ hybridization revealed human papilloma virus (HPV) infection. This clearly showed that the verrucous carcinoma of the penis resulted from the HPV infection. The patient has survived for 14 months after surgery without local recurrence or metastasis.

Cardiovascular Implications of Erectile Dysfunction

MedlinePlus

... the penis are not able to dilate during sexual stimulation because of endothelial dysfunction, the penis cannot fill ... blood to the penis to dilate better during sexual stimulation. The PDE5-Is decrease blood pressure a little ...

Women's Preferences for Penis Size: A New Research Method Using Selection among 3D Models

PubMed Central

Park, Jaymie; Leung, Shannon

2015-01-01

Women’s preferences for penis size may affect men’s comfort with their own bodies and may have implications for sexual health. Studies of women’s penis size preferences typically have relied on their abstract ratings or selecting amongst 2D, flaccid images. This study used haptic stimuli to allow assessment of women’s size recall accuracy for the first time, as well as examine their preferences for erect penis sizes in different relationship contexts. Women (N = 75) selected amongst 33, 3D models. Women recalled model size accurately using this method, although they made more errors with respect to penis length than circumference. Women preferred a penis of slightly larger circumference and length for one-time (length = 6.4 inches/16.3 cm, circumference = 5.0 inches/12.7 cm) versus long-term (length = 6.3 inches/16.0 cm, circumference = 4.8 inches/12.2 cm) sexual partners. These first estimates of erect penis size preferences using 3D models suggest women accurately recall size and prefer penises only slightly larger than average. PMID:26332467

Women's Preferences for Penis Size: A New Research Method Using Selection among 3D Models.

PubMed

Prause, Nicole; Park, Jaymie; Leung, Shannon; Miller, Geoffrey

2015-01-01

Women's preferences for penis size may affect men's comfort with their own bodies and may have implications for sexual health. Studies of women's penis size preferences typically have relied on their abstract ratings or selecting amongst 2D, flaccid images. This study used haptic stimuli to allow assessment of women's size recall accuracy for the first time, as well as examine their preferences for erect penis sizes in different relationship contexts. Women (N = 75) selected amongst 33, 3D models. Women recalled model size accurately using this method, although they made more errors with respect to penis length than circumference. Women preferred a penis of slightly larger circumference and length for one-time (length = 6.4 inches/16.3 cm, circumference = 5.0 inches/12.7 cm) versus long-term (length = 6.3 inches/16.0 cm, circumference = 4.8 inches/12.2 cm) sexual partners. These first estimates of erect penis size preferences using 3D models suggest women accurately recall size and prefer penises only slightly larger than average.

[Congenital buried penis in the child: about a case].

PubMed

Rami, Mohamed; Bakkaly, Achraf El; Bouljrouf, Jaouad; Lafia, Toualouth; Bouhafs, Mohammed Amine; Belkacem, Rachid

2017-01-01

Congenital buried penis in the child is a congenital malformation where the penis appears small in size while all the parts of the organ are normal (the urethra, the erectile tissue and the glans penis). Our study aimed to describe our experience in the surgical treatment of this abnormality. We report the case of a 18-months old infant with bilateral hydrocele initially admitted to the Emergency Department and then referred to our Department. Clinical examination showed buried penis with tight foreskin and a dilation of the preputial reservoir due to urine. Surgical procedure included several steps: Z-shaped incision, pulling back of the foreskin of the penis, release of the adhesions surrounding the corpus cavernosum and ventral penile skin coverage using bladder catheter kept for a week to protect the wound healing. Aesthetic and functional result was satisfactory after 1-year follow-up. Congenital buried penis is a very debated subject in the literature. Our technique was simple and easily reproducible. Voiding difficulties and urinary infection are the main indications of this surgical procedure.

Penis swelling due to foreign body reaction after injection of silicone.

PubMed

Plaza, Tobias; Lautenschlager, Stephan

2010-09-01

A 19-year-old man presented with phimosis and painful swelling of the penis four weeks after augmentation with silicone in Thailand. Histology revealed a foreign body reaction to silicone. Infectious causes were ruled out. Granulomatous foreign body reactions to silicone are common, but there are few case reports on reactions following silicone injection for penis enlargement. Foreign body reactions should be included in the differential diagnosis of penis swelling.

Penis Envy and the Female Oedipus Complex: A Plea to Reawaken an Ineffectual Debate.

PubMed

Zepf, Siegfried; Seel, Dietmar

2016-06-01

Going along with Laplanche's assumption that there is no endogenous sexuality, the authors discuss Freud's concepts of the female Oedipus complex and penis envy and some of its proposed alternatives. The female oedipal conflict turns out to be the outcome of a projective identification with the Oedipus complexes of the mother and father. In the context of the rivalry with the mother, penis envy refers to the maternal power over the father's penis that the daughter wants to have in herself, while, in the context of the rivalry with the father, penis envy arises from the jealousy of the father's penis that the daughter believes is necessary to have on herself in order to satisfy her mother. The authors conclude that in Freud's day such insights were already available, which might have culminated in the conceptualization they present in this paper.

Clinical application of scrotal flap on penis lengthening.

PubMed

Zhuo, Qinqiang; Li, Shirong; Wu, Julong; Wang, Zhenxiang; Yang, Dongyun; Tao, Ling

2009-03-01

To investigate the clinical application of the scrotal flap on penis lengthening. One hundred and fifty-two patients were operated using the scrotal flap from July 1998 to January 2008 at the Department of Plastic and Aesthetic, Surgery Southwest Hospital, Chongqing, China. The procedure consisted of designing a positive sign shaped incision 1.5cm above the root of the penis, dissect and release the superficial suspensory ligament and part of the deep suspensory ligament, then cover the elongated cavernosum with proper scrotal flap. Six-month to 5-year follow-up showed that all patients were satisfied with the good contour and function of the penis. The operation was successful. The method of using scrotal flap on penis lengthening has the following advantages: simple operation, reliable blood supply of the flap, one-stage operation, and satisfactory postoperative results. It is a preferable operation technique for penis lengthening.

Neurological bypass for sensory innervation of the penis in patients with spina bifida.

PubMed

Overgoor, Max L E; Kon, Moshe; Cohen-Kettenis, Peggy T; Strijbos, Saskia A M; de Boer, Niels; de Jong, Tom P V M

2006-09-01

Most male patients with spina bifida have normal sexual desires. During puberty they begin to realize that they can achieve erection and sexual intercourse but without any sensation in the penis. We hypothesized that restored sensation in the penis would greatly contribute to their quality of life and sexual health. In this prospective study we investigated the outcome of a new operative neurological bypass procedure in patients with spina bifida. In 3 patients who were 17, 18 and 21 years old with a spinal lesion at L5, L4 and L3-L4, respectively, the sensory ilioinguinal nerve (L1) was cut distal in the groin and joined by microneurorrhaphy to the divided ipsilateral dorsal nerve of the penis (S2-4) at the base of the penis. All patients underwent preoperative and postoperative neurological and psychological evaluations. By 15 months postoperatively all patients had achieved excellent sensation on the operated side of the glans penis. They were unequivocally positive about the results and the penis had become more integrated into the body image. In 2 patients masturbation became more meaningful and 1 became more sexually active with and without his partner. The newly designed neurological bypass procedure in patients with spina bifida resulted in excellent sensibility in the glans penis. The new sensation appeared to contribute to the quality of the patient sexuality and sexual functioning as well as to the feeling of being a more normal and complete individual who is more conscious of the penis. This new operation might become standard treatment in patients with spina bifida in the future.

Treatment of men complaining of short penis.

PubMed

Shamloul, Rany

2005-06-01

To report the outcome of a sex education-integrated treatment program of men complaining of a short-sized penis. This study included 92 patients presenting to our department in the past 2 years complaining of a small-sized penis. History, with particular stress on the duration of the complaint and sexual habits of the patients, was collected from all patients. All patients were asked to complete the International Index of Erectile Function short-form questionnaire. Also all patients were tutored by an andrologist on sex education. Penile length and girth were measured twice using a tape measure in both flaccid and fully stretched states. Every patient was informed that if his flaccid and stretched penis size was 4 cm and 7 cm or more, respectively, it was considered normal. All patients complained of a short penis in either the flaccid or erect state. Of the 92 patients, 66 (71.7%) complained of a short penis only in the flaccid state, and 26 (28.3%) complained of a short penis in both the flaccid and the erect state. None of the patients had erectile dysfunction. None of the patients had short penis according to our measurements. Almost all patients overestimated the normal penile size. Most men found the combination of sex education with standard penile measurements helpful and relieving. Men complaining of short penis could be treated using basic principles of sex education with objective methods of penile size evaluation. This combination can correct any previous sexual misconceptions, relieve unnecessary anxiety concerning penile size, and decrease the desire to undertake still-to-be verified lengthening procedures.

Curvature of the penis

MedlinePlus

... penis. Alternative Names Peyronie disease Images Male reproductive anatomy Male reproductive system References Elder JS. Anomalies of the penis and urethra. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016: ...

Penis Fracture: Is It Possible?

MedlinePlus

... occur due to aggressive masturbation or taqaandan, a cultural practice in which the top of an erect penis is forcefully bent. A penis fracture is a painful injury. Signs might include a cracking sound, immediate loss of the erection, or the development of dark ...

The Role of Hedgehog-Interacting Protein in Maintaining Cavernous Nerve Integrity and Adult Penile Morphology

PubMed Central

Angeloni, Nicholas L.; Bond, Christopher W.; Monsivais, Diana; Tang, Yi; Podlasek, Carol A.

2010-01-01

Introduction Sonic hedgehog (SHH) is an essential regulator of smooth muscle apoptosis in the penis that has significant clinical potential as a therapy to suppress post-prostatectomy apoptosis, an underlying cause of erectile dysfunction (ED). Thus an understanding of how SHH signaling is regulated in the adult penis is essential to move the field of ED research forward and to develop new treatment strategies. We propose that hedgehog-interacting protein (HIP), which has been shown to bind SHH protein and to play a role in SHH regulation during embryogenesis of other organs, is a critical regulator of SHH signaling, penile morphology, and apoptosis induction. Aims We have examined HIP signaling in the penis and cavernous nerve (CN) during postnatal differentiation of the penis, in CN-injured, and a diabetic model of ED. Methods HIP localization/abundance and RNA abundance were examined by immunohistochemical (IHC) analysis and real-time reverse transcriptase-polymerase chain reaction (RT-PCR) in Sprague-Dawley rats between the ages of 7 and 92 days old, in CN-injured Sprague-Dawley rats and in BioBreeding/Worcester diabetic rats. HIP signaling was perturbed in the pelvic ganglia and in the penis and TUNEL assay was performed in the penis. CN tie, lidocaine, and anti-kinesin experiments were performed to examine HIP signaling in the CN and penis. Results In this study we are the first to demonstrate that HIP undergoes anterograde transport to the penis via the CN, that HIP perturbation in the pelvic ganglia or the penis induces apoptosis, and that HIP plays a role in maintaining CN integrity, penile morphology, and SHH abundance. Conclusions These studies are significant because they show HIP involvement in cross-talk (signaling) between the pelvic ganglia and penis, which is integral for maintenance of penile morphology and they suggest a mechanism of how nerves may regulate target organ morphology and function. PMID:19515211

[Status of penis and testicular development and effects of overweight/obesity on them in boys in the Zhengzhou area].

PubMed

Zhang, Yao-Dong; Tan, Li-Na; Luo, Shu-Ying; Chen, Yong-Xing; Wei, Hai-Yan

2015-01-01

To evaluate the current status of penis and testicular development in boys and the effects of overweight/obesity on their development in the Zhengzhou area of Henan Province. Height, weight, waist circumference, hip circumference, penis length and testicular volume were measured in 3 546 4 to 12-year-old boys. The penis length and testicular volume were compared between the overweight/obesity and normal weight groups. Before 9 years of age, the testicular volume was progressively smaller, and after 9 years old, it gradually increased. By the age of 11, it increased rapidly. The penis length increased gradually between 4 and 11 years of age, and after the age of 11 it increased rapidly. Phimosis was found in 144 cases (4.01%) and cryptorchidism was found in 18 cases (0.51%). A total of 639 (18.02%) boys were overweight or obese among 3 546 boys. At the ages of 6 and 7 years, the testicular volume in the overweight/obesity group was greater than in the normal control group (P<0.05). The penis length in the overweight/obesity group was significantly shorter than in the normal control group (P<0.05) by the age of 11 years. The correlation analysis showed that the testicular volume at the ages of 4 and 5 years was positively correlated with height, weight, BMI, waist circumference and hip circumference in overweight/obese boys. The penis length at the ages of 7 and 8 years was negatively correlated with weight, waist circumference and hip circumference. By the age of 12 years, the penis length was positively correlated with the height. The development of penis and testicles in boys in the Zhengzhou area is in line with the level of sex development of Chinese boys. Overweight/obesity adversely affects the development of penis and testicles.

Six years follow-up of a penis replantation in a child.

PubMed

de Lagausie, Pascal; Jehanno, Pascal

2008-03-01

Total amputation of the penis is very rare in a child. This article presents a case of a traumatic penile amputation at the base of the perineum, with scissors, in a 4-year-old child. Six hours after the aggression, the penis was replanted. Three weeks after the intervention, except for skin necrosis, the results were excellent. Six years afterward, this child has done very well from pediatric, psychological, urological, and plastic surgery points of view. Sensibility and erections are present and normal. Longer follow-ups particularly during puberty are necessary. Total amputation of the penis is a very rare accident in a child. Partial lesions are more common, particularly during circumcision. As in adult cases, replantation of the penis in a child needs a clean section by scissors or a knife, a correct conservation of the penis (in ice but without direct contact), and a short period between the lesion and the surgical procedure. All these conditions explain that very few cases are reported in the literature. We present a case of amputation of the penis in a 4-year-old child, with good results 6 years afterward.

Neurilemmoma of the glans penis: ultrasonography and magnetic resonance imaging findings.

PubMed

Jung, Dae Chul; Hwang, Sung Il; Jung, Sung Il; Kim, Sun Ho; Kim, Seung Hyup

2006-01-01

Neurilemmoma of the glans penis is rare, and no imaging findings have been reported. A case of neurilemmoma of the glans penis is presented. Ultrasonography (US) and magnetic resonance imaging revealed a well-defined small mass in the glans penis. The mass appeared hypoechoic on gray-scale US and hypervascular on color Doppler US. Magnetic resonance imaging revealed high signal intensity of the mass on a T2-weighted image and strong enhancement on a contrast-enhanced T1-weighted image.

Fracture of the penis--report of seven cases.

PubMed

Sharma, M Birkumar; Singh, Th Sudhirchandra; Khumukcham, Sridartha; Chito, Th; Sharma, B Bobby

2011-01-01

Fracture of the penis is an uncommon emergency consisting of rupture of the tunica albuginea of the corpus cavernosum resulting from blunt trauma over an erect penis. Prompt diagnosis and early surgical repair are essential to ensure a successful outcome with minimal complications. Delay may result in devastating physical and psychological disabilities that are potentially avoidable. Here in this article, 7 cases of fracture penis are being reported, who had been managed successfully by surgery in 6 cases and one case treated conservatively as he refused surgery.

The Association between Penis Size and Sexual Health among Men Who Have Sex with Men

PubMed Central

Grov, Christian; Parsons, Jeffrey T.; Bimbi, David S.

2010-01-01

Larger penis size has been equated with a symbol of power, stamina, masculinity, and social status. Yet, there has been little research among men who have sex with men assessing the association between penis size and social-sexual health. Survey data from a diverse sample of 1,065 men who have sex with men were used to explore the association between perceived penis size and a variety of psychosocial outcomes. Seven percent of men felt their penis was “below average,” 53.9% “average,” and 35.5% “above average.” Penis size was positively related to satisfaction with size and inversely related to lying about penis size (all p < .01). Size was unrelated to condom use, frequency of sex partners, HIV status, or recent diagnoses of HBV, HCV, gonorrhea/Chlamydia/urinary tract infections, and syphilis. Men with above average penises were more likely to report HPV and HSV-2 (Fisher’s exact p ≤ .05). Men with below average penises were significantly more likely to identify as “bottoms” (anal receptive) and men with above average penises were significantly more likely to identify as tops (anal insertive). Finally, men with below average penises fared significantly worse than other men on three measures of psychosocial adjustment. Though most men felt their penis size was average, many fell outside this “norm.” The disproportionate number of viral skin-to-skin STIs (HSV-2 and HPV) suggest size may play a role in condom slippage/breakage. Further, size played a significant role in sexual positioning and psychosocial adjustment. These data highlight the need to better understand the real individual-level consequences of living in a penis-centered society. PMID:19139986

Management of Penile Fracture

PubMed Central

Wani, Imtiaz

2008-01-01

Objectives To study clinical features and treatment of patients diagnosed with fractured penis. Methods All patients diagnosed with penis fracture from March 2000-March 2007 were retrospectively studied. No invasive investigation was used for diagnosis. Results Surgical intervention was done in 52 patients while 5 patients were managed conservatively. The constant finding recorded in all cases was that penis fracture occurred in erect penises. Most fractures were observed in the 16-30 years age group (50.88%). Left lateral tear was present in 53.84% cases. One patient had gangrene of penile skin after surgery. Conclusion Penis Fracture is not so uncommon as reported. A trauma to erect penis is mandatory for fracture to occur. Surgical intervention is the preferred mode of treatment. PMID:22359706

Fatal Fat Embolism After Penis Enlargement by Autologous Fat Transfer: A Case Report and Review of the Literature.

PubMed

Zilg, Brita; Råsten-Almqvist, Petra

2017-09-01

Fat embolism is an incidental finding in cases of long bone fractures or other trauma, but it is also associated with liposuction and autologous fat transfer, a procedure where fat from liposuction is injected back into the same patient's face, breast, buttocks or penis. We here present a case of sudden death by fat embolism in a healthy young male, caused by a simple penis enlargement procedure, in which fat was injected into the penis shaft. We suggest that the risk of fat embolization might be higher when pretraumatized tissue is subjected to fat injection, like in this case, where a penis elongation was performed before the fat injection. © 2017 American Academy of Forensic Sciences.

A Salvage Operation for Total Penis Amputation Due to Circumcision

PubMed Central

Gundeslioglu, Ayse Ozlem

2013-01-01

Circumcision is one of the most common rituals in Jewish and Islamic cultures. It may also be performed for phimosis correction or the treatment of recurrent balanitis. Although circumcision is considered to be a technically easy and safe surgical procedure with no significant risk, it may lead to severe complications such as necrotizing fasciitis or total penis amputation. In this report, we present a case of penis amputation at two levels occurring with third-degree burns due to electrocautery during circumcision. Although penile replantation was attempted, it was unsuccessful due to burn damage to the veins. After restoration of the functional structures, the penis was buried in the inguinal area by reepithelization to maintain blood circulation. The recovery of the penis was successful. This case is presented as a novel example of groin flap surgery to achieve a functionally and aesthetically acceptable outcome in a salvage operation for a penis with significant traumatic injury, which has not been previously reported in the literature. PMID:23730602

Relationship between self-discrepancy and worries about penis size in men with body dysmorphic disorder.

PubMed

Veale, David; Miles, Sarah; Read, Julie; Bramley, Sally; Troglia, Andrea; Carmona, Lina; Fiorito, Chiara; Wells, Hannah; Wylie, Kevan; Muir, Gordon

2016-06-01

We explored self-discrepancy in men with body dysmorphic disorder (BDD) concerned about penis size, men without BDD but anxious about penis size, and controls. Men with BDD (n=26) were compared to those with small penis anxiety (SPA; n=31) and controls (n=33), objectively (by measuring) and investigating self-discrepancy: actual size, ideal size, and size they felt they should be according to self and other. Most men under-estimated their penis size, with the BDD group showing the greatest discrepancy between perceived and ideal size. The SPA group showed a larger discrepancy than controls. This was replicated for the perceptions of others, suggesting the BDD group internalised the belief that they should have a larger penis size. There was a significant correlation between symptoms of BDD and this discrepancy. This self-actual and self-ideal/self-should discrepancy and the role of comparing could be targeted in therapy. Copyright © 2016. Published by Elsevier Ltd.

Primary tuberculosis of the glans penis.

PubMed

Jimenez Parra, Jose David; Alvarez Bandres, Silvia; Garcia Garcia, Diego; Torres Varas, Lorena; Sotil Arrieta, Amaia; Jimenez Calvo, Jesus

2014-03-01

Tuberculosis of the penis is an extremely rare disease with few cases reported in the literature. We present the case of a 64 year-old man with a whitish papular-ampullary eruption in the glans penis. After antibiotic/antimycotic therapy and several topical ointments for 3 months without response he was referred to our Department. Biopsy of the ulceration edge was performed and pathology result showed a chronic granulomatous inflammatory necrotizing lesion with granulomatous vasculitis lesions, without tumor infiltration. Systemic examination to rule out other tuberculosis foci was negative. With de suspicion of primary tuberculosis of the glans penis, anti tuberculosis therapy with Isoniazid and Piridoxine was started. Within a period of five months the ulceration healed significantly. Currently, the patient is still asymptomatic without glans penis lesions. Primary glans penis tuberculosis is a rare disease, but we must consider it (both primary and secondary forms) to try to avoid diagnostic delays that may cause prejudice for the patient. This condition promptly responds to anti tuberculosis therapy as evidenced by our case and many other reports.

Rare malformation of glans penis: arteriovenous malformation.

PubMed

Akin, Y; Sarac, M; Yucel, S

2013-01-01

Pediatric glans penis malformations, especially arteriovenous malformations (AVM), are very rare. Herein, we report two rare cases. A 14-year-old boy attended our outpatient clinic with chief complaints of purple swelling and rapidly growing lesion on the glans penis. The lesion was excised surgically after physical and radiological evaluations. Pathology reported AVM and the patient is being followed up. The second case is a 2-year-old boy who was admitted with a big lesion involving glans penis and genital area that has been present since birth. In physical and radiological evaluations, lesion on the glans penis was pulsatile. Parents of the patient did not want any surgery and patient has been in follow-up. Diagnosis of the vascular lesions on glans penis is very easy by physical and radiological examinations today. Long-term follow-up is very important for AVM. Clinicians must make a careful effort to document new glans lesions in the pediatric population and decrease anxiety in the parents of affected children.

Characteristics of PCR-SSCP and RAPD-HPCE methods for identifying authentication of Penis et testis cervi in Traditional Chinese Medicine based on cytochrome b gene.

PubMed

Li, Mingcheng; Gao, Lijun; Qu, Li; Sun, Jingyu; Yuan, Guangxin; Xia, Wei; Niu, Jiamu; Fu, Guilian; Zhang, Lihua

2016-07-01

The use of Penis et testis cervi, as a kind of precious Traditional Chinese Medicine (TCM), which is derived from dry deer's testis and penis, has been recorded for many years in China. There are abundant species of deer in China, the Penis et testis from species of Cervus Nippon and Cervus elaphusL were authentic, others species were defined as adulterant (different subspecies of deer) or counterfeits (different species). Identification of their origins or authenticity becomes a key in controlling the herbal products. A modified column chromatography was used to extract mitochondrial DNA of dried deer's testis and penis from sika deer (C. Nippon) and red deer (C. elaphusL) in addition to adulterants and counterfeits. Column chromatography requires for a short time to extract mitochondrial DNA of high purity with little damage of DNA molecules, which provides the primary structure of guarantee for the specific PCR; PCR-SSCP method showed a clear intra-specific difference among patterns of single-chain fragments, and completely differentiate Penis et testis origins from C. Nippon and C. elaphusL. RAPD-HPCE was based on the standard electropherograms to compute a control spectrum curve as similarity reference (R) among different samples. The similarity analysis indicated that there were significant inter-species differences among Penis et testis' adulterant or counterfeits. Both techniques provide a fast, simple, and accurate way to directly identify among inter-species or intra-species of Penis et testis.

A Freudian Looks at Freud and Feminity.

ERIC Educational Resources Information Center

Moldawsky, Stanley

This article deals with the author's interpretation of the Freudian concept of penis envy. Penis envy is viewed as a psychological phenomenon rather than a biological phenomenon characterized as the "bedrock of feminity." Based on his experiences as a psychoanalyst, the author states that penis envy involves the child's early…

Pathological Fracture of the Femur by Metastatic Carcinoma Penis-a Rare Presentation.

PubMed

Hussain, Shabbir; Solanki, Fanindra Singh; Sharma, Deepti B; Sharma, Dhananjay

2016-04-01

We report herein a clinical case of a patient with femur fracture due to metastasis from penile squamous cell carcinoma. A young man, who was treated for carcinoma penis, presented with pathological fracture of femur and lung metastasis from metastatic carcinoma penis after 18 months. Long bone metastasis from penile cancer is extremely rare, to the best of our knowledge; this is the first report of a patient with penile cancer spread to the femur from primary squamous cell carcinoma of the penis.

Ischemia of the glans penis following circumcision: case report and revision of the literature.

PubMed

Pepe, Pietro; Pietropaolo, Francesco; Candiano, Giuseppe; Pennisi, Michele

2015-03-31

Ischemic complications of the glans penis are rare and commonly result from trauma, inadvertent administration of vasoconstrictive solutions, diabetes mellitus, circumcision and vasculitis; we refer about a young man with severe ischemia of the glans penis following circumcision. The patient had undergone circumcision 5 days before in a surgery department under local anesthesia (1% mepivacaine hydrochloride). The patient noticed a brownish color and edema of the glans penis at 24 h after he opened the wound dressing, but arrived to our hospital only 5 days after circumcision because these findings had progressed. Physical examination revealed the black color or necrotic appearance of the glans penis, and edema on the dorsal penile skin. The patient underwent antibiotic, antiplatatelet, corticosteroid and iperbaric therapy achieving a complete restitutio ad integrum.

Modified penoplasty for concealed penis in children.

PubMed

Yang, Tianyou; Zhang, Liyu; Su, Cheng; Li, Zhongmin; Wen, Yingquan

2013-09-01

To report a modified penoplasty technique for concealed penis in children. Between January 2006 and June 2012, 201 cases of concealed penis were surgically repaired with modified penoplasty. The modified penoplasty technique consisted of 3 major steps: (1) degloved the penile skin and excised the inner prepuce, (2) advanced penoscrotal skin to cover penile shaft, and (3) fixed the penis base and reconstructed the penoscrotal angle. Two hundred one cases of concealed penis were enrolled in this study over a period of 6 years. Mean age at the time of surgery was 5.3 years (range 1-13 years) and mean operative time was 40 minutes (range 30-65minutes). All patients were routinely followed up at 1, 3, and 6 months after surgery. Most patients developed postoperative edema and were resolved within 1 month, whereas 20 cases developed prolonged postoperative edema, especially at the site of frenulum, which took 3 months to be resolved. Ten cases had retraction after surgery. No erection difficulties were recorded. Patients/parents reported better hygiene and improved visualization and accessibility of penis after surgery and were satisfied with the cosmetic outcome. The result of this study shows that the modified penoplasty technique is a simple, safe, and effective procedure for concealed penis with satisfied cosmetic outcome. Copyright © 2013 Elsevier Inc. All rights reserved.

Surgical correction of buried penis after traffic accident - a case report.

PubMed

Masuda, Hiroshi; Azuma, Haruhito; Segawa, Naoki; Iwamoto, Yusaku; Inamoto, Teruo; Takasaki, Noboru; Katsuoka, Yoji

2004-06-08

Buried penis, most commonly seen in children, is particularly debilitating in adults, resulting in inability to void while standing and it also affects vaginal penetration. We report a case of buried penis due to a traffic accident, which caused dislocation of the fractured pubic bone that shifted inside and pulled the penis by its suspensory ligament. A 55-year-old man was admitted to our hospital with a chief complaint of hidden penis while in the sitting position. He had suffered a pelvic fracture in a traffic accident four years previously, and his penis was covered with suprapubic fat when he was in a sitting position. He was unable to have sexual intercourse. We performed a penile lengthening procedure, including inverse V-Y-plasty of the dorsal skin of the penile root, suspensory desmotomy and fat removal, under general anesthesia. There was a good cosmetic result with satisfactory penile erection, which allowed successful sexual intercourse after surgery. We performed penile elongation surgery with inverse V-Y-plasty of the dorsal skin of the penile root, suspensory desmotomy, and fat removal. Surgical treatment of buried penis achieves marked aesthetic and functional improvement, and benefits the majority of patients, resulting in satisfactory erection and successful sexual intercourse.

Surgical correction of buried penis after traffic accident – a case report

PubMed Central

Masuda, Hiroshi; Azuma, Haruhito; Segawa, Naoki; Iwamoto, Yusaku; Inamoto, Teruo; Takasaki, Noboru; Katsuoka, Yoji

2004-01-01

Background Buried penis, most commonly seen in children, is particularly debilitating in adults, resulting in inability to void while standing and it also affects vaginal penetration. We report a case of buried penis due to a traffic accident, which caused dislocation of the fractured pubic bone that shifted inside and pulled the penis by its suspensory ligament. Case presentation A 55-year-old man was admitted to our hospital with a chief complaint of hidden penis while in the sitting position. He had suffered a pelvic fracture in a traffic accident four years previously, and his penis was covered with suprapubic fat when he was in a sitting position. He was unable to have sexual intercourse. We performed a penile lengthening procedure, including inverse V-Y-plasty of the dorsal skin of the penile root, suspensory desmotomy and fat removal, under general anesthesia. There was a good cosmetic result with satisfactory penile erection, which allowed successful sexual intercourse after surgery. Conculsion We performed penile elongation surgery with inverse V-Y-plasty of the dorsal skin of the penile root, suspensory desmotomy, and fat removal. Surgical treatment of buried penis achieves marked aesthetic and functional improvement, and benefits the majority of patients, resulting in satisfactory erection and successful sexual intercourse. PMID:15182380

Neural Influences on Sonic Hedgehog and Apoptosis in the Rat Penis1

PubMed Central

Bond, Christopher; Tang, Yi; Podlasek, Carol A.

2010-01-01

The role of sonic hedgehog (SHH) in maintaining corpora cavernosal morphology in the adult penis has been established; however, the mechanism of how SHH itself is regulated remains unclear. Since decreased SHH protein is a cause of smooth muscle apoptosis and erectile dysfunction (ED) in the penis, and SHH treatment can suppress cavernous nerve (CN) injury-induced apoptosis, the question of how SHH signaling is regulated is significant. It is likely that neural input is involved in this process since two models of neuropathy-induced ED exhibit decreased SHH protein and increased apoptosis in the penis. We propose the hypothesis that SHH abundance in the corpora cavernosa is regulated by SHH signaling in the pelvic ganglia, neural activity, or neural transport of a trophic factor from the pelvic ganglia to the corpora. We have examined each of these potential mechanisms. SHH inhibition in the penis shows a 12-fold increase in smooth muscle apoptosis. SHH inhibition in the pelvic ganglia causes significantly increased apoptosis (1.3-fold) and decreased SHH protein (1.1-fold) in the corpora cavernosa. SHH protein is not transported by the CN. Colchicine treatment of the CN resulted in significantly increased smooth muscle apoptosis (1.2-fold) and decreased SHH protein (1.3-fold) in the penis. Lidocaine treatment of the CN caused a similar increase in apoptosis (1.6-fold) and decrease in SHH protein (1.3-fold) in the penis. These results show that neural activity and a trophic factor from the pelvic ganglia/CN are necessary to regulate SHH protein and smooth muscle abundance in the penis. PMID:18256331

Sexual Functioning and Behavior of Men with Body Dysmorphic Disorder Concerning Penis Size Compared with Men Anxious about Penis Size and with Controls: A Cohort Study

PubMed Central

Veale, David; Miles, Sarah; Read, Julie; Troglia, Andrea; Wylie, Kevan; Muir, Gordon

2015-01-01

Introduction Little is known about the sexual functioning and behavior of men anxious about the size of their penis and the means that they might use to try to alter the size of their penis. Aim To compare sexual functioning and behavior in men with body dysmorphic disorder (BDD) concerning penis size and in men with small penis anxiety (SPA without BDD) and in a control group of men who do not have any concerns. Methods An opportunistic sample of 90 men from the community were recruited and divided into three groups: BDD (n = 26); SPA (n = 31) and controls (n = 33). Main Outcome Measures The Index of Erectile Function (IEF), sexual identity and history; and interventions to alter the size of their penis. Results Men with BDD compared with controls had reduced erectile dysfunction, orgasmic function, intercourse satisfaction and overall satisfaction on the IEF. Men with SPA compared with controls had reduced intercourse satisfaction. There were no differences in sexual desire, the frequency of intercourse or masturbation across any of the three groups. Men with BDD and SPA were more likely than the controls to attempt to alter the shape or size of their penis (for example jelqing, vacuum pumps or stretching devices) with poor reported success. Conclusion Men with BDD are more likely to have erectile dysfunction and less satisfaction with intercourse than controls but maintain their libido. Further research is required to develop and evaluate a psychological intervention for such men with adequate outcome measures. PMID:26468378

Infrapubic Liposuction for Penile Length Augmentation in Patients with Infrapubic Adiposities.

PubMed

Ghanem, Hussein; ElKhaiat, Yaser Ibrahim; Motawi, Ahmed T; AbdelRahman, Islam Fathy Soliman

2017-04-01

Hidden penis, inconspicuous and concealed penis are synonyms for the same entity "buried penis" where the penile shaft is hidden below the surface of the prepubic fat to an extent that gives an impression of a short penis, despite corporeal length being normal. The aim of our work is the reduction in the amount of the suprapubic fat by liposuction to reveal the buried penis and assess the results, patient satisfaction and possible complications. The procedure of suprapubic liposuction was carried out on ten men who were attending the outpatient clinic of Andrology complaining of small-sized penis. Pre-, immediate (on table) postoperative and 3 months postoperative skin to tip flaccid and stretched penile lengths were measured. Patient satisfaction was assessed using the five-point Likert scale. There was a statistically significant increase between the pre- and postoperative flaccid and stretched penile lengths in our patients with a p value <0.001 in both. An acquired adult buried penis is a correctable problem. Simple buried penis due to excess fat at the mons pubis should be differentiated from other complex cases that may require combined techniques to achieve good results with minor complications. Suprapubic liposuction is a very safe and successful procedure with minor or no complications if performed meticulously. It could improve self-esteem along with the associated physical and esthetic concerns. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Sexual Functioning and Behavior of Men with Body Dysmorphic Disorder Concerning Penis Size Compared with Men Anxious about Penis Size and with Controls: A Cohort Study.

PubMed

Veale, David; Miles, Sarah; Read, Julie; Troglia, Andrea; Wylie, Kevan; Muir, Gordon

2015-09-01

Little is known about the sexual functioning and behavior of men anxious about the size of their penis and the means that they might use to try to alter the size of their penis. To compare sexual functioning and behavior in men with body dysmorphic disorder (BDD) concerning penis size and in men with small penis anxiety (SPA without BDD) and in a control group of men who do not have any concerns. An opportunistic sample of 90 men from the community were recruited and divided into three groups: BDD (n = 26); SPA (n = 31) and controls (n = 33). The Index of Erectile Function (IEF), sexual identity and history; and interventions to alter the size of their penis. Men with BDD compared with controls had reduced erectile dysfunction, orgasmic function, intercourse satisfaction and overall satisfaction on the IEF. Men with SPA compared with controls had reduced intercourse satisfaction. There were no differences in sexual desire, the frequency of intercourse or masturbation across any of the three groups. Men with BDD and SPA were more likely than the controls to attempt to alter the shape or size of their penis (for example jelqing, vacuum pumps or stretching devices) with poor reported success. Men with BDD are more likely to have erectile dysfunction and less satisfaction with intercourse than controls but maintain their libido. Further research is required to develop and evaluate a psychological intervention for such men with adequate outcome measures.

[Penal bone of American mink (Mustela vison Brisson, 1756)].

PubMed

Gościcka, D; Gielecki, J

1990-01-01

30 male minks were examined anatomically, histologically, and radiologically. It was found that penis bone constituted the always-present part of their penis. It was shown, on the grounds of both the X-ray and histological examinations, that there is the connective tissue basis for osteogenesis of penis bone closer ending.

Urethrocutaneous fistula following fracture penis.

PubMed

Mahapatra, Raj Kumar Sinha; Ray, Rajendra Prasad; Mishra, Swetank; Pal, Dilip Kumar

2014-10-01

Penile fracture is an emergency in urology. Early surgical management is recommended, to prevent long term complications. Although urethrocavernosal fistula is one of the described complications following fracture penis repair in literature, no case of urethrocuteneous fistula has been reported till now. Here we report the first case of urethrocutaneous fistula following repair of fracture penis.

Buried penis: An unrecognized risk factor in the development of invasive penile cancer.

PubMed

Abdulla, Alym; Daya, Dean; Pinthus, Jehonathan; Davies, Timothy

2012-10-01

One of the documented benefits of neonatal circumcision is protection against invasive penile cancer. To date there have been a handful of published cases of invasive penile cancer in men circumcised as neonates. We report a case of a 73-year-old man, with a history of neonatal circumcision with no evidence of previous human papillomavirus exposure, who developed a buried penis secondary to obesity. He was diagnosed with Grade 2, pT3N0 squamous cell carcinoma of the penis. This report suggests that buried penis may pose a risk factor for the development of penile cancer despite the protective effects of neonatal circumcision. Thus periodic examination of a buried penis is warranted even in patients with no risk factors for penile cancer. A review of the literature is provided.

Women who prefer longer penises are more likely to have vaginal orgasms (but not clitoral orgasms): implications for an evolutionary theory of vaginal orgasm.

PubMed

Costa, Rui Miguel; Miller, Geoffrey F; Brody, Stuart

2012-12-01

Research indicates that (i) women's orgasm during penile-vaginal intercourse (PVI) is influenced by fitness-related male partner characteristics, (ii) penis size is important for many women, and (iii) preference for a longer penis is associated with greater vaginal orgasm consistency (triggered by PVI without concurrent clitoral masturbation). To test the hypothesis that vaginal orgasm frequency is associated with women's reporting that a longer than average penis is more likely to provoke their PVI orgasm. Three hundred twenty-three women reported in an online survey their past month frequency of various sexual behaviors (including PVI, vaginal orgasm, and clitoral orgasm), the effects of a longer than average penis on likelihood of orgasm from PVI, and the importance they attributed to PVI and to noncoital sex. Univariate analyses of covariance with dependent variables being frequencies of various sexual behaviors and types of orgasm and with independent variable being women reporting vs. not reporting that a longer than average penis is important for their orgasm from PVI. Likelihood of orgasm with a longer penis was related to greater vaginal orgasm frequency but unrelated to frequencies of other sexual behaviors, including clitoral orgasm. In binary logistic regression, likelihood of orgasm with a longer penis was related to greater importance attributed to PVI and lesser importance attributed to noncoital sex. Women who prefer deeper penile-vaginal stimulation are more likely to have vaginal orgasm, consistent with vaginal orgasm evolving as part of a female mate choice system favoring somewhat larger than average penises. Future research could extend the findings by overcoming limitations related to more precise measurement of penis length (to the pubis and pressed close to the pubic bone) and girth, and large representative samples. Future experimental research might assess to what extent different penis sizes influence women's satisfaction and likelihood of vaginal orgasm. © 2012 International Society for Sexual Medicine.

[Effectiveness of penile ventral scrotum cohesion place wedge cutting and improved Brisson technique for congenital buried penis].

PubMed

Zhang, Huafeng

2013-09-01

To investigate the effectiveness of the penile ventral scrotum cohesion place wedge cutting and improved Brisson technique for congenital buried penis. Between March 2010 and June 2012, 68 boys with congenital buried penis were treated by the penile ventral scrotum cohesion place wedge cutting and improved Brisson technique, with a median age of 4 years and 10 months (range, 3 months-13 years). Of 68 cases, 14 were classified as phimosis type, 14 as rope belt type, 20 as moderate type, and 20 as severe type. The body of penis developed well and had no deformity. After operation, complications were observed, and the effectiveness was evaluated by the designed questionnaire. Early postoperative complications occurred in 11 cases, including obvious adhesion of the outside wrapping mouth in 4 cases, scrotal skin bloat in 5 cases, and distal foreskin necrosis in 2 cases; long-term complications occurred in 9 cases, including abdominal incision scar formation in 4 cases, wrapping mouth scar stricture in 3 cases, and short penis in 2 cases. Primary healing of incision was obtained in the other boys. Fifty-four cases were followed up 6-12 months (mean, 8 months). According to the designed questionnaire, satisfaction rate with the overall view in parents was 77.78% (42/54); the clinical improvement rate was 85.19% (46/54); exposure of the penis was satisfactory in parents of 50 cases; and the parents had no psychological burden of penis exposure in 46 cases, which were significantly improved when compared with preoperative ones (P < 0.05). The boys had no psychological burden of penis exposure in 29 cases (53.70%) after operation, showing no significant difference when compared with preoperative one (18 cases, 33.33%) (chi2 = 1.22, P = 0.31). Application of the penile ventral scrotum cohesion place wedge cutting and improved Brisson technique can effectively correct congenital buried penis.

Central Somatosensory Networks Respond to a De Novo Innervated Penis: A Proof of Concept in Three Spina Bifida Patients.

PubMed

Kortekaas, Rudie; Nanetti, Luca; Overgoor, Max L E; de Jong, Bauke M; Georgiadis, Janniko R

2015-09-01

Spina bifida (SB) causes low spinal lesions, and patients often have absent genital sensation and a highly impaired sex life. TOMAX (TO MAX-imize sensation, sexuality and quality of life) is a surgical procedure whereby the penis is newly innervated using a sensory nerve originally targeting the inguinal area. Most TOMAX-treated SB patients initially experience penile stimulation as inguinal sensation, but eventually, the perception shifts to penis sensation with erotic feelings. The brain mechanisms mediating this perceptual shift, which are completely unknown, could hold relevance for understanding the brain's role in sexual development. The aim of this study was to study how a newly perceived penis would be mapped onto the brain after a lifelong disconnection. Three TOMAX-treated SB patients participated in a functional magnetic resonance imagery experiment while glans penis, inguinal area, and index finger were stimulated with a paint brush. Brush stimulation-induced activation of the primary somatosensory cortex (SI) and functional connectivity between SI and remote cerebral regions. Stimulation of the re-innervated side of the glans penis and the intact contralateral inguinal area activated a very similar location on SI. Yet, connectivity analysis identified distinct SI functional networks. In all three subjects, the middle cingulate cortex (MCC) and the parietal operculum-insular cortex (OIC) were functionally connected to SI activity during glans penis stimulation, but not to SI activity induced by inguinal stimulation. Investigating central somatosensory network activity to a de novo innervated penis in SB patients is feasible and informative. The consistent involvement of MCC and OIC above and beyond the brain network expected on the basis of inguinal stimulation suggests that these areas mediate the novel penis sensation in these patients. The potential role of MCC and OIC in this process is discussed, along with recommendations for further research. © 2015 International Society for Sexual Medicine.

Use of Macrolane VRF 30 in emicircumferential penis enlargement.

PubMed

Sito, Giuseppe; Marlino, Sergio; Santorelli, Adriano

2013-02-01

Penis enlargement is increasingly in demand. Methods for penis enlargement can be classified into surgical, nonsurgical (filling), and mechanical. Each method has shown only relatively successful results. A new formulation of injectable, stabilized, hyaluronic acid (HA)-based, nonanimal gel is available that may have applications for this use. The authors propose a new technique for emicircumferential-injection filling of the penis and assess the safety and efficacy of this procedure compared with lipofilling. The authors retrospectively reviewed the charts of 83 patients who underwent penis enlargement with either their HA-injection technique or lipofilling between December 2007 and July 2011. Safety, efficacy, and patient satisfaction were assessed. The circumferential enlargement obtained from both techniques ranged from 3.2 to 4.5 cm, with a decrement during erection. In all patients, the increase in penis length ranged from 1.8 to 3.6 cm. No complications were seen in patients treated with HA, whereas 8 patients treated with lipofilling developed granuloma, and another experienced fat necrosis. The vast majority (n = 72) of patients reported being "very satisfied" with the results. The ideal technique for penis enlargement should be nonsurgical, with a satisfactory and predictable result, a low rate of complications, and long-term stability. Emicircumferential enlargement with HA filler meets these requirements. However, results have been durable but not definitive, and repeated treatment (with associated costs) is necessary.

Glans wings are separated ventrally by the septum glandis and frenulum penis: MRI documentation and surgical implications

PubMed Central

Özbey, Hüseyin; Kumbasar, Ali

2017-01-01

Objective In the normal human penis, the glans wings are in apposition in the midline ventrally, and are separated by the “septum glandis” and “frenulum” of the prepuce. However, most of the hypospadias repair techniques include dissection of the glans wings and their approximation enclosing the neourethra within the glans. Material and methods In order to obtain detailed information about the normal anatomy of glans penis, magnetic resonance imaging (MRI) findings of the penis were studied in three adults. Transverse, and sagittal sections of the penis were performed with a 1.5-T MRI scanner. Results The present MRI study has confirmed that the glans wings do not fuse at the ventral midline and they are seperated by a fibrous tissue (septum glandis). This fibrous tissue is connected to the frenulum, traversing the wings of the glans penis. The glanular urethra forming the fossa navicularis has a wider caliber than the proximal urethra, and its walls are radiologically seen as the extension of that fibrous tissue. Conclusion The male urethra is not a uniform tubular structure and has distinct attachments in glans penis. The glans wings are separated ventrally by the septum glandis and frenulum. In hypospadias, the septum glandis and frenulum are entirely missing structures. Therefore, in hypospadias surgery, the anatomical features of the glanular urethra must be taken into consideration. PMID:29201519

Simple Anchoring of the Penopubic Skin to the Prepubic Deep Fascia in Surgical Correction of Buried Penis

PubMed Central

Jung, Eun-hong; Jang, Seok-heun; Lee, Jae-won

2011-01-01

Purpose The aim of this study was to categorize concealed penis and buried penis by preoperative physical examination including the manual prepubic compression test and to describe a simple surgical technique to correct buried penis that was based on surgical experience and comprehension of the anatomical components. Materials and Methods From March 2007 to November 2010, 17 patients were diagnosed with buried penis after differentiation of this condition from concealed penis. The described surgical technique consisted of a minimal incision and simple fixation of the penile shaft skin and superficial fascia to the prepubic deep fascia, without degloving the penile skin. Results The mean age of the patients was 10.2 years, ranging from 8 years to 15 years. The median follow-up was 19 months (range, 5 to 49 months). The mean penile lengths were 1.8 cm (range, 1.1 to 2.5 cm) preoperatively and 4.5 cm (range, 3.3 to 5.8 cm) postoperatively. The median difference between preoperative and postoperative penile lengths was 2.7 cm (range, 2.1 to 3.9 cm). There were no serious intra- or postoperative complications. Conclusions With the simple anchoring of the penopubic skin to the prepubic deep fascia, we obtained successful subjective and objective outcomes without complications. We suggest that this is a promising surgical method for selected patients with buried penis. PMID:22195270

A rare case of acquired lymphangioma circumscriptum of the penis.

PubMed

Adikari, S; Philippidou, M; Samuel, M

2017-02-01

Acquired lymphangioma circumscriptum is a rare occurrence on the penis. We report a case of a 47-year-old man who presented with a single lesion of acquired lymphangioma circumscriptum on the penis resembling genital warts. We report the case to increase awareness of this rare condition which may mimic sexually transmitted infections such as genital warts.

What is the origin of the arterial vascularization of the corpora cavernosa? A computer-assisted anatomic dissection study

PubMed Central

Diallo, Djibril; Zaitouna, Mazen; Alsaid, Bayan; Quillard, Jeannine; Droupy, Stéphane; Benoit, Gérard; Bessede, Thomas

2013-01-01

The purpose of this study was to identify the microscopic arterial vascularization of the corpora cavernosa (CC) of the penis using computer-assisted anatomic dissection (CAAD), determine the contribution of the different penile arteries towards this vascularization, detail the nature of cavernospongiosum shunts, and locate the anastomoses between these different arteries. Tissue specimens were taken from five donors who donated their bodies to science. The specimens were fixed in 10% formalin and sliced into a series of five 5-μm sections at intervals of 200 μm. The first section was stained with hematoxylin-eosin or Masson's trichrome and the second with anti-protein S100. The cavernous artery of the penis is not the only source of arterial vascularization of the CC. In four of the five cases studied, we found two to four perforating branches arising from the dorsal arteries of the penis that join up with the cavernous artery of the penis or that are solely responsible for the vascularization of the distal third of the penis. The bulbo-urethral and urethral arteries are situated outside of the tunica albuginea of the corpus spongiosum on their lateral and dorsal sides. The anastomoses do not occur between the cavernous artery of the penis and the corpus spongiosum but between the cavernous artery of the penis and the urethral artery on the surface of the tunica albuginea. All of these arteries are accompanied by nerve branches. The CC were found to be vascularized by both cavernous and dorsal arteries of the penis. Intrapenile vascularization is organized around four arterial axes, which are anastomosed by multiple neurovascular shunts. PMID:23981086

Quantitative somatosensory testing of the penis: optimizing the clinical neurological examination.

PubMed

Bleustein, Clifford B; Eckholdt, Haftan; Arezzo, Joseph C; Melman, Arnold

2003-06-01

Quantitative somatosensory testing, including vibration, pressure, spatial perception and thermal thresholds of the penis, has demonstrated neuropathy in patients with a history of erectile dysfunction of all etiologies. We evaluated which measurement of neurological function of the penis was best at predicting erectile dysfunction and examined the impact of location on the penis for quantitative somatosensory testing measurements. A total of 107 patients were evaluated. All patients were required to complete the erectile function domain of the International Index of Erectile Function (IIEF) questionnaire, of whom 24 had no complaints of erectile dysfunction and scored within the "normal" range on the IIEF. Patients were subsequently tested on ventral middle penile shaft, proximal dorsal midline penile shaft and glans penis (with foreskin retracted) for vibration, pressure, spatial perception, and warm and cold thermal thresholds. Mixed models repeated measures analysis of variance controlling for age, diabetes and hypertension revealed that method of measurement (quantitative somatosensory testing) was predictive of IIEF score (F = 209, df = 4,1315, p <0.001), while site of measurement on the penis was not. To determine the best method of measurement, we used hierarchical regression, which revealed that warm temperature was the best predictor of erectile dysfunction with pseudo R(2) = 0.19, p <0.0007. There was no significant improvement in predicting erectile dysfunction when another test was added. Using 37C and greater as the warm thermal threshold yielded a sensitivity of 88.5%, specificity 70.0% and positive predictive value 85.5%. Quantitative somatosensory testing using warm thermal threshold measurements taken at the glans penis can be used alone to assess the neurological status of the penis. Warm thermal thresholds alone offer a quick, noninvasive accurate method of evaluating penile neuropathy in an office setting.

[Tuberculosis of the penis: report of a case and review of the literature].

PubMed

Tanikawa, K; Matsushita, K; Ohkoshi, M

1985-06-01

Tuberculosis of the penis is a rare disease. We report a case of tuberculosis of the penis. A 51-year-old man noticed a painless induration with a central ulceration on the glans penis. He had a history of tuberculosis of cervical lymph-nodes, right epididymis and leg skin. Examination of the other parts showed no evidence of tuberculosis. Tuberculin test was strongly positive. The skin lesion of the glans was excised. The pathology was epithelioid cell granuloma with Langhans' giant cell, indicative of tuberculosis. But acid-fast bacilli were not detected in the Ziehl-Neelsen preparation of the tissue. The patient was treated with isoniazid, rifampicin and cycloserine. After the treatment for approximately 5 months, recurrence was not observed and enlargement of cervical lymphadenopathy improved. We reviewed 39 cases of tuberculosis of the penis reported in Japan during the past 14 years.

Skin resurfacing in a circumferential full thickness burn to the penis: lessons learnt.

PubMed

Jabir, Shehab; Frew, Quentin; Thompson, Richard; Dziewulski, Peter

2013-08-13

A circumferential full-thickness burn to the penis is a rarely encountered injury. However, when it does occur, it proves a management challenge to the plastic and burns surgeon in terms of reconstruction. This is due to the need of not only regaining adequate function of the organ, but also because of the need for a pleasing aesthetic outcome. Split-skin grafts have been utilised successfully to resurface full thickness burns of the penis and have given good results. Yet the success of split-skin grafts, especially those applied to an anatomically challenging region of the body such as the penis, depends on a number of carefully thought-out steps. We discuss the case of a circumferential full-thickness burn to the penis which was treated with split-skin grafting and highlight important pitfalls that the plastic and burns surgeon need to be aware of to ensure a successful outcome.

Skin resurfacing in a circumferential full thickness burn to the penis: lessons learnt

PubMed Central

Jabir, Shehab; Frew, Quentin; Thompson, Richard; Dziewulski, Peter

2013-01-01

A circumferential full-thickness burn to the penis is a rarely encountered injury. However, when it does occur, it proves a management challenge to the plastic and burns surgeon in terms of reconstruction. This is due to the need of not only regaining adequate function of the organ, but also because of the need for a pleasing aesthetic outcome. Split-skin grafts have been utilised successfully to resurface full thickness burns of the penis and have given good results. Yet the success of split-skin grafts, especially those applied to an anatomically challenging region of the body such as the penis, depends on a number of carefully thought-out steps. We discuss the case of a circumferential full-thickness burn to the penis which was treated with split-skin grafting and highlight important pitfalls that the plastic and burns surgeon need to be aware of to ensure a successful outcome. PMID:23946511

Adolescent "Saxophone Penis" Secondary to Crohn's Disease: Misdiagnosed as Being Posttraumatic.

PubMed

Marshall, Claire; Markiewicz, Dorota; Bewley, Anthony

2016-01-01

We describe a patient with a "saxophone penis" mistakenly diagnosed as having posttraumatic changes. A careful history and attention to blood tests at presentation may have alerted clinicians that there was a nontraumatic cause for our patient's disease. It is essential that clinicians consider "metastatic" anogenital Crohn's disease as a possible cause of "saxophone penis". © 2016 Wiley Periodicals, Inc.

[Complication of self-injection with petroleum jelly for penis augmentation].

PubMed

Gröger, A; Boliglowa, D; Sippel, C; Wiebols, A; Menke, H

2015-03-01

An increasing number of complications after penis enlargement procedures, sometimes self-performed, are being observed in Germany and in the other countries. This report presents a case of a 43-year-old patient who presented with multiple fistulas, paraffinomas and bacterial superinfection after having injected petroleum jelly into his penis. In order to remove the foreign bodies as well as the infected and necrotic tissue the complete epithelium had to be radically excised. After further local and surgical wound treatment penis reconstruction with a full thickness skin graft was performed which later led to a functional and aesthetical complete restoration to the original condition.

A rare cause of glans penis masses in childhood: Fibroepithelial polyp

PubMed Central

Şencan, Arzu; Şencan, Aydın; Günşar, Cüneyt; Çayırlı, Hasan; Neşe, Nalan

2015-01-01

Fibroepithelial polyps of glans penis are very rarely seen in childhood. A 6-month-old male admitted to our institution with a slowly enlarging glans penis mass on the ventral side of the glans penis. The mass was totally excised, and hystopathological diagnosis was a fibroepithelial polyp. All of the reported cases published previously, except one, are of adult age and all of them have been associated with the history of long-term condom catheter use. The presence of the case in childhood; however, suggests that the pathology might be congenital. This is the second pediatric case presented in the English literature. PMID:25552832

Kissing Nevus of the Penis.

PubMed

Jiang, Shan; Chen, Yan; Hinchliffe, Taylor E; Wu, Tianfu; Stephen, Tyring

2018-03-01

Kissing nevus is a very rare congenital melanocytic nevus. Here, we describe one case of kissing nevus on the penis. A 15-year boy presented with asymptomatic black to dark brown color patches on his penis. Histopathological findings showed that there were nests and cords of nevus cells in upper dermis. No significant cytologic atypia and mitoses were noted. Immunohistochemical stains revealed a partial positive for HMB-45 only in upper dermis and a stronger positivity for S-100 in almost all nevus cells. We diagnosed the lesion as kissing nevus of penis. The patient and his parents refused further treatment, and the patient is being followed in our clinic.

[Self-amputation of the penis treated immediately: Case report and review of the literature].

PubMed

Odzébé, A W S; Bouya, P A; Otiobanda, G F; Banga Mouss, R; Nzaka Moukala, C; Ondongo Atipo, A M; Ondziel Opara, A S

2015-12-01

Self-amputation of the penis treated immediately: case report and review of the literature. Self-amputation of the penis is rare in urological practice. It occurs more often in a context psychotic disease. It can also be secondary to alcohol or drugs abuse. Treatment and care vary according on the severity of the injury, the delay of consultation and the patient's mental state. The authors report a case of self-amputation of the penis in an alcoholic context. The authors analyze the etiological and urological aspects of this trauma. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

A rare cause of glans penis masses in childhood: Fibroepithelial polyp.

PubMed

Şencan, Arzu; Şencan, Aydın; Günşar, Cüneyt; Çayırlı, Hasan; Neşe, Nalan

2015-01-01

Fibroepithelial polyps of glans penis are very rarely seen in childhood. A 6-month-old male admitted to our institution with a slowly enlarging glans penis mass on the ventral side of the glans penis. The mass was totally excised, and hystopathological diagnosis was a fibroepithelial polyp. All of the reported cases published previously, except one, are of adult age and all of them have been associated with the history of long-term condom catheter use. The presence of the case in childhood; however, suggests that the pathology might be congenital. This is the second pediatric case presented in the English literature.

New Technique for the Treatment of Buried Penis in Children.

PubMed

Liu, Feng; Lin, Tao; He, Dawei; Wei, Guanghui; Liu, Junhong; Liu, Xing; Hua, Yi; Zhang, Deying; Lu, Peng; Wu, Shengde; Li, Xuliang

2016-02-01

To present our treatment experience of buried penis, which has no consensus therapeutic technique for all cases of buried penis, by using a new technique for the repair of this condition, in which the approach is through the ventral penile root. We performed a retrospective review of 153 patients (median age: 6.5 years) who underwent repair of a buried penis between March 2005 and March 2013. The technique involves the creation of a wedge-shaped cut of the ventral penile skin, followed by fixation of the subcutaneous penile skin at the base of the degloved penis to the Buck fascia at the 2- and 10-o'clock positions. The ventral outer preputial skin is split down the midline, and the dorsal inner preputial skin is cut with oblique incision. All patients were followed for an average of 12 months after repair. Other than 2 cases (1.3%) of trapped penis with a ring of scar tissue, which required subsequent excision, there were no complications and the cosmetic appearance was satisfactory. The described ventral penile approach is a simple and effective procedure with good cosmetic outcomes and few complications. Copyright © 2016 Elsevier Inc. All rights reserved.

Stunting of the penis in Heleobia parchappii (Mollusca: Cochliopidae) and its relationship with parasitism.

PubMed

Merlo, Matías J; Parietti, Manuela; Etchegoin, Jorge A

2017-02-08

Penis anatomy is used to discriminate species of gastropods belonging to the family Cochliopidae; however, this characteristic may be affected by the presence of parasites. To evaluate the possible effect of parasites on penis length and number of papillae in Heleobia parchappii, 195 males were collected from the Nahuel Rucá Lagoon, Argentina. Male snails were only infected by trematode digeneans (total prevalence 45.13%). Three out of 9 species of digeneans registered showed prevalence values higher than 10%: Microphallus szidati, M. simillimus, and Notocotylidae sp. 1. The penis length of non-parasitized males and those parasitized by M. szidati and M. similimus increased with increased snail length; however, this increase was lower in infected snails. In the case of snails infected with Notocotylidae sp. 1, no relationship between shell length and penis length was apparent. Differences in the life cycles of these 3 digeneans could explain the null or lower penis growth rate in relation to host body growth. In contrast, no change was observed in the number of penial papillae of H. parchappii when these snails were infected by larval digeneans compared to those that were not infected. This indicates that penial papillae may be a more stable characteristic than penis length to discriminate between species within the Cochliopidae. The study of penial papillae should be central in the taxonomy and identification of new species within the Cochliopidae, as well as in previously described species.

[EFFECTIVENESS OF ADVANCED SKIN FLAP AND V-SHAPED VENTRAL INCISION ALONG THE ROOT OF PENILE SHAFT FOR CONCEALED PENIS].

PubMed

Lin, Junshan; Li, Dumiao; Zhang, Jianxing; Wu, Qiang; Xu, Yali; Lin, Li

2015-09-01

To investigate effectiveness of advanced skin flap and V-shaped ventral incision along the root of penile shaft for concealed penis in children. Between July 2007 and January 2015, 121 boys with concealed penis were treated with advanced skin flap and V-shaped ventral incision along the root of penile shaft. The age varied from 18 months to 13 years (mean, 7.2 years). Repair was based on a vertical incision in median raphe, complete degloving of penis and tacking its base to the dermis of the skin. Advanced skin flap and a V-shaped ventral incision along the root of penile shaft were used to cover the penile shaft. The operation time ranged from 60 to 100 minutes (mean, 75 minutes). Disruption of wound occurred in 1 case, and was cured after dressing change; and primary healing of incision was obtained in the others. The follow-up period ranged from 3 months to 7 years (median, 24 months). All patients achieved good to excellent cosmetic results with a low incidence of complications. The results were satisfactory in exposure of penis and prepuce appearance. No obvious scar was observed. The penis had similar appearance to that after prepuce circumcision. A combination of advanced skin flap and V-shaped ventral incision along the root of penile shaft is a simple, safe, and effective procedure for concealed penis with a similar appearance result to the prepuce circumcision.

GIANT PEDUNCULATED SEBORRHEIC KERATOSIS OF PENIS

PubMed Central

Thakur, Jagdeep S; Thakur, Anamika; Chauhan, C G S; Diwana, Vijay K; Chauhan, D C

2008-01-01

Seborrheic keratosis of the penis is a rare entity. It has been mistaken as genital warts and differentiation is only made on histopathology. We are reporting a case presenting as multiple giant polypoidal lesions on the penile skin for the last 20 years. Seborrheic keratosis should be considered in the differential diagnosis of pedunculated lesions of the penis. The histopathology after shave excision will be diagnostic. PMID:19967020

Relative importance of prenatal and postnatal androgen action in determining growth of the penis and anogenital distance in the rat before, during and after puberty.

PubMed

van den Driesche, S; Scott, H M; MacLeod, D J; Fisken, M; Walker, M; Sharpe, R M

2011-12-01

Experimental animal studies show that measurement of anogenital distance (AGD) and/or penis length may provide lifelong 'read-outs' of foetal androgen exposure during the masculinization programming window (MPW). However, variation in postnatal androgen exposure may complicate interpretation of such measurements. This is important to clarify if such measurements are to be applied to humans. The present aim was to evaluate effects of prenatal and/or postnatal manipulation of androgen production/action on growth of AGD and the penis in rats. Pregnant rats were treated daily before (e13.5-e21.5) and after birth (postnatal days 1-15) with either vehicle, 500 mg/kg di(n-butyl) phthalate (DBP) or 100 mg/kg flutamide (postnatal only) in prenatal + postnatal treatment combinations (N = 6 treatment combinations); DBP impairs androgen production whereas flutamide impairs androgen action. Male offspring were killed on postnatal day 8 (prepuberty), 25 (early puberty) or 90 (adulthood) when AGD was measured, the penis dissected out and its weight and length measured; plasma testosterone and ventral prostate weight were measured at day 90 to assess endogenous androgen exposure. In controls, penis length, girth and AGD increased 2.2-, 5.3-and 5.9-fold respectively from day 8 to day 90. Significant inhibition of penis growth and final length and girth was induced by treatments that inhibited postnatal androgen action. Conversely, growth and ultimate (adult) AGD was inhibited by prenatal inhibition of androgen production whereas postnatal androgen inhibition had negligible effect. Nevertheless, AGD and penis length were highly correlated at every age (R(2) > 0.33; p < 0.0001). However, altered endogenous androgen exposure may confound interpretation of changes in adults exposed prenatally/postnatally to DBP/flutamide. We conclude that AGD provides a lifelong guide to prenatal androgen exposure (in the MPW) whereas penis size reflects both prenatal + postnatal androgen exposure. At the group treatment level, prepubertal measurement of either AGD or penis size accurately predicts their size in adulthood. © 2011 The Authors. International Journal of Andrology © 2011 European Academy of Andrology.

Targeting NADPH oxidase decreases oxidative stress in the transgenic sickle cell mouse penis.

PubMed

Musicki, Biljana; Liu, Tongyun; Sezen, Sena F; Burnett, Arthur L

2012-08-01

Sickle cell disease (SCD) is a state of chronic vasculopathy characterized by endothelial dysfunction and increased oxidative stress, but the sources and mechanisms responsible for reactive oxygen species (ROS) production in the penis are unknown. We evaluated whether SCD activates NADPH oxidase, induces endothelial nitric oxide synthase (eNOS) uncoupling, and decreases antioxidants in the SCD mouse penis. We further tested the hypothesis that targeting NADPH oxidase decreases oxidative stress in the SCD mouse penis. SCD transgenic (sickle) mice were used as an animal model of SCD. Hemizygous (hemi) mice served as controls. Mice received an NADPH oxidase inhibitor apocynin (10 mM in drinking water) or vehicle. Penes were excised at baseline for molecular studies. Markers of oxidative stress (4-hydroxy-2-nonenal [HNE]), sources of ROS (eNOS uncoupling and NADPH oxidase subunits p67(phox) , p47(phox) , and gp91(phox) ), and enzymatic antioxidants (superoxide dismutase [SOD]1, SOD2, catalase, and glutathione peroxidase-1 [GPx1]) were measured by Western blot in penes. Sources of ROS, oxidative stress, and enzymatic antioxidants in the SCD penis. Relative to hemi mice, SCD increased (P<0.05) protein expression of NADPH oxidase subunits p67(phox) , p47(phox) , and gp91(phox) , 4-HNE-modified proteins, induced eNOS uncoupling, and reduced Gpx1 expression in the penis. Apocynin treatment of sickle mice reversed (P<0.05) the abnormalities in protein expressions of p47(phox) , gp91(phox) (but not p67(phox) ) and 4-HNE, but only slightly (P>0.05) prevented eNOS uncoupling in the penis. Apocynin treatment of hemi mice did not affect any of these parameters. NADPH oxidase and eNOS uncoupling are sources of oxidative stress in the SCD penis; decreased GPx1 further contributes to oxidative stress. Inhibition of NADPH oxidase upregulation decreases oxidative stress, implying a major role for NADPH oxidase as a ROS source and a potential target for improving vascular function in the SCD mouse penis. © 2012 International Society for Sexual Medicine.

Functional anatomy and ultrasound examination of the canine penis.

PubMed

Goericke-Pesch, Sandra; Hölscher, Catharina; Failing, Klaus; Wehrend, Axel

2013-07-01

The aim of this study was to identify the functional-anatomical structures of the canine penis during and after erection to demonstrate the respective changes to provide a basis for further examinations of pathological conditions like priapism. Additionally, a gray-scale analysis was performed to quantify results from the ultrasound examination. In total, 80 dogs were examined. In group (Gr.) A, 44 intact or castrated dogs were examined, and in Gr. B, 36 dogs were examined during erection and after complete detumescence of the penis. The following parameters were assessed: (1) using physical measurements: length of the Pars longa glandis [Plg] and length of the Bulbus glandis [Bg]; and (2) using ultrasound: total penile diameter, width of the erectile tissue of the Plg, diameter of the Corpus spongiosum [Cs] including the penile bone and urethra, vertical diameter, circumference of the penis, cross-sectional area, and area of the Cs including the urethra. The mentioned parameters could be assessed in all dogs of Gr. A and Gr. B with the only exception being the urethra that could be visualized using ultrasound in some dogs only and predominantly in the erected penis (Gr. B). Concomitantly, the erectile tissue of the Plg and the Cs was more heterogenous and hypo- to anechoic during erection compared with dogs in Gr. A and Gr. B after detumescence. Comparing the results in Gr. B, the length of the Plg and the Bg were decreased approximately 40.6% and 38.0%, the total width of the penis 40.5%, the total width of the erectile tissue of the Plg 48.0%, and the width of the Cs 15.6% during detumescence compared with erection. Comparing the decrease in size at the different locations (apex penis, middle of Plg, middle of Bg) for vertical diameter, total circumference, and cross-section area, it was largest at the Bg. B-mode ultrasound is a suitable tool to investigate not only the morpho-functional structures of the resting canine penis, but also of the erected and detumescent penis, and to investigate the underlying changes during erection and detumenscence. Copyright © 2013 Elsevier Inc. All rights reserved.

Targeting NADPH Oxidase Decreases Oxidative Stress in the Transgenic Sickle Cell Mouse Penis

PubMed Central

Musicki, Biljana; Liu, Tongyun; Sezen, Sena F.; Burnett, Arthur L.

2012-01-01

Introduction Sickle cell disease (SCD) is a state of chronic vasculopathy characterized by endothelial dysfunction and increased oxidative stress, but the sources and mechanisms responsible for reactive oxygen species (ROS) production in the penis are unknown. Aims We evaluated whether SCD activates NADPH oxidase, induces endothelial nitric oxide synthase (eNOS) uncoupling, and decreases antioxidants in the SCD mouse penis. We further tested the hypothesis that targeting NADPH oxidase decreases oxidative stress in the SCD mouse penis. Methods SCD transgenic (sickle) mice were used as an animal model of SCD. Hemizygous (hemi) mice served as controls. Mice received an NADPH oxidase inhibitor apocynin (10 mM in drinking water) or vehicle. Penes were excised at baseline for molecular studies. Markers of oxidative stress (4-hydroxy-2-nonenal [HNE]), sources of ROS (eNOS uncoupling and NADPH oxidase subunits p67phox, p47phox, and gp91phox), and enzymatic antioxidants (superoxide dismutase [SOD]1, SOD2, catalase, and glutathione peroxidase-1 [GPx1]) were measured by Western blot in penes. Main Outcome Measures Sources of ROS, oxidative stress, and enzymatic antioxidants in the SCD penis. Results Relative to hemi mice, SCD increased (P < 0.05) protein expression of NADPH oxidase subunits p67phox, p47phox, and gp91phox, 4-HNE-modified proteins, induced eNOS uncoupling, and reduced Gpx1 expression in the penis. Apocynin treatment of sickle mice reversed (P < 0.05) the abnormalities in protein expressions of p47phox, gp91phox (but not p67phox) and 4-HNE, but only slightly (P > 0.05) prevented eNOS uncoupling in the penis. Apocynin treatment of hemi mice did not affect any of these parameters. Conclusion NADPH oxidase and eNOS uncoupling are sources of oxidative stress in the SCD penis; decreased GPx1 further contributes to oxidative stress. Inhibition of NADPH oxidase upregulation decreases oxidative stress, implying a major role for NADPH oxidase as a ROS source and a potential target for improving vascular function in the SCD mouse penis. PMID:22620981

Medicinal Leech Therapy for Glans Penis Congestion After Primary Bladder Exstrophy-Epispadias Repair in an Infant: A Case Report.

PubMed

Wagenheim, Gavin N; Au, Jason; Gargollo, Patricio C

2016-01-01

Many postoperative complications have been reported after repair of classic bladder exstrophy. We present a case of medicinal leech therapy for glans penis congestion following exstrophy repair in an infant. A 2-week-old male with classic bladder exstrophy underwent complete primary repair. On postoperative day 1, he developed rapidly worsening glans penis venous congestion. Medicinal leech therapy was instituted with antibiotics and blood transfusions to maintain a hematocrit >30%. After 24 hours, venous congestion improved and therapy was discontinued. The patient's remaining hospital course was uncomplicated. Medicinal leeches are an effective therapy to relieve glans penis venous congestion. Copyright © 2015 Elsevier Inc. All rights reserved.

Primary extramedullary plasmacytoma of the penis: a case report.

PubMed

Wang, Yao; Li, Hong-Yan; Liang, Ting-Ting; Han, Yu-Ping; Wang, Xue-Ju; Wei, Xin; Fan, Li; Wang, Wei-Hua

2013-10-01

Extramedullary plasmacytoma involving the penis is extremely rare. Here, we describe a case of primary extramedullary plasmacytoma of the penis in a 64-year-old man who presented with a palpable penile mass. Nuclear magnetic resonance imaging revealed the presence of a large, round non-encapsulated mass in the perineum. A contrast-enhanced computed tomography scan of the pelvis showed that the mass was located in the tunica albuginea and corpora cavernosa at the base of the penis. The mass encased the urethra and demonstrated no marked enhancement during the arterial phase. The patient underwent successful surgical resection of the tumor. Histologically, the tumor was composed primarily of neoplastic plasma cells that were positive for CD38, vimentin and Ki 67. Postoperatively, the patient recovered well and exhibited no evidence of development of multiple myeloma, local recurrence or distant metastasis at 2 months post-surgery. To the best of our knowledge, our case represents the first documented case of human primary extramedullary plasmacytoma of the penis.

The effect of hypoxia on neuroeffector transmission in the bovine retractor penis and rat anococcygeus muscles.

PubMed Central

Bowman, A.; McGrath, J. C.

1985-01-01

The effects of reducing the PO2 of the bathing fluid were studied on non-adrenergic non-cholinergic (NANC) transmission in isolated preparations of the bovine retractor penis muscle, the rat anococcygeus muscle, the guinea-pig taenia caeci and the guinea-pig urinary bladder. Hypoxia rapidly and reversibly impaired NANC transmission in the bovine retractor penis and rat anococcygeus muscles but did not affect transmission in the guinea-pig taenia caeci or bladder, suggesting that different NANC mechanisms are involved. Although neurally-evoked relaxation of the bovine retractor penis was impaired by hypoxia, relaxations produced by vasoactive intestinal peptide, prostaglandin E1, sodium nitroprusside or an inhibitory factor isolated from the bovine retractor penis were unaffected. Since the inhibitory factor is similar to, and may actually be the NANC transmitter, the results suggest that the site of action of hypoxia in impairing transmission is prejunctional at the inhibitory nerve endings. PMID:2994787

Penile cancer

MedlinePlus

Cancer - penis; Squamous cell cancer - penis; Glansectomy; Partial penectomy ... cancer may include: Chemotherapy -- uses medicines to kill cancer cells Radiation -- uses high-powered x-rays to kill ...

Surgical treatment of lymphedema of the penis and scrotum.

PubMed

Modolin, Miguel; Mitre, Anuar Ibrahim; da Silva, José Carlos Faes; Cintra, Wilson; Quagliano, Ana Paula; Arap, Sami; Ferreira, Marcus Castro

2006-08-01

Lymphedema of the penis and scrotum, regardless of its etiology, is determined by reduced lymphatic flow with subsequent enlargement of the penis and scrotum. The clinical course of this condition is characterized by extreme discomfort for patients, with limitation of local hygiene, ambulation, sexual intercourse, and voiding in the standing position. The purpose of the present study is to present the experience and results of the treatment of lymphedema of the penis and scrotum by removing affected tissues and correcting the penoscrotal region. Seventeen patients with lymphedema of the penis and scrotum were treated with a modified Charles procedure, which consists of the excision of the affected skin followed by scrotoplasty and midline suture simulating the scrotal raphe. The penis is covered with a split-thickness skin graft by means of a zigzag suture on its ventral surface. Regression of symptoms and improvement of previous clinical conditions were verified in the follow-up which ranged from 6 months to 6 years. One patient who had undergone lymphadenectomy with radiation therapy due to penile cancer had recurrent scrotum lymphedema. The modified Charles procedure for the treatment of penoscrotal lymphedema is easily reproducible and allows better local hygiene, easier ambulation, voiding in the standing position, resuming sexual intercourse, and finally, better cosmetic results in the affected area with remarkable improvement in quality of life.

Superficial Tunica Albuginea Rupture as Initial Starting Point of Peyronie's Disease: A Topic for Interdisciplinary Consideration

PubMed Central

Bayerl, Manfred

2015-01-01

Peyronie's disease is a connective tissue disorder in the soft tissue of the penis. The underlying cause of Peyronie's disease is not well understood but is thought to be caused by trauma or injury to the penis during sexual intercourse. The purpose of the interdisciplinary cooperation between urological surgery and physics is the development of a physical simulation tool in order to give prognosis of possible tunica albuginea fibre rupture at a certain degree of deviation of the penis. For our group the first challenge was to translate the human organ of the penis into a physical model. Starting and marginal parameters had to be defined, whereby some of them had to be based on assumption, as physical data of the human living tissue have rarely been measured up to now. The algorithm and its dependencies had to be developed. This paper is a first step of a three-dimensional mathematical-physical simulation with the assumption of a 100% filled rigid penis. The calculation gives proof of the hypothesis that the fibre-load-angle of the penis is less than 12 degrees. Thus physical simulation is able to provide the surgeon with a simple instrument to calculate and forecast the risk of the individual patient. PMID:25648614

The visceromotor and somatic afferent nerves of the penis.

PubMed

Diallo, Djibril; Zaitouna, Mazen; Alsaid, Bayan; Quillard, Jeanine; Ba, Nathalie; Allodji, Rodrigue Sètchéou; Benoit, Gérard; Bedretdinova, Dina; Bessede, Thomas

2015-05-01

Innervation of the penis supports erectile and sensory functions. This article aims to study the efferent autonomic (visceromotor) and afferent somatic (sensory) nervous systems of the penis and to investigate how these systems relate to vascular pathways. Penises obtained from five adult cadavers were studied via computer-assisted anatomic dissection (CAAD). The number of autonomic and somatic nerve fibers was compared using the Kruskal-Wallis test. Proximally, penile innervation was mainly somatic in the extra-albugineal sector and mainly autonomic in the intracavernosal sector. Distally, both sectors were almost exclusively supplied by somatic nerve fibers, except the intrapenile vascular anastomoses that accompanied both somatic and autonomic (nitrergic) fibers. From this point, the neural immunolabeling within perivascular nerve fibers was mixed (somatic labeling and autonomic labeling). Accessory afferent, extra-albugineal pathways supplied the outer layers of the penis. There is a major change in the functional type of innervation between the proximal and distal parts of the intracavernosal sector of the penis. In addition to the pelvis and the hilum of the penis, the intrapenile neurovascular routes are the third level where the efferent autonomic (visceromotor) and the afferent somatic (sensory) penile nerve fibers are close. Intrapenile neurovascular pathways define a proximal penile segment, which guarantees erectile rigidity, and a sensory distal segment. © 2015 International Society for Sexual Medicine.

The Evolutionary Implications of Hemipenial Morphology of Rattlesnake Crotalus durissus terrificus (Laurent, 1768) (Serpentes: Viperidae: Crotalinae)

PubMed Central

Porto, Marcovan; de Oliveira, Marco Antonio; Pissinatti, Lorenzo; Rodrigues, Renata Lopes; Rojas-Moscoso, Julio Alejandro; Cogo, José Carlos; Metze, Konradin; Antunes, Edson; Nahoum, César; Mónica, Fabíola Z.; De Nucci, Gilberto

2013-01-01

Most amniotes vertebrates have an intromittent organ to deliver semen. The reptile Sphenodon and most birds lost the ancestral penis and developed a cloaca-cloaca mating. Known as hemipenises, the copulatory organ of Squamata shows unique features between the amniotes intromittent organ. They are the only paired intromittent organs across amniotes and are fully inverted and encapsulated in the tail when not in use. The histology and ultrastructure of the hemipenes of Crotalus durissus rattlesnake is described as the evolutionary implications of the main features discussed. The organization of hemipenis of Crotalus durissus terrificus in two concentric corpora cavernosa is similar to other Squamata but differ markedly from the organization of the penis found in crocodilians, testudinata, birds and mammals. Based on the available data, the penis of the ancestral amniotes was made of connective tissue and the incorporation of smooth muscle in the framework of the sinusoids occurred independently in mammals and Crotalus durissus. The propulsor action of the muscle retractor penis basalis was confirmed and therefore the named should be changed to musculus hemipenis propulsor.The retractor penis magnus found in Squamata has no homology to the retractor penis of mammals, although both are responsible for the retraction of the copulatory organ. PMID:23840551

Reliability and determinants of anogenital distance and penis dimensions in male newborns from Chiapas, México

PubMed Central

Romano-Riquer, S. Patricia; Hernández-Ávila, Mauricio; Gladen, Beth C.; Cupul-Uicab, Lea A.; Longnecker, Matthew P.

2013-01-01

Summary Development of the perineum as well as the external genitalia is determined by dihydrotestosterone, resulting in a greater anogenital distance (AGD) in males than females. In animal experiments with hormonally active agents, anogenital distance is used as a bioassay of fetal androgen action. Use of anogenital distance in human studies has been rare. Because anogenital distance has been an easy-to-measure, sensitive outcome in animal studies, we developed an anthropometric protocol for measurement of anogenital distance in human males. In this paper we describe the method for measurement of three anogenital distances, their reliability, and an assessment of predictors for each in the context of an epidemiological study. We compare the reliabilities and predictors to those for stretched penis length and penis width. A cross-sectional study of 781 newly-delivered male infants was conducted in 2002–2003 in Chiapas, México. Replicate measures were obtained on nearly all subjects. The reliability of the measures of anogenital distance (0.82–0.91) were higher than for stretched penis length (0.78) and width (0.75). Birthweight and gestational length were more strongly related to anogenital distance than to penis length. Anogenital distance was not related to penis length (r = 0.03). Our large study clearly shows that AGD can be measured well in newborn males, and that the measurements were more reliable than those of penis length. Whether AGD measures in humans relate to clinically important outcomes, however, remains to be determined, as does its utility as a measure of androgen action in epidemiological studies. PMID:17439530

Buried penis after newborn circumcision.

PubMed

Eroğlu, Egemen; Bastian, Okan W; Ozkan, Hilda C; Yorukalp, Ozlem E; Goksel, Ayla K

2009-04-01

Buried penis may develop after circumcision, mostly during infancy, presumably due to peripubic fat. A surgical approach may be recommended for psychological benefits to patients and parents, and because it is believed that this condition will not improve on its own with time. The aim of this study was to assess the natural history of buried penis after newborn circumcision. During a routine visit to the pediatrician infants with buried penis were assessed by a single pediatric surgeon between January 2004 and June 2007. In December 2007 all of these children were reexamined by the same pediatric surgeon and the natural growth of the genitalia was analyzed. A total of 88 infants were enrolled in the study. When they were first examined they were 3 to 6 months old (mean 3.3). In December 2007, after reexamination, patients were divided into groups based on age, including those younger than 1 year (14 patients), 1 to 3 years (59) and older than 3 years (15). The aspect of the genitalia was evaluated by the same pediatric surgeon for each patient. Buried penis was noted in 14 of 14 patients younger than 1 year (100%), 19 of 59 patients 1 to 3 years old (32.2%) and 1 of 15 patients older than 3 years (6.7%). Buried penis after newborn circumcision is not permanent. As infants get older, and after beginning to walk, the appearance usually turns out to be normal. This resolution may be due to growth and/or maturation alone. Based on our results, we do not recommend surgery for buried penis in children younger than 3 years.

A new technique for augmentation phalloplasty: albugineal surgery with bilateral saphenous grafts--three years of experience.

PubMed

Austoni, E; Guarneri, A; Cazzaniga, A

2002-09-01

Penile augmentation surgery is a highly controversial issue due to the low level of standardisation of surgical techniques. The aim of the study is to illustrate a new technique to solve the problem of enlarging the penis by means of additive surgery on the albuginea of the corpora cavernosa, guaranteeing a real increase in size of the erect penis. Between 1995 and 1997, 39 patients who requested an increase in the diameter of their penises underwent augmentation phalloplasty with bilateral saphena grafts. The patients considered eligible for surgery were patients with either hypoplasia of the penis or functional penile dysmorphophobia. All the patients included in our study presented normal erection at screening. The average penis diameter in a flaccid state and during erection was found to be 2.1cm (1.6-2.7 cm) and 2.9 cm (2.2-3.7 cm), respectively. Before surgery the patients were informed of the experimental nature of the surgical procedure. The increase in volume of the corpora cavernosa was achieved by applying saphena grafts to longitudinal openings made bilaterally in the albuginea along the whole length of the penis. No major complications and specifically no losses of sensitivity of the penis or erection deficiencies occurred during the post-operative follow-up period. All the patients resumed their sexual activity in 4 months. A measurement of the penile dimensions was carried out 9 months after surgery. No clinical meaningful increases in the diameter of the flaccid penis were documented. The average penis diameter during erection was found to be 4.2 cm (3.4-4.9) with post-surgery increases in diameter varying from 1.1 to 2.1cm (p<0.01). The penile enlargement phalloplasty technique with albuginea surgery suggested by the authors definitely is indicated for increasing the volume of the corpora cavernosa during erection. Albuginea surgery with saphena grafts has been found to be free from aesthetic and functional complications with excellent patient satisfaction.

Sildenafil Promotes eNOS Activation and Inhibits NADPH Oxidase in the Transgenic Sickle Cell Mouse Penis

PubMed Central

Musicki, Biljana; Bivalacqua, Trinity J.; Champion, Hunter C.; Burnett, Arthur L.

2014-01-01

Introduction Sickle cell disease (SCD)-associated vasculopathy in the penis is characterized by aberrant nitric oxide and phosphodiesterase (PDE) 5 signaling, and by increased oxidative stress. Preliminary clinical trials show that continuous treatment with PDE5 inhibitor sildenafil unassociated with sexual activity decreases priapic activity in patients with SCD. However, the mechanism of its vasculoprotective effect in the penis remains unclear. Aims We evaluated whether continuous administration of PDE5 inhibitor sildenafil promotes eNOS function at posttranslational levels and decreases superoxide-producing enzyme NADPH oxidase activity in the sickle cell mouse penis. Methods SCD transgenic mice were used as an animal model of SCD. WT mice served as controls. Mice received treatment with the PDE5 inhibitor sildenafil (100 mg/kg/day) or vehicle for 3 weeks. eNOS phosphorylation on Ser-1177 (positive regulatory site), eNOS interactions with heat-shock protein 90 (HSP90) (positive regulator), phosphorylated AKT (upstream mediator of eNOS phosphorylation on Ser-1177), an NADPH oxidase catalytic subunit gp91(phox), and a marker of oxidative stress (4-hydroxy-2-nonenal [HNE]) were measured by Western blot. Main Outcome Measures Effect of continuous sildenafil treatment on eNOS posttranslational activation, NADPH oxidase catalytic subunit, and oxidative stress in the penis of the sickle cell mouse. Results Continuous treatment with sildenafil reversed (P < 0.05) the abnormalities in protein expressions of P-eNOS (Ser-1177), eNOS/HSP90 interaction, P-AKT, protein expression of gp91(phox), and 4-HNE, in the sickle cell mouse penis. Sildenafil treatment of WT mice did not affect any of these parameters. Conclusion Our findings that sildenafil enhances eNOS activation and inhibits NADPH oxidase function in the sickle cell mouse penis offers a vasculoprotective molecular basis for the therapeutic effect of sildenafil in the penis in association with SCD. PMID:24251665

Sildenafil promotes eNOS activation and inhibits NADPH oxidase in the transgenic sickle cell mouse penis.

PubMed

Musicki, Biljana; Bivalacqua, Trinity J; Champion, Hunter C; Burnett, Arthur L

2014-02-01

Sickle cell disease (SCD)-associated vasculopathy in the penis is characterized by aberrant nitric oxide and phosphodiesterase (PDE) 5 signaling, and by increased oxidative stress. Preliminary clinical trials show that continuous treatment with PDE5 inhibitor sildenafil unassociated with sexual activity decreases priapic activity in patients with SCD. However, the mechanism of its vasculoprotective effect in the penis remains unclear. We evaluated whether continuous administration of PDE5 inhibitor sildenafil promotes eNOS function at posttranslational levels and decreases superoxide-producing enzyme NADPH oxidase activity in the sickle cell mouse penis. SCD transgenic mice were used as an animal model of SCD. WT mice served as controls. Mice received treatment with the PDE5 inhibitor sildenafil (100 mg/kg/day) or vehicle for 3 weeks. eNOS phosphorylation on Ser-1177 (positive regulatory site), eNOS interactions with heat-shock protein 90 (HSP90) (positive regulator), phosphorylated AKT (upstream mediator of eNOS phosphorylation on Ser-1177), an NADPH oxidase catalytic subunit gp91(phox), and a marker of oxidative stress (4-hydroxy-2-nonenal [HNE]) were measured by Western blot. Effect of continuous sildenafil treatment on eNOS posttranslational activation, NADPH oxidase catalytic subunit, and oxidative stress in the penis of the sickle cell mouse. Continuous treatment with sildenafil reversed (P < 0.05) the abnormalities in protein expressions of P-eNOS (Ser-1177), eNOS/HSP90 interaction, P-AKT, protein expression of gp91(phox), and 4-HNE, in the sickle cell mouse penis. Sildenafil treatment of WT mice did not affect any of these parameters. Our findings that sildenafil enhances eNOS activation and inhibits NADPH oxidase function in the sickle cell mouse penis offers a vasculoprotective molecular basis for the therapeutic effect of sildenafil in the penis in association with SCD. © 2013 International Society for Sexual Medicine.

Diagnosis of penile fracture in primary care: a case report

PubMed Central

Akpinar, Ersin

2009-01-01

Introduction Penile fracture has been reported with sexual intercourse, masturbation, rolling over or falling on to the erect penis. Classically the history is with a sudden snap, pain, detumescence and a hematoma of the penis with deformity. Immediate surgical treatment is recommended. The patients may delay the admission due to fear and embarrassment or the condition may usually be underreported. Case presentation A 32-year-old man presented to primary care complaining of discoloration of penis without any significant history or symptom. Physical examination revealed swollen, ecchymotic, and deviated circumcised penis. Conclusion Although frequent and common diseases represent the majority of daily work, the primary care physician should be alert for possible unexpected history or symptom of a rare and often serious condition. PMID:19830047

Disposable penis and its replenishment in a simultaneous hermaphrodite

PubMed Central

Sekizawa, Ayami; Seki, Satoko; Tokuzato, Masakazu; Shiga, Sakiko; Nakashima, Yasuhiro

2013-01-01

Although it is often thought that sexual selection is weaker in simultaneous hermaphrodites than in gonochorists, some simultaneous hermaphrodites exhibit bizarre mating behaviour. In the simultaneously hermaphroditic nudibranch Chromodoris reticulata, we found a peculiar mating behaviour, wherein the nudibranch autotomized its penis after each copulation and was able to copulate again within 24 h. To have sufficient length to be replenished for three copulations, the penis is compressed and spiralled internally. No other animal is known to repeatedly copulate using such ‘disposable penes’. Entangled sperm masses were observed on the outer surface of the autotomized penis, which is equipped with many backward-pointed spines. There is a possibility that the nudibranch removes sperm already stored in a mating partner's sperm storage organ(s). PMID:23407499

Lesions and Neoplasms of the Penis: A Review.

PubMed

Heller, Debra S

2016-01-01

In addition to practitioners who care for male patients, with the increased use of high-resolution anoscopy, practitioners who care for women are seeing more men in their practices as well. Some diseases affecting the penis can impact on their sexual partners. Many of the lesions and neoplasms of the penis occur on the vulva as well. In addition, there are common and rare lesions unique to the penis. A review of the scope of penile lesions and neoplasms that may present in a primary care setting is presented to assist in developing a differential diagnosis if such a patient is encountered, as well as for practitioners who care for their sexual partners. A familiarity will assist with recognition, as well as when consultation is needed.

Thrombosis of the dorsal vein of the penis (Mondor's Disease): A case report and review of the literature.

PubMed

Nazir, Syed Sajjad; Khan, Muneer

2010-07-01

Superficial thrombophlebitis of the dorsal vein of the penis (penile Mondor's Disease) is an important clinical diagnosis that every family practitioner should be able to recognize. Dorsal vein thrombosis is a rare disease with pain and induration of the dorsal part of the penis. The possible causes comprise traumatism, neoplasms, excessive sexual activity, or abstinence. The differential diagnosis must be established with Sclerotizing lymphangitis and peyronies disease and doppler ultrasound is the imaging diagnostic technique of choice. Proper diagnosis and consequent reassurance can help to dissipate the anxiety typically experienced by the patients with this disease. We describe the symptoms, diagnosis, and treatment of the superficial thrombophlebitis of the dorsal vein of the penis.

Cheng's method for reconstruction of a functionally sensitive penis.

PubMed

Cheng, K X; Zhang, R H; Zhou, S; Jiang, K C; Eid, A E; Huang, W Y

1997-01-01

This article introduces a new surgical method for one-stage reconstruction of the penis. It is applied to the reconstruction of the microphallus as well as to traumatic cases with the residual stump of the amputated penis not less than 3 cm long. By transferring the original glans or the residual penile stump to the anterior portion of the newly reconstructed penile body with microsurgical techniques, we have thus rebuilt a penis with more satisfactory results in both appearance and erotic sensation. Seven patients are reported here who were operated on by this method and who have been followed up for 18 months to 10 years. The good results achieved and the method's advantages over other methods are demonstrated and discussed.

A new surgical procedure for phallic reconstruction in partial penis necrosis: penile elongation in combination with glanuloplasty.

PubMed

Xiao, Kaiyan; Cheng, Kaixiang; Song, Nan

2014-01-01

The radial forearm flap transfer has proved to be the standard technique in penile reconstruction. However, this operation still leads to a residual scar on the forearm. In the reconstruction of partial penis necrosis, achieving a desirable appearance and functional recovery while minimizing donor-site damage remains an unsolved problem. In this study, we report our experience using penile elongation combined with glanuloplasty to rebuild the partially necrotic penis.A retrospective review of a consecutive series of 33 patients with partial penis necrosis after microwave thermotherapy (not from our hospital) from December 2008 to May 2012 was conducted at the Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital. These patients, with an age range from 20 to 36 years, first underwent a scrotal skin flap transfer to cover residual cavernosum. The penis was simultaneously elongated at the proximal end. Six months later, all patients received glanuloplasty using expanded polytetrafluoroethylene that was implanted at the distal end of transferred scrotal skin flap to create the neoglans.Anthropometric measurements of preoperative and postoperative penile length were performed with an average follow-up period of 28 months. The mean extended penile length average was 2.57 cm, ranging from 3.16 to 5.73 cm. Patients' satisfaction rate was 88%. In addition, preoperative and postoperative photographs were reviewed for objective and subjective assessment of outcome parameters such as appearance of neophallus, urination, and erogenous sensation. Most importantly, the rebuilt penis postoperatively showed almost normal shape and restoration of basic physiologic function in most of the patients, with an acceptable complication rate. These preliminary results may provide a useful strategy for the reconstruction of a partially necrotic penis using a novel, simple, and effective approach.

Metastasis to the penis in a patient with adenocarcinoma of lung, case report and literature review.

PubMed

Zheng, Fu-Fu; Zhang, Zhong-Yun; Dai, Yu-Ping; Liang, Yue-You; Deng, Chun-Hua; Tao, Yu

2009-01-01

Metastasis of lung cancer to the penis is very rare; it causes various clinical symptoms seriously affecting the quality of life. Early recognition and appropriate management will likely enhance survival in these patients. Here, we report a case of penile metastasis secondary to pulmonary carcinoma along with a review of the literature. One case of penile metastasis secondary to pulmonary carcinoma was detected in a 51-year-old patient who was admitted to the First Affiliated Hospital of Sun Yat-Sen University with persistent cough along with swelling of the perineum and penis. The clinical features, diagnosis, and treatment of this disease along with a relevant literature are reviewed and discussed. A MEDLINE search was performed to identify similar reports in the literature. CT scan revealed lung mass, and a glans penis ulcer and enlargement of inguinal lymph nodes was discovered upon physical examination. CT-guided percutaneous puncture of the lung mass revealed adenocarcinoma of lung, and biopsies of the glans penis ulcer and inguinal lymph nodes confirmed metastatic adenocarcinoma. The patients received chemotherapy and died of acute pulmonary embolism in less than 2 months. Metastasis of lung cancer to the penis is extremely rare. It presents an advanced form of lung cancer, and thus survival is extremely short. Although treatment of penile metastasis is almost always palliative, early recognition may enhance survival for these patients.

Position paper: Management of men complaining of a small penis despite an actually normal size.

PubMed

Ghanem, Hussein; Glina, Sidney; Assalian, Pierre; Buvat, Jacques

2013-01-01

With the worldwide increase in penile augmentation procedures and claims of devices designed to elongate the penis, it becomes crucial to study the scientific basis of such procedures or devices, as well as the management of a complaint of a small penis in men with a normal penile size. The aim of this work is to study the scientific basis of opting to penile augmentation procedures and to develop guidelines based on the best available evidence for the management of men complaining of a small penis despite an actually normal size. We reviewed the literature and evaluated the evidence about what the normal penile size is, what patients complaining of a small penis usually suffer from, benefits vs. complications of surgery, penile stretching or traction devices, and outcome with patient education and counseling. Repeated presentation and detailed discussions within the Standard Committee of the International Society for Sexual Medicine were performed. Recommendations are based on the evaluation of evidence-based medical literature, widespread standards committee discussion, public presentation, and debate. We propose a practical approach for evaluating and counseling patients complaining of a small-sized penis. Based on the current status of science, penile lengthening procedure surgery is still considered experimental and should only be limited to special circumstances within research or university institutions with supervising ethics committees. © 2012 International Society for Sexual Medicine.

Successful Second Microsurgical Replantation for Amputated Penis.

PubMed

Fujiki, Masahide; Ozaki, Mine; Kai, Akiko; Takushima, Akihiko; Harii, Kiyonori

2017-09-01

Penile amputation is a rare emergency, but the best method for its repair is required due to the organ's functional and societal role. Since the first successful microsurgical replantation of the amputated penis, microsurgical techniques have matured and become the standard treatment for the penile replantation. However, the successful second microsurgical replantation for amputated penis has been rarely reported. We present the case of a 40-year-old man with schizophrenia who had a past history of penile self-mutilation and successful replantation at another hospital 2 years ago. After stopping oral medication for schizophrenia, he again cut his penis with a kitchen knife. We successfully replanted the amputated penis by anastomosing both circumflex arteries, the superficial dorsal vein, and the deep dorsal vein using microsurgical techniques. Postoperatively, the foreskin of the replanted penis gradually developed partial necrosis, requiring surgical debridement. The aesthetic and functional results were satisfactory and retrograde urethrography showed no evidence of leakage and stricture of the urethra. Although skin necrosis after penile replantation has been reported as an unavoidable process owing to the nature of injury, the rate would be higher after secondary replantation because of scar formation due to the previous operation. Therefore, our case of successful secondary replantation suggests that skin necrosis would be a predictable postoperative complication and the debridement timing of the devitalized foreskin should be closely monitored, and also secondary amputation is not a contraindication of replantation.

[Primary peripheral T-cell lymphoma of the penis: a case report and review of the literature].

PubMed

Shi, Yan-Lin; Yin, Hong-Lin; Zhou, Xiao-Jun; Zhou, Hang-Bo; Lu, Zhen-Feng

2008-11-01

To report a case of primary peripheral T-cell lymphoma of the penis. We analyzed the clinicopathological characteristics of the case of primary peripheral T-cell lymphoma using histological, cytochemical and immunohistochemical methods and by review of the literature. The patient was a 65 years old man and presented with a diffuse enlargement of the penis as the initial sign, followed by erosive ulcer in the caput penis and inguinal lymphadenectasis. The tumor was pathohistologically manifested as an epidermal ulcer, with tumorous necrosis around the capillary, infiltrative growth and atypical changes of the neoplastic cells and proliferation of capillaries. Immunohistochemically, the tumor cells were positive for CD43 and CD3, but negative for CD20, CD79a, CD34, CD30, CD56 and CD34. Clinically it responded to the chemotherapy designed for peripheral T-cell lymphoma. Primary peripheral T-cell lymphoma of the penis is an extremely rare malignant tumor, the diagnosis of which relies on histopathological examination, immunohistochemical staining and differentiation between squamous cell carcinoma and other types of lymphoma.

Penicillin resistance compromises Nod1-dependent proinflammatory activity and virulence fitness of neisseria meningitidis.

PubMed

Zarantonelli, Maria Leticia; Skoczynska, Anna; Antignac, Aude; El Ghachi, Meriem; Deghmane, Ala-Eddine; Szatanik, Marek; Mulet, Céline; Werts, Catherine; Peduto, Lucie; d'Andon, Martine Fanton; Thouron, Françoise; Nato, Faridabano; Lebourhis, Lionel; Philpott, Dana J; Girardin, Stephen E; Vives, Francina Langa; Sansonetti, Philippe; Eberl, Gérard; Pedron, Thierry; Taha, Muhamed-Kheir; Boneca, Ivo G

2013-06-12

Neisseria meningitidis is a life-threatening human bacterial pathogen responsible for pneumonia, sepsis, and meningitis. Meningococcal strains with reduced susceptibility to penicillin G (Pen(I)) carry a mutated penicillin-binding protein (PBP2) resulting in a modified peptidoglycan structure. Despite their antibiotic resistance, Pen(I) strains have failed to expand clonally. We analyzed the biological consequences of PBP2 alteration among clinical meningococcal strains and found that peptidoglycan modifications of the Pen(I) strain resulted in diminished in vitro Nod1-dependent proinflammatory activity. In an influenza virus-meningococcal sequential mouse model mimicking human disease, wild-type meningococci induced a Nod1-dependent inflammatory response, colonizing the lungs and surviving in the blood. In contrast, isogenic Pen(I) strains were attenuated for such response and were out-competed by meningococci sensitive to penicillin G. Our results suggest that antibiotic resistance imposes a cost to the success of the pathogen and may potentially explain the lack of clonal expansion of Pen(I) strains. Copyright © 2013 Elsevier Inc. All rights reserved.

A new plastic surgical technique for adult congenital webbed penis

PubMed Central

Chen, Yue-bing; Ding, Xian-fan; Luo, Chong; Yu, Shi-cheng; Yu, Yan-lan; Chen, Bi-de; Zhang, Zhi-gen; Li, Gong-hui

2012-01-01

Objective: To introduce a novel surgical technique for correction of adult congenital webbed penis. Methods: From March 2010 to December 2011, 12 patients (age range: 14–23 years old) were diagnosed as having a webbed penis and underwent a new surgical procedure designed by us. Results: All cases were treated successfully without severe complication. The operation time ranged from 20 min to 1 h. The average bleeding volume was less than 50 ml. All patients achieved satisfactory cosmetic results after surgery. The penile curvature disappeared in all cases and all patients remained well after 1 to 3 months of follow-up. Conclusions: Adult webbed penis with complaints of discomfort or psychological pressure due to a poor profile should be indicators for surgery. Good corrective surgery should expose the glans and coronal sulcus, match the penile skin length to the penile shaft length dorsally and ventrally, and provide a normal penoscrotal junction. Our new technique is a safe and effective method for the correction of adult webbed penis, which produces satisfactory results. PMID:22949367

Meatal stenosis

MedlinePlus

... clean and dry. Avoid exposing the newly circumcised penis to any irritants. They may cause inflammation and ... Meatal stenosis References Elder JS. Anomalies of the penis and urethra. In: Kliegman RM, Stanton BF, St. ...

Sclerosing lymphangitis of the penis associated with marked penile oedema and skin erosions.

PubMed

Karray, Mehdi; Litaiem, Noureddine; Jones, Mariem; Zeglaoui, Faten

2017-07-27

Sclerosing lymphangitis of the penis is a benign, under-reported condition consisting of a asymptomatic firm cord-like swelling around the coronal sulcus of the penis usually affecting men in the second or third decade of life. Penile oedema and erosions are rarely reported. Clinical signs may be remarkable contrasting with the self-limited character of the disease. We report a new case of sclerosing lymphangitis of the penis occurring in a 59-year-old patient marked by penile swelling and several overlying skin erosions, and discuss the clinical features and the pathogenesis aspects of the disease. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Presence of accessory penis, colonic duplication and several other congenital anomalies in a child: a very rare association.

PubMed

Chatterjee, Sayan; Mondal, Prabodh Chandra; Pandey, Shashi Bhushan; Achar, Arun

2014-10-01

An accessory penis is a very rare anomaly. Only five cases have been reported thus far to our knowledge. We present the case of a child aged 2 years and 10 months who had a penis-like structure (containing phallus and glans) attached to the right buttock. Associated anomalies were a non-communicating type of colonic duplication, a paramedian stenosed anal opening, a horse-shoe kidney, posterior urethral valves, scoliosis of the lumbo-sacral spine, polydactyly and equino-varus deformity of the right foot. As far as we can tell, this is the first report of an accessory penis associated with colonic duplication and other congenital anomalies. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Thrombosis of the dorsal vein of the penis (Mondor’s Disease): A case report and review of the literature

PubMed Central

Nazir, Syed Sajjad; Khan, Muneer

2010-01-01

Superficial thrombophlebitis of the dorsal vein of the penis (penile Mondor’s Disease) is an important clinical diagnosis that every family practitioner should be able to recognize. Dorsal vein thrombosis is a rare disease with pain and induration of the dorsal part of the penis. The possible causes comprise traumatism, neoplasms, excessive sexual activity, or abstinence. The differential diagnosis must be established with Sclerotizing lymphangitis and peyronies disease and doppler ultrasound is the imaging diagnostic technique of choice. Proper diagnosis and consequent reassurance can help to dissipate the anxiety typically experienced by the patients with this disease. We describe the symptoms, diagnosis, and treatment of the superficial thrombophlebitis of the dorsal vein of the penis. PMID:21116369

[Kaposi's sarcoma of the penis in a HIV-seronegative patient].

PubMed

Touzani, Mohammed Alae; Yddoussalah, Othmane

2017-01-01

Sarcomas of the penis account for less than 5% of all tumors of the penis. They are dominated by Kaposi's sarcoma that mainly affects HIV-positive patients. However, recent studies have shown a relationship between Kaposi's sarcoma and HHV-8 infection (Human herpes virus-8), which explains why this sarcoma occurs in non-immunocompromised and HIV-seronegative patients. We here report the case of a 72-year old patient, with no previous medical history, reporting of gradual onset of tumor-like granulation tissue of 3 years duration at the level of the gland, without secondary location. Given the patient's clinical condition, epidermoid carcinoma or sarcomatoid carcinoma of the penis were suspected. Initial biopsy was negative, the second was in favor of Kaposi's sarcoma, confirmed by immunohistochemistry. The patient underwent chemotherapy.

Scabies: Disease Symptoms

MedlinePlus

... Wrist Elbow Armpit Penis Nipple Waist Buttocks Shoulder blades The head, face, neck, palms, and soles often ... knee, and on the penis, breast, or shoulder blades. Possible Complications The intense itching of scabies leads ...

Sequential contrast-enhanced MR imaging of the penis.

PubMed

Kaneko, K; De Mouy, E H; Lee, B E

1994-04-01

To determine the enhancement patterns of the penis at magnetic resonance (MR) imaging. Sequential contrast material-enhanced MR images of the penis in a flaccid state were obtained in 16 volunteers (12 with normal penile function and four with erectile dysfunction). Subjects with normal erectile function showed gradual and centrifugal enhancement of the corpora cavernosa, while those with erectile dysfunction showed poor enhancement with abnormal progression. Sequential contrast-enhanced MR imaging provides additional morphologic information for the evaluation of erectile dysfunction.

[Fracture of the penis].

PubMed

Kogan, M I; Obeĭd, M T; Siziakin, D V

2007-01-01

Rupture of the cavernous bodies is a serious penile trauma which may result in severe long-term consequences. Standard suturing of the cavernous body is accompanied with posttraumatic complications: erectile dysfunction and distortion of the penis. The results of examination and treatment of 38 patients with rupture of the tunica albuginea of the penile cavernous bodies are presented. The technique of the cavernous body wound suturing was perfected. Long-term sequences of fracture of the penis in conservative policy and different methods of cavernous body wound suturing are compared.

A case of transient lymphangiectasis of the penis.

PubMed

Misson, A; Deswysen, A C; Tennstedt, D; Muschart, X

2014-08-01

Physicians are likely to encounter patients with penis disorders and can be caught off guard by these uncommon pathologies, especially because they occur in a sensitive anatomical location. Here, we report the case of a patient presenting with benign transient lymphangiectasis of the penis (BTLP), including its differential diagnosis and treatment. Conclusion headings: BTLP is not an uncommon pathology and diagnosis is based only on medical history and clinical examination. The differentiation between Mondor's disease and BTLP is not necessary for treatment.

Ultrasound Diagnosis of Penile Fracture.

PubMed

Nizamani, Waseem Mehmood; Ali, Syed Imtiaz; Vaswani, Aneel Kumar; Shahani, Bhesham Kumar

2015-10-01

A rare but possibly underreported urological emergency is penile fracture which results from tear in the tunica albuginea of the penis. The proposed etiology is forceful manipulation of an erect penis or secondary to blunt trauma. We would like to report a case of young patient presenting with large penile shaft hematoma and deformity. The patient did not provide obvious history of trauma or sexual intercourse. The ultrasound of penis was performed which suggested the diagnosis of penile fracture and ultrasound findings were correlated with peroperative findings.

Care for an Uncircumcised Penis

MedlinePlus

... tip of the penis. This is called foreskin retraction. Most boys will be able to retract their ... how to retract his own foreskin. But foreskin retraction should never be forced. Until the foreskin fully ...

Penis

MedlinePlus

... Ambiguous genitalia Penile prosthesis Priapism Images Male reproductive anatomy References Elder JS. Anomalies of the penis and urethra. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016: ...

All about Puberty (For Kids)

MedlinePlus

... may experience something called nocturnal emissions (or wet dreams). This is when the penis becomes erect when ... the penis. That's why they're called wet dreams — they happen when you're sleeping and your ...

21 CFR 876.3350 - Penile inflatable implant.

Code of Federal Regulations, 2010 CFR

2010-04-01

... implanted in the penis, connected to a reservoir filled with radiopaque fluid implanted in the abdomen, and... rigidity to the penis. This device is used in the treatment of erectile impotence. (b) Classification...

21 CFR 876.3350 - Penile inflatable implant.

Code of Federal Regulations, 2014 CFR

2014-04-01

... implanted in the penis, connected to a reservoir filled with radiopaque fluid implanted in the abdomen, and... rigidity to the penis. This device is used in the treatment of erectile impotence. (b) Classification...

21 CFR 876.3350 - Penile inflatable implant.

Code of Federal Regulations, 2011 CFR

2011-04-01

... implanted in the penis, connected to a reservoir filled with radiopaque fluid implanted in the abdomen, and... rigidity to the penis. This device is used in the treatment of erectile impotence. (b) Classification...

21 CFR 876.3350 - Penile inflatable implant.

Code of Federal Regulations, 2013 CFR

2013-04-01

... implanted in the penis, connected to a reservoir filled with radiopaque fluid implanted in the abdomen, and... rigidity to the penis. This device is used in the treatment of erectile impotence. (b) Classification...

21 CFR 876.3350 - Penile inflatable implant.

Code of Federal Regulations, 2012 CFR

2012-04-01

... implanted in the penis, connected to a reservoir filled with radiopaque fluid implanted in the abdomen, and... rigidity to the penis. This device is used in the treatment of erectile impotence. (b) Classification...

Painful sexual intercourse caused by a disproportionately long penis: an historical note on a remarkable treatment devised by Guilhelmius Fabricius Hildanus (1560-1634).

PubMed

Kompanje, Erwin J O

2006-10-01

Between 1598 and 1641, the famous surgeon Guilhelmius Fabricius Hildanus (1560-1634) published 600 medical and surgical observations in his Observationum et curationum chirurgicarum centuriae I-VI. One of the case reports bears the title 'Pain and infertility caused by a too large penis.' The woman described in this case report most likely suffered from positional deep dyspareunia. Hildanus invented in 1593 a remarkable made-to-measure device. This device was a very well-considered and faultless curative for the woman's dyspareunia. It seemed that the dyspareunia had a simple cause: the disproportional large penis of the woman's husband. Four hundred years later, Hildanus' forgotten penis shortening device deserves a resurrection in today's medical practice. This remarkable and almost forgotten case report is described and discussed.

Fracture penis: a case more heard about than seen in general surgical practice.

PubMed

Sahoo, Manash Ranjan; Nayak, Anil Kumar; Nayak, Tapan Kumar; Anand, S

2013-06-12

A 36-year-old man presented to the emergency department with a history of trauma to genitalia during intercourse. The patient reported the forceful collision between his penis and the bed and audible clicking sound with swollen penis thereafter. On examination, the genitalia was swollen with an 'S' shaped deformity. The skin over the swelling was apparently normal, with no local rise of temperature. A provisional diagnosis was made after clinical evaluation. Scrotum and testes examination revealed no abnormality. A subcoronal circumferential incision with de-gloving of penile skin was used to access the tunica. A rent in tunica albuginea and corpora cavernosa identified and the defect repaired with absorbable suture material after removal of clot and properly maintaining haemostasis. The patient's postoperative recovery was uneventful. The following case report demonstrates a typical case of fracture penis.

Cutaneous corpuscular receptors of the human glans clitoris: descriptive characteristics and comparison with the glans penis.

PubMed

Shih, Cheryl; Cold, Christopher J; Yang, Claire C

2013-07-01

The female genital sensory pathways that initiate sexual arousal reflexes begin with cutaneous corpuscular receptors in the glabrous genital skin, including those of the glans clitoris. The aim of this study is to characterize the corpuscular receptors of the glans clitoris. In addition, we compared basic features with the receptors of the glans penis. Number of stained receptors. Five cadaveric vulvectomy specimens and four cadaveric penile specimens were used. They were serially sectioned and stained with hematoxylin and eosin. Selected blocks were stained with Masson's trichrome, and immunohistochemical staining was done with neuronal markers S-100 and neurofilament. Using the three stains, we identified an abundance of corpuscular receptors within the glans clitoris, as compared with the surrounding prepuce. These receptors were of varied arrangements, situated in the subepithelial tissues of the glans clitoris. They were indistinguishable from the receptors of the glans penis. The number of receptors per 100× high-powered field ranged from 1 to 14, whereas the receptor density in the glans penis ranged from 1 to 3. A second type of receptor, the Pacinian corpuscle, was identified within the suspensory ligament along the trunks of the dorsal nerve but not within the glans itself. The glans clitoris is densely innervated with cutaneous corpuscular receptors, and these receptors are morphologically similar to the corpuscular receptors of the glans penis. The glans clitoris has greater variability in receptor density compared with the glans penis. © 2013 International Society for Sexual Medicine.

Aesthetic neo-glans reconstruction after penis-sparing surgery for benign, premalignant or malignant penile lesions

PubMed Central

Palminteri, Enzo; Fusco, Fernando; Berdondini, Elisa; Salonia, Andrea

2011-01-01

Purpose To describe the technique and results of penis-sparing surgery combined with a cosmetic neo-glans reconstruction for benign, pre-malignant or malignant penile lesions. Patients and methods Twenty-one patients (mean age 61 years) with penile lesions with a broad spectrum of histopathology underwent organ-sparing surgery with neo-glans reconstruction, using a free split-thickness skin graft harvested from the thigh. Three patients were treated by glans-skinning and glans-resurfacing, 10 by glansectomy and neo-glans reconstruction, four by partial penectomy and a neo-glans reconstruction, and four by neo-glans reconstruction after a traditional partial penectomy. Results The mean follow-up was 45 months; all patients were free of primary local disease. All patients were satisfied with the appearance of the penis after surgery, and recovered their sexual ability, although sensitivity was reduced as a consequence of glans/penile amputation. Conclusion In benign, premalignant or malignant penile lesions, penis-sparing surgery combined with a cosmetic neo-glans reconstruction can be used to assure a normally appearing and functional penis, while fully eradicating the primary local disease. PMID:26579279

Direct mass spectrometric peptide profiling and sequencing of nervous tissues to identify peptides involved in male copulatory behavior in Lymnaea stagnalis

NASA Astrophysics Data System (ADS)

Dreisewerd, Klaus; Kingston, Robert; Geraerts, Wijnand P. M.; Li, Ka Wan

1997-12-01

Matrix-assisted laser desorption mass spectrometry (MALDI-MS) was performed directly on a small piece of single penis nerve of the pond snail, Lymnaea stagnalis, and reveals the presence of complex peptide profiles, including many hitherto undescribed peptides. Two of the peptides have molecular weights corresponding exactly to the previously described Lymnaea small cardioactive peptides (SCP) A and B. We confirmed their identities by structural characterization of the two peptides directly from a single penis nerve by matrix-assisted laser desorption ionization high-energy collision tandem MS analysis. MALDI-MS of nervous tissues also demonstrates that a cluster of central neurons, which send their axons to the penis nerve, contain the two peptides. As the penis nerve is the nerve that innervates the penis complex, we propose that the peptides are involved in the modulation of male copulatory processes. A bioassay indeed showed that the peptides increase the contraction frequency of the vas deference in a dose-dependent manner. The results demonstrate the potential of direct MALDI-MS analysis of nervous tissue to complement or substitute conventional biochemical techniques for the identification and localization of neuropeptides.

Mondor's disease of penis: a forgotten disease.

PubMed

Kumar, B; Narang, T; Radotra, B D; Gupta, S

2005-12-01

Mondor's disease of penis is an uncommon genital condition involving the penile sulcus in a circumferential manner. Although this disorder is almost always self limited, it is associated with considerable psychological stress and sexual disharmony. All patients attending the sexually transmitted disease clinic during 1991-2003 were examined for evidence of Mondor's disease of penis. Detailed history and clinical findings were recorded in a specially designed proforma. Histopathological examination and staining with CD31 and CD34 monoclonal antibodies was also done in 11 patients. 18 out of 1296 patients attending the sexually transmitted diseases (STD) clinic during the study period were found to have penile Mondor's disease, giving an incidence of 1.39%. 17 patients had history of one or more episodes of STDs. Histopathological specimens showed prominent vessels with plump endothelial cells and thickened blood vessel walls. The occasional vessel showed complete occlusion of its lumen. In our study we did not find any evidence of lymphatic involvement. Non-lymphatic vessels, mainly veins, were predominantly involved. In our opinion Mondor's phlebitis of penis or Mondor's disease of penis are better terms to describe the condition rather than non-venereal sclerosing lymphangitis.

Mondor's disease of penis: a forgotten disease

PubMed Central

Kumar, B; Narang, T; Radotra, B; Gupta, S

2005-01-01

Background: Mondor's disease of penis is an uncommon genital condition involving the penile sulcus in a circumferential manner. Although this disorder is almost always self limited, it is associated with considerable psychological stress and sexual disharmony. Methods: All patients attending the sexually transmitted disease clinic during 1991–2003 were examined for evidence of Mondor's disease of penis. Detailed history and clinical findings were recorded in a specially designed proforma. Histopathological examination and staining with CD31 and CD34 monoclonal antibodies was also done in 11 patients. Results: 18 out of 1296 patients attending the sexually transmitted diseases (STD) clinic during the study period were found to have penile Mondor's disease, giving an incidence of 1.39%. 17 patients had history of one or more episodes of STDs. Histopathological specimens showed prominent vessels with plump endothelial cells and thickened blood vessel walls. The occasional vessel showed complete occlusion of its lumen. Conclusions: In our study we did not find any evidence of lymphatic involvement. Non-lymphatic vessels, mainly veins, were predominantly involved. In our opinion Mondor's phlebitis of penis or Mondor's disease of penis are better terms to describe the condition rather than non-venereal sclerosing lymphangitis. PMID:16326851

Penis invalidating cicatricial outcomes in an enlargement phalloplasty case with polyacrylamide gel (Formacryl).

PubMed

Parodi, P C; Dominici, M; Moro, U

2006-01-01

The present article reports the case of a patient subjected to polyacrylamide polymers-composed gel cutaneous infiltration in the penis for cosmetic purposes, resulting in severe invalidating outcomes. A significant tissue reaction to the subcutaneous injection of polyacrylamide gel for the penis enlargement purpose resulted in permanent and invalidating scars both on the esthetic and functional levels. Such a result must be simply taken into account both singly and in the light of the international literature to exclude this method as standard uro-andrologic activity.

Kissing nevus of the penis: a case report and dermatoscopic findings*

PubMed Central

Godinho, Nivea; Nai, Gisele Alborghetti; Schaefer, Arnaldo Luiz Flávio; Schaefer, Luiza Vasconcelos

2017-01-01

Divided nevus, also known as kissing nevus, is a rare variant of congenital melanocytic nevi in which there are two adjacent nevi in areas of the body that undergo embryonic cleavage. The original description of this type of lesion was on the eyelid. The location on the penis is even rarer, with only 17 case reports in the literature so far, and only one of them described the dermoscopic findings. We report the case of a patient with divided nevus of the penis and its clinical, dermoscopic and histopathological features. PMID:29267459

Severe gangrene at the glans penis requiring penectomy as the first major complication of Buerger's disease.

PubMed

Pham, Khanh N; Sokoloff, Mitchell H; Steiger, Charles A

2016-01-01

We report an interesting case of Buerger's disease that manifested at the glans penis in a 56 year-old former smoker. Penile involvement in Buerger's disease is rare. Our patient had no prior extremity or digit amputations in his 4-year history of Buerger's disease. However, our patient did suffer from recurrent penile ulcers over an 8-week timeframe that ultimately progressed to a gangrenous, unsalvageable glans penis. He underwent a partial penectomy and urethral reconstruction with excellent post-operative results.

Controversy erupts in Brazil over penis nicknames.

PubMed

1995-10-09

Commissioned by the Brazilian health ministry to conduct a publicity campaign designed to encourage the use of condoms, the Master Communication and Marketing company conducted a survey in which it collected dozens of nicknames for the penis. The television component of the campaign involves an actor who holds a heart-to-heart conversation with his penis, recommending that it use condoms and showing it, with a candle, how to do so. "Braulio" was chosen as the name for the penis. Braulio, however, is a common men's name in Brazil. Shortly after the launch of the campaign, men named Braulio staged numerous protests against the use of their name. The Health Minister subsequently suspended the campaign on September 23, 1995, to allow selection of an alternate name for the penis. The campaign has resumed, this time using eight impersonal expressions such as "partner" and "him" to identify the penis, and is planned to run for three months despite the controversy. A journalist formerly named Braulio has officially changed his name to avoid being mocked, a lawyer in Sao Paulo named Braulio will continue to head a suit against the government filed by a group of Braulios alleging moral damage, and the Catholic Church criticizes the bluntness of the campaign, which mentions oral and anal sex on the radio. Nonetheless, a health ministry poll of almost 1000 people found that 80% supported the campaign. The coordinator of the Program of Sexually Transmitted Diseases insists that the blunt language is necessary to reach the lower-income, less-educated masculine population. Official figures indicate that 80% of the slightly more than 71,000 registered AIDS cases in Brazil are among men aged 19-35 years, and it is among men aged 20-40 years that HIV is spreading most rapidly. The health ministry has been bombarded with alternate nicknames for the penis since the initial uproar, enough to fill a book. The article points out that the nicknames vary according to region.

Adult-acquired hidden penis in obese patients: a critical survey of the literature.

PubMed

Cavayero, Chase T; Cooper, Meghan A; Harlin, Stephen L

2015-03-01

Hidden penis is anatomically defined by a lack of firm attachments of the skin and dartos fascia to the underlying Buck fascia. To critically appraise the research evidence that could support the most effective surgical techniques for adult-acquired hidden penis in obese patients. Studies investigating patients with a diagnosis of hidden penis were identified. Of these studies, only those with adult patients classified as overweight or obese (body mass index >25) were included in the review. Three reviewers examined the abstracts of the studies identified in the initial Medline search, and abstracts considered potentially relevant underwent full-text review. Studies that included patients with congenital, iatrogenic (eg, circumcision issues or aesthetic genital surgery), or traumatic causes of hidden penis were excluded. Studies that did not define the diagnostic criteria for hidden penis were excluded to minimize the risk of definition bias. The quality of evidence for each study was determined after considering the following sources of bias: method of allocation to study groups, data analysis, presence of baseline differences between groups, objectivity of outcome, and completeness of follow-up. Using these criteria, studies were then graded as high, moderate, or low in quality. Seven studies with a total of 119 patients met the inclusion criteria. All but 1 of the studies were nonrandomized. One study provided a clear presentation of results and appropriate statistical analysis. Six studies accounted for individual-based differences, and 1 study failed to account for baseline differences altogether. Four studies addressed follow-up. One study was of high quality, 2 were of moderate quality, and 4 were of low quality. Building a clinical practice guideline for the surgical management of hidden penis has proven difficult because of a lack of high-quality, statistically significant data in the research synthesis. The authors elucidate the challenges and epitomize the collective wisdom of surgeons who have investigated this problem and emphasize the need for rigorous evaluative studies. © 2015 The American Osteopathic Association.

Penis deformity after intra-urethral liquid paraffin administration in a young male: a case report

PubMed Central

Kokkonouzis, Ioannis; Antoniou, Georgios; Droulias, Athanasios

2008-01-01

Background Self-induced injections of liquid substances mainly for penis enlargement is a well-documented but still rather uncommon practice in the western world. Case presentation Herein we present the case of a 30-year-old male who self-inflicted, twice in a six-month-period, intra-urethral liquid paraffin and tied up his penis with a cord in order to achieve both enlargement and elongation. He arrived in our emergency department suffering from suprapubic pain; physical examination revealed a rather unique deformity of the penis. He finally refused any treatment and absconded. Conclusion Side effects after paraffin administration are various and sometimes severe. Most of the times surgical treatment is needed and radical excision together with follow-up seems the best modality. Such practices emphasize on the public's misbelieves and that some aspects of sexual medicine are yet covered with the veil of misconception. PMID:18840268

Penis deformity after intra-urethral liquid paraffin administration in a young male: a case report.

PubMed

Kokkonouzis, Ioannis; Antoniou, Georgios; Droulias, Athanasios

2008-10-07

Self-induced injections of liquid substances mainly for penis enlargement is a well-documented but still rather uncommon practice in the western world. Herein we present the case of a 30-year-old male who self-inflicted, twice in a six-month-period, intra-urethral liquid paraffin and tied up his penis with a cord in order to achieve both enlargement and elongation. He arrived in our emergency department suffering from suprapubic pain; physical examination revealed a rather unique deformity of the penis. He finally refused any treatment and absconded. Side effects after paraffin administration are various and sometimes severe. Most of the times surgical treatment is needed and radical excision together with follow-up seems the best modality. Such practices emphasize on the public's misbelieves and that some aspects of sexual medicine are yet covered with the veil of misconception.

[A case of iatrogenic scrotal elephantiasis: reconstruction of the scrotal purse and the cutaneous sleeve of the penis with local skin flaps].

PubMed

Masia, D-R; Castus, P; Delia, G; Casoli, V; Martine, D

2008-02-01

Scrotal elephantiasis is a pathology of often unknown etiology. Symptomatology is characterized by an oedematius infiltration of skin and subcutaneous tissue, hard-bound aspect and purplished color. The scrotum, the penis and the perineal area are gradually affected. This pathology is very invalidating for the patient, on functional, sexual and aesthetic aspects. The authors present the case of a 58-year-old man with an enormous scrotal mass invading the penis and drowning the testicular elements, which were impossible to palpate. The aetiology was determined by exclusion and an iatrogenic origin following the cure of bilateral inguinal hernia was retained. Resection of the scrotal mass was performed. The reconstruction of the scrotal purse and the cutaneous sleeve of the penis were carried out using local flaps of the remaining healthy skin.

Dermo beta brachytherapy with 188-Re in squamous cell carcinoma of the penis: a new therapy.

PubMed

Carrozzo, Anna Maria; Sedda, Antioco Franco; Muscardin, Luca; Donati, Pietro; Cipriani, Cesidio

2013-04-01

Squamous cell carcinoma of the penis (SCCP) is the most common penis neoplasia, favoured by phimosis, HPV infection and scleroatrophic lichen. The classic therapy is surgical with anatomic demolition, which often causes important psychological problems. Other non-demolitive therapies can be utilized, such as radiotherapy, brachytherapy and topical medical treatment. We propose a new non-invasive therapy called "Dermo beta brachytherapy (DBBT) with 188-Re" in which a synthetic inert resin-matrix containing a radioactive beta-emitting isotope is applied on the surface of the tumor lesion. A total of 15 patients with a histologically confirmed diagnosis of SCCP were enrolled for treatment (DBBT). Of the 15 patients, 12 healed, 1 was lost at follow-up and 2 did not respond to therapy. The results indicate that DBBT is an effective treatment for SCC of the penis, sparing the anatomical integrity of the organ, and allowing normal sexual activity.

Size Matters: Penis Size and Sexual Position in Gay Porn Profiles.

PubMed

Brennan, Joseph

2018-01-01

This article combines qualitative and quantitative textual approaches to the representation of penis size and sexual position of performers in 10 of the most visited gay pornography Web sites currently in operation. Specifically, in excess of 6,900 performer profiles sourced from 10 commercial Web sites are analyzed. Textual analysis of the profile descriptions is combined with a quantitative representation of disclosed penis size and sexual position, which is presented visually by two figures. The figures confirm that these sites generally market themselves as featuring penises that are extraordinarily large and find a sample-wide correlation between smaller penis sizes (5-6.5 inches) and receptive sexual acts (bottoming), and larger (8.5-13 inches) with penetrative acts (topping). These observations are supported through the qualitative textual readings of how the performers are described on these popular sites, revealing the narratives and marketing strategies that shape the construction of popular porn brands, performers, and profitable fantasies.

Fracture penis: a case more heard about than seen in general surgical practice

PubMed Central

Sahoo, Manash Ranjan; Nayak, Anil Kumar; Nayak, Tapan Kumar; S, Anand

2013-01-01

A 36-year-old man presented to the emergency department with a history of trauma to genitalia during intercourse. The patient reported the forceful collision between his penis and the bed and audible clicking sound with swollen penis thereafter. On examination, the genitalia was swollen with an ‘S’ shaped deformity. The skin over the swelling was apparently normal, with no local rise of temperature. A provisional diagnosis was made after clinical evaluation. Scrotum and testes examination revealed no abnormality. A subcoronal circumferential incision with de-gloving of penile skin was used to access the tunica. A rent in tunica albuginea and corpora cavernosa identified and the defect repaired with absorbable suture material after removal of clot and properly maintaining haemostasis. The patient's postoperative recovery was uneventful. The following case report demonstrates a typical case of fracture penis. PMID:23761607

Successful replantation of an amputated penis: a case report and review of the literature

PubMed Central

2014-01-01

Introduction Amputation of the penis is a rare traumatic injury reported from various parts of the world as isolated cases. A complete reconstruction of all penile structures should be attempted in one stage which provides the best chance for full rehabilitation of the patient. Case presentation We report the case of a 35-year-old Berber man who was admitted at the Emergency Department for incomplete criminal amputation of his penis, which was successfully reattached by using a macrosurgical technique. After surgery, near-normal appearance and function including a good urine flow and absence of urethral stricture, capability of erection and near normal sensitivity, were observed. Conclusions The importance of using macrosurgical reimplantation in incomplete penile amputation in order to achieve better functional and cosmetic results is discussed. In addition, we also highlight the potential anatomical role of corpus spongiosum in the arterial and venous blood supply to the penis. PMID:24716477

Penile Dysmorphic Disorder: Development of a Screening Scale.

PubMed

Veale, David; Miles, Sarah; Read, Julie; Troglia, Andrea; Carmona, Lina; Fiorito, Chiara; Wells, Hannah; Wylie, Kevan; Muir, Gordon

2015-11-01

Penile dysmorphic disorder (PDD) is shorthand for men diagnosed with body dysmorphic disorder, in whom the size or shape of the penis is their main, if not their exclusive, preoccupation causing significant shame or handicap. There are no specific measures for identifying men with PDD compared to men who are anxious about the size of their penis but do not have PDD. Such a measure might be helpful for treatment planning, reducing unrealistic expectations, and measuring outcome after any psychological or physical intervention. Our aim was, therefore, to validate a specific measure, termed the Cosmetic Procedure Screening Scale for PDD (COPS-P). Eighty-one male participants were divided into three groups: a PDD group (n = 21), a small penis anxiety group (n = 37), and a control group (n = 23). All participants completed the COPS-P as well as standardized measures of depression, anxiety, social phobia, body image, quality of life, and erectile function. Penis size was also measured. The final COPS-P was based on nine items. The scale had good internal reliability and significant convergent validity with measures of related constructs. It discriminated between the PDD group, the small penis anxiety group, and the control group. This is the first study to develop a scale able to discriminate between those with PDD and men anxious about their size who did not have PDD. Clinicians and researchers may use the scale as part of an assessment for men presenting with anxiety about penis size and as an audit or outcome measure after any intervention for this population.

Fracture of the penis. A report of two cases.

PubMed

Ugwu, B T; Liman, H U; Sani, A A; Mohammed, A M

2009-06-01

We present two cases of fracture of the penis in two young men at the extremes of the social strata the first an unemployed tailor while the other a practicing engineer. The first one was a bachelor while the other was married with children. In the first case, the fracture occurred during masturbation while in the second case it occurred during consensual intercourse with his wife on top. In the first case the fracture occurred at the base of the penis with associated rupture of the deep dorsal vein while in the second case it affected the mid-shaft with urethral rupture and blood at the tip of the penis at presentation. Both of them presented within two hours of their injuries with deformed, swollen and tender penis. Laubscher's subcoronal sleeve operation with evacuation of clots and repair of the tear with absorbable sutures to ensure a leak-proof repair was promptly performed with no complications. Both patients experienced spontaneous erection whilst in hospital even with indwelling catheter in place. The wife of the second case became pregnant six months after the repair. Counseling was successful with the engineer but was unsuccessful with the tailor-bachelor who continued with masturbation despite professional help. Though we published the first case of fracture of the penis in this centre almost a decade ago, we still found it necessary to report these new cases managed after we created awareness of this uncommon condition in our environment in order to highlight the presentations and the factors that influenced outcome.

[Ladder step strategy for surgical repair of congenital concealed penis in children].

PubMed

Wang, Fu-Ran; Zhong, Hong-Ji; Chen, Yi; Zhao, Jun-Feng; Li, Yan

2016-11-01

To assess the feasibility of the ladder step strategy in surgical repair of congenital concealed penis in children. This study included 52 children with congenital concealed penis treated in the past two years by surgical repair using the ladder step strategy, which consists of five main steps: cutting the narrow ring of the foreskin, degloving the penile skin, fixing the penile skin at the base, covering the penile shaft, and reshaping the prepuce. The perioperative data of the patients were prospectively collected and statistically described. Of the 52 patients, 20 needed remodeling of the frenulum and 27 received longitudinal incision in the penoscrotal junction to expose and deglove the penile shaft. The advanced scrotal flap technique was applied in 8 children to cover the penile shaft without tension, the pedicled foreskin flap technique employed in 11 to repair the penile skin defect, and excision of the webbed skin of the ventral penis performed in another 44 to remodel the penoscrotal angle. The operation time, blood loss, and postoperative hospital stay were 40－100 minutes, 5－30 ml, and 3－6 days, respectively. Wound bleeding and infection occurred in 1 and 5 cases, respectively. Follow-up examinations at 3 and 6 months after surgery showed that all the children had a satisfactory penile appearance except for some minor complications (2 cases of penile retraction, 2 cases of redundant ventral skin, and 1 case of iatrogenic penile curvature). The ladder step strategy for surgical repair of congenital concealed penis in children is a simple procedure with minor injury and satisfactory appearance of the penis.

An experimental study: quantitatively evaluating the change of the content of collagen fibres in penis with two-dimensional ShearWave™ Elastography.

PubMed

Qiao, X-H; Zhang, J-J; Gao, F; Li, F; Bai, M; Du, L-F; Xing, J-F

2017-06-01

The purpose of this study was to explore the value of two-dimensional ShearWave ™ Elastography (2D-SWE) on quantitatively evaluating the change of the content of collagen fibres in penis. Twenty male Sprague Dawley rats were divided into the pre-sexual maturity group (Group 1) and the sexual decline group (Group 2) according to age. The ultrafast ultrasound device Aixplorer ® (SuperSonic Imagine, Aix-en-Provence, France) was used for 2D-SWE imaging of penis, and the measurement index was shear wave stiffness (SWS). The immunohistochemistry was used to analyse the content of collagen fibres in penis, and the measurement index was positive area percentage (PAP). The differences of SWS between the two groups and PAP between the two groups were analysed. SWS of Group 1 and Group 2 was 10.18 ± 1.09 and 8.02 ± 1.34 kPa, and SWS of Group 2 was significantly lower than Group 1 (p < .01). PAP of Group 1 and Group 2 was 4.83 ± 3.61% and 16.41 ± 10.02%, and PAP of Group 2 was significantly higher than Group 1 (p < .01). Our results indicate that when the content of collagen fibres changes, SWS of penis measured with 2D-SWE would change significantly as well. Two-dimensional SWE can be used to quantitatively evaluate the change of the content of collagen fibres in penis. © 2016 Blackwell Verlag GmbH.

Surgical and Functional Outcomes Following Buried Penis Repair With Limited Panniculectomy and Split-thickness Skin Graft.

PubMed

Hampson, Lindsay A; Muncey, Wade; Chung, Paul H; Ma, C C; Friedrich, Jeffrey; Wessells, Hunter; Voelzke, Bryan B

2017-12-01

To report surgical and functional outcomes of buried penis surgery. Outcomes following buried penis surgery at the University of Washington were assessed from June 1, 2005 to June 1, 2016. Patient demographic and surgical data were abstracted from a retrospective chart review. All patients were attempted to be contacted by phone for long-term follow-up. Uni- and multivariate analysis was performed to evaluate for association with any complication. A total of 42 men underwent buried penis repair surgery (mean short-term follow-up 8.1 months). There was an overall 33% 90-day complication rate (21 events). In univariate analysis, body mass index (BMI; P = .02) and no history of gastric bypass (P = .03) were significant predictors of any complication. In multivariate analysis, only BMI remained significant (odds ratio 1.1 for each increase in unit of BMI, 95% confidence interval 1.01-1.27). Twenty-seven patients were reached for long-term follow-up (mean 39 months). Patients reported improvements in every functional domain that was assessed. Of the patients, 85% reported they would undergo buried penis surgery again, 74% that surgery led to a positive change in their lives, and 85% that the surgery had remained a long-term success. Surgical correction of buried penis with penile split-thickness skin graft and limited panniculectomy is well tolerated and results in functional, long-term improvements. BMI is associated with an increased likelihood of a complication following surgery. Copyright © 2017 Elsevier Inc. All rights reserved.

From the history of penis reconstruction.

PubMed

Veselý, J; Haage, J

1999-01-01

The authors present an account of the history of penis reconstruction following a diagnosis of transsexualism as well as after loss due to injury or for oncological reasons. A basic review is presented of the classical as well as microsurgical reconstruction methods.

Genital size: a common adolescent male concern.

PubMed

Lee, Peter A; Reiter, Edward O

2002-02-01

Long before adolescence, males hear insinuations about adequacy of penis size. This concern may heighten during teen years and persist to varying degrees into adulthood. Men tend to underestimate their own penis size. This chapter provides objective information about anatomy and growth of the penis, including data about normal sizes. Published data indicate that, although full growth may be reached at different ages during adolescence, size is similar for most adult males. Hopefully, this information will provide the basis for teenaged males to develop a healthy perspective and to avoid intimidation by unfounded claims about sexual enhancement or size enlargement techniques.

[Pulsative hematoma--a penile fracture complication].

PubMed

Dorde, Nale; Mićić, Sava

2007-01-01

Fracture of the penis is a direct blunt trauma of the erect or semi-erect penis. It can be treated by conservative or surgical means. Retrospective analyses of conservative penile fracture treatment reveal frequent immediate and later complications. We presented a 41-year-old patient with pulsative hematoma caused by an unusual fracture of the penis. Fracture had appeared 40 days before the admittance during a sexual intercourse. The patient was treated surgically. Pulsative hematoma (pulsative diverticulum) is a very rare, early complication of a conservatively treated penile fracture. Surgical treatment has an advantage over surgical one, which was confirmed by our case report.

[Complete necrosis of the penis and testes by strangulation in a psychotic patient].

PubMed

Bart, S; Culty, T; Pizzoferrato, A-C; Thibault, F; Girault, N; Chartier-Kastler, E; Richard, F

2008-07-01

Complete necrosis of the penis and scrotum due to strangulation of the external genitalia is unusually encountered in urologic emergencies. Urological conservative management is recommended. Delayed presentation is a major source of complications. We report the case of a psychotic patient, who was transferred from the emergency department in a context of complete necrosis of the external genitalia. This patient's history included chronic psychotic disorder and positive HIV serology, but he refused to take either neuroleptic or antiretroviral therapy. Complete amputation of the penis and bilateral orchidectomy were performed. We report the first six months of medical management.

Infantile fibrosarcoma of the penis in a 2-year-old boy.

PubMed

Taib, Fahisham; Mohamad, Norsarwany; Mohamed Daud, Mohamed Ashraf; Hassan, Aniza; Singh, Mutum Samarendra; Nasir, Ariffin

2012-10-01

Fibrosarcoma is rare in the pediatric age group. It generally involves the extremities and the trunk but rarely involves the genital area. We report a case of a large fungating infantile fibrosarcoma of the penis in a 2-year-old Malay boy. Partial recovery of the penile structure was achieved after chemotherapy. The difficulty in managing the social and surgical aspect of this case is discussed in our report. To the best of our knowledge, this is the first case report of infantile fibrosarcoma involving the penis in an Asian region. Copyright © 2012 Elsevier Inc. All rights reserved.

Incidentally Detected Penile Metastases in a Patient of Carcinoma Urinary Bladder on Follow-up FDG PET/CT.

PubMed

Parida, Girish Kumar; Tripathy, Sarthak; Roy, Shambo Guha; Singhal, Abhinav; Das, Chandanjyoti; Shamim, Shamim Ahmed

2017-05-01

Penis is an extremely uncommon site for metastases to occur and is often associated with very grave prognosis. Most of the secondary tumors originating in the penis have primaries from prostate, urinary bladder, and gastrointestinal tract. We hereby report a 65-year-old man, known case of carcinoma urinary bladder, who came for FDG PET/CT for metastatic workup. PET/CT study revealed FDG-avid mass lesion in the root and shaft of the penis, making it suggestive of metastases, which was confirmed later by MRI correlation.

Tuberculosis of the Penis: A Review of the Literature.

PubMed

Venyo, Anthony Kodzo-Grey

2015-01-01

Background. Tuberculosis of the penis (TBP) is rare. Aim. To review the literature. Method. Various internet data bases were searched. Literature Review. TBP could be primary or secondary, may develop following circumcision performed by a person who had pulmonary Tb, and may be transmitted to the penis from ejaculation, contamination from clothing, or from contact with endometrial secretions, following an earlier pulmonary Tb or Tb elsewhere. TBP presents with a painless/painful small nodule, ulcer, mass on penis which gradually enlarges, and induration/swelling of penis, with or without erectile dysfunction. Inguinal lymph nodes may or may not be palpable. The patient's voiding is normal. There may or may not be history of circumcision, pulmonary Tb, and BCG immunization. TBP mimics penile carcinoma, granulomatous syphilis penile ulcer, genital herpes simplex, granuloma inguinale, and HIV infection. Diagnosis is established by microscopic examination finding of granulomas +/-AFB in penile discharge or biopsy of lesion or culture of Tb organism from discharge or biopsy specimens or positive Elisa serology/PCR for Tb. PTBs respond to first- or 2nd-line anti-Tb 6-month treatment. Close contacts should be screened. Extrapulmonary Tb should be excluded. Conclusions. Clinicians should consider possibility of PTB in cases of penile lesions and erectile failure.

eNOS-uncoupling in age-related erectile dysfunction

PubMed Central

Johnson, JM; Bivalacqua, TJ; Lagoda, GA; Burnett, AL; Musicki, B

2011-01-01

Aging is associated with ED. Although age-related ED is attributed largely to increased oxidative stress and endothelial dysfunction in the penis, the molecular mechanisms underlying this effect are not fully defined. We evaluated whether endothelial nitric oxide synthase (eNOS) uncoupling in the aged rat penis is a contributing mechanism. Correlatively, we evaluated the effect of replacement with eNOS cofactor tetrahydrobiopterin (BH4) on erectile function in the aged rats. Male Fischer 344 ‘young’ (4-month-old) and ‘aged’ (19-month-old) rats were treated with a BH4 precursor sepiapterin (10 mg/kg intraperitoneally) or vehicle for 4 days. After 1-day washout, erectile function was assessed in response to electrical stimulation of the cavernous nerve. Endothelial dysfunction (eNOS uncoupling) and oxidative stress (thiobarbituric acid reactive substances, TBARS) were measured by conducting western blot in penes samples. Erectile response was significantly reduced in aged rats, whereas eNOS uncoupling and TBARS production were significantly increased in the aged rat penis compared with young rats. Sepiapterin significantly improved erectile response in aged rats and prevented increase in TBARS production, but did not affect eNOS uncoupling in the penis of aged rats. These findings suggest that aging induces eNOS uncoupling in the penis, resulting in increased oxidative stress and ED. PMID:21289638

Penis morphology in a Burmese amber harvestman

NASA Astrophysics Data System (ADS)

Dunlop, Jason A.; Selden, Paul A.; Giribet, Gonzalo

2016-02-01

A unique specimen of the fossil harvestman Halitherses grimaldii Giribet and Dunlop, 2005 (Arachnida: Opiliones) from the Cretaceous (ca. 99 Ma) Burmese amber of Myanmar reveals a fully extended penis. This is the first record of a male copulatory organ of this nature preserved in amber and is of special importance due to the age of the deposit. The penis has a slender, distally flattened truncus, a spatulate heart-shaped glans and a short distal stylus, twisted at the tip. In living harvestmen, the penis yields crucial characters for their systematics. Male genital morphology in H. grimaldii appears to be unique among the wider Dyspnoi clade to which this fossil belongs. The large eyes in the fossil differ markedly from other members of the subfamily Ortholasmatinae to which H. grimaldii was originally referred. Based on recent data, it has been argued that large eyes may be plesiomorphic for Palpatores (i.e. the suborders Eupnoi and Dyspnoi), potentially rendering this character plesiomorphic for the fossil too. Thus, the unique structure of the penis seen here, and the probable lack of diaphanous teeth, present in all other extant non-acropsopilionid Dyspnoi, suggest that H. grimaldii represents a new, extinct family of large-eyed dyspnoid harvestmen, Halithersidae fam. nov.; a higher taxon in amber diagnosed here on both somatic and genital characters.

Management of concealed penis with modified penoplasty.

PubMed

Xu, Jian-Guo; Lv, Chuan; Wang, Yu-Chong; Zhu, Ji; Xue, Chun-Yu

2015-03-01

To investigate the effect of penile degloving in combination with penoscrotal angle reconstruction for the correction of concealed penis. A foreskin circumcision incision was made along the coronal sulcus. After a sharp dissection under the superficial layer of tunica albuginea, the penile shaft was degloved to release the fibrous bands of the tunica dartos. Through a longitudinal incision or Z-plasty at the penoscrotal junction, securing of the tunica albuginea to the proximal tunica dartos was performed. The penoscrotal angle was reconstructed. This procedure effectively corrected the concealed penis, while correcting other problems such as phimosis. From August 2008 to August 2013, we performed 41 procedures for concealed penis. Correction was successful in all patients with an improved median length of 2.1 cm in the flaccid state. Follow-up ranged from 6 months to 2 years, and satisfactory cosmetic outcomes were obtained without scars or erectile discomfort. Our technique includes degloving and penoscrotal angle reconstruction, which provides proper visualization for fixation of the penile base. The longitudinal or Z-plasty incision also opened the degloving dead cavity, which was good for drainage. The procedure is straight forward with good functional and cosmetic outcomes and is thus ideal for correction of the concealed penis. Copyright © 2015 Elsevier Inc. All rights reserved.

Penis morphology in a Burmese amber harvestman.

PubMed

Dunlop, Jason A; Selden, Paul A; Giribet, Gonzalo

2016-02-01

A unique specimen of the fossil harvestman Halitherses grimaldii Giribet and Dunlop, 2005 (Arachnida: Opiliones) from the Cretaceous (ca. 99 Ma) Burmese amber of Myanmar reveals a fully extended penis. This is the first record of a male copulatory organ of this nature preserved in amber and is of special importance due to the age of the deposit. The penis has a slender, distally flattened truncus, a spatulate heart-shaped glans and a short distal stylus, twisted at the tip. In living harvestmen, the penis yields crucial characters for their systematics. Male genital morphology in H. grimaldii appears to be unique among the wider Dyspnoi clade to which this fossil belongs. The large eyes in the fossil differ markedly from other members of the subfamily Ortholasmatinae to which H. grimaldii was originally referred. Based on recent data, it has been argued that large eyes may be plesiomorphic for Palpatores (i.e. the suborders Eupnoi and Dyspnoi), potentially rendering this character plesiomorphic for the fossil too. Thus, the unique structure of the penis seen here, and the probable lack of diaphanous teeth, present in all other extant non-acropsopilionid Dyspnoi, suggest that H. grimaldii represents a new, extinct family of large-eyed dyspnoid harvestmen, Halithersidae fam. nov.; a higher taxon in amber diagnosed here on both somatic and genital characters.

Persistent, widespread papilloma formation on the penis of a horse: a novel presentation of equine papillomavirus type 2 infection.

PubMed

Knight, Cameron G; Munday, John S; Rosa, Brielle V; Kiupel, Matti

2011-12-01

A 9-year-old gelding presented with approximately 100 papillomas that covered about 75% of the distal penis. Biopsy was performed, and histology showed evidence of viral cytopathic change and koilocytosis. Polymerase chain reaction using DNA extracted from biopsied tissue amplified equine papillomavirus type 2 (EcPV-2) DNA sequences. Sixteen months later, the horse was re-examined and the appearance of the papillomas was unchanged. Equine papillomavirus type 2 DNA sequences were again amplified from both biopsied tissue and swabs of the penis. Papillomavirus was localized to the lesions by immunohistochemistry and in situ hybridization. An examination 2 years after the initial presentation revealed no detectable change in the appearance of the penis. The large number of papillomas and their failure to regress over an extended period support a clinical classification of papillomatosis. To the authors' knowledge, this is the first report of papillomatosis of the equine penis. This novel clinical manifestation suggests that persistent EcPV-2 infection is possible in horses. As there is evidence that EcPV-2 may promote development of equine penile squamous cell carcinoma, understanding the natural history of EcPV-2 infections may be important in preventing equine penile neoplasia. © 2011 The Authors. Veterinary Dermatology. © 2011 ESVD and ACVD.

Tuberculosis of the Penis: A Review of the Literature

PubMed Central

Venyo, Anthony Kodzo-Grey

2015-01-01

Background. Tuberculosis of the penis (TBP) is rare. Aim. To review the literature. Method. Various internet data bases were searched. Literature Review. TBP could be primary or secondary, may develop following circumcision performed by a person who had pulmonary Tb, and may be transmitted to the penis from ejaculation, contamination from clothing, or from contact with endometrial secretions, following an earlier pulmonary Tb or Tb elsewhere. TBP presents with a painless/painful small nodule, ulcer, mass on penis which gradually enlarges, and induration/swelling of penis, with or without erectile dysfunction. Inguinal lymph nodes may or may not be palpable. The patient's voiding is normal. There may or may not be history of circumcision, pulmonary Tb, and BCG immunization. TBP mimics penile carcinoma, granulomatous syphilis penile ulcer, genital herpes simplex, granuloma inguinale, and HIV infection. Diagnosis is established by microscopic examination finding of granulomas +/−AFB in penile discharge or biopsy of lesion or culture of Tb organism from discharge or biopsy specimens or positive Elisa serology/PCR for Tb. PTBs respond to first- or 2nd-line anti-Tb 6-month treatment. Close contacts should be screened. Extrapulmonary Tb should be excluded. Conclusions. Clinicians should consider possibility of PTB in cases of penile lesions and erectile failure. PMID:26435877

Resurfacing the Penis of Complex Hypospadias Repair ("Hypospadias Cripples").

PubMed

Fam, Mina M; Hanna, Moneer K

2017-03-01

After the creation of a neourethra in a "hypospadias cripple," resurfacing the penis with healthy skin is a significant challenge because local tissue is often scarred and unusable. We reviewed our experience with various strategies to resurface the penis of hypospadias cripples. We retrospectively reviewed the records of 215 patients referred after multiple unsuccessful hypospadias repairs from 1981 to 2014. In 130 of 215 patients we performed resurfacing using local penile flaps using various techniques, including Byars flaps, Z-plasty or double Z-plasty, or a dorsal relaxing incision. Of the 215 patients 85 did not have adequate healthy local penile skin to resurface the penis after urethroplasty. Scrotal skin was used to resurface the penis in 54 patients, 6 underwent tissue expansion of the dorsal penile skin during a 12 to 16-week period prior to penile resurfacing, 23 underwent full-thickness skin grafting and another 4 received a split-thickness skin graft. Of the 56 patients who underwent fasciomyocutaneous rotational flaps, tissue expansion or a combination of both approaches 54 (96.4%) finally had a successful outcome. All 6 patients who underwent tissue expansion had a successful outcome without complications and were reported on previously. All 23 full-thickness skin grafts took with excellent results. All 4 patients who underwent fenestrated split-thickness skin grafting had 100% graft take but secondary contraction and ulceration were associated with sexual activity. In our experience scrotal skin flaps, tissue expansion of the dorsal penile skin and full-thickness skin grafts serve as reliable approaches in resurfacing the penis in almost any hypospadias cripple lacking healthy local skin. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Doppler ultrasound study of penis in men with systemic sclerosis: a correlation with Doppler indices of renal and digital arteries.

PubMed

Rosato, E; Barbano, B; Gigante, A; Cianci, R; Molinaro, I; Quarta, S; Digiulio, M A; Messineo, D; Pisarri, S; Salsano, F

2013-01-01

Erectile dysfunction (ED) prevalence in male systemic sclerosis (SSc) is high and its pathogenesis is unclear. The aim of the study is to assess correlation between Doppler ultrasound indices of penis and kidneys or digital arteries in male systemic sclerosis. Fourteen men with systemic sclerosis were enrolled in this study. Erectile function was investigated by the International Index of Erectile Function-5. Peak systolic velocity, end diastolic velocity, resistive index, pulsative index, and systolic/diastolic ratio were measured on the cavernous arteries at the peno-scrotal junction in the flaccid state, on the interlobar artery of both kidneys and all ten proper palmar digital arteries. Ten (71 percent) patients have an International Index of Erectile Function-5 less than 21. Reduction of penis peak systolic velocity was observed in all SSc subjects. Doppler indices of cavernous arteries correlate with the International Index of Erectile Function-5. The renal and digital arteries resistive index demonstrated a good correlation (p less than 0.0001) with International Index of Erectile Function-5. A positive correlation exists between penis and kidney arteries Doppler indices: end diastolic velocity (p less than 0.05, r=0.54), resistive index (p less than 0.0001, r=0.90), systolic/diastolic ratio (p less than 0.01, r=0.69). A positive correlation was observed between penis and digital arteries Doppler indices: peak systolic velocity (p less than 0.01, r=0.68), end diastolic velocity (p less than 0.01, r=0.75), resistive index (p less than 0.001, r=0.79), systolic/diastolic ratio (p less than 0.05, r=0.59). A correlation exists between arterial impairment of penis and renal or digital arteries.

Organizational effects of the antiandrogen, Vinclozolin, on penis development in the mouse.

PubMed

Amato, Ciro M; Boyd, Morgan; Yang, Joshua; McCoy, Krista A

2018-04-14

Endocrine disrupting chemicals (EDCs) are pollutants found throughout the environment that disrupt normal endocrine processes. In mice, penis development is thought to be most susceptible to EDCs during a critical developmental window occurring on embryonic days (E) 15.5-17.5. However, androgen signaling begins on E13.5 when Androgen Receptor (AR) protein is found in the genitalia and testosterone is circulating. We hypothesize that disrupting androgen signaling prior to the established critical window sensitizes the penis to future androgen disruption. To test this hypothesis, CD1 dams were exposed to Vinclozolin or a corn oil solvent control on E13.5 and E14.5 and AR levels were measured with immunohistochemistry on E14.5. Early antiandrogen exposure reduced AR within nuclei and decreased intensity of AR expression within E14.5 genitalia. To evaluate the influence of antiandrogen exposure before the known critical window of penis development, two groups of pregnant dams (n = 3) were exposed to Vinclozolin starting at either E13.5 or E14.5 and continued exposure through E16.5. Histology and M.O.U.S.E. scoring were used to quantify penis abnormalities. To account for differences in total doses mice experienced due to differences in length of dosing time, we compared animals that received the same total doses. Exposure to antiandrogens on E13.5 exacerbated malformations when exposure was continued through sexually dimorphic development. Both exposure time and Vinclozolin dose are important for severity of Vinclozolin-induced penis abnormalities in mice. This work shows, antiandrogen exposure prior to sensitive periods can exacerbate the effects of later antiandrogen exposure on reproductive development.

Recognition and Construction of Top, Bottom, and Versatile Orientations in Gay/Bisexual Men.

PubMed

Moskowitz, David A; Roloff, Michael E

2017-01-01

Research on gay and bisexual men's sexual position self-label (i.e., being a top, bottom, or versatile during anal sex) has revealed only independent snapshots of its development by focusing primarily on the influence of penis size. Moreover, the basic chronology of development of the sexual position self-label has barely been addressed. In response, we implemented a survey of 282 gay and bisexual men that measured demographics (including height and penis size), age of sexual recognitions, sexual position self-label, and attitudinal constructs suggested by previous literature as important (e.g., pleasure, control, anxieties, and gender typicality). Results suggested that men's sexual position self-label was learned over a 15-year timespan. Ages of first same-sex genital manipulation and first anal sex experiences were related to age at first self-labeling. With respect to predictors of labels, a multivariate path model was created. The model did not support the direct importance of penis size, but identified indirect paths that linked penis size to top/bottom identification (e.g., smaller penis sizes leading to topping-anxieties and thus, a bottom label). Finding bottoming to be pleasurable and the importance of sexual control dynamics were the only two direct predictors. The path model substantiated the reliance both bottoms and tops show towards seeking (or not seeking among tops) gender typical, sexually dominant partners. It also supported previous evidence regarding race; specifically, while race may activate differences in sexual behavioral dynamics, it is not a great predictor of the sexual position self-label. This study shows that sexual position self-labeling has enormous complexity and cannot be reduced down to penis size.

Saxophone penis due to primary lymphoedema

PubMed Central

Jain, Vishal K.; Singh, Sangram; Garge, Saurabh; Negi, Anupama

2009-01-01

Congenital lymphoedema is a rare disorder that may result in disfiguring edema of the male genitalia. The treatment of persistent lymphoedema is surgical and consists of meticulous excision of all subcutaneous layers of the affected skin, combined with reconstruction of the penis and or scrotum. PMID:20419030

21 CFR 348.50 - Labeling of external analgesic drug products.

Code of Federal Regulations, 2013 CFR

2013-04-01

...). “Apply a small amount to head and shaft of penis before intercourse, or use as directed by a doctor. Wash...). “Apply 3 or more sprays, not to exceed 10, to head and shaft of penis before intercourse, or use as...

21 CFR 348.50 - Labeling of external analgesic drug products.

Code of Federal Regulations, 2012 CFR

2012-04-01

...). “Apply a small amount to head and shaft of penis before intercourse, or use as directed by a doctor. Wash...). “Apply 3 or more sprays, not to exceed 10, to head and shaft of penis before intercourse, or use as...

21 CFR 348.50 - Labeling of external analgesic drug products.

Code of Federal Regulations, 2014 CFR

2014-04-01

...). “Apply a small amount to head and shaft of penis before intercourse, or use as directed by a doctor. Wash...). “Apply 3 or more sprays, not to exceed 10, to head and shaft of penis before intercourse, or use as...

[Hypervascularization syndrome of the penis following arterialization of the dorsal penile vein for erectile impotence].

PubMed

Fritsch, P; Grubauer, G; Hilty, N; Biedermann, H

1989-07-01

A hypervascularization syndrome following arterialization of the deep dorsal vein of the penis to amend venous erectile impotence is a rare cause of penile ulcers that has not previously been described in the dermatological literature. Arterialization is performed by installing a shunt from the inferior epigastric artery or a venous bypass from the femoral artery to the deep dorsal vein of the penis, resulting in a blockage of venous outflow and in retrograde inflow into the corpora cavernosa. Complications arise as a result of persistently elevated blood pressure in the deep venous system and the erectile tissue in 10-20% of cases and are most often linked to dilatation of the shunt: the consequences are enlargement and induration of the glans, hazard of phimosis and paraphimosis, pulsation of the penis, micturation difficulties and, ultimately, ulceration of the glans. Surgical reduction of the arterial inflow ("banding" of the shunt) is the only therapeutic procedure that reduces hypervascularization without compromising the newly gained erectile function.

New Insights on the Morphology of Adult Mouse Penis1

PubMed Central

Rodriguez, Esequiel; Weiss, Dana A.; Yang, Jennifer H.; Menshenina, Julia; Ferretti, Max; Cunha, Tristan J.; Barcellos, Dale; Chan, Lok Yun; Risbridger, Gail; Cunha, Gerald R.; Baskin, Laurence S.

2011-01-01

ABSTRACT The adult mouse penis represents the end point of masculine sex differentiation of the embryonic genital tubercle and contains bone, cartilage, the urethra, erectile bodies, several types of epithelium, and many individual cell types arrayed into specific anatomical structures. Using contemporary high-resolution imaging techniques, we sought to provide new insights to the current description of adult mouse penile morphology to enable understanding of penile abnormalities, including hypospadias. Examination of serial transverse and longitudinal sections, scanning electron microscopy, and three-dimensional (3D) reconstruction provided a new appreciation of the individual structures in the adult mouse penis and their 3D interrelationships. In so doing, we discovered novel paired erectile bodies, the male urogenital mating protuberance (MUMP), and more accurately described the urethral meatus. These morphological observations were quantified by morphometric analysis and now provide accurate morphological end points of sex differentiation of mouse penis that will be the foundation of future studies to identify normal and abnormal penile development. PMID:21918128

[Trombosis of the dorsal penis vein (of Mondor's phlebitis). Presentation of a new case].

PubMed

Rodríguez Faba, O; Parra Muntaner, L; Gómez Cisneros, S C; Martín Benito, J L; Escaf Barmadah, S

2006-01-01

We present a new case of trombosis of the superficial dorsal penis vein called Penile Mondor's disease. The characteristics of the disease are reviewed and the most usual diagnostic and therapeutic methods. The case of a 41 year old man is reviewed who consulted for pain and induration on the proximal part of the penis. After phisical examination and Eco-doppler was made the diagnosis of Mondor's disease. He receibed treatment with non steroidal antiinflamatories and antibiotics. The dorsal vein thrombosis is a rare disease with pain an induration of the dorsal part of the penis. The ethiology can be traumatic, neoplasic, excesive sexual activity or abstinence. Is necesary the diferencial diagnosis with esclerosant linphangitis and the most important imaging is the Eco-doppler. The treatment is based in non steroidal antiinflamatories and antibiotics wit infection. The local aplication of heparine can be useful and the surgery with thrombectomy and resection is for persistent cases.

Penile and sexual rehabilitation in a patient with lymphedema of the penis.

PubMed

Pereira de Godoy, Jose Maria; de Fatima Guerreiro Godoy, Maria; Spessoto, Luis Cesar; Nestor Facio, Fernando

2013-01-01

The aim of this study is to report on penile rehabilitation in lymphedema of the penis with a new compression mechanism and the implantation of a penile prosthesis for sexual rehabilitation. The case of a 72-year-old patient with a history of edema of the penis for 6 years is reported. The patient reported that he had had periods of edema and redness and that the swelling had worsened over time. A clinical diagnosis of lymphedema of unknown etiology was made; the hypotheses were that the etiology was late congenital lymphedema of the penis or lymphedema aggravated by inflammation and/or infection. A new compression mechanism made using a cotton-polyester fabric (low elasticity and ribbed) was employed. The continued use of compression therapy led to almost complete reduction of the edema and the patient tried to return to be sexually active. A specific medication was used for erectile dysfunction; however, it resulted in no improvement and so a penile prosthesis was implanted. Copyright © 2013 S. Karger AG, Basel.

Transdermal water-in-oil nanocarriers of nitric oxide for triggering penile erection.

PubMed

Nam, Eunryel; Yoo, Saejong; Kim, Hwi-Yool; Kim, Young-Rok; Heo, Yun Jung

2018-05-09

Men's sexual health can have significant effects on a man's self-esteem, sexual relationship and male reproductive functions. Although commercially available drugs (e.g., VIAGRA and CIALIS) show effective treatment of erectile dysfunction (ED), patients with severe ED fail to respond to these medicines. Topical nitric-oxide (NO) delivery to penis can be a painless, alternative solution with severe ED because NO triggers erection and diffuses to the trabecular arteries and smooth muscles in the penis. We here develop water-in-oil (W/O) nanoemulsions (NEs) that contain NO and can directly spread on the penis. We optimize NE formation conditions including hydrophilic-lipophilic balance (HLB) and ratio of oil, water and surfactants. Then, by spreading NEs on penis skin of intact middle aged dogs, we verify medication effects and safety of the NEs in vivo. The water-in-oil NEs can be a promising non-invasive medication for ED patients with low response to a phosphodiesterase type 5 (PDE5) inhibitor, thus increasing quality of life in the aging society.

Hemodynamics of erection in man

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shirai, M.; Ishii, N.

1981-02-01

Inquiry was made into the theory that closure of the efferent vein from the corpora cavernosa is essential for erection of the human penis. To determine whether the venous closure is indeed a prerequisite to human penile erection, two tests were carried out in men: (1) direct infusion in 133Xe into corpora cavernosa and (2) performance of carvernosography. In each case, penile erection was induced by providing the subject with sexual stimulation. The behavioral changes were studied through the 133Xe clearance curve and the contrast medium, respectively. When the penis remained flaccid, the 133Xe clearance curve followed a gentle pathmore » and the contrast medium could be noted within the penis for a relatively long period. However, on erection with sexual stimulation, the 133Xe clearance curve fell rapidly instead of following the gentle course expected in the case of venous closure. Also, the contrast medium quickly flowed out of the corpora cavernosa. The human penis therefore can well erect without closure of the efferent vein from the corpora cavernosa.« less

Congenital completely buried penis in boys: anatomical basis and surgical technique.

PubMed

Liu, Xing; He, Da-wei; Hua, Yi; Zhang, De-ying; Wei, Guang-hui

2013-07-01

WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Surgical correction of the congenital completely buried penis (CCBP) is a difficult challenge and there is no unanimous consensus about the surgical 'gold standard' and patient eligibility for surgery. In the present study, dysgenetic fundiform ligaments were found to be attached to the distal or middle shaft of the penis. This abnormality can be successfully corrected by releasing the fundiform ligament and mobilising the scrotal skin to cover the length of the penile shaft. The study shows that the paucity and traction of the penile skin and an abnormal fundiform ligament are important anatomical defects in CCBP. Dorsal curve and severe shortage of penile skin in erectile conditions are the main indications for surgical correction. To present our experience of anatomical findings for congenital completely buried penis (CCBP), which has no unanimous consensus regarding the 'gold standard' for surgical correction and patient eligibility, by providing our surgical technique and illustrations. Between February 2006 and February 2011, 22 children with a median (range) age of 4.2 (2.5-5.8) years, with CCBP underwent surgical correction by one surgeon. Toilet training and photographs of morning erections by parents were advised before surgery. The abnormal anatomical structure of buried penis during the operation was observed. The technique consisted of the release of the fundiform ligament, fixation of the subcutaneous penile skin at the base of the degloved penis, penoscrotal Z-plasty and mobilisation of the penile and scrotal skin to cover the penile shaft. In reflex erectile conditions, CCBP presents varying degrees of dorsal curve and shortage of penile skin. Dysgenetic fundiform ligaments were found to be attached to the distal or middle shaft of the penis in all patients. All wounds healed well and the cosmetic outcome was good at 6-month follow-up after the repair. The appearance of the dorsal curve in CCBP mainly results from the traction of penile dorsal skin and the abnormal attachment of the fundiform ligament to the shaft. This abnormality can be successfully corrected by releasing the abnormal fundiform ligament and mobilising scrotal skin to cover the length of the penile shaft. © 2013 BJU International.

Giant lymphedema of the penis and scrotum: a case report.

PubMed

Vives, Franklin; García-Perdomo, Herney Andrés; Ocampo-Flórez, Ginna Marcela

2016-01-01

Lymphedema of the penis and scrotum is a rare entity characterized by enlargement of the skin and subcutaneous tissue of the genital region due to lymphatic drainage impairment. This clinical condition is more frequent in tropical countries due to a higher incidence of filariasis, which, in turn, is the main etiology. We describe the case of a 33-year-old man with large lymphedema of the scrotum and penis due to an acute and chronic inflammatory process, foreign body granuloma, and marked hyalinization. Four consecutive surgical interventions were necessary to remove the great part of the affected tissue, which enabled satisfactory results and improved the patient's quality of life.

Elephantiasis Nostras Verrucosa. Excision with full-thickness skin grafting of the penis, scrotum, and perineal area.

PubMed

Judge, Nathan; Kilic, Ali

2016-11-13

Elephantiasis nostras verrucosa is a rare cutaneous complication of chronic lymphatic obstruction. It is most commonly caused by bacterial infection, trauma, neoplasia, obesity, and venous stasis. In this report, we describe a case of elephantiasis nostras verrucosa involving the scrotum and perineal area in a 32-year-old. The lesions were excised, and full-thickness skin grafting of the penis, scrotum, and perineal skin was performed. This case demonstrates the efficacy of excision with full-thickness skin grafting of the penis, scrotum, and perineal area in a patient with elephantiasis nostras verrucosa confined to the scrotum and perineal region.

Gangrene of the penis, scrotum, and perineum, occurred after radiotherapy of rectal cancer

PubMed Central

Życzkowski, Marcin; Bryniarski, Piotr; Nowakowski, Krzysztof; Muskała, Bartosz; Paradysz, Andrzej

2013-01-01

We present a case of a 58-year-old man hospitalized because of gangrene of the penis and scrotum, after radiochemotherapy for rectal cancer. At the time of the admission the patient presented with extensive gangrene with necrosis affecting the scrotum and the penis. During the first day of hospitalization the patient was operated. Due to the progress of the disease he had to be operated again. The status of the patient, which initially was very bad, was gradually improving. He was discharged from the hospital after 59 days in a good general state with good wound healing. PMID:24707380

Lymphangioma circumscriptum of the penis: a case report.

PubMed

Kokcam, Ibrahim

2007-06-01

We report a case of lymphangioma circumscriptum of the penis in a 19-year-old male. The lesions developed during puberty and resembled molluscum contagiosum and genital herpes. The case is presented because of its rarity and to increase diagnostic awareness and treatment with non-surgical intervention.

Pyoderma Gangranosum of the Penis

PubMed Central

Kim, Tae Heung; Oh, Seung Young

2009-01-01

We report a patient who developed pyoderma gangrenosum in the penis with invasion of the distal urethra. The patient was treated with prednisolone and thalidomide, followed by a reconstructive surgical repair using a scrotal island flap. We report this case with a brief review of the literature. PMID:19949683

Effects of Vitamin D Restricted Diet Administered during Perinatal and Postnatal Periods on the Penis of Wistar Rats

PubMed Central

Fernandes-Lima, Flávia; Gregório, Bianca M.; Nascimento, Fernanda A. M.; Costa, Waldemar S.; Sampaio, Francisco J. B.

2018-01-01

Vitamin D deficiency is common in pregnant women and infants. The present study aimed to investigate the effects of vitamin D restricted diet on the Wistar rats offspring penis morphology. Mother rats received either standard diet (SC) or vitamin D restricted (VitD) diet. At birth, offspring were divided into SC/SC (from SC mothers, fed with SC diet) and VitD/VitD (from VitD mothers, fed with VitD diet). After euthanasia the penises were processed for histomorphometric analysis. The VitD/VitD offspring displayed metabolic changes and reduction in the cross-sectional area of the penis, corpus cavernosum, tunica albuginea, and increased area of the corpus spongiosum. The connective tissue, smooth muscle, and cell proliferation percentages were greater in the corpus cavernosum and corpus spongiosum in the VitD/VitD offspring. The percentages of sinusoidal spaces and elastic fibers in the corpus cavernosum decreased. The elastic fibers in the tunica albuginea of the corpus spongiosum in the VitD/VitD offspring were reduced. Vitamin D restriction during perinatal and postnatal periods induced metabolic and structural changes and represented important risk factors for erectile dysfunction in the penis of the adult offspring. These findings suggest that vitamin D is an important micronutrient in maintaining the cytoarchitecture of the penis. PMID:29850540

Primary cutaneous adenosquamous carcinoma of the penis: the first characterization of HPV status in this rare and diagnostically challenging entity with review of glandular carcinomas of the penis.

PubMed

Rush, P S; Shiau, J M; Hibler, B P; Longley, B J; Downs, T M; Bennett, D D

2016-12-01

Glandular and pseudoglandular tumors of the penile skin are extremely uncommon and can present diagnostic challenges. Primary adenosquamous carcinoma of the penis is an extremely rare tumor, composed of distinct areas of malignant squamous and glandular cells, making it a diagnostically challenging entity. The World Health Organization (WHO) recognizes several subtypes of squamous cell carcinoma (SCC), each with its own distinctive pathologic appearance, clinical associations and prognosis. Among these variants is the exceedingly uncommon adenosquamous carcinoma (ASC), representing 1%-2% of all SCC of the penis. Recent large studies have interrogated the presence of human papillomavirus (HPV) in malignant penile tumors and have shown specific morphologic patterns and clinical presentations to associate with HPV status. However, given the rarity of the adenosquamous variant of SCC, it has largely been excluded from these studies. The glandular components of these lesions can present a confusing appearance, particularly when a large tumor is represented on a small biopsy. Here we describe a difficult histologic presentation of this rare tumor, with the first published characterization of the HPV status of this subtype. This case represents a distinctly unusual case of metastatic HPV-positive primary cutaneous adenosquamous carcinoma of the penis. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A new surgical technique for concealed penis using an advanced musculocutaneous scrotal flap.

PubMed

Han, Dong-Seok; Jang, Hoon; Youn, Chang-Shik; Yuk, Seung-Mo

2015-06-19

Until recently, no single, universally accepted surgical method has existed for all types of concealed penis repairs. We describe a new surgical technique for repairing concealed penis by using an advanced musculocutaneous scrotal flap. From January 2010 to June 2014, we evaluated 12 patients (12-40 years old) with concealed penises who were surgically treated with an advanced musculocutaneous scrotal flap technique after degloving through a ventral approach. All the patients were scheduled for regular follow-up at 6, 12, and 24 weeks postoperatively. The satisfaction grade for penile size, morphology, and voiding status were evaluated using a questionnaire preoperatively and at all of the follow-ups. Information regarding complications was obtained during the postoperative hospital stay and at all follow-ups. The patients' satisfaction grades, which included the penile size, morphology, and voiding status, improved postoperatively compared to those preoperatively. All patients had penile lymphedema postoperatively; however, this disappeared within 6 weeks. There were no complications such as skin necrosis and contracture, voiding difficulty, or erectile dysfunction. Our advanced musculocutaneous scrotal flap technique for concealed penis repair is technically easy and safe. In addition, it provides a good cosmetic appearance, functional outcomes and excellent postoperative satisfaction grades. Lastly, it seems applicable in any type of concealed penis, including cases in which the ventral skin defect is difficult to cover.

Am I normal? A systematic review and construction of nomograms for flaccid and erect penis length and circumference in up to 15,521 men.

PubMed

Veale, David; Miles, Sarah; Bramley, Sally; Muir, Gordon; Hodsoll, John

2015-06-01

To systematically review and create nomograms of flaccid and erect penile size measurements. Study key eligibility criteria: measurement of penis size by a health professional using a standard procedure; a minimum of 50 participants per sample. samples with a congenital or acquired penile abnormality, previous surgery, complaint of small penis size or erectile dysfunction. Synthesis methods: calculation of a weighted mean and pooled standard deviation (SD) and simulation of 20,000 observations from the normal distribution to generate nomograms of penis size. Nomograms for flaccid pendulous [n = 10,704, mean (SD) 9.16 (1.57) cm] and stretched length [n = 14,160, mean (SD) 13.24 (1.89) cm], erect length [n = 692, mean (SD) 13.12 (1.66) cm], flaccid circumference [n = 9407, mean (SD) 9.31 (0.90) cm], and erect circumference [n = 381, mean (SD) 11.66 (1.10) cm] were constructed. Consistent and strongest significant correlation was between flaccid stretched or erect length and height, which ranged from r = 0.2 to 0.6. relatively few erect measurements were conducted in a clinical setting and the greatest variability between studies was seen with flaccid stretched length. Penis size nomograms may be useful in clinical and therapeutic settings to counsel men and for academic research. © 2014 The Authors. BJU International © 2014 BJU International.

Structural and stereological analysis of elastic fibers in the glans penis of young men.

PubMed

Andrade, F; Cardoso, G P; Bastos, Ana Luiza; Costa, W; Chagas, M; Babinski, M

2012-01-01

The extracellular matrix is an important element in penile function and pathology, although little is known about its components in human glans. This study evaluates the morphological organization and volumetric density of elastic fibers in the glans penis of young men without any evidence of urogenital disease at autopsy or medical history. Penile glans were obtained from five young men who died of causes not related to the urogenital tract, ranging in age from 18 to 30 years (mean 24 years). Samples were fixed in formalin, embedded in paraffin, and histologically processed. Tissue was analyzed by light microscopy using Weigert's resorcin-fuchsin, after previous oxidation with oxone. The point-counting method was used for morphometrical evaluation. Quantities were expressed as volumetric densities (Vv) and were determined on 25 random fields for each individual. Elastic system fibers were easily identified. These fibers had tortuous profile and surrounded sinusoids in the glans penis. An irregular elastic fibers network was identified in the mucosa, while in the corpus spongiosum the elastic fibers were longitudinally distributed. Volumetric density of elastic fibers in the glans penis is 29.4% ± 3.1. These data could provide valuable information in order to draw parallels regarding patients with erectile dysfunction. Further studies regarding extracellular matrix of the penis are necessary to better elucidate the relation between elastic fibers and erectile dysfunction.

Myointimoma of the glans penis.

PubMed

Vardar, Enver; Gunlusoy, Bulent; Arslan, Murat; Kececi, Sibel

2007-03-01

Myointimoma is a recently described benign tumor, which is regarded as a rare type of mesenchymal tumor of the penis. The present patient was a 50-year-old man who had a nodule located in the glans penis. He had a 2 month history of a mass. An excisional biopsy was performed. The histological findings revealed a multinodular tumor that was characterized by spindle-shaped cells located in the intravascular area. This case, in addition to 11 cases reported in the literature, demonstrates that the myointimoma is frequently misdiagnosed on clinical and pathological grounds because of its rarity. Histological and immunohistochemical features are summarized on the basis of the present case and previously published reports.

Penile enlargement surgery.

PubMed

Alter, G J

1998-06-01

Aesthetic surgery to improve the appearance of the penis, scrotum, and pubic region has successfully evolved. Penile lengthening is performed by releasing the suspensory ligament of the penis followed by use of penile weights. Girth is increased by wrapping a dermal-fat graft around the penile circumference. The choice of surgery is determined by the patient's anatomy and desires.

Penis captivus--did it occur?

PubMed Central

Taylor, F K

1979-01-01

The symptom of penis captivus during sexual intercourse has had a largely hearsay existence in medical history, and rumour has embellished the drama of its occurrence. It is not entirely mythical, however. It seems to have been a symptom of great rarity in former times and to have vanished perhaps completely in this century. PMID:509182

Sildenafil Citrate-Restored eNOS and PDE5 Regulation in Sickle Cell Mouse Penis Prevents Priapism Via Control of Oxidative/Nitrosative Stress

PubMed Central

Hsu, Lewis L.; Berkowitz, Dan E.; Champion, Hunter C.; Burnett, Arthur L.

2013-01-01

Sildenafil citrate revolutionized the practice of sexual medicine upon its federal regulatory agency approval approximately 15 years ago as the prototypical phosphodiesterase type 5 inhibitor indicated for the treatment of male erectile dysfunction. We now provide scientific support for its alternative use in the management of priapism, a clinical disorder of prolonged and uncontrolled penile erection. Sildenafil administered continuously to sickle cell mice, which show a priapism phenotype, reverses oxidative/nitrosative stress effects in the penis, mainly via reversion of uncoupled endothelial nitric oxide synthase to the functional coupled state of the enzyme, which in turn corrects aberrant signaling and function of the nitric oxide/cyclic GMP/protein kinase G/phosphodiesterase type 5 cascade. Priapism tendencies in these mice are reverted partially toward normal neurostimulated erection frequencies and durations after sildenafil treatment in association with normalized cyclic GMP concentration, protein kinase G activity and phosphodiesterase type 5 activity in the penis. Thus, sildenafil exerts pleiotropic effects in the penis that extend to diverse erection disorders. PMID:23844149

Male circumcision and penis enhancement in Southeast Asia: matters of pain and pleasure.

PubMed

Hull, T H; Budiharsana, M

2001-11-01

This paper reviews some uniquely male sexual health concerns in Southeast Asia, with particular attention to Indonesia. These include various forms of male circumcision, different types of 'penis enhancement' carried out across the region and the use of dry sex by women. These practices appear to be motivated by specific notions of sexual pleasure, based on indigenous gender constructs. Although they may or may not pose a serious public health problem, as markers of misguided or exploitative gender relations they do reveal important aspects of social psychology related to sexuality and sexual health. Male circumcision provides an ideal opportunity to consider male reproductive health needs and risks in Indonesia, Malaysia and the Philippines. Practices that involve cutting the male genitals need to be addressed in ways that stress the importance of sexual relationships based on mutual respect and open communication. Penis implants and inserts and other penis augmentation devices, as well as dry sex practices, are potentially dangerous to both men and women, and of questionable value in bringing pleasure to either, and should be discouraged.

Phenomenology of men with body dysmorphic disorder concerning penis size compared to men anxious about their penis size and to men without concerns: a cohort study.

PubMed

Veale, David; Miles, Sarah; Read, Julie; Troglia, Andrea; Carmona, Lina; Fiorito, Chiara; Wells, Hannah; Wylie, Kevan; Muir, Gordon

2015-03-01

Men with body dysmorphic disorder (BDD) may be preoccupied with the size or shape of the penis, which may be causing significant shame or impairment. Little is known about the characteristics and phenomenology of such men and whether they can be differentiated from men with small penis anxiety (SPA) (who do not have BDD), and men with no penile concerns. Twenty-six men with BDD, 31 men with SPA, and 33 men without penile concerns were compared on psychopathology, experiences of recurrent imagery, avoidance and safety-seeking behaviours. Men with BDD had significantly higher scores than both the SPA group and no penile concern group for measures of imagery, avoidance, safety seeking and general psychopathology. The groups differed on the phenomenology of BDD specific to penile size preoccupation clearly from the worries of SPA, which in turn were different to those of the men without concerns. The common avoidance and safety seeking behaviours were identified in such men that may be used clinically. Copyright © 2014 Elsevier Ltd. All rights reserved.

Sildenafil citrate-restored eNOS and PDE5 regulation in sickle cell mouse penis prevents priapism via control of oxidative/nitrosative stress.

PubMed

Bivalacqua, Trinity J; Musicki, Biljana; Hsu, Lewis L; Berkowitz, Dan E; Champion, Hunter C; Burnett, Arthur L

2013-01-01

Sildenafil citrate revolutionized the practice of sexual medicine upon its federal regulatory agency approval approximately 15 years ago as the prototypical phosphodiesterase type 5 inhibitor indicated for the treatment of male erectile dysfunction. We now provide scientific support for its alternative use in the management of priapism, a clinical disorder of prolonged and uncontrolled penile erection. Sildenafil administered continuously to sickle cell mice, which show a priapism phenotype, reverses oxidative/nitrosative stress effects in the penis, mainly via reversion of uncoupled endothelial nitric oxide synthase to the functional coupled state of the enzyme, which in turn corrects aberrant signaling and function of the nitric oxide/cyclic GMP/protein kinase G/phosphodiesterase type 5 cascade. Priapism tendencies in these mice are reverted partially toward normal neurostimulated erection frequencies and durations after sildenafil treatment in association with normalized cyclic GMP concentration, protein kinase G activity and phosphodiesterase type 5 activity in the penis. Thus, sildenafil exerts pleiotropic effects in the penis that extend to diverse erection disorders.

Urothelial carcinoma involving the distal penis.

PubMed

Dason, Shawn; Sheikh, Adeel; Wang, Jing Gennie; Tauqir, Syeda; Davies, Timothy O; Shayegan, Bobby

2012-04-01

Urothelial carcinoma (UC) rarely metastasizes to the penis and skin. We report the case of a 73-year-old man with UC metastases to the corpus spongiosum and dermis of the distal penis. We also review the clinicopathologic characteristics and management options for UC metastasizing to the penis. The patient presented with priapism and edema of the genital region. This follows a 5-year history of urothelial carcinoma in situ that progressed to invasive cancer despite intravesical immunotherapy. Seventeen months prior to presentation, the patient underwent a radical cystectomy with adjuvant chemotherapy. The cystectomy specimen demonstrated a pT4a N2 M0 G3 UC and margins were positive for carcinoma in situ. Follow-up had been negative for recurrence until his presentation with priapism. Incisional biopsy of the glans revealed UC and radical penectomy was performed with negative margins. The penile specimen demonstrated extensive involvement of the corpus spongiosum by UC with lymphovascular invasion and subepidermal involvement. Three months after penectomy, the patient presented with inguinal nodal recurrence. Palliative radiotherapy was administered and the patient passed away eight months after surgery.

Unusual asymptomatic presentation of bladder cancer metastatic to the penis.

PubMed

Giunchi, Francesca; Vasuri, Francesco; Valerio, Vagnoni; Montagnani, Ilaria; Nelli, Federico; Fiorentino, Michelangelo; Raspollini, Maria Rosaria

2017-06-01

Penile metastasis is an extremely rare event and mainly originate from primary pelvic tumor sites such us urinary bladder, gastro-intestinal tract and prostate and more rarely from respiratory system, bone tumors and melanoma. Here we describe the unusual presentation of two bladder urothelial cancer metastatic to the penis with no relevant clinical symptoms. Namely, a 69 years-old man with a warthy lesions of the foreskin and the glans misunderstood for a condylomata that at histological and immunohistochemical analysis showed a bladder urothelial carcinoma; and a 71 years-old man with reddish skin lesion of the glans, a previous history of bladder and urethral carcinoma and histological pagetoid spread of urothelial cancer to the glans. Recurrent bladder urothelial carcinoma is usually a visceral disease that rarely presents as a superficial asymptomatic skin lesion. The two reported cases were asymptomatic superficial penis metastases with a relatively slow growth and a fairy good prognosis after conservative surgical approach. Accurate clinical examination of the penis is mandatory for males with history of bladder cancer. Copyright © 2016 Elsevier GmbH. All rights reserved.

Three cases of subcutaneous granuloma annulare of the penis: a rare presentation of a common disease.

PubMed

Toepfer, Nicholas J; Wessner, Scott R; Elston, Dirk M; Simmons, Jennifer; Sumfest, Joel M

2011-09-01

To describe three patients who presented to a single institution within four years of each other with isolated granuloma annulare of the penis. Granuloma annulare is an inflammatory disease of the dermis that can affect men of any age including childhood. Granuloma annulare of the penis is a remarkably uncommon presentation with only 12 cases previously reported. A retrospective review of pathologic records was conducted confirming three cases of penile granuloma annulare diagnosed at our institution. The three cases are described in detail including the history, presentation, histological findings and treatment of each patient. The clinical variants, characteristic histology, classic clinical presentation, differential diagnosis and recurrence following surgery of granuloma annulare are reviewed. We describe three individuals from a single institution with isolated granuloma annulare of the penis suggesting this condition is more common than previously thought. Patients with penile granuloma annulare may present to practicing urologists and it is important to be familiar with this idiopathic subcutaneous disorder in order to avoid unnecessary aggressive surgery. Copyright © 2011 Elsevier Inc. All rights reserved.

Pubic contouring after massive weight loss in men and women: correction of hidden penis, mons ptosis, and labia majora enlargement.

PubMed

Alter, Gary J

2012-10-01

Weight gain and subsequent weight loss usually result in unsightly large fat deposition in the pubic areas along with ptosis of the fat pad and skin. Men also complain of burying of the penis and the woman complains of labia majora enlargement, both causing secondary sexual dysfunction, hygiene issues, discomfort, and aesthetic concerns. Even with weight loss, most of these deformities persist. The hidden (buried) penis is characterized by a lack of firm attachments between the Buck fascia surrounding the tunica albuginea of the corpora and the dartos fascia and skin. Successful treatment requires the penile skin and dartos fascia to be stabilized to the penile corporal bodies to make the penis one integrated unit. The method of surgery is usually to excise and lift excess pubic skin, eliminate the pubic fat without creating a significant pubic concavity, and stabilize the penile skin to the corporal bodies with tacking sutures dorsally and ventrally. If inadequate penile skin is present, scrotal flaps or skin grafts are used to cover the penis. Treatment of the mons pubis requires similar pubic lifting, fat excision, and pubic tacking. Labia majora reduction requires skin and usually fat excision. Results are excellent with the use of these techniques. Pubic contouring after massive weight loss in men and women is very successful and safe if performed meticulously. Treatment improves self-esteem along with the associated physical and aesthetic deformities.

Sexual function outcomes following fracture of the penis

PubMed Central

Nason, Gregory J.; McGuire, Barry B.; Liddy, Stephen; Looney, Aisling; Lennon, Gerald M.; Mulvin, David W.; Galvin, David J.; Quinlan, David M.

2013-01-01

Introduction: Fracture of the penis is a rare urological emergency which occurs as a result of abrupt trauma to an erect penis. There is paucity of data regarding long-term sexual function or erectile potency following fracture of the penis. The aim of this study is to objectively assess the overall sexual function following fracture of the penis. Methods: A retrospective analysis of 21 penile fractures was performed. A voluntary telephone questionnaire was performed to assess long term outcomes using three validated questionnaires-the Erection Hardness Grading Scale, the International Index of Erectile Function (IIEF-5) and the Brief Male Sexual Function inventory (BMSFI). Results: The mean age was 33.1 years (range: 19–63). The median follow up was 46 months (range: 3–144). All fractures were a result of sexual misadventure and all were surgically repaired. There were two concomitant urethral injuries. Seventeen patients were contactable. Fourteen patients demonstrated no evidence of erectile dysfunction (ED) (IIEF-5>22), 1 patient reported symptoms of mild ED (IIEF-5, 17–21) and one patient reported mild to moderate ED (IIEF-5, 12–16). No patients reported insufficient erection for penetration (EHGS: 1 or 2). Regarding the overall BMSFI, 13 (83%) patients were mostly satisfied or very satisfied with their sex life within the previous month. Conclusion: In a small surgical series of men with penile fracture managed within a short time frame from presentation, we demonstrate erectile potency is maintained. Long-term overall sexual satisfaction is promising. PMID:24032060

A role for the melanocortin 4 receptor in sexual function.

PubMed

Van der Ploeg, Lex H T; Martin, William J; Howard, Andrew D; Nargund, Ravi P; Austin, Christopher P; Guan, Xiaoming; Drisko, Jennifer; Cashen, Doreen; Sebhat, Iyassu; Patchett, Arthur A; Figueroa, David J; DiLella, Anthony G; Connolly, Brett M; Weinberg, David H; Tan, Carina P; Palyha, Oksana C; Pong, Sheng-Shung; MacNeil, Tanya; Rosenblum, Charles; Vongs, Aurawan; Tang, Rui; Yu, Hong; Sailer, Andreas W; Fong, Tung Ming; Huang, Cathy; Tota, Michael R; Chang, Ray S; Stearns, Ralph; Tamvakopoulos, Constantin; Christ, George; Drazen, Deborah L; Spar, Brian D; Nelson, Randy J; MacIntyre, D Euan

2002-08-20

By using a combination of genetic, pharmacological, and anatomical approaches, we show that the melanocortin 4 receptor (MC4R), implicated in the control of food intake and energy expenditure, also modulates erectile function and sexual behavior. Evidence supporting this notion is based on several findings: (i) a highly selective non-peptide MC4R agonist augments erectile activity initiated by electrical stimulation of the cavernous nerve in wild-type but not Mc4r-null mice; (ii) copulatory behavior is enhanced by administration of a selective MC4R agonist and is diminished in mice lacking Mc4r; (iii) reverse transcription (RT)-PCR and non-PCR based methods demonstrate MC4R expression in rat and human penis, and rat spinal cord, hypothalamus, brainstem, pelvic ganglion (major autonomic relay center to the penis), but not in rat primary corpus smooth muscle cavernosum cells; and (iv) in situ hybridization of glans tissue from the human and rat penis reveal MC4R expression in nerve fibers and mechanoreceptors in the glans of the penis. Collectively, these data implicate the MC4R in the modulation of penile erectile function and provide evidence that MC4R-mediated proerectile responses may be activated through neuronal circuitry in spinal cord erectile centers and somatosensory afferent nerve terminals of the penis. Our results provide a basis for the existence of MC4R-controlled neuronal pathways that control sexual function.

A creative therapy in treating cavernous hemangioma of penis with copper wire.

PubMed

Zhang, Dong; Zhang, Haiyang; Sun, Peng; Li, Peng; Xue, Aibing; Jin, Xunbo

2014-10-01

Cavernous hemangiomas of penis are rare benign lesions infrequently described in the literature. No completely satisfactory treatment has been found to correct the cosmetic deformities especially the extensive hemangiomas of corpus penis. In light of the promising application of copper wire/needle in vascular malformations, we began a clinical study to investigate the safety, feasibility, and cosmetic effect of copper wire therapy in treating cavernous hemangioma of penis. Seven patients ranging in age from 12 to 32 years with penile cavernous hemangiomas entered our study from 2005 to 2011. All patients received treatments with percutaneous copper wires. Perioperative data including mean operation time, estimated blood loss, length of copper wire retention, and length of hospital stay were analyzed. All possible complications were noted, and cosmetic result was evaluated. Patients were followed up after discharge from the hospital. All operations were successful, and no obvious complications were observed. The patients were satisfied with the aesthetic results. Follow-up time ranged from 1 to 5 years. Recurrence was discovered in a patient with the largest lesion of corpus penis 2 months after the treatment. Secondary procedure was carried out with the same technique, and no lesions were found later. The shortage of studies on this topic prevented us from defining a therapeutic reference standard. The results of our study confirmed that copper wire therapy was a simple, safe, and useful option for penile cavernous hemangioma. © 2013 International Society for Sexual Medicine.

[Penis-preserving surgery in patients with primary penile urethral cancer].

PubMed

Maek, M; Musch, M; Arnold, G; Kröpfl, D

2014-12-01

Primary urethral cancer in males is a rare entity with only approximately 800 cases described, which is why it is difficult to formulate evidence-based guidelines for treatment. For tumors in the pT2 stage with a localization distal to the membranous urethra, a penis-preserving operation can be carried out. In the period from November 2006 to February 2014 a total of 4 patients with primary urethral cancer underwent a penis-preserving urethral resection. The tumor characteristics and treatment results were collated retrospectively. Of the four patients one had a transitional cell carcinoma of the mid-penile urethra in stage pT2 G2. In two out of the four patients a squamous cell carcinoma (PEC) was present in the mid-penile urethra in stages pT2 G2 and pT2 G3, respectively, with concomitant carcinoma in situ (CIS). The fourth patient had a PEC of the fossa terminalis in stage pT2 G2. Initially all patients underwent a penis-preserving resection. In one case, despite an initial R0 resection a local recurrence occurred and a complete penectomy was performed. Irradiation and lymphadenectomy were not carried out. At a mean follow-up of 37 months all patients are currently in complete remission. Primary penile urethral cancer can be treated by a penis-preserving operation. Close follow-up is essential because recurrence can arise despite an initial R0 resection.

Classification System for Individualized Treatment of Adult Buried Penis Syndrome.

PubMed

Tausch, Timothy J; Tachibana, Isamu; Siegel, Jordan A; Hoxworth, Ronald; Scott, Jeremy M; Morey, Allen F

2016-09-01

The authors present their experience with reconstructive strategies for men with various manifestations of adult buried penis syndrome, and propose a comprehensive anatomical classification system and treatment algorithm based on pathologic changes in the penile skin and involvement of neighboring abdominal and/or scrotal components. The authors reviewed all patients who underwent reconstruction of adult buried penis syndrome at their referral center between 2007 and 2015. Patients were stratified by location and severity of involved anatomical components. Procedures performed, demographics, comorbidities, and clinical outcomes were reviewed. Fifty-six patients underwent reconstruction of buried penis at the authors' center from 2007 to 2015. All procedures began with a ventral penile release. If the uncovered penile skin was determined to be viable, a phalloplasty was performed by anchoring penoscrotal skin to the proximal shaft, and the ventral shaft skin defect was closed with scrotal flaps. In more complex patients with circumferential nonviable penile skin, the penile skin was completely excised and replaced with a split-thickness skin graft. Complex patients with severe abdominal lipodystrophy required adjacent tissue transfer. For cases of genital lymphedema, the procedure involved complete excision of the lymphedematous tissue, and primary closure with or without a split-thickness skin graft, also often involving the scrotum. The authors' overall success rate was 88 percent (49 of 56), defined as resolution of symptoms without the need for additional procedures. Successful correction of adult buried penis often necessitates an interdisciplinary, multimodal approach. Therapeutic, IV.

Effects of modified penoplasty for concealed penis in children.

PubMed

Chen, Chao; Li, Ning; Luo, Yi-Ge; Wang, Hong; Tang, Xian-Ming; Chen, Jia-Bo; Dong, Chun-Qiang; Liu, Qiang; Dong, Kun; Su, Cheng; Yang, Ti-Quan

2016-10-01

To evaluate the effect of modified penoplasty in the management of concealed penis. We retrospectively reviewed 96 consecutive patients with concealed penis, which had been surgically corrected between July 2013 and July 2015. All patients underwent modified Shiraki phalloplasty. All patients were scheduled for regular follow-up at 1, 3, and 6 months after the surgery. Data on the patients' age, operative time, postoperative complications, and parents' satisfaction grade were collected and analyzed. The mean follow-up period was 17.4 months (range 7-31 months). The mean operative time was 63.2 ± 8.7 min. The mean perpendicular penile length was 1.89 ± 0.77 cm preoperatively and 4.42 ± 0.87 cm postoperatively, with an improved mean length of 2.5 ± 0.68 cm in the flaccid state postoperatively (p < 0.05). The patients' satisfaction grades after the surgery were improved significantly (p < 0.05). Fifty-two patients had penile lymphedema postoperatively; however, it disappeared spontaneously within 3 months. Additionally, postoperative wound infection occurred in two patients. There were no complications such as flap necrosis, penile shaft contracture, voiding difficulty, and erection difficulties. The modified Shiraki phalloplasty for concealed penis can achieve maximum utilization of prepuce to assure coverage of the exposed penile shaft. It has fewer complications, achieving marked asthetics, and functional improvement. It is a relatively ideal means for treating concealed penis.

Fracture of the penis: an atypical presentation.

PubMed

Waseem, Muhammad; Upadhyay, Ruchi; Kapoor, Ramnath; Agyare, Samuel

2013-08-13

Fracture of the penis is an uncommon injury presenting to the emergency department (ED). Personal embarrassment and social scenarios associated with this condition may result in underreporting. Patients often delay seeking medical attention, and even when they do, as in our case report, they may withhold the condition for a significant time. ED physicians need to be aware of the social inhibitions and the need for early diagnosis and prompt treatment. A delay in treatment increases the risk of complications such as ischemia, necrosis and penile deformity.Fracture of the penis is caused by rupture of the tunica albuginea of one or both corpora cavernosa by a blunt trauma to the erect penis. Diagnosis is usually clinical as evident by the characteristic history and clinical presentation. Diagnostic modalities aid in the management of the fracture and associated injuries if present. But promptness in the recognition and initiation of treatment can significantly reduce the chances of post-injury complications. We present a case of penile fracture in a young male who presented to the ED with abdominal pain, but careful history and physical examination revealed penile fracture. A delay in diagnosis could have led to complications. Our case report is an attempt to emphasize the need to suspect injury to the penis in a young adult who might present to the emergency department with an entirely different complaint and also to treat any penile trauma as an emergency. This report provides evidence of an uncommon and underreported clinical entity. A review of the pertinent literature is included.

Penile paraffinoma after subcutaneous injection of paraffin. Treatment with a two step cutaneous plasty of the penile shaft with scrotal skin.

PubMed

Oñate Celdrán, Julián; Sanchez Rodríguez, Carlos; Tomás Ros, Mariano; González Valverde, Francisco Miguel; Morga Egea, Juan Pedro; Ruiz Marín, Miguel; Valdelvira Nadal, Pedro; Jiménez López, José Miguel; Fontana Compiano, Luis Oscar

2012-06-01

To report a rare case of penile paraffinoma caused by the subcutaneous or intra-urethral injection of foreign substances containing long-chain saturated hydrocarbons. These were injected in order to increase the penis size which generated a chronic granulomatous inflammatory reaction. This is a rare practice in the western world. We present the case of a 32-year-old Bulgarian male who presented with a two-year history of elastic, slightly painful penis swelling after subcutaneous liquid paraffin injection. The proposed treatment was excision of the affected tissue and penile reconstruction in a two-stage procedure. The operative procedure was successful and the patient had good aesthetic and functional results. Paraffin and other materials injected into the penis can produce many complications. Foreign body granuloma, skin necrosis, penile deformity, chronic and unhealed ulcer, painful erection, and the inability to achieve a satisfactory sexual relationship are some of the resulting complications. Intralesional or systemic steroids have been used in primary sclerosing lipogranuloma resulting in the disappearance of the granuloma, but in our opinion the treatment of choice should be radical excision, and, if necessary, secondary reconstruction of the penis. The injection of foreign substances to enhance penis size is currently an unjustifiable practice. However, it is still carried out, especially in Eastern Europe and Asia. In most cases surgical treatment is needed to treat the complications and the best modality seems to be radical excision together with follow-up.

Anatomy of pudendal nerve at urogenital diaphragm--new critical site for nerve entrapment.

PubMed

Hruby, Stephan; Ebmer, Johannes; Dellon, A Lee; Aszmann, Oskar C

2005-11-01

To investigate the relations of the pudendal nerve in this complex anatomic region and determine possible entrapment sites that are accessible for surgical decompression. Entrapment neuropathies of the pudendal nerve are an uncommon and, therefore, often overlooked or misdiagnosed clinical entity. The detailed relations of this nerve as it exits the pelvis through the urogenital diaphragm and enters the mobile part of the penis have not yet been studied. Detailed anatomic dissections were performed in 10 formalin preserved hemipelves under 3.5x loupe magnification. The pudendal nerve was dissected from the entrance into the Alcock canal to the dorsum of the penis. The branching pattern of the nerve and its topographic relationship were recorded and photographs taken. The anatomic dissections revealed that the pudendal nerve passes through a tight osteofibrotic canal just distal to the urogenital diaphragm at the entrance to the base of the penis. This canal is, in part, formed by the inferior ramus of the pubic bone, the suspensory ligament of the penis, and the ischiocavernous body. In two specimens, a fusiform pseudoneuromatous thickening was found. The pudendal nerve is susceptible to compression at the passage from the Alcock canal to the dorsum of the penis. Individuals exposed to repetitive mechanical irritation in this region are especially endangered. Diabetic patients with peripheral neuropathy can have additional compression neuropathy with decreased penile sensibility and will benefit from decompression of the pudendal nerve.

Human glans penis augmentation using injectable hyaluronic acid gel.

PubMed

Kim, J J; Kwak, T I; Jeon, B G; Cheon, J; Moon, D G

2003-12-01

Although augmentation phalloplasty is not an established procedure, some patients still need enlargement of their penis. Current penile augmentation is girth enhancement of penile body by dermofat graft. We performed this study to identify the efficacy and the patient's satisfaction of human glans penis augmentation with injectable hyaluronic acid gel. In 100 patients of subjective small penis (Group I) and 87 patients of small glans after dermofat graft (Group II), 2 cm(3) of hyaluronic acid gel was injected into the glans penis, subcutaneously. At 1 y after injection, changes of glandular diameter were measured by tapeline. Patient's visual estimation of glandular size (Gr 0-4) and patient's satisfaction (Grade (Gr) 0-4) were evaluated, respectively. Any adverse reactions were also evaluated. The mean age of patients was 42.2 (30-70) y in Group I and 42.13 (28-61) y in Group II. The maximal glandular circumference was significantly increased compared to basal circumference of 9.13+/-0.64 cm in Group I (P<0.01) and 9.49+/-1.05 cm in Group II (P<0.01) at 1 y after injection. Net increase of maximal glandular circumference after glans augmentation was 14.93+/-0.80 mm in Group I and 14.78+/-0.89 mm in Group II. In patient's visual estimation, more than 50% of injected volume was maintained in 95% of Group 1 and 100% of Group II. The percentage of postoperative satisfaction (Gr 4, 5) was 77% in Group 1 and 69% in Group II. There was no abnormal reaction in area feeling, texture, and color. In most cases, initial discoloration by glandular swelling recovered to normal within 2 weeks. There were no signs of inflammation and no serious adverse reactions in all cases. These results suggest that injectable hyaluronic acid gel is a safe and effective material for augmentation of glans penis.

If there’s a penis, it’s most likely a man: Investigating the social construction of gender using eye tracking

PubMed Central

Briken, Peer; Dekker, Arne

2018-01-01

In their foundational work on the social construction of gender, Kessler and McKenna (1978) investigated the relationship between gender attribution and genital attribution. We used digital reproductions of the original stimuli to replicate their findings in the current social context. To further investigate the underlying decision processes we applied eye tracking. The stimuli shown varied in the composition of gender cues: from those more commonly associated with maleness to associated with femaleness. Applying the ethnomethodological approach originally used, participants were asked to decide for each stimulus whether they saw a man or a woman and to indicate subjective confidence with the decision. In line with the original results we found that the genital attribution contributed immensely to the gender attribution. Also, male gender was ascribed more often when the penis was present than was female gender when the vulva was shown. Eye tracking revealed that overall most dwell time as a proxy for important information was dedicated to the head, chest and genital areas of all the stimuli. Total dwell time depended on whether the gender attribution was made in line with the depicted genital, if the genital was a penis. Attributing female gender when a penis was present was associated with longer total dwell time, unlike attributing male gender with a vulva shown. This is indicative of higher cognitive effort and more difficulty ignoring the penis as opposed to the vulva. We interpret this finding in context of the persistent male dominance as well as to the socio-cultural understanding of the vulva as a concealed and therefore seemingly absent organ. In summary, we were able to show that the gender attribution is still closely linked to genital attribution when having a binary forced choice task and that the penis is a special cue in this attribution process. PMID:29494689

Ontogenetic Profile of the Expression of Thyroid Hormone Receptors in Rat and Human Corpora Cavernosa of the Penis

PubMed Central

Carosa, Eleonora; Di Sante, Stefania; Rossi, Simona; Castri, Alessandra; D'Adamo, Fabio; Gravina, Giovanni Luca; Ronchi, Piero; Kostrouch, Zdenek; Dolci, Susanna; Lenzi, Andrea; Jannini, Emmanuele A

2010-01-01

Introduction In the last few years, various studies have underlined a correlation between thyroid function and male sexual function, hypothesizing a direct action of thyroid hormones on the penis. Aim To study the spatiotemporal distribution of mRNA for the thyroid hormone nuclear receptors (TR) α1, α2 and β in the penis and smooth muscle cells (SMCs) of the corpora cavernosa of rats and humans during development. Methods We used several molecular biology techniques to study the TR expression in whole tissues or primary cultures from human and rodent penile tissues of different ages. Main Outcome Measure We measured our data by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) amplification, Northern blot and immunohistochemistry. Results We found that TRα1 and TRα2 are both expressed in the penis and in SMCs during ontogenesis without development-dependent changes. However, in the rodent model, TRβ shows an increase from 3 to 6 days post natum (dpn) to 20 dpn, remaining high in adulthood. The same expression profile was observed in humans. While the expression of TRβ is strictly regulated by development, TRα1 is the principal isoform present in corpora cavernosa, suggesting its importance in SMC function. These results have been confirmed by immunohistochemistry localization in SMCs and endothelial cells of the corpora cavernosa. Conclusions The presence of TRs in the penis provides the biological basis for the direct action of thyroid hormones on this organ. Given this evidence, physicians would be advised to investigate sexual function in men with thyroid disorders. Carosa E, Di Sante S, Rossi S, Castri A, D'Adamo F, Gravina GL, Ronchi P, Kostrouch Z, Dolci S, Lenzi A, and Jannini EA. Ontogenetic profile of the expression of thyroid hormone receptors in rat and human corpora cavernosa of the penis. J Sex Med 2010;7:1381–1390. PMID:20141582

Skin reduction technique for correction of lateral deviation of the erect straight penis.

PubMed

Shaeer, Osama

2014-07-01

Lateral deviation of the erect straight penis (LDESP) refers to a penis that despite being straight in the erect state, points laterally, yet can be directed forward manually without the use of force. While LDESP should not impose a negative impact on sexual function, it may have a negative cosmetic impact. This work describes skin reduction technique (SRT) for correction of LDESP. Counseling was offered to males with LDESP after excluding other abnormalities. Surgery was performed in case of failed counseling. In the erect state, the degree and direction of LDESP were noted. Skin on the base of the penis on the contralateral side of LDESP was excised from the base of the penis and the edges approximated to correct LDESP. Further excision was repeated if needed. The incision was closed in two layers. Long-term efficacy of SRT was the main outcome measure. Out of 183 males with LDESP, 66.7% were not sexually active. Counseling relieved 91.8% of cases. Fifteen patients insisted on surgery, mostly from among the sexually active where the complaint was mutual from the patient and partner. SRT resulted in full correction of the angle of erection in 12 cases out of 15. Two had minimal recurrence, and one had major recurrence indicating re-SRT. LDESP is more common a complaint among those who have not experienced coital relationship, and is mostly relieved by counseling. However, sexually active males with this complaint are more difficult to relieve by counseling. A minority of patients may opt for surgical correction. SRT achieves a forward erection in such patients, is minimally invasive, and relatively safe, provided the angle of erection can be corrected manually without force. Shaeer O. Skin reduction technique for correction of lateral deviation of the erect straight penis. © 2014 International Society for Sexual Medicine.

Is glans penis width a risk factor for complications after hypospadias repair?

PubMed

Faasse, M A; Johnson, E K; Bowen, D K; Lindgren, B W; Maizels, M; Marcus, C R; Jovanovic, B D; Yerkes, E B

2016-08-01

Recent studies have suggested that a smaller glans penis size may be associated with a higher likelihood of complications after hypospadias repair. Accurate identification of risk factors other than the well-understood variable of meatal location would allow development of better prognostic models and individualized risk stratification. To test the hypothesis that a smaller width of the glans penis predicts adverse outcomes after hypospadias surgery. Prospectively recorded clinical data were reviewed from a single-institution registry of primary hypospadias repairs performed between 2011 and 2014. Follow-up records were examined for occurrence of complications. Urethroplasty complications were defined to include meatal stenosis, dehiscence, urethrocutaneous fistula, urethral stricture, and/or urethral diverticulum. The subset of meatal stenosis and dehiscence were regarded as glanular complications. Regression analyses were performed to determine association between glans width and occurrence of complications. Because pre-operative androgen stimulation is known to increase glans penis size, separate subgroup analyses were included of patients with and without pre-operative use of testosterone cream. A total of 159 patients met criteria for inclusion in the study cohort: 140 patients underwent a single-stage repair, while 19 patients had a two-stage repair. The median glans penis width was 15 mm (range 10-22). Eighty-four patients (53%) received testosterone cream pre-operatively and had a significantly wider glans penis than the 75 patients who did not (median 15.5 vs 14 mm; P < 0.001). Median clinical follow-up was 7 months (IQR 1-12), with a minimum time elapsed since surgery of 10 months at the time of chart review. Twenty-four patients (15%) had one or more urethroplasty complications, including 11 (7%) with glanular complications. Overall, there was no statistically significant association between glans width and urethroplasty complications (P = 0.26) or glanular complications (P = 0.90) (Summary Table). Subgroup analyses of patients with and without pre-operative testosterone also revealed no significant associations between glans width and complications. Glans penis width was not a risk factor for complications after hypospadias repair. This finding differs from the results of other recent studies and encourages further research into the value of measuring penile parameters in patients undergoing hypospadias repair. Copyright © 2016 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Novel Application of Micro-Computerized Tomography for Morphologic Characterization of the Murine Penis.

PubMed

O'Neill, Marisol; Huang, Gene O; Lamb, Dolores J

2017-12-01

The murine penis model has enriched our understanding of anomalous penile development. The morphologic characterization of the murine penis using conventional serial sectioning methods is labor intensive and prone to errors. To develop a novel application of micro-computerized tomography (micro-CT) with iodine staining for rapid, non-destructive morphologic study of murine penis structure. Penises were dissected from 10 adult wild-type mice and imaged using micro-CT with iodine staining. Images were acquired at 5-μm spatial resolution on a Bruker SkyScan 1272 micro-CT system. After images were acquired, the specimens were washed of any remaining iodine and embedded in paraffin for conventional histologic examination. Histologic and micro-CT measurements for all specimens were made by 2 independent observers. Measurements of penile structures were made on virtual micro-CT sections and histologic slides. The Lin concordance correlation coefficient demonstrated almost perfect strength of agreement for interobserver variability for histologic section (0.9995, 95% CI = 0.9990-0.9997) and micro-CT section (0.9982, 95% CI = 0.9963-0.9991) measurements. Bland-Altman analysis for agreement between the 2 modalities of measurement demonstrated mean differences of -0.029, 0.022, and -0.068 mm for male urogenital mating protuberance, baculum, and penile glans length, respectively. There did not appear to be a bias for overestimation or underestimation of measured lengths and limits of agreement were narrow. The enhanced ability offered by micro-CT to phenotype the murine penis has the potential to improve translational studies examining the molecular pathways contributing to anomalous penile development. The present study describes the first reported use of micro-CT with iodine staining for imaging the murine penis. Producing repeated histologic sections of identical orientation was limited by inherent imperfections in mounting and tissue sectioning, but this was compensated for by using micro-CT reconstructions to identify matching virtual sections. This study demonstrates the successful use of micro-CT with iodine staining, which has the potential for submicron spatial resolution, as a non-destructive method of characterizing murine penile morphology. O'Neill M, Huang GO, Lamb DJ. Novel Application of Micro-Computerized Tomography for Morphologic Characterization of the Murine Penis. J Sex Med 2017;14:1533-1539. Copyright © 2017. Published by Elsevier Inc.

Hypercholesterolemia-induced erectile dysfunction: endothelial nitric oxide synthase (eNOS) uncoupling in the mouse penis by NAD(P)H oxidase

PubMed Central

Musicki, Biljana; Liu, Tongyun; Lagoda, Gwen A.; Strong, Travis D.; Sezen, Sena F.; Johnson, Justin M.; Burnett, Arthur L.

2010-01-01

INTRODUCTION Hypercholesterolemia induces erectile dysfunction (ED) mostly by increasing oxidative stress and impairing endothelial function in the penis, but the mechanisms regulating reactive oxygen species (ROS) production in the penis are not understood. AIMS We evaluated whether hypercholesterolemia activates nicotinamide adenine dinucleotide phosphate (NAD[P]H) oxidase in the penis, providing an initial source of ROS to induce endothelial nitric oxide synthase (eNOS) uncoupling and endothelial dysfunction resulting in ED. METHODS Low-density-lipoprotein receptor (LDLR)–null mice were fed Western diet for 4 weeks to induce early-stage hyperlipidemia. Wild type (WT) mice fed regular chow served as controls. Mice received NAD(P)H oxidase inhibitor apocynin (10 mM in drinking water) or vehicle. Erectile function was assessed in response to cavernous nerve electrical stimulation. Markers of endothelial function (phospho [P]-vasodilator-stimulated-protein [VASP]-Ser-239), oxidative stress (4-hydroxy-2-nonenal [HNE]), sources of ROS (eNOS uncoupling and NAD[P]H oxidase subunits p67phox, p47phox, and gp91phox), P-eNOS-Ser-1177, and eNOS were measured by Western blot in penes. MAIN OUTCOME MEASURES Molecular mechanisms of ROS generation and endothelial dysfunction in hypercholesterolemia-induced ED. RESULTS Erectile response was significantly (P<0.05) reduced in hypercholesterolemic LDLR-null mice compared to WT mice. Relative to WT mice, hypercholesterolemia increased (P<0.05) protein expressions of NAD(P)H oxidase subunits p67phox, p47phox and gp91phox, eNOS uncoupling, and 4-HNE-modified proteins, and reduced (P<0.05) P-VASP-Ser-239 expression in the penis. Apocynin treatment of LDLR-null mice preserved (P<0.05) maximal intracavernosal pressure, and reversed (P < 0.05) the abnormalities in protein expressions of gp67phox and gp47phox, 4-HNE, P-VASP-Ser-239, and eNOS uncoupling in the penis. Apocynin treatment of WT mice did not affect any of these parameters. Protein expressions of P-eNOS-Ser-1177 and total eNOS were unaffected by hypercholesterolemia. CONCLUSION Activated NAD(P)H oxidase in the penis is an initial source of oxidative stress resulting in eNOS uncoupling, thus providing a mechanism of eNOS uncoupling and endothelial dysfunction in hypercholesterolemia-induced ED. PMID:20626609

Injection of Vaseline under Penis Skin for the Purpose of Penis Augmentation.

PubMed

Karakan, Tolga; Ersoy, Erim; Hasçiçek, Metin; Ozgür, Berat Cem; Ozcan, Serkan; Aydın, Arif

2012-01-01

Penile foreign body injection is an uncommon entity produced by penile paraffin, mineral oil, and vaseline injections for the purpose of penile enlargement. Generally, penile subcutaneous and glandular injections for penile augmentation are performed by a nonmedical person, under unacceptable conditions. It will be an aim to share our experiences about penile vaseline injection.

Superficial Dorsal Vein Rupture Imitating Penile Fracture

PubMed Central

Topsakal, Medih; Kavukcu, Ender; Karadeniz, Tahir

2011-01-01

Dorsal vein rupture of the penis is a rare condition, and few cases have been reported in the literature. Herein we report a 41-year-old man who presented with mildly painful and acute swollen penis, which initially imitated a penile fracture but was surgically explored and shown to be a superficial dorsal vein rupture. PMID:21556219

Erectile dysfunction due to a 'hidden' penis after pelvic trauma.

PubMed

Simonis, L A; Borovets, S; Van Driel, M F; Ten Duis, H J; Mensink, H J

1999-02-01

We describe a twenty-six year old patient who presented us with a dorsally retracted 'hidden' penis, which was entrapped in scar tissue and prevesical fat, 20y after a pelvic fracture with symphysiolysis. Penile 'lengthening' was performed by V-Y plasty, removal of fatty tissue, dissection of the entrapped corpora cavernosa followed by ventral fixation.

Physiological considerations in radionuclide imaging of the penis during impotence therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chaudhuri, T.K.; Fink, S.; Burger, R.H.

1989-01-01

The increased use of intracorporeal drugs in the treatment of impotence has advanced our understanding of erectile physiology. Radionuclide imaging of the penis (nuclear penogram) has provided clinicians with a noninvasive, objective measure of blood flow and blood pool changes during erection and with assistance in the quantitative documentation of therapeutic effect. 39 references.

Self injection of foreign materials into the penis.

PubMed

Ahmed, U; Freeman, A; Kirkham, A; Ralph, D J; Minhas, S; Muneer, A

2017-02-01

Injection of the subcutaneous tissues of the penis for enlargement of penile girth has been practised for many years by laypeople and medical practitioners alike. However, with recognition of the complications, the practice has died out. We report a series of five patients who presented having injected foreign materials into the subcutaneous tissues of their penises, including paraffin and mineral oils. Our patients had a variable time course of presentation ranging from 1 day following injection to over 26 years. Self-injection of the subcutaneous tissues of the penis is an unusual presentation for a penile mass but should be considered as a differential diagnosis in patients with a long latent period to presentation or with characteristic magnetic resonance imaging and histological appearances.

Self injection of foreign materials into the penis

PubMed Central

Freeman, A; Kirkham, A; Ralph, DJ; Minhas, S; Muneer, A

2017-01-01

Injection of the subcutaneous tissues of the penis for enlargement of penile girth has been practised for many years by laypeople and medical practitioners alike. However, with recognition of complications, the practice has died out. We report a series of five patients who presented having injected foreign materials into the subcutaneous tissues of their penises, including paraffin and mineral oils. Our patients had a variable time course of presentation ranging from 1 day following injection to over 26 years. Self-injection of the subcutaneous tissues of the penis is an unusual presentation for a penile mass but should be considered as a differential diagnosis in patients with a long latent period to presentation or with characteristic magnetic resonance imaging and histological appearances. PMID:27869491

Traumatic Penile Injury: From Circumcision Injury to Penile Amputation

PubMed Central

Park, Jae Young; Song, Yun Seob

2014-01-01

The treatment of external genitalia trauma is diverse according to the nature of trauma and injured anatomic site. The classification of trauma is important to establish a strategy of treatment; however, to date there has been less effort to make a classification for trauma of external genitalia. The classification of external trauma in male could be established by the nature of injury mechanism or anatomic site: accidental versus self-mutilation injury and penis versus penis plus scrotum or perineum. Accidental injury covers large portion of external genitalia trauma because of high prevalence and severity of this disease. The aim of this study is to summarize the mechanism and treatment of the traumatic injury of penis. This study is the first review describing the issue. PMID:25250318

Mineral Oil-induced Sclerosing Lipogranuloma of the Penis

PubMed Central

Bjurlin, Marc A.; Carlsen, Jens; Grevious, Mark; Jordan, Michael D.; Taylor, Aisha; Divakaruni, Naveen

2010-01-01

Sclerosing lipogranuloma of the penis results from injection of high viscosity fluid for the purpose of penile augmentation and may have devastating cosmetic and sexual function consequences. Although rare, sclerosing lipogranuloma should be considered in the differential diagnosis of subcutaneous induration or nodules of the male genitalia as it may mimic carcinoma and poses a diagnostic challenge in patients reluctant to admit to injection therapy. Surgical excision with penile reconstruction is the mainstay of treatment. The authors present a case of a 35-year-old Myanmarese man with a sclerosing lipogranuloma of the penis due to injection of mineral oil successfully managed with penile biopsy and excision with split-thickness skin graft phalloplasty and provide a review of the current literature. PMID:20877525

Painful erections secondary to rare epithelioid hemangioma of the penis.

PubMed

Barber, Evan; Domes, Trustin

2014-09-01

Epithelioid hemangioma is a rare benign vascular tumour that atypically involves the penis and usually presents as a painful nodule. A 35-year-old man presented with a 5-month history of painful erections without a clinically apparent lesion or deformity. Magnetic resonance imaging (MRI) with pharmacologically induced erection demonstrated a 1.3-cm nodular lesion deep to the skin at the base of his penis. Following local excision of the lesion, which was diagnosed as an epithelioid hemangioma, the patient was symptom free. This case demonstrates a rare etiology of painful erections with a unique presentation. To the authors' knowledge, it is also the first report of MRI with intracavernosal injection of trimix to assess for a specific cause of painful erections.

Cytology of the outer penis epithelium of Buccinum undatum (L.) from the arctic region — an observation of the imposex phenomenon

NASA Astrophysics Data System (ADS)

Brick, M.; Bolte, M.

1994-03-01

TBT (tributyltin)-induced imposex is observed in female Buccinum undatum from the arctic region. The fine structure of the male penis epithelium was investigated and the results were compared between specimens from non-polluted (Spitsbergen, Norway) and highly-polluted (Brittany, France) areas. Differences in the arrangement and structure of the apical microvilli-border, the intercellular spaces, RER and SER content, as well as a high rate of parasitism in the tissue of individuals from Brittany can be detected between the species of both areas. The results indicate a higher degree of pathological changes in the penis epithelial cells of individuals from TBT-polluted areas than in those from Spitsbergen.

Anatomy of mole external genitalia: Setting the record straight

PubMed Central

Sinclair, Adriane Watkins; Glickman, Stephen; Baskin, Lawrence; Cunha, Gerald R.

2016-01-01

Anatomy of male and female external genitalia of adult mice (Mus musculus) and broad-footed moles (Scapanus latimanus) was re-examined to provide more meaningful anatomical terminology. In the past the perineal appendage of male broad-footed moles has been called the penis, while the female perineal appendage has been given several terms (e.g. clitoris, penile clitoris, peniform clitoris and others). Histological examination demonstrates that perineal appendages of male and female broad-footed moles are the prepuce, which in both sexes are covered externally with a hair-bearing epidermis and lacks erectile bodies. The inner preputial epithelium is non-hair-bearing and defines the preputial space in both sexes. The penis of broad-footed moles lies deep within the preputial space, is an “internal organ” in the resting state and contains the penile urethra, os penis, and erectile bodies. The clitoris of broad-footed moles is defined by a U-shaped clitoral epithelial lamina. Residing within clitoral stroma encompassed by the clitoral epithelial lamina is the corpus cavernosum, blood-filled spaces and the urethra. External genitalia of male and female mice are anatomically similar to that of broad-footed moles with the exception that in female mice the clitoris contains a small os clitoridis and lacks defined erectile bodies, while male mice have an os penis and a prominent distal cartilaginous structure within the male urogenital mating protuberance (MUMP). Clitori of female broad-footed moles lack an os clitoridis but contain defined erectile bodies, while male moles have an os penis similar to the mouse but lack the distal cartilaginous structure. PMID:26694958

Evaluation and management of gunshot wounds of the penis: 20-year experience at an urban trauma center.

PubMed

Kunkle, David A; Lebed, Brett D; Mydlo, Jack H; Pontari, Michel A

2008-04-01

Although gunshot injuries to the penis occur relatively infrequently in patients with penetrating trauma, they often present dilemmas of subsequent evaluation and management. We review our extensive experience with gunshot wounds to the penis at a high volume urban trauma center. The urologic trauma database was retrospectively reviewed to extract and compile information from the records of 63 patients treated for gunshot wounds to the penis. Data were accumulated for a 20-year period from 1985 to 2004 with regard to findings on physical examination, diagnostic evaluation, associated injuries, management, and outcome. We detail our technique of penile exploration and artificial erection in the management of these injuries. Penile gunshot wounds were associated with additional injuries in 53 of 63 (84%) patients. A total of 48 (76%) patients were taken to the operating room and 44 (70%) penile explorations were performed. Evaluation included retrograde urethrogram in 50 of 63 (79%) patients and was diagnostic for urethral injury in 11 of 12 (92%) cases. Primary urethral repair was performed in 8 of 12 (67%) patients with urethral injury versus 4 of 12 (33%) who underwent urinary diversion by means of suprapubic cystotomy. Evaluation and management of gunshot wounds to the penis may potentially be complex. Retrograde urethrogram should be performed in all cases except the most insignificant and superficial wounds. We describe our technique of penile exploration and artificial erection, noting excellent results in patients for whom follow-up is available. Additional studies are needed to prospectively evaluate techniques for management of gunshot urethral injuries.

Priapism associated with lumbar stenosis in a dog.

PubMed

Payan-Carreira, R; Colaço, B; Rocha, C; Albuquerque, C; Luis, M; Abreu, H; Pires, M A

2013-08-01

Priapism, a persistent long-lasting involuntary erection of the penis, is uncommon in dogs. In this report, the case of a 13-year-old male Pointer, referred to our services due to persistent exposition of the penis, is described. This condition was consecutive to an intermittent priapism situation lasting for several days, which has been initially attributed to the inflammation and haematoma associated with a perianal bite. The owners became unable to retract the penis into the prepuce. At presentation, the dog was anorectic for 48 h, intolerant to manipulation, and showed poor body condition and unsteady locomotion. During physical evaluation, a marked engorgement of the local vessels in the prepuce and penis was found. An abdominal X-ray was asked under the suspicion of a neurogenic origin for the clinical situation, which showed evidences of spondylosis. After discussion of the clinical condition, the owners asked for euthanasia. The necropsy confirmed the engorgement of the regional vessels deriving from the pudendal arteries and blood accumulation within all the cavernous spaces, accompanied by congestion and thrombosis within the erectile structures of the penis. No significant changes were observed in the pelvic organs that could be at the origin of priapism. The lumbar-sacral spinal regions were carefully inspected and evidenced signs of L7-S1 stenosis due to spondylosis. The case presented herein is a rare situation of priapism of neurogenic origin in a dog. Necropsy findings suggest that it was consecutive to cauda equina compression due to lumbar spinal stenosis. © 2013 Blackwell Verlag GmbH.

Pyogenic Granuloma of the Penis: An Uncommon Lesion with Unusual Presentation

PubMed Central

Katmeh, Rateb F.; Johnson, Luke; Kempley, Eilis; Kotecha, Shrinal; Hamarneh, Wael; Chitale, Sudhanshu

2017-01-01

We present the case of a 37-year-old man who presented with a penile lesion that engorged on erection. Ultrasound examination demonstrated vascularity of the lesion and the decision was made to perform a complete excision. Histological analysis confirmed the diagnosis of a pyogenic granuloma of the penis. Follow-up demonstrated no recurrence at 3 months. PMID:28413384

[Sexual possibilities following total penis amputation].

PubMed

Hengeveld, M W; Boon, T A

1993-07-17

A male aged 45 was subjected to total penis amputation because of a penile carcinoma; a perineal urethral stoma was created. The postoperative course was uneventful. One month after the last operation the patient for the first time felt the need for sexual contact, but his wife hesitated. After medical-sexological counselling, the partners achieved satisfactory sexual functioning with the husband occasionally having an orgasm.

Antecedents of Pregnancy and Pregnancy Attrition in First Term Women Marines

DTIC Science & Technology

1989-11-01

pregnant (18%) b. conception (pregnancy) is most likely if the man and woman both reach orgasm at the same time (13%) c. douching is an effective means of...some space at the tip for the ejaculate (4%) b. use a new one every time intercourse occurs (4%) c. hold it on the penis when withdrawing the penis from

[Self-administration of an oil solution in the penis].

PubMed

Rebassa Llull, M J; Muñoz Vélez, D; Ferrutxe Frau, J; Gutiérrez Sanz-Gadea, C; Mus Malleu, A; Torrens Darder, I; Ozonas Moragues, M

2000-09-01

We report the case of a patient who has autoinjected himself the penis and the scrotum with a solution constituted by petroleum, vaseline, oxygenated water and ketoconazol gel. Treatment consists in the excision of the injected deposit of lipid material and antibiotic therapy with good result at 4 months. We review the existing literature related with this exceptional pathology.

An empirical study of Freud's penis-baby equation.

PubMed

Jones, R L

1994-03-01

One hypothesis of traditional psychoanalytic theory holds that a cardinal aspect of the "natural" development of femininity involves the woman's substitution of the wish for a baby in place of her original wish for a penis. The current study modified and extended earlier research examining the validity of Freud's this "penis-baby" theory. College-aged women and men were presented with either subliminal or supraliminal auditory messages concerned with either pregnancy or penetration themes. Subjects' written responses to Holtzman ink-blots, obtained both before and after exposure to an auditory message, were content-coded for phallic imagery and sexual imagery. Consistent with Freud's speculations about the phallic significance of pregnancy for women, female subjects who were exposed to the subliminal pregnancy message produced significantly more phallic imagery responses to ink-blots than did women in any of the other experimental conditions (p < .01). The phallic imagery production of males did not vary significantly as a function of message condition. Implications of these findings are discussed in the context of modern revisions to Freud's psychology of women and the current psychoanalytic conceptualization of penis envy as a highly condensed mental product with many layers of meaning.

A reconsideration of object choice in women: phallus or fallacy.

PubMed

Frenkel, R S

1996-01-01

Within the context of Freud's theory of instinctual drives, analytic data from three female patients are presented which refute his concept that penis envy is the basis for female object choice. Contrary to Freud's theory, these patients did not feel their genitalia or genital arousal were inadequate. Rather, they believed their genital sexuality and fantasies were powerful and gratifying, but dangerous and bad. Their subsequent guilt and fears led secondarily to their defensive wish to have a penis to avoid their core conflicts; their penis envy was pathological. The data unequivocally demonstrate that the clitoris is not an inferior organ, but is the locus for the initiation of intense pleasure and occasional orgasm as early as ages four to six, when vaginal awareness also is present. In addition the material provides evidence that girls choose fathers to feel loved and valued, and that their wish for a baby is not a substitute for a relinquished wish for a penis. Observational studies and a vignette suggest that the instinctual drives of the genital phase coalesce with a change in object relations, forming an important motivation for a girl to switch her primary love object from her mother to her father.

A Comprehensive Atlas of the Adult Mouse Penis

PubMed Central

Phillips, Tiffany R.; Wright, David K.; Gradie, Paul E.; Johnston, Leigh A.; Pask, Andrew J.

2016-01-01

Mice are routinely used to study the development of the external genitalia and, in particular, the process of male urethral closure. This is because misplacement of the male penile urethra, or hypospadias, is amongst the most common birth defects reported in humans. While mice present a tractable model to study penile development, several structures differ between mice and humans, and there is a lack of consensus in the literature on their annotation and developmental origins. Defining the ontology of the mouse prepuce is especially important for the relevance and interpretation of mouse models of hypospadias to human conditions. We have developed a detailed annotation of the adult mouse penis that addresses these differences and enables an accurate comparison of murine and human hypospadias phenotypes. Through MRI data, gross morphology and section histology, we define the origin of the mouse external and internal prepuces, their relationship to the single human foreskin as well as provide a comprehensive view of the various structures of the mouse penis and their associated muscle attachments within the body. These data are combined to annotate structures in a novel 3D adult penis atlas that can be downloaded, viewed at any angle, and manipulated to examine the relationship of various structures. PMID:26112156

Concealed epispadias associated with a buried penis.

PubMed

Sol Melgar, Ricardo; Gorduza, Daniela; Demède, Delphine; Mouriquand, Pierre

2016-12-01

The aim was to describe the clinical presentation and the surgical management of penile epispadias associated with a buried penis in five children. This is a 5-year retrospective review of patients presenting with a buried penis, a congenital defect of the penile skin shaft associated with an unretractable foreskin for whom a penile epispadias was found at the time of surgery. All had undergone surgery combining a Cantwell-Ransley procedure and refashioning of the penile skin following the authors' technique. Three children had a glanular epispadias and two had a midshaft epispadias. Four had a satisfactory outcome, and one required a complementary urethroplasty for glanular dehiscence. Buried penis and epispadias are usually isolated congenital anomalies, although they can be associated. It is therefore recommended to warn parents about the possibility of underlying penile anomaly in children with buried penises and unretractable foreskin. Careful palpation of the dorsum of the glans through the foreskin looking for a dorsal cleft could indicate an associated epispadiac urethra. Surgical correction of both anomalies can be done at the same time. Parents of boys with buried penises should be warned that underlying penile anomaly may exist. Copyright © 2016 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Trace elemental analysis in cancer-afflicted tissues of penis and testis by PIXE technique

NASA Astrophysics Data System (ADS)

Naga Raju, G. J.; John Charles, M.; Bhuloka Reddy, S.; Sarita, P.; Seetharami Reddy, B.; Rama Lakshmi, P. V. B.; Vijayan, V.

2005-04-01

PIXE technique was employed to estimate the trace elemental concentrations in the biological samples of cancerous penis and testis. A 3 MeV proton beam was employed to excite the samples. From the present results it can be seen that the concentrations of Cl, Fe and Co are lower in the cancerous tissue of the penis when compared with those in normal tissue while the concentrations of Cu, Zn and As are relatively higher. The concentrations of K, Ca, Ti, Cr, Mn, Br, Sr and Pb are in agreement within standard deviations in both cancerous and normal tissues. In the cancerous tissue of testis, the concentrations of K, Cr and Cu are higher while the concentrations of Fe, Co and Zn are lower when compared to those in normal tissue of testis. The concentrations of Cl, Ca, Ti and Mn are in agreement in both cancerous and normal tissues of testis. The higher levels of Cu lead to the development of tumor. Our results also support the underlying hypothesis of an anticopper, antiangiogenic approach to cancer therapy. The Cu/Zn ratios of both penis and testis were higher in cancer tissues compared to that of normal.

Severe forms of concealed penis without hypospadias: Surgical strategies

PubMed Central

de Jesus, Lisieux Eyer; Dekermacher, Samuel; Anderson, Kleber M.

2015-01-01

Introduction: Concealed penis (CP) may vary in severity and includes megaprepuce (MP) as a variant. Many different surgical strategies have been described in order to maximize penile exposure and to deal with skin deficiency. We describe the strategies that we use to overcome technical problems in severe cases of CP. Materials and Methods: Six consecutive cases of severe CP (including 3 with MP) were treated in a 2-year period between January 2011 and April 2013. These patients were treated using extensive degloving, removal of dysplastic dartos, Alexander's preputial flap, scrotal flaps and skin grafts. Three patients had been previously circumcised. Cases associated with hypospadias, obesity, disorders of sexual differentiation and micropenises were excluded. Results: All six patients attained good results, with good exposure of the penis, ability to void standing with a well-directed flow and reasonable esthetic results. A technical algorithm for the treatment of primary or recurring cases of CP is proposed. Conclusion: Alexander’ s distally based ventral preputial flap is a useful technical resource to treat MP cases. Free skin grafts and/or laterally based scrotal flaps may be used to cover the penis after release in severe cases of CP. PMID:26604447

Rectal adenocarcinoma infiltrating the bulbar urethra and metastasising to the penis

PubMed Central

James, Mathews; Amaranathan, Anandhi; Nelamangala Ramakrishnaiah, Vishnu Prasad; Toi, Pampa Chakrabarty

2016-01-01

Secondary penile tumours from rectal carcinoma is a known clinical entity but can be missed unless carefully evaluated. We report a case of rectal adenocarcinoma with synchronous painless penile nodules. A patient presented with constipation and rectal bleeding. He had an anorectal growth as well as palpable nodules on his penis. Rectal biopsy yielded adenocarcinoma. Imaging revealed direct infiltration of tumour into the bulb of the penis as well as distal shaft lesions. Fine-needle aspiration cytology of the penile nodule showed metastatic adenocarcinoma. Diversion colostomy was performed and the patient referred for chemoradiation. Since he did not have any urinary symptoms, the penile lesions were left unaltered. Repeat imaging after concurrent chemoradiotherapy showed no response. The prognosis was explained and the patient was given palliative clinic care. PMID:27312852

Angiomatous reaction Kaposi-sarcoma-like as a side effect of topical corticosteroid therapy in lichen sclerosus of the penis.

PubMed

Catricalà, Caterina; Marenda, Samantha; Muscardin, Luca Maria; Donati, Pietro; Lepri, Andrea; Eibenschutz, Laura

2009-01-01

Lichen sclerosus (LS) is a chronic inflammatory skin condition usually located in the anogenital area. Topical corticosteroid therapy is the first choice treatment which may arrest or delay the progression of the disorder. We report the case of a 74-year-old man presented with a 6-month history of nodular lesions localized on penis. The man had a previous history of genital lesions that had been diagnosed as LS and treated with long-term topical corticosteroid therapy. After 3 months of corticosteroid therapy, the patient observed the appearance of several nodular erythematous lesions on the penis with progressive disappearance of the clinical symptoms of LS. These purple to red asymptomatic angiomatoid nodules resembled the clinical features of Kaposi sarcoma.

Metastasis to the Glans Penis: An Unusual Site of Rectal Cancer Recurrence.

PubMed

Nunes, Beatriz; Matias, Margarida; Alves, António; Jorge, Marília

2015-01-01

Secondary malignancy of the penis is a rare clinical condition, often associated with disseminated genitourinary malignancies. The prognosis is poor and the treatment options include penectomy, local surgical excision, radiation therapy, chemotherapy and supportive therapy. Neither of these therapeutic options lead to superior treatment outcomes in the literature. The authors report the case of a 66 year-old man with a metastasis to the glans penis from a rectal adenocarcinoma, diagnosed two years after radical treatment for primary disease. The patient underwent palliative treatment with radiotherapy and chemotherapy, remaining asymptomatic and disease-free at one year follow-up. Close follow-up of patients with history of rectal adenocarcinoma is very important. Radiochemotherapy is a feasible and effective therapeutic option for penile metastasis, addressing both disease control and symptomatic improvement.

Correction of concealed penis with preservation of the prepuce.

PubMed

Valioulis, I A; Kallergis, I C; Ioannidou, D C

2015-10-01

By definition, congenital concealed penis presents at birth. Children are usually referred to physicians because of parental anxiety caused by their child's penile size. Several surgical procedures have been described to treat this condition, but its correction is still technically challenging. The present study reports a simple surgical approach, which allows preservation of the prepuce. During the last 6 years, 18 children with concealed penis (according to the classification by Maizels et al.) have been treated in the present department (mean age 4.5 years, range 3-12 years). Patients with other conditions that caused buried penis were excluded from the study. The operation was performed through a longitudinal midline ventral incision, which was extended hemi-circumferentially at the penile base. The dysgenetic dartos was identified and its distal part was resected. Dissection of the corpora cavernosa was carried down to the suspensory ligament, which was sectioned. Buck's fascia was fixed to Scarpa's fascia and shaft skin was approximated in the midline. Penoscrotal angle was fashioned by Z-plasty or V-Y plasty. The median follow-up was 24 months (range 8-36). The postoperative edema was mild and resolved within a week. All children had good to excellent outcomes. The median pre-operative to postoperative difference in penile length in the flaccid state was 2.6 cm (range 2.0-3.5). No serious complications or recurrent penile retraction were noted. Recent literature mostly suggests that concealed penis is due to deficient proximal attachments of dysgenetic dartos. Consequences of this include: difficulties in maintaining proper hygiene, balanitis, voiding difficulties with prepuce ballooning and urine spraying, and embarrassment among peers. Surgical treatment for congenital concealed penis is warranted in children aged 3 years or older. The basis of the technique is the perception that in boys with congenital concealed penis, the penile integuments are normal but they have abnormal attachments, and that incision of the skin and dartos will allow the shaft to extend. Furthermore, incisions of the fundiform and suspensory ligaments facilitate this maneuver. With this technique, the blood supply of the penile skin is not interrupted and postoperative lymphedema, a difficult complication to deal with, is prevented. One major advantage is the preservation of the prepuce, giving a normal penile appearance and an excellent cosmetic result. The method proposed here is simple and has no serious complications. It is suggested that this condition be treated in pre-school-aged children in order to prevent psychological impairment. Copyright © 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Biometry of the hypospadic penis after hormone therapy (testosterone and estrogen): A randomized, double-blind controlled trial.

PubMed

Paiva, Kelly Christina de Castro; Bastos, André Netto; Miana, Laura Pimenta; Barros, Eveline de Souza; Ramos, Plínio Santos; Miranda, Lara Meneguelli; Faria, Natália Maia; Avarese de Figueiredo, André; de Bessa, José; Netto, José Murillo B

2016-08-01

The use of preoperative hormonal stimulation before hypospadias surgery aims to increase penile size and achieve better surgical results; however, the rules are not clear in the literature. We evaluated the effects of topical testosterone and estrogen in the hypospadic penis regarding biometric measures, side effects, and serum hormonal levels. To our knowledge, this is the first study using estradiol prior to hypospadias surgery. Sixty-nine children with hypospadias were randomly divided into three study groups: a control group (CG) of 17 children given placebo cream; a testosterone group (TG) of 28 children who used 1% testosterone propionate; and an estradiol group (EG) of 24 children using 0.01% estradiol. All subjects applied the topical ointment on the entire penis, twice daily for 30 days before surgical correction. Biometric evaluation of the penis included penile length and diameter, glans diameter, distance from the urethral meatus to the tip, and the width of the urethral plate. These measurements as well as serum hormone level, and side effects were evaluated prior to hormone use, and 30 and 90 days after. After 30 days an increase in penile diameter and length and diameter of the glans were observed in TG (p < 0.05). The width of the urethral plate and distance from meatus to the tip increased in TG, although not significantly. The most frequent side effects were appearance of pubic hair and darkening of the genital skin, mainly in TG, but these were transient and disappeared after 90 days of treatment. No significant variations were seen in serum hormonal levels (Table). As in previous studies, an increase in penile length and diameter, and glans diameter was observed with the use of testosterone. Proximal urethral plate width and distance from the meatus to the tip of the penis had a tendency to increase also in TG. Estradiol did not change biometric measure of the penis. Few side effects occurred after both hormones, and any that did improved after 90 days follow-up and did not change hormone serum levels. Preoperative use of topical testosterone increases penile size, diameter of the penis and glans. The use of estradiol does not change penile biometry. Side effects occur mainly with the use of testosterone and are transient. No significant and persistent hormonal changes were observed. Copyright © 2016 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Penile enlargement: from medication to surgery.

PubMed

Nugteren, Helena M; Balkema, G T; Pascal, A L; Schultz, W C M Weijmar; Nijman, J M; van Driel, M F

2010-01-01

Penis lengthening pills, stretch apparatus, vacuum pumps, silicone injections, and lengthening and thickening operations are available for men who worry about their penis size. Surgery is thus far the only proven scientific method for penile enlargement. In this article, we consider patient selection, outcome evaluation, and techniques applied. In our view, sexological counseling and detailed explanation of risks and complications are mandatory before any operative intervention.

Ruptured superficial dorsal vein of the penis masquerading as a penile fracture: case report.

PubMed

Perlmutter, Adam E; Roberts, Lawrence; Farivar-Mohseni, Hesam; Zaslau, Stanley

2007-08-01

Acute onset of pain, swelling, and ecchymosis of the penis during sexual intercourse indicate a penile fracture until proven otherwise. However, there have been few case reports of isolated injuries to the dorsal penile artery or dorsal vein mimicking a penile fracture. Presented herein is a rare case of a patient who ruptured his superficial dorsal vein during intercourse.

A phase II study of 13-cis retinoic acid plus interferon alpha-2a in advanced stage penile carcinoma: an Eastern Cooperative Oncology Group study (E3893).

PubMed

Skeel, Roland T; Huang, Jie; Manola, Judith; Wilding, George; Dreicer, Robert; Walker, Paul; Muggia, Franco; Crawford, E David; Dutcher, Janice P; Loehrer, Patrick J

2003-01-01

Combined biological therapy with 13-cis-retinoic acid (13-cRA) and interferon alpha-2a (IFN alpha-2a) was reported to be highly effective in squamous cell carcinoma of the cervix and skin. Squamous cell carcinoma of the penis is rare in the United States, accounting for less than 1/2% of all male malignancies. Because of the association of infection with human papillomavirus with both carcinomas of the cervix and penis and their shared squamous cell histology, we carried out a phase II study of 13-cRA and IFN alpha-2a in carcinoma of the penis. Eighteen ambulatory patients with surgically unresectable, recurrent, and/or metastatic squamous cell carcinoma of the penis were treated with IFN alpha-2a, 3MU/day administered subcutaneously and 13-cRA, 1 mg/kg orally daily for at least eight weeks, unless intolerable toxicity occurred. One patient was ineligible; one patient withdrew prior to treatment. Among the 16 eligible, treated patients, there was one complete response. Fourteen patients had progressive disease as their only treatment effect. Two patients were unevaluable for tumor response because they had no follow-up tumor measurements. No unexpected treatment-related toxicities were found on study. The only common form of grade 3 toxicity was hypertriglyceridemia found in eight of the 17 patients (47%). No toxicities above grade 3 were observed. In contrast to its benefit in squamous cell carcinomas of the cervix and skin, the combination of 13-cRA and IFN alpha-2a has low efficacy in advanced carcinoma of the penis.

Autologous dermal graft combined with a modified degloving procedure for penile augmentation in young adults: a preliminary study.

PubMed

Zhang, G-X; Weng, M; Wang, M-D; Bai, W-J

2016-09-01

In order to evaluate the effect of penile enhancement, we retrospectively reviewed the data of the patients operated with autologous dermal graft implantation combined with a modified penile degloving procedure. The patients with the complaints of small penis, asking for penile augmentation, and normal erectile function were psychologically screened and enrolled. Data of follow-up visit including patient demographics, medical history, surgical procedure, patient-reported outcomes were analysed. In all, 30 eligible persons were operated. After degloving of the penis, the suspensory ligament was incised and the tunica albuginea was fixed to the proximal tunica dartos at the penile base. Then, the dermis graft was implanted on the dorsal surface of the tunica albuginea. The file of follow-up visit was available in 17 (57%) patients. The mean age was 23.7 years (19-35 years) and the mean follow-up was 13 months (range, 4-24 months). During the follow-up period, the average gain in the penis length was 2.7 cm in flaccid and 0.8 cm in erection, respectively. And the average gain in the penis circumference was 1.5 cm in flaccid and 1.2 cm in erection, respectively. Also, psychosexual sexual self-esteem and confidence of the patients were significantly improved (p < 0.001). Overall, 13 (76%) patients reported satisfaction with the penile appearance. We believe that the surgery is both safe and effective in the enhancement of the penis, however, further clinical studies with a larger patient population are necessary. © 2016 American Society of Andrology and European Academy of Andrology.

Abnormal morphology of the penis in male rats exposed neonatally to diethylstilbestrol is associated with altered profile of estrogen receptor-alpha protein, but not of androgen receptor protein: a developmental and immunocytochemical study.

PubMed

Goyal, H O; Braden, T D; Williams, C S; Dalvi, P; Mansour, M M; Mansour, M; Williams, J W; Bartol, F F; Wiley, A A; Birch, L; Prins, G S

2004-05-01

Objectives of the study were to determine developmental changes in morphology and expression of androgen receptor (AR) and estrogen receptor (ER)alpha in the body of the rat penis exposed neonatally to diethylstilbestrol (DES). Male pups received DES at a dose of 10 microg per rat on alternate days from Postnatal Day 2 to Postnatal Day 12. Controls received olive oil vehicle only. Tissue samples were collected on Days 18 (prepuberty), 41 (puberty), and 120 (adult) of age. DES-induced abnormalities were evident at 18 days of age and included smaller, lighter, and thinner penis, loss of cavernous spaces and associated smooth muscle cells, and increased deposition of fat cells in the corpora cavernosa penis. Fat cells virtually filled the entire area of the corpora cavernosa at puberty and adulthood. Plasma testosterone (T) was reduced to an undetectable level, while LH was unaltered in all treated groups. AR-positive cells were ubiquitous and their profile (incidence and staining intensity) did not differ between control and treated rats of the respective age groups. Conversely, ERalpha-positive cells were limited to the stroma of corpus spongiosus in all age groups of both control and treated rats, but the expression in treated rats at 18 days was up-regulated in stromal cells of corpora cavernosa, coincident with the presence of morphological abnormalities. Hence, this study reports for the first time DES-induced developmental, morphological abnormalities in the body of the penis and suggests that these abnormalities may have resulted from decreased T and/or overexpression of ERalpha.

Vaginal orgasm is associated with vaginal (not clitoral) sex education, focusing mental attention on vaginal sensations, intercourse duration, and a preference for a longer penis.

PubMed

Brody, Stuart; Weiss, Petr

2010-08-01

Evidence was recently provided for vaginal orgasm, orgasm triggered purely by penile-vaginal intercourse (PVI), being associated with better psychological functioning. Common sex education and sexual medicine approaches might undermine vaginal orgasm benefits. To examine the extent to which women's vaginal orgasm consistency is associated with (i) being told in childhood or adolescence that the vagina was the important zone for inducing female orgasm; (ii) how well they focus mentally on vaginal sensations during PVI; (iii) greater PVI duration; and (iv) preference for above-average penis length.   In a representative sample of the Czech population, 1,000 women reported their vaginal orgasm consistency (from never to almost every time; only 21.9% never had a vaginal orgasm), estimates of their typical foreplay and PVI durations, what they were told in childhood and adolescence was the important zone for inducing female orgasm, their degree of focus on vaginal sensations during PVI, and whether they were more likely to orgasm with a longer than average penis. The association of vaginal orgasm consistency with the predictors noted above. Vaginal orgasm consistency was associated with all hypothesized correlates. Multivariate analysis indicated the most important predictors were being educated that the vagina is important for female orgasm, being mentally focused on vaginal sensations during PVI, and in some analyses duration of PVI (but not foreplay) and preferring a longer than average penis. Focusing attention on penile-vaginal sensation supports vaginal orgasm and the myriad benefits thereof. Brody S, and Weiss P. Vaginal orgasm is associated with vaginal (not clitoral) sex education, focusing mental attention on vaginal sensations, intercourse duration, and a preference for a longer penis. © 2009 International Society for Sexual Medicine.

Presence of stem/progenitor cells in the rat penis.

PubMed

Lin, Guiting; Alwaal, Amjad; Zhang, Xiaoyu; Wang, Jianwen; Wang, Lin; Li, Huixi; Wang, Guifang; Ning, Hongxiu; Lin, Ching-Shwun; Xin, Zhongcheng; Lue, Tom F

2015-01-15

Tissue resident stem cells are believed to exist in every organ, and their identification is commonly done using a combination of immunostaining for putative stem cell markers and label-retaining cell (LRC) strategy. In this study, we employed these approaches to identify potential stem cells in the penis. Newborn rats were intraperitoneally injected with thymidine analog, 5-ethynyl-2-deoxyuridine (EdU), and their penis was harvested at 7 h, 3 days, 1 week, and 4 weeks. It was processed for EdU stains and immunofluorescence staining for stem cell markers A2B5, PCNA, and c-kit. EdU-positive cells were counted for each time point and co-localized with each stem cell marker, then isolated and cultured in vitro followed by their characterization using flowcytometry and immunofluorescence. At 7 h post-EdU injection, 410 ± 105.3 penile corporal cells were labeled in each cross-section (∼28%). The number of EdU-positive cells at 3 days increased to 536 ± 115.6, while their percentage dropped to 25%. Progressively fewer EdU-positive cells were present in the sacrificed rat penis at longer time points (1 and 4 weeks). They were mainly distributed in the subtunic and perisinusoidal spaces, and defined as subtunic penile progenitor cells (STPCs) and perisinusoidal penile progenitor cells (PPCs). These cells expressed c-kit, A2B5, and PCNA. After culturing in vitro, only ∼0.324% corporal cells were EdU-labeled LRCs and expressed A2B5/PCNA. Therefore, labeling of penis cells by EdU occurred randomly, and label retaining was not associated with expression of c-kit, A2B5, or PCNA. The penile LRCs are mainly distributed within the subtunic and perisinusoidal space.

Reference standard of penile size and prevalence of buried penis in Japanese newborn male infants.

PubMed

Matsuo, Nobutake; Ishii, Tomohiro; Takayama, John I; Miwa, Masayuki; Hasegawa, Tomonobu

2014-01-01

The present study set forth the reference values for penile size and determined the prevalence of buried penis in Japanese full-term newborns. The stretched penile length was measured and the presence of buried penis was assessed at 1-7 days of age in 547 Japanese full-term newborn infants born between 2008 and 2012 in Tokyo. The stretched penile lengths were compared at 1-12 hours and 1-7 days of age in 63 infants and by two observers in 73 infants to estimate postnatal changes and interobserver variation, respectively. The mean stretched penile length was 3.06 cm (SD, 0.26; 95% confidence interval [CI], 3.04-3.08) and the mean ratio of penile length to body length was 6.24 × 100(-1) (SD, 0.55 × 100(-1)), both of which were significantly smaller than those in Caucasian newborn infants. Buried penis was identified in 20 of 547 infants (3.7%; 95% CI, 2.1-5.2%). The first measurements of penile length at 1-12 hours were significantly smaller than the next measurements at 1-7 days (95% CI of the difference, 0.22-0.34). The 95% CI for the limits of agreement in the penile lengths measured by the two observers was -0.58 to -0.40 for the lower limit and 0.33 to 0.51 for the upper limit. These findings indicate that the penile length should be assessed after 24 hours of age by the reference standard of the same ethnicity for identifying micropenis and that buried penis is not uncommon in Japanese full-term newborns.

Ventral Slit Scrotal Flap: A New Outpatient Surgical Option for Reconstruction of Adult Buried Penis Syndrome.

PubMed

Westerman, Mary E; Tausch, Timothy J; Zhao, Lee C; Siegel, Jordan A; Starke, Nathan; Klein, Alexandra K; Morey, Allen F

2015-06-01

We present a novel technique using ventral slit with scrotal skin flaps (VSSF) for the reconstruction of adult buried penis without skin grafting. An initial ventral slit is made in the phimotic ring, and the penis is exposed. To cover the defect in the ventral shaft skin, local flaps are created by making a ventral midline scrotal incision with horizontal relaxing incisions. The scrotal flaps are rotated to resurface the ventral shaft. Clinical data analyzed included preoperative diagnoses, length of stay, blood loss, and operative outcomes. Complications were also recorded. Fifteen consecutive patients with a penis trapped due to lichen sclerosus (LS) or phimosis underwent repair with VSSF. Each was treated in the outpatient setting with no perioperative complications. Mean age was 51 years (range, 26-75 years), and mean body mass index was 42.6 kg/m(2) (range, 29.8-53.9 kg/m(2)). The majority of patients (13 of 15, 87%) had a pathologic diagnosis of LS. Mean estimated blood loss was 57 cc (range, 25-200 cc), mean operative time was 83 minutes (range, 35-145 minutes), and all patients were discharged on the day of surgery. The majority of patients (11 of 15, 73.3%) remain satisfied with their results and have required no further intervention. Recurrences in 3 of 15 (20.0%) were due to LS, panniculus migration, and concealment by edematous groin tissue; 2 of these patients underwent subsequent successful skin grafting. VSSF is a versatile, safe, and effective reconstructive option in appropriately selected patients with buried penis, which enables reconstruction of penile shaft skin defects without requiring complex skin grafting. Copyright © 2015 Elsevier Inc. All rights reserved.

Penile Dislocation with Inversion: A Rare Complication of Blunt Pelvic Injury

PubMed Central

Sahadev, Ravindra; Jadhav, Vinay; Munianjanappa, Narendra Babu; Shankar, Gowri

2018-01-01

Penile injuries in children are usually uncommon and are predominantly associated with pelvic trauma or as postcircumcision injuries. The authors present a rare case of penile dislocation with penile inversion in a 5-year-old child occurring due to blunt pelvic injury. The child presented 3 months after pelvic injury with a suprapubic catheter for urinary diversion and absent penis with only penile skin visible. The presence of dislocated penile body was detected on magnetic resonance imaging, which was subsequently confirmed intraoperatively. During the surgery, the dislocated penis was identified and mobilized into its normal anatomical position within the remnant penile skin. Very few cases of penile dislocation have been reported in the literature. Pubic fracture with pulling of suspensory ligament resulting in dislocation of the penis would have been the probable mechanism of injury. PMID:29681700

A Case of Masson's Tumor of the Penis Presenting as Chronic Pelvic Pain Syndrome.

PubMed

Yanev, Krasimir; Krastanov, Aleksander; Georgiev, Marincho; Tonev, Andrian; Timev, Alexander; Elenkov, Angel

2018-03-17

The intravascular papillary endothelial hyperplasia (IPEH) or Masson's tumor is an unusual and rare benign disease.It is histologically characterized by papillary and anastomosing channel-like structures lined by proliferating e n dothelium. Radiologically, it is usually presented as a heterogenic solid mass with contrast enhancement, withareas resembling necrosis and thrombosis. These signs can easily be attributed to malignancy. The urogenital tractis extremely rarely affected with only 8 cases described in the kidneys and one of the penis. We present a rarecase of IPEH at the base of the penis, visible only on MRI, causing chronic pelvic pain and erectile dysfunction.According to available English literature our case is the first in this pelvic location and only the second to affect thepenis. Radical excision of the formation cured the condition.

[Partial gangrene of the scrotum and penis. A complication of sclerotherapy of testicular hydrocele].

PubMed

Dahl, B H

1993-04-20

Localized gangrene of the scrotum and penis as a complication to tetracycline sclerotherapy for hydrocele has not been reported before. I describe the complication in a 56 year-old man who was admitted to our plastic surgery unit for excision and reconstruction four days after sclerotherapy. The procedure of tapping and injection, and how to avoid this type of complication, are discussed.

Precisely proportioned: intertidal barnacles alter penis form to suit coastal wave action

PubMed Central

Neufeld, Christopher J; Palmer, A. Richard

2008-01-01

For their size, barnacles possess the longest penis of any animal (up to eight times their body length). However, as one of few sessile animals to copulate, they face a trade-off between reaching more mates and controlling ever-longer penises in turbulent flow. We observed that penises of an intertidal barnacle (Balanus glandula) from wave-exposed shores were shorter than, stouter than, and more than twice as massive for their length as, those from nearby protected bays. In addition, penis shape variation was tightly correlated with maximum velocity of breaking waves, and, on all shores, larger barnacles had disproportionately stouter penises. Finally, field experiments confirmed that most of this variation was due to phenotypic plasticity: barnacles transplanted to a wave-exposed outer coast produced dramatically shorter and wider penises than counterparts moved to a protected harbour. Owing to the probable trade-off between penis length and ability to function in flow, and owing to the ever-changing wave conditions on rocky shores, intertidal barnacles appear to have acquired the capacity to change the size and shape of their penises to suit local hydrodynamic conditions. This dramatic plasticity in genital form is a valuable reminder that factors other than the usual drivers of genital diversification—female choice, sexual conflict and male–male competition—can influence genital form. PMID:18252665

Precisely proportioned: intertidal barnacles alter penis form to suit coastal wave action.

PubMed

Neufeld, Christopher J; Palmer, A Richard

2008-05-07

For their size, barnacles possess the longest penis of any animal (up to eight times their body length). However, as one of few sessile animals to copulate, they face a trade-off between reaching more mates and controlling ever-longer penises in turbulent flow. We observed that penises of an intertidal barnacle (Balanus glandula) from wave-exposed shores were shorter than, stouter than, and more than twice as massive for their length as, those from nearby protected bays. In addition, penis shape variation was tightly correlated with maximum velocity of breaking waves, and, on all shores, larger barnacles had disproportionately stouter penises. Finally, field experiments confirmed that most of this variation was due to phenotypic plasticity: barnacles transplanted to a wave-exposed outer coast produced dramatically shorter and wider penises than counterparts moved to a protected harbour. Owing to the probable trade-off between penis length and ability to function in flow, and owing to the ever-changing wave conditions on rocky shores, intertidal barnacles appear to have acquired the capacity to change the size and shape of their penises to suit local hydrodynamic conditions. This dramatic plasticity in genital form is a valuable reminder that factors other than the usual drivers of genital diversification--female choice, sexual conflict and male-male competition--can influence genital form.

Penile paraffinoma and ulcers of penis.

PubMed

Bobik, O; Bobik, O

2011-01-01

The authors describe a case of 33 year old Caucasian married man with an irregular 6 cm penile mass associated with multiple penile ulcers. He reluctantly admitted that 10 years ago he had multiple mineral oil (Vaseline) self injections into the penis, for penile enlargement purposes. The patient had a surgical intervention 10 years ago, but he has recurrent ulcers on his penis. We have administered an intravenous antibiotic therapy combined with local therapy. The term paraffinoma describes a distinct histopathological finding that results from the injection of foreign oily substances into the skin. Although such procedure may be considered rare, they are still performed in some countries. The major point we want emphasis is following: a lot of people seek penile augmentations, it is necessary to remind physicians and the public that nonscientific and inadequate procedure such as Vaseline may lead to debilitating and destructive consequences (Tab. 1, Ref. 12).

[Idiopathic elephantiasis of the penis: a case report].

PubMed

Yamamoto, Keisuke; Matsuoka, Yasuhiro; Takao, Tetsuya; Tsujimur, Akira; Okuyama, Akihiko; Kubo, Tateki; Hosokawa, Kou; Kakuta, Yoichi; Yamaguchi, Seiji

2009-03-01

We report a case of idiopathic elephantiasis of penis. A 41-year-old man was refered to our hospital with a painful penile swelling and severe miction pain. He had no particular past or familial history, and had never been to tropical or semitropical region. Physical examination showed a prominent swelling and flection of his penis. Magnetic resonance imaging revealed a significant thickening of the penile skin and subcutaneous tissue. Due to the difficulty of voiding, an urethral catheter was placed. The penile skin biopsy showed no malignancy. Under the diagnosis of penile elephantiasis, the resection of abnormal penile skin and penile plasty with the split skin graft from his thigh was performed. Histopathological findings showed nonspecific inflammation. The skin graft was successfully adapted. He could urinate smoothly without pain after the urethral catheter was removed. There has been no recurrence 6 months after the operation. He recovered normal micturition and sexual function.

Penile fracture at Tribhuvan University Teaching Hospital: a retrospective analysis.

PubMed

Athar, Z; Chalise, P R; Sharma, U K; Gyawali, P R; Shrestha, G K; Joshi, B R

2010-06-01

Fracture of the penis is rupture of the tunica albuginea and the usual cause is abrupt bending of the erect penis by blunt trauma. Trauma during sexual relation is responsible for approximately one third of all cases. The incidence of urethral injuries associated with this condition ranged from 2.0% to 38.0%. Twelve patients who presented to emergency over a period of 4 years with diagnosis of penile fracture were reviewed retrospectively. Patient's profile and all relevant data were noted from charts. The etiology of fracture was related to coital activity in 6 (50.0%) cases while other denied such act. Surgery was performed on all the patients and discharged from hospital on removal of urethral catheter. Follow up continued until restoration of normal penile function without complaint. So fracture of the penis is an injury that can be diagnosed clinically and needs emergency surgical correction for better result.

Penile fracture following husband abuse: a case report.

PubMed

Dienye, Paul O; Jebbin, Nze J; Gbeneol, Precious K

2009-12-01

The case of a 35-year-old fisherman who presented in a rural clinic with a sudden onset of painful penile swelling affecting the left lateral side with associated rapid detumescence is reported. He had tried to coerce his wife to a sexual intercourse when she forcefully bent his penis. He was initially managed with cold applications, oral diclofenac potassium, chymoral, and splinting of the penis and then referred to the urological services of a teaching hospital. He defaulted only to re-present about 2 weeks later with some improvement in his symptoms. Further advice to see the urologist was also rebuffed on financial grounds. When he reported about 1 month later, he was assessed to have grade 3 erectile dysfunction. In conclusion, penile fracture is a rare condition which follows unphysiological bending of the tumescent penis during sexual intercourse or masturbation. That following husband abuse is rarer. The sequelae can be devastating.

Imaging findings of juvenile xanthogranuloma of the penis.

PubMed

Bradford, Ray K; Choudhary, Arabinda K

2009-02-01

Juvenile xanthogranuloma (JXG) is a rare benign self-limiting lesion presenting in early childhood. It is the commonest variant of non-Langerhans cell histiocytosis and usually presents as a cutaneous mass. It might have a systemic component and also might be associated with other conditions, notably neurofibromatosis and juvenile chronic myelogenous leukemia. Penile masses are unusual in childhood and we describe a case of JXG involving the penis. Although four cases of JXG of the penis have been reported in the literature, this is the first with imaging of the penile lesion. We discuss the clinical and radiological findings, differential diagnosis and management of these cases. High awareness of these lesions in the differential diagnosis of penile masses presenting in early childhood is important to avoid potentially unnecessary ablative genital surgery. Careful assessment should also be made for any systemic involvement and for associated pathologies.

[Micropenis].

PubMed

Bouvattier, C

2014-06-01

Micropenis represents a clinical sign that should be diagnosed at birth (or in utero) by the detection of a normally structured penis with a length 2.5 SD below the mean for age. Micropenis can be classified as due to deficient testosterone secretion or action. Evaluation of the gonadotropic and testicular function during the mini-puberty is often helpful in evaluating the etiology. Management of micropenis should focus on achieving a suitable penis length, in order to allow an adequate urination, normal sexual intercourses and a good self-body image. Irrespective of the underlying cause, a short course of T should be tried in patients with micropenis to assess the ability of the penis to respond to it. Topical 5a-dihydrotestosterone gel has also been reported to be effective. Children with hypopituitarism and GH deficiency respond to appropriate hormonal therapy. Psychological counseling is helpful and often necessary. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Penile fracture: penoscrotal approach with degloving of penis after Magnetic Resonance Imaging (MRI).

PubMed

Antonini, Gabriele; Vicini, Patrizio; Sansalone, Salvatore; Garaffa, Giulio; Vitarelli, Antonio; De Berardinis, Ettore; Von Heland, Magnus; Giovannone, Riccardo; Casciani, Emanuele; Gentile, Vincenzo

2014-03-28

Fracture of the penis, a relatively uncommon emergency in Urology, consists in the traumatic rupture of the tunica albuginea of the corpus cavernosum. Examination and clinical history can be highly suspicious of penile fracture in the majority of cases and ultrasonography (USS) can be useful to identify the exact location of the tunical rupture, which is proximal in 2/3 of cases and therefore manageable through a penoscrotal approach. Although expensive and not readily available in the acute setting, Magnetic Resonance Imaging (MRI) may play a role in the differential diagnosis with rupture of a circumflex or dorsal vein of the penis or when the tunical rupture is not associated with tear of the overlying Buck's fascia. This form of imaging is more sensitive than USS at identifying the presence of a tunical tear. The treatment of choice is immediate surgical repair, which allows preserving erectile function and minimizing corporeal fibrosis.

Necrotizing granulomatous inflammation of the glans penis.

PubMed

Christodoulidou, Michelle; Bunker, Christopher B; Trevisan, Giorgia; Muneer, Asif

2016-08-24

We describe the case of a 73-year-old man who presented with a 10-month history of an ulcerating lesion on the glans penis. Initially this was thought to be an invasive squamous cell carcinoma but a biopsy showed histological features consistent with necrotizing granulomatous inflammation. Extensive serological, immunological and microbiological tests only showed a positive antinuclear and perinuclear antineutrophil cytoplasmic antibodies indicating a possible autoimmune aetiology but an underlying systemic cause was not identified. Treatment with oral corticosteroids limited the inflammatory process but due to the gross destruction of the glans penis, he still required a glansectomy and split-skin graft reconstruction from which he recovered well. Although this patient ultimately required surgery for this rare presentation, this case highlights the differential diagnosis of penile ulceration (that transcends neoplasia) and the importance of performing and interpreting penile biopsies before undertaking potentially mutilating definitive surgery. 2016 BMJ Publishing Group Ltd.

Occurrence of phantom genitalia after gender reassignment surgery.

PubMed

Ramachandran, V S; McGeoch, Paul D

2007-01-01

Transsexuals are individuals who identify as a member of the gender opposite to that which they are born. Many transsexuals report that they have always had a feeling of a mismatch between their inner gender-based "body image" and that of their body's actual physical form. Often transsexuals undergo gender reassignment surgery to convert their bodies to the sex they feel they should have been born. The vivid sensation of still having a limb although it has been amputated, a phantom limb, was first described by Weir Mitchell over a century ago. The same phenomenon is also occurs after amputation of the penis or a breast. Around 60% of men who have had to have their penis amputated for cancer will experience a phantom penis. It has recently been shown that a significant factor in these phantom sensations is "cross-activation" between the de-afferented cortex and surrounding areas. Despite this it also known that much of our body image is innately "hard-wired" into our brains; congenitally limbless patients can still experience phantom sensations. We hypothesise that, perhaps due to a dissociation during embryological development, the brains of transsexuals are "hard-wired" in manner, which is opposite to that of their biological sex. We go on to predict that male-to-female transsexuals will be much less likely to experience a phantom penis than a "normal" man who has had his penis amputated for another reason. The same will be true of female-to-male transsexuals who have had breast removal surgery. We also predict that some female-to-male transsexuals will have a phantom penis even although there is not one physically there. We believe that this is an easily testable hypothesis, which, if correct, would offer insights into both the basis of transsexuality and provide farther evidence that we have a gender specific body image, with a strong innate component that is "hard-wired" into our brains. This would furnish us with a better understanding the mechanism by which nature and nurture interact to link the brain-based internal body image with external sexual morphology. We would emphasise here that transsexuality should not be regarded as "abnormal" but instead as part of the spectrum of human behaviour.

On the therapy of induratio penis plastica (Peyronies disease) by means of radium moulages.

PubMed

Alth, G; Koren, H; Gasser, G; Eidler, R

1985-01-01

In the past 50 years 2210 patients suffering from induratio penis plastica were admitted to our department. In 69% of the cases an improvement could be observed within 18 months after radium moulage therapy. By improving radium protection the therapy may now be performed without any significant exposure of the testes. A 15 year old patient is the youngest case reported in world literature. Trend analyses show a case shift towards the senium.

Penile fracture: surgical repair and late effects on erectile function.

PubMed

Ateyah, Ahmed; Mostafa, Taymour; Nasser, Taha Abdel; Shaeer, Osama; Hadi, Ahmed Abdel; Al-Gabbar, Mohammed Abd

2008-06-01

Penile fracture is described as a traumatic rupture of the tunica albuginea because of blunt injury of an erect penis. To assess the etiology, treatment maneuvers, and late effects of penile fractures treated by surgical repair. Thirty-three patients diagnosed provisionally as having fractured penises. Thirty patients were managed by immediate surgical repair and three by delayed repair. International Index of Erectile Function-5 for married cases and Single-question Self-report of Erectile Dysfunction questionnaires and recording complications after 2, 3, and 6 months. The most common cause of fracture penis is self-inflicted acute bending (54.5%). The tear was visualized by ultrasound in 20/30 patients (66.7%) mostly on the right proximal third of the penis. All tears were unilateral with mean length 2.0 +/- 0.9 cm (range 0.5-4 cm). All patients who completed their follow-up after 6 months (N = 24) were able to achieve an adequate erection except two married cases who felt mild erectile dysfunction. Penile nodules were the most common postoperative complication (41.7%) after 6 months' follow-up. Patients treated with immediate or delayed repair had comparable complications. Fracture penis is not uncommon as an emergency that must be repaired either immediately or delayed. Clinical diagnosis is more predictive than ultrasound in diagnosis and determining the site of the tear. Ultrasound may be of value in patients where there is clinical doubt.

Long-term Results of Ventral Penile Curvature Repair in Childhood.

PubMed

Golomb, Dor; Sivan, Bezalel; Livne, Pinhas M; Nevo, Amihay; Ben-Meir, David

2018-02-01

To assess the postpubertal outcome of ventral penile curvature repaired in infancy in terms of recurrence and aesthetics. Postpubertal patients treated for hypospadias and ventral penile curvature in infancy at a tertiary medical center were invited to undergo assessment of the quality of the repair. Findings were compared between patients with a straight penis after skin release and patients who required dorsal plication. The cohort included 27 patients of mean age 16.5 years who were reported with straight penis after surgery. Postpubertal curvature was found in 6 of 14 patients (43%) successfully treated by skin release and 10 of 13 patients (77%) who underwent dorsal plication (P = .087). Significant curvature (≥30 degrees) was found in 1 of 14 patients in the skin-release group and 4 of 13 in the dorsal plication group (P = .16). Rates of redo urethroplasty were 2 of 14 (14%) and 5 of 10 (50%), respectively. Patient satisfaction with the appearance of the penis did not differ significantly. Ventral penile curvature repaired in infancy often recurs after puberty. The need for dorsal plication has a trend-level association with recurrence of penile curvature in puberty. It might also be related to the degree of postpubertal penile curvature and the need for redo urethroplasty. Procedure type does not affect patient satisfaction with the postpubertal appearance of the penis. Copyright © 2017 Elsevier Inc. All rights reserved.

The dosimetry of brachytherapy-induced erectile dysfunction

DOE Office of Scientific and Technical Information (OSTI.GOV)

Merrick, Gregory S.; Butler, Wayne M

2003-12-31

There is emerging evidence that brachytherapy-induced erectile dysfunction (ED) is technique-related and may be minimized by careful attention to source placement. Herein, we review the relationship between radiation doses to the prostate gland/surrounding structures and the development of brachytherapy-induced ED. The permanent prostate brachytherapy literature was reviewed using MEDLINE searches to ensure completeness. Although the site-specific structure associated with brachytherapy-induced ED remains unknown, there is an increasing body of data implicating the proximal penis. With day 0 CT-based dosimetry, the dose to 50% (D{sub 50}) and 25% (D{sub 25}) of the bulb of the penis should be maintained below 40%more » and 60% mPD, respectively, while the crura D{sub 50} should be maintained below 28% mPD to maximize post-brachytherapy potency. To date, there is no data to suggest that either radiation doses to the neurovascular bundles or choice of isotope is associated with brachytherapy-induced ED, while conflicting data has been reported regarding radiation dose to the prostate and the use of supplemental external beam radiation therapy. Although the etiology of brachytherapy-induced ED is likely multifactorial, the available data supports the proximal penis as an important site-specific structure. Refinements in implant technique, including preplanning and intraoperative seed placement, will result in lower radiation doses to the proximal penis with potential improvement in potency preservation.« less

Buried penis: classification surgical approach.

PubMed

Hadidi, Ahmed T

2014-02-01

The purpose of this study was to describe morphological classification of congenital buried penis (BP) and present a versatile surgical approach for correction. Sixty-one patients referred with BP were classified into 3 grades according to morphological findings: Grade 1-29 patients with Longer Inner Prepuce (LIP) only, Grade II-20 patients who presented with LIP associated with indrawn penis that required division of the fundiform and suspensory ligaments, and Grade III-12 patients who had in addition to the above, excess supra-pubic fat. A ventral midline penile incision extending from the tip of prepuce down to the penoscrotal junction was used in all patients. The operation was tailored according to the BP Grade. All patients underwent circumcision. Mean follow up was 3 years (range 1 to 10). All 61 patients had an abnormally long inner prepuce (LIP). Forty-seven patients had a short penile shaft. Early improvement was noted in all cases. Satisfactory results were achieved in all 29 patients in grade I and in 27 patients in grades II and III. Five children (Grades II and III) required further surgery (9%). Congenital buried penis is a spectrum characterized by LIP and may include in addition; short penile shaft, abnormal attachment of fundiform, and suspensory ligaments and excess supra-pubic fat. Congenital Mega Prepuce (CMP) is a variant of Grade I BP, with LIP characterized by intermittent ballooning of the genital area. Copyright © 2014 Elsevier Inc. All rights reserved.

Sonic Hedgehog Protein Is Decreased and Penile Morphology Is Altered in Prostatectomy and Diabetic Patients

PubMed Central

Angeloni, Nicholas L.; Bond, Christopher W.; McVary, Kevin T.; Podlasek, Carol A.

2013-01-01

Erectile dysfunction (ED) is a debilitating medical condition and current treatments are ineffective in patients with cavernous nerve (CN) injury, due to penile remodeling and apoptosis. A critical regulator of penile smooth muscle and apoptosis is the secreted protein sonic hedgehog (SHH). SHH protein is decreased in rat prostatectomy and diabetic ED models, SHH inhibition in the penis induces apoptosis and ED, and SHH treatment at the time of CN injury suppresses smooth muscle apoptosis and promotes regeneration of erectile function. Thus SHH treatment has significant translational potential as an ED therapy if similar mechanisms underlie ED development in patients. In this study we quantify SHH protein and morphological changes in corpora cavernosal tissue of control, prostatectomy and diabetic patients and hypothesize that decreased SHH protein is an underlying cause of ED development in prostatectomy and diabetic patients. Our results show significantly decreased SHH protein in prostatectomy and diabetic penis. Morphological remodelling of the penis, including significantly increased apoptotic index and decreased smooth muscle/collagen ratio, accompanies declining SHH. SHH signaling is active in human penis and is altered in a parallel manner to previous observations in the rat. These results suggest that SHH has significant potential to be developed as an ED therapy in prostatectomy and diabetic patients. The increased apoptotic index long after initial injury is suggestive of ongoing remodeling that may be clinically manipulatable. PMID:23967143

Mal-Development of the Penis and Loss of Fertility in Male Rats Treated Neonatally with Female Contraceptive 17α-Ethinyl Estradiol: A Dose-Response Study and a Comparative Study with a Known Estrogenic Teratogen Diethylstilbestrol

PubMed Central

Mathews, Ensa; Braden, Tim D.; Williams, Carol S.; Williams, John W.; Bolden-Tiller, Olga; Goyal, Hari O.

2009-01-01

The objectives of this study were to find a minimal dose of 17α-ethinyl estradiol (EE) that is detrimental to the developing penis and fertility and to compare estrogenic effects between EE and diethylstilbestrol (DES). Neonatal rats received EE at 10 ng (1 μg/kg), 100 ng, 1 μg, or 10 μg per pup on alternate days from postnatal days 1 to 11 (dose-response study) or received EE or DES at 100 ng per pup daily from postnatal days 1 to 6 (comparative study). Effects of EE were dose dependent, with ≥ 100-ng dose inducing significant (p < 0.05) reductions in penile length, weight, and diameter. Additionally, the penis was malformed, characterized by underdeveloped os penis and accumulation of fat cells. Fertility was 0% in the ≥ 1-μg groups, in contrast to 60% in the 100-ng group and 100% in the 10-ng and control groups. Animals treated with ≥ 10 ng had significant reductions in the weight of bulbospongious muscle, testis, seminal vesicle, epididymal fat pad, and in epididymal sperm numbers. A comparison of EE and DES effects showed similar reductions in penile weight and length and the weight of bulbospongiosus muscle, testis, seminal vesicle, epididymis, and epididymal fat pad in both adolescent and adult rats. While 5/6 control males sired, only 1/6 in the EE group and 0/6 in the DES group sired. Hence, neonatal exposure to EE at 10 ng (environmentally relevant dose) adversely affects male reproductive organs. A dose ten times higher than this leads to permanently mal-developed penis and infertility. Furthermore, EE and DES exposures show similar level of toxicity to male reproductive organs. PMID:19729556

A new clinical method for the assessment of penile endothelial function using the flow mediated dilation with plethysmography technique.

PubMed

Dayan, Lior; Greunwald, Illan; Vardi, Yoram; Jacob, Giris

2005-04-01

Penile endothelial function (EnF) is 1 of the major factors involved in the pathophysiology of erectile dysfunction. EnF assessment could offer crucial information on the etiology and degree of severity of cavernosal vascular pathology. In the present study we propose a new technique for the evaluation of penile EnF and test its applicability using strain gauge plethysmography. A total of 23 healthy subjects (13 younger and 10 older than 40 years) with no history of erectile dysfunction were studied. The flow mediated dilation technique was applied to the arm and penis in both age groups for the assessment of EnF. Baseline blood flow and the sequential flow recordings after rapid cessation of 5 minutes of ischemia were obtained in both organs. Baseline flow in the penis was significantly higher (approximately 3-fold) than that in the forearm and was not affected by age in either organ. Both measures of penile EnF, ie area under the flow-time curve (AUC) and maximal flow obtained after ischemia were significantly lower in the older group compared to the younger group (p <0.01 and p <0.02, respectively). Individual penile AUC and maximal flow were significantly correlated with age (r = 0.55, p <0.01 and r = 0.50, p <0.02, respectively). Finally a positive, significant correlation existed between penile and forearm AUC (p <0.05, r = 0.48). The implementation of the flow mediated dilation technique using mercury strain gauge plethysmography is simple and applicable for the assessment of penile EnF. Endothelial function parameters in the penis were found to correlate with those in the forearm, thus support for the validity of the technique is given. Further strength for the validity of this procedure in the penis comes from the comparison between the forearm and penis, and the relation to subject age.

Feline penile erection induced by topical glans penis application of combination alprostadil and SEPA (Topiglan).

PubMed

Usta, M F; Sanabria, J; Bivalacqua, T J; Hellstrom, W J G; Sanabriav, J

2004-02-01

The objective of this study was to evaluate the efficacy of topically applied prostaglandin E1 (PGE(1))+5% SEPA (soft enhancement of percutaneous absorption) on the glans penis in a feline erection model. Erectile response after glans penis administration of PGE(1)+5% SEPA cream (Topiglan, MacroChem Co., Lexington, MA, USA) was compared to the erectile response after intracavernosal administration of the triple-drug combination (1.65 mg papaverine, 25 microg phentolamine, and 0.5 microg PGE(1)). The placebo cream and increasing concentrations (0.25%, 2.5 mg/ml; 0.5%, 5 mg/ml; and 1%, 10 mg/ml) of PGE(1)+5% SEPA were applied in a total volume of 0.1 ml via a plastic needle-less syringe. The control triple-drug combination was administrated intracavernosally via a 30-gauge needle at the completion of each experiment to serve as a control reference. With each application of placebo, PGE(1)+SEPA, and the triple-drug combination, changes in intracavernosal pressure and systemic blood pressure were continuously monitored. Topical application of PGE(1)+SEPA induced increases in intracavernosal pressure in a dose-dependent manner, with minimal effects on systemic blood pressure. The increases obtained with 1% PGE(1) Topiglan cream were similar to the intracavernosal pressure values elicited by the standard intracavernosal triple-drug combination. These data demonstrate that topical glans penis application of PGE(1)+SEPA can induce an erectile response in cats with minimal systemic adverse effects. Oral pharmacological agents are the first-line treatment for male ED. Studies investigating the effectiveness of noninvasive modalities such as topical therapy should continue, because these agents have the potential to avoid the systemic effects commonly seen with oral therapies. Additionally, topical therapy may also benefit patients who are unresponsive to oral agents or have explicit contraindications. Topical PGE(1) application to the glans penis may become an important treatment option in selected patients suffering from erectile dysfunction.

Critical androgen-sensitive periods of rat penis and clitoris development.

PubMed

Welsh, Michelle; MacLeod, David J; Walker, Marion; Smith, Lee B; Sharpe, Richard M

2010-02-01

Androgen control of penis development/growth is unclear. In rats, androgen action in a foetal 'masculinisation programming window' (MPW; e15.5-e18.5)' predetermines penile length and hypospadias occurrence. This has implications for humans (e.g. micropenis). Our studies aimed to establish in rats when androgen action/administration affects development/growth of the penis and if deficits in MPW androgen action were rescuable postnatally. Thus, pregnant rats were treated with flutamide during the MPW +/- postnatal testosterone propionate (TP) treatment. To assess penile growth responsiveness, rats were treated with TP in various time windows (late foetal, neonatal through early puberty, puberty onset, or combinations thereof). Phallus length, weight, and morphology, hypospadias and anogenital distance (AGD) were measured in mid-puberty (d25) or adulthood (d90) in males and females, plus serum testosterone in adult males. MPW flutamide exposure reduced adult penile length and induced hypospadias dose-dependently; this was not rescued by postnatal TP treatment. In normal rats, foetal (e14.5-e21.5) TP exposure did not affect male penis size but increased female clitoral size. In males, TP exposure from postnatal d1-24 or at puberty (d15-24), increased penile length at d25, but not ultimately in adulthood. Foetal + postnatal TP (e14-postnatal d24) increased penile size at d25 but reduced it at d90 (due to reduced endogenous testosterone). In females, this treatment caused the biggest increase in adult clitoral size but, unlike in males, phallus size was unaffected by TP during puberty (d15-24). Postnatal TP treatment advanced penile histology at d25 to more resemble adult histology. AGD strongly correlated with final penis length. It is concluded that adult penile size depends critically on androgen action during the MPW but subsequent growth depends on later androgen exposure. Foetal and/or postnatal TP exposure does not increase adult penile size above its 'predetermined' length though its growth towards this maximum is advanced by peripubertal TP treatment.

Androgen action in the masculinization programming window and development of male reproductive organs.

PubMed

Macleod, D J; Sharpe, R M; Welsh, M; Fisken, M; Scott, H M; Hutchison, G R; Drake, A J; van den Driesche, S

2010-04-01

We have shown previously that deficient androgen action within a masculinization programming window (MPW; e15.5-e18.5 in rats) is important in the origin of male reproductive disorders and in programming male reproductive organ size, but that androgen action postnatally may be important to achieve this size. To further investigate importance of the MPW, we used two rat models, in which foetal androgen production or action was impaired during the MPW by exposing in utero to either di(n-butyl) phthalate (DBP) or to flutamide. Reduced anogenital distance (AGD) was used as a monitor of androgen production/action during the MPW. Offspring were evaluated in early puberty (Pnd25) to establish if reproductive organ size was altered. The testes, penis, ventral prostate (VP) and seminal vesicles (SV) were weighed and penis length measured. Both DBP and flutamide exposure in the MPW significantly reduced penis, VP and SV size along with AGD at Pnd25; AGD and organ size were highly correlated. In DBP-, but not flutamide-, exposed animals, testis weight was also reduced and correlated with AGD. Intratesticular testosterone was also measured in control and DBP-exposed males during (e17.5) or after (e21.5) the MPW and related to AGD at e21.5. To evaluate the importance of postnatal androgen action in reproductive organ growth, the effect of combinations of prenatal and postnatal maternal treatments on AGD and penis size at Pnd25 was evaluated. In prenatally DBP-exposed animals, further postnatal exposure to either DBP or flutamide significantly reduced AGD and penis size in comparison with prenatal DBP exposure alone. In comparison, rats exposed postnatally to testosterone propionate after prenatal vehicle-exposure showed considerable increase in these parameters vs. controls. In conclusion, we show that the size of all male reproductive organs is programmed by androgen exposure in the MPW, but that growth towards this size is dependent on androgen action postnatally.

Circumcision and Reduced Risk of Self-Reported Penile Coital Injuries: Results from a Randomized Controlled Trial in Kisumu, Kenya

PubMed Central

Mehta, Supriya D.; Krieger, John N.; Agot, Kawango; Moses, Stephen; Ndinya-Achola, Jeckoniah O.; Parker, Corette; Bailey, Robert C.

2011-01-01

Purpose Injuries to the penis during intercourse represent one hypothesized mechanism by which uncircumcised men are at increased risk for HIV. There are no published, systematically collected data regarding mild penile coital trauma. We identified risks for self-reported penile coital injuries in men aged 18–24 in our randomized trial of circumcision to prevent HIV in Kisumu, Kenya. Materials and Methods Each participant underwent standardized interview, medical history, and physical examination, at baseline and 6, 12, 18, and 24 months after enrollment. Self-reported penile coital injuries were assessed at each visit: penis feels sore during sex; penis gets scratches, cuts or abrasions during sex; skin of the penis bleeds after sex. Generalized estimating equation analysis estimated odds ratios (OR) for penile coital injuries. Results February 2002–September 2005, 2,784 participants were randomized. At baseline, 1,775 (64.4%) men reported any coital injury: 1,313 (47.6%) soreness; 1,328 (48.2%) scratches, abrasions, or cuts; 461 (16.7%) bleeding. In multivariable analysis, coital injury risk was lower for circumcised than uncircumcised men: soreness [OR=0.71, 95% CI 0.64–0.80], scratches/abrasions/cuts [OR=0.52, 95% CI 0.46–0.59], bleeding [OR=0.62, 95% CI 0.51–0.75], any coital injury [OR=0.61, 95% CI 0.54–0.68]. Other significant risks (p<0.05) included: increasing age, multiple recent sex partners, HSV-2 seropositivity, and genital ulcers. Condom use, cleaning the penis soon after intercourse, and being married/cohabiting were protective (p<0.05, each). Conclusions Self-reported penile coital injuries were common in these healthy young men. Circumcised men were at lower risk for coital injuries. Verifying penile coital injuries, mechanism of acquisition, and association with HIV risk is needed. PMID:20483156

Single center outcomes after reconstructive surgical correction of adult acquired buried penis: measurements of erectile function, depression, and quality of life.

PubMed

Rybak, James; Larsen, Stephen; Yu, Michelle; Levine, Laurence A

2014-04-01

Management of adult acquired buried penis is a troublesome situation for both patient and surgeon. The buried penis has been associated with significant erectile and voiding dysfunction, depression, and overall poor quality of life (QOL). To identify outcomes following reconstructive surgery with release of buried penis, escutcheonectomy, and circumcision with or without skin grafting. We retrospectively identified 11 patients treated by a single surgeon between 2007 and 2011, patient ages were 44-69; complete data review was available on all 11. Validated European Organisation for Research and Treatment of Cancer 15 QOL, Center for Epidemiologic Studies Depression Scale (CES-D), and International Index of Erectile Function (IIEF) surveys assessed patient QOL, depression, and erectile function pre- and postoperatively. Mean body mass index (BMI) was 48.8 (42.4-64.6). Mean operative time was 191 minutes (139-272). Mean length of stay was 2.1 days. Ten of 11 patients required phallic skin grafting. There was one perioperative complication resulting in respiratory failure and overnight stay in the intensive care unit. Wound complications were seen in 2/11 patients, and 1 needed surgical debridement for superficial wound infection. Skin graft take was seen in 100% of the patients. Ninety-one percent of patients noted significant improvement in voiding postoperatively. Ninety-one percent of patients reported significant erectile dysfunction preoperatively. Subsequently, IIEF scores improved post surgery by an average of 7.7 points. Clinical depression was noted to be present in 7/11 patients preoperatively and 2/11 postoperatively based on CES-D surveys. QOL improved significantly in 10/11 compared with preoperative baseline; however, many patients noted significant difficulties based on their weight and other comorbidities. Management of adult acquired buried penis is a challenging, yet correctable problem. In our series it appears that by using established surgical techniques we were able to achieve significant improvements in erectile function, QOL, and measures of depression. © 2014 International Society for Sexual Medicine.

Reinnervating the penis in spina bifida patients in the United States: ilioinguinal-to-dorsal-penile neurorrhaphy in two cases.

PubMed

Jacobs, Micah A; Avellino, Anthony M; Shurtleff, David; Lendvay, Thomas S

2013-10-01

Penile sensation is absent in some patients with myelomeningocele owing to the dysfunction of the pudendal nerve. Here, we describe the introduction of penile sensation via ilioinguinal-to-dorsal-penile neurorrhaphy in two patients with penile anesthesia due to neural tube defects. To establish penile sensation via ilioinguinal-to-dorsal-penile-nerve neurorrhaphy. A 20-year-old and a 35-year-old male with L5/S1 myelomeningocele were both highly functioning and ambulatory, with intact ilioinguinal nerve distribution sensation but anesthesia of the penis and glans. They were sexually active and able to ejaculate antegrade. Both had high International Index of Erectile Function scores for confidence to achieve erection sufficient for intercourse. An incision was made from anterior superior iliac crest to the glans penis to expose the inguinal canal and ilioinguinal nerve. The ilioinguinal and dorsal penile nerve were transected and anastomosed. The anastomotic site was then wrapped in a hemostatic agent and a drain was left in place. For penile rehabilitation, both patients were instructed to stimulate the penis while looking at the genitalia to encourage redistribution of perceived sensation. Presence of erogenous penile sensation was tested by neurologic examination and patient feedback, and patients completed sexual health questionnaires. Both patients reported paresthesias of the groin with penile stimulation 1 month after surgery. Both patients are now 24 months postoperative and have erogenous sensation on the ipsilateral glans and shaft during intercourse. Neither patient has difficulty achieving or maintaining erections. We present two patients with dorsal penile reinnervation via the ilioinguinal nerve. Although nerve reinnervation has been used in urological procedures, this is the first description of an attempt to resupply penile sensation via the dorsal penile nerve in the United States with a minimum of 18 months follow-up. Early follow-up suggests successful neuronal remapping and regained sensation of the penis. © 2013 International Society for Sexual Medicine.

Urinary incontinence following transurethral prostatectomy presenting as self inflicted penile gangrene

PubMed Central

Mukherjee, Subhabrata; Sinha, Rajan Kumar; Ghosh, Nabankur; Karmakar, Dilip

2015-01-01

An elderly diabetic man with a 67 g prostate developed a moderate degree of stress urinary incontinence along with urge urinary incontinence after transurethral resection of the prostate. Initially, he did not perform the recommended pelvic floor exercise and wrapped a rubber band around his penis to control the problem. He presented with late development of penile gangrene requiring partial amputation of his penis. The stress urinary incontinence subsided on subsequent follow-up. The patient is now doing well. PMID:26055582

Novel Optical Methods for Identification, Imaging, and Preservation of the Cavernous Nerves Responsible for Penile Erections during Prostate Cancer Surgery

DTIC Science & Technology

2009-03-01

wavelength, pulse energy, and pulse rate) to produce strongest and most rapid erectile response as measured by intracavernosal pressure in the penis ...PC Fiber Rod Housing Optics 5-mm-ID Port Probe Handle Probe Stem Enlarged View of Probe Tip Oscilloscope FunctionGenerator Thulium Fiber Laser Shutter...rapid erectile response as measured by intracavernosal pressure (ICP) in the penis . ICP values were increased from an initial range of 30-40 mmHg

Herpes zoster involving penis and scrotum: an unusual occurrence.

PubMed

Arshad, Abdul Rehman; Alvi, Kamran Yousaf; Chaudhary, Ammad Akram

2015-03-01

Herpes zoster is an infectious vesicular skin rash in a dermatomal distribution caused by Varicella zoster virus. It occurs very uncommonly in sacral dermatomes. We describe a case with rash on penis and scrotum due to involvement of S2 dermatome in a young male. The disease followed an uneventful course and the patient recovered completely without any sequelae or complications. This case is being presented to highlight its unusual location and to discuss differentiation from another viral infection commonly seen at this site.

External-beam irradiation of carcinoma of the penis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sagerman, R.H.; Yu, W.S.; Chung, C.T.

1984-07-01

Twenty-four patients with biopsy-proved squamous-cell carcinoma of the penis underwent external-beam radiation therapy between 1966 and 1980. Fifteen were treated for the primary tumor and 9 for metastatic inguinal lymphadenopathy; no patient received prophylactic nodal irradiation. Seven out of 9 tumors in stage I, 2/3 in stage II, and 1/3 in stage IV were controlled for three years. Control of fixed, inoperable groin nodes was poor, and none of these patients survived beyond 1 1/2 years.

Penile epidermal inclusion cyst: a late complication of penile girth enhancement surgery.

PubMed

Park, Hyun Jun; Park, Nam Cheol; Park, Sung Woo; Jern, Tae Kyung; Choi, Kyung-Un

2008-09-01

Epidermal inclusion cysts are benign lesions that can develop in any part of the body. However, the finding of an epidermal inclusion cyst in the penis is rare. The aim of this article was to present the management of a case of a penile epidermal inclusion cyst that occurred because of late complications of a penile girth enhancement surgery. A 52-year-old man presented with a painless, slowly growing mass in the penis, which was first noted after a penile girth enhancement surgery 20 years ago. A cystic mobile mass about 2 cm in depth was found surrounding the coronal sulcus. Excision of the mass was performed for diagnosis and treatment. There was no communication with the urethra. The pathological diagnosis was an epidermal inclusion cyst of the penis. A penile epidermal inclusion cyst in adult men is rare. It can develop after an inadequate procedure for penile girth enhancement, and should be treated by complete resection.

Partial segmental thrombosis of the corpus cavernosum presenting with perineal pain.

PubMed

Christodoulidou, Michelle; Parnham, Arie; Ramachandran, Navin; Muneer, Asif

2016-11-22

We describe the case of a man aged 43 years who presented with a 2-week history of a palpable lump in the right proximal penile shaft. This was preceded by a 6-month history of perineal pain, accompanied by erectile dysfunction. An urgent MRI scan of his penis identified a thrombus within the right crus and corpus of the penis. His thrombophilia screen was normal. The patient was started on oral anticoagulation and a phosphodiesterase inhibitor (PDE-5i) to prevent thrombus progression and maintain erectile function. At 5 months, the patients' symptoms had resolved and an MRI showed a reduction in the thrombus size. MRI is a useful imaging modality to diagnose a thrombus within the corpus cavernosum in patients presenting with a history of penile and perineal pain together with a palpable lump. The non-enhancement of the lesion helps to differentiate this from alternative rare lesions within the penis and perineum. 2016 BMJ Publishing Group Ltd.

Assembling a Functional Clitoris and Vulva from a Pseudo-Penis: A Surgical Technique for an Adult Woman with Congenital Adrenal Hyperplasia.

PubMed

Tjalma, Wiebren A A

2017-06-01

Congenital adrenal hyperplasia (CAH) is associated with a genital deformation that might cause a negative body image. The genital ambiguity is generally "corrected" surgically during early infancy. The advantage is a psychological benefit. The disadvantages are multiple surgical procedures and the loss of orgasm. A 22-year-old woman with CAH consulted for genital reconstructive surgery. She had a pseudopenis of 4 cm and could achieve an orgasm by masturbating. During surgery, the penis was dismantled and with the preserved glans penis and the corpora cavernosa, a clitoris and vestibules were constructed, respectively. On the basis of the anamneses during the follow-up, she had a functional vagina and could still achieve orgasms. Genital correction surgery for CAH at an older age was easier, could be done in 1 step, and enabled the preservation of orgasm. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Seasonal variation in imposex intensity of Thais clavigera

NASA Astrophysics Data System (ADS)

Li, Zhengyan

2005-06-01

Imposex, specifically caused by TBT pollution, refers to the superimposition of male sexual characteristics in gastropod females. Seasonal variation of imposex intensity in Thais clavigera from both slightly and severely contaminated sites in Hong Kong waters was studied from 1988 to 1999. The male penis length showed significant difference between both sites and seasons. It was shortest during late autumn and early winter (October to December) and longest during spring and early summer (February to June). Female penis length also showed significant difference between sites. It did not change seasonally, however. The RPS (Relative Penis Size) index was the highest during autumn and early winter, and the lowest during spring and early summer. The VDS (Vas Deferens Sequence) index remained stable throughout the sampling period. This study showed that VDS index is a better indicator when we compare relative intensity of imposex. The comparison can only be meaningful provided the samples from different locations are taken during the same season.

Sinusoidal constriction and vascular hypertrophy in the diabetes-induced rabbit penis.

PubMed

Pereira, Vivian Alves; Abidu-Figueiredo, Marcelo; Pereira-Sampaio, Marco Aurelio; Chagas, Mauricio Alves; Costa, Waldemar Silva; Sampaio, Francisco J B

2013-01-01

To assess the morphological changes of penile vascular structures and the corpus cavernosum area in alloxan-induced diabetic rabbits. Twenty male rabbits (2 months old) were divided into two groups with 10 rabbits each, the control group (CG) and the diabetic group (DG). The animals from DG received an intravenous injection of alloxan (100mg/kg) to induce the diabetes. Ten weeks after the induction of diabetes, all animals were euthanized. Two fragments of the penile shaft were harvested and samples were processed and paraffin embedded. Sections (5 µm) were cut and stained for histological and immunohistochemical markers. Nuclear protrusion toward the lumen, and cytoplasmic vacuolization were observed in the tunica intima of the dorsal artery of the penis in DG. The thicknesses of the tunica media increased significantly in DG (p = 0.0350). It was also observed a significant increase in the area of the tunica media (p = 0.0179). There was no significant change in smooth muscle cell density in the tunica media of the dorsal artery of the penis (p = 0.0855). The collagen fiber pattern of the tunica adventitia of the dorsal artery of the penis was different between the control and diabetic groups. There was a significant decrease in the area occupied by the cavernous sinuses in DG (p = 0.0013). Alloxan-induced diabetes mellitus in rabbits promotes important changes in penile vascular structures, thereby decreasing blood supply and affecting penile hemodynamics, leading to erectile dysfunction.

Genetically-induced Estrogen Receptor Alpha mRNA (Esr1) Overexpression Does Not Adversely Affect Fertility or Penile Development in Male Mice

PubMed Central

Heath, John; Abdelmageed, Yazeed; Braden, Tim D.; Williams, Carol S.; Williams, John W.; Paulose, Tessie; Hernandez-Ochoa, Isabel; Gupta, Rupesh; Flaws, Jodi A.; Goyal, Hari O.

2011-01-01

Previously, we reported that estrogen receptor alpha mRNA (Esr1) or protein (ESR1) overexpression resulting from neonatal exposure to estrogens in rats was associated with infertility and mal-developed penis characterized by reduced length and weight and abnormal accumulation of fat cells. The objective of this study was to determine if mutant male mice overexpressing Esr1 are naturally infertile or have reduced fertility and/or develop abnormal penis. The fertility parameters, including fertility and fecundity indices, numbers of days from the day of cohabitation to the day of delivery, and numbers of pups per female, were not altered from controls, as a result of Esr1 overexpression. Likewise, penile morphology, including the length, weight, and diameter and os penis development, was not altered from controls. Conversely, weights of the seminal vesicles and bulbospongiosus and levator ani (BS/LA) muscles were significantly (P < 0.05) lower as compared to controls; however, the weight of the testis, the morphology of the testis and epididymis, and the plasma and testicular testosterone concentration were not different from controls. Hence, the genetically-induced Esr1 overexpression alone, without an exogenous estrogen exposure during the neonatal period, is unable to adversely affect the development of the penis as well as other male reproductive organs, except limited, but significant, reductions in weights of the seminal vesicles and BS/LA muscles. PMID:20930192

Surgical correction of ectopic penis and scrotum associated with bilateral orchidopexy.

PubMed

Sobral, Daniel Santos Rocha; Silva, Helder Damásio da; Damázio, Eulálio

2017-01-01

Ectopic penis is usually associated with penoscrotal transposition, and it is rarely observed in isolation. We report a surgical approach for an extremely rare case. A 10-year-old male patient with bilateral cryptorchidism and ectopic penis and scrotum in perineal area, with no penoscrotal transposition, representing an association not yet described in literature. A previous orchiopexy failed due to ectopic scrotum. By means of an inverted Y incision, the penis was mobilized and a perineal skin flap in form of a testicular sac was prepared. Finally orchiopexy was performed. The surgery was essential to treat cryptorchidism and to improve the self-image of the patient. RESUMO O pênis ectópico geralmente ocorre associado à transposição peno-escrotal, sendo raro isoladamente. Relatamos uma abordagem cirúrgica para um caso extremamente raro. Tratava-se de paciente do sexo masculino, 10 anos, com criptorquidia bilateral e pênis e escroto ectópicos, na região perineal, sem transposição peno-escrotal, representando uma associação ainda não descrita na literatura. Orquidopexia prévia sem sucesso, devido à ectopia do escroto. Por meio de uma incisão em Y invertido, mobilizou-se o pênis e preparou-se um retalho da pele perineal em forma de bolsa testicular. Por fim, realizou-se a orquidopexia. A cirurgia foi fundamental para tratar a criptorquidia e promover ganho na autoimagem do paciente.

Ecology and Evolution of Phenotypic Plasticity in the Penis and Cirri of Barnacles.

PubMed

Hoch, J Matthew; Schneck, Daniel T; Neufeld, Christopher J

2016-10-01

Most barnacles are sessile, simultaneous hermaphrodites that reproduce by copulation. This is achieved through the extension of a muscular penis, famous for being the proportionally largest in the animal kingdom. The penis is a long cylindrical or conical organ, composed of a series of folded rings, allowing it to stretch to great lengths. The penises are covered with chemosensory setae allowing them to seek out receptive neighbors. For many species, the condition of the penis changes seasonally. In the most extreme circumstances, it degenerates and is shed during the first post-mating molt and is re-grown for the next mating season. Barnacle penises have been shown to exhibit phenotypic plasticity in response to many different challenges. When exposed to heavy waves, diameter is increased by thickening both the cuticle and muscles. When mates are far, length increases by adding ringed annulations. Experiments have shown that these plastic traits are modular, capable of changing independently from each other and that they improve mating ability. Alternate strategies to increase reproductive ability by barnacles include the production of dwarf and complemental males, sperm casting and sperm leakage, and aerial copulation. All of these mating strategies may have important implications for the study of reproductive biology, life history, and sex allocation theory. © The Author 2016. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology. All rights reserved. For permissions please email: journals.permissions@oup.com.

The role of ultrasonography in the diagnosis and management of penile trauma.

PubMed

Dell'Atti, Lucio

2016-09-01

In this prospective study, we studied the role of ultrasonography (US) in the diagnosis and management of penile trauma. Between 2007 and 2014, 14 patients (mean age 39 years) with suspected penile fracture underwent US examinations. Almost all patients had a history of injury during sexual intercourse or manipulation of the penis. US examinations were performed in transversal and longitudinal planes starting at the level of the glans and moving down to the base of the penis. Color-Doppler was used to identify the vascular pattern or to see any abnormal vascularity. The most common blunt injury to the penis that occurred in nine patients was penile fracture due to rupture of the corpus cavernosum. A tear occurred in only one of the corpora cavernosa. US showed an irregular hypoechoic or hyperechoic defect at the cavernosal rupture site. Four patients presented an injury to the subtunical venous plexus in the absence of complete tunical disruption. One patient had urethral rupture with inability to urinate and apparent urethrorrhagia. Ten patients underwent surgical operation, while four patients were observed and discharged after 2 days. Mean follow-up was 32 months (range 3-58). After 8 to 12 weeks, all of them were able to be sexually active as before. Angulations of penis persisted in one patient. US may be the preferred imaging technique for evaluation of penile fracture before surgery. It is easy to perform, non-invasive, widely available, and inexpensive, although it requires an experienced team.

Surgical repair of idiopathic scrotal elephantiasis.

PubMed

Zacharakis, Evangelos; Dudderidge, Tim; Zacharakis, Emmanouil; Ioannidis, Evangelos

2008-02-01

Scrotal lymphedema (scrotal elephantiasis) is uncommon outside of filariasis endemic regions. We present a case of a 65-year-old with idiopathic lymphedema of the scrotum and functional impairment of the penis. The patient underwent surgical excision of the edematous subcutaneous tissues and plastic reconstruction of his penis and scrotum. Three years later, the patient showed no signs of local recurrence, had complete restoration of urinary and sexual function and was extremely satisfied with the result. Surgical management was an effective strategy in the management of scrotal lymphedema in this case.

Granulomatous Inflammation of the Penis and Scrotum Following Application of Topical Cream.

PubMed

Khan, Amir Ishaq; Mehta, Akanksha; Sekhar, Aarti; Ellis, Carla L

2017-05-01

Granulomas are collections of histiocytes that develop as an inflammatory response to bacterial and fungal infections, as well as foreign substances. We discuss here the case of a 49-year-old male who presented with a penile and scrotal mass with granulomatous inflammation, after application of a topical cream for enhancement of erectile function. While granuloma formation can often be seen with penile injections, this case presents the rare development of a foreign body granuloma after topical cream application on the penis and scrotum.

Lymphangioma circumscriptum of the penis mimicking venereal lesions.

PubMed

Gupta, S; Radotra, B D; Javaheri, S M; Kumar, B

2003-09-01

Lymphangioma circumscriptum (LC) involving the penis is rare. We report two patients with penile LC. The lesions developed in early infancy in one patient, and during puberty in the other. The lesions resembled molluscum contagiosum in one and genital warts in the other. The first patient was previously treated with a diagnosis of venereal disease. A literature search found only 4 LC patients with penile lesions reported in the English literature. These cases are presented for their rarity, and to increase diagnostic vigilance and desirability of non-intervention.

RADIUM TREATMENT OF THE PLASTIC INDURATION OF THE PENIS AND THE PROBLEM OF THE RAY-PROTECTION (in Hungarian)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Karpati, G.; Rojtor, I.; Patkai, G.

1963-08-01

On the basis of experiences obtained in a large material it was found that radium treatment of the plastic induration of the penis is very useful especially in the form of moulage and application. In the cases suitable to the radium moulage treatment approximately 1500 r doses are administered in a series, and in the case of application, doses of 2000 r are given. From measurements using a special protective shield, complete radiation protection of the testes is obtained. (P.C.H.)

Critical androgen-sensitive periods of rat penis and clitoris development

PubMed Central

Welsh, Michelle; MacLeod, David J; Walker, Marion; Smith, Lee B; Sharpe, Richard M

2010-01-01

Androgen control of penis development/growth is unclear. In rats, androgen action in a foetal ‘masculinisation programming window’ (MPW; e15.5–e18.5)’ predetermines penile length and hypospadias occurrence. This has implications for humans (e.g. micropenis). Our studies aimed to establish in rats when androgen action/administration affects development/growth of the penis and if deficits in MPW androgen action were rescuable postnatally. Thus, pregnant rats were treated with flutamide during the MPW ± postnatal testosterone propionate (TP) treatment. To assess penile growth responsiveness, rats were treated with TP in various time windows (late foetal, neonatal through early puberty, puberty onset, or combinations thereof). Phallus length, weight, and morphology, hypospadias and anogenital distance (AGD) were measured in mid-puberty (d25) or adulthood (d90) in males and females, plus serum testosterone in adult males. MPW flutamide exposure reduced adult penile length and induced hypospadias dose-dependently; this was not rescued by postnatal TP treatment. In normal rats, foetal (e14.5–e21.5) TP exposure did not affect male penis size but increased female clitoral size. In males, TP exposure from postnatal d1–24 or at puberty (d15–24), increased penile length at d25, but not ultimately in adulthood. Foetal + postnatal TP (e14–postnatal d24) increased penile size at d25 but reduced it at d90 (due to reduced endogenous testosterone). In females, this treatment caused the biggest increase in adult clitoral size but, unlike in males, phallus size was unaffected by TP during puberty (d15–24). Postnatal TP treatment advanced penile histology at d25 to more resemble adult histology. AGD strongly correlated with final penis length. It is concluded that adult penile size depends critically on androgen action during the MPW but subsequent growth depends on later androgen exposure. Foetal and/or postnatal TP exposure does not increase adult penile size above its ‘predetermined’ length though its growth towards this maximum is advanced by peripubertal TP treatment. PMID:19656234

[Replantation of amputated penis in Chinese men: a meta-analysis].

PubMed

Li, Gui-Zhong; Man, Li-Bo; He, Feng; Huang, Guang-Lin

2013-08-01

To evaluate the methods for the replantation of the amputated penis in Chinese men. We performed a meta-analysis on the domestic literature relating replantation of the amputated penis, particularly its successful methods published from 1964 to January 2012. We identified 109 reports on 111 cases of replantation of the amputated penis that met the inclusion criteria, including 103 adults and 8 children. The mean age, warm ischemia time and total ischemia time were 29 +/- 11 years (range 2 - 56 years), 5.2 +/- 5.7 hours (range 0 - 38 hours) and 6.3 +/- 5.7 hours (range 1 - 38 hours). Fifty-three of the cases were treated by microsurgery and 44 by non-microsurgery. Complications occurred in 81 (73%) of the cases, including ED in 14 cases, urethral stricture in 16, urinary fistula in 8, skin necrosis in 58 and skin sensory abnormality in 31. The incidences of ED, urethral stricture and urinary fistula exhibited significant differences between the microsurgery and non-microsurgery groups of the partial amputation patients (P < 0.05). The incidence of ED was correlated negatively with the number of anastomosed dorsal nerves (r = -0.3, P = 0.05), anastomosis of dorsal veins (r = -0.2, P = 0.02) and anastomosis of arteries (r = -0.2, P = 0.03), but positively with skin sensory abnormality (r = 0.4, P < 0.01), that of urethral stricture negatively with the anastomosis of dorsal nerves (r = -0.2, P = 0.02) and arteries (r = -0.2, P = 0.016), but positively with the anastomosis of corpus cavernosum (r = 0.3, P = 0.01), that of skin necrosis negatively with the total number of anastomosed blood vessels (r = -0.2, P = 0.04), and that of complications negatively with the number of anastomosed dorsal nerves (r = -0.3, P = 0.01), dorsal veins (r = -0.2, P = 0.04), arteries (r = -0.2, P = 0.023) and micro-anastomosis (r = -0.3, P < 0.05). Early micro-anastomosis of the most possible penile dorsal veins, arteries and dorsal nerves is essential for the survival of the replanted penis and reduction of complications, and therefore can be regarded as a "standard" method for penile replantation in China.

Glans Penis Augmentation Using Hyaluronic Acid Gel as an Injectable Filler

PubMed Central

Kwak, Tae Il; Kim, Je Jong

2015-01-01

Glans penis augmentation (GPA) has received little attention from experts despite the existence of a subset of patients who may be dissatisfied with a small glans or poor tumescence of the glans during erection. Recently, GPA using an injectable filler or implantation of a graft or filler has been developed. Despite a demanding injection technique and inevitable uneven undulation of the glandular surface, GPA using injectable hyaluronic acid (HA) gel is a novel and useful therapy and an effective and safe procedure for soft tissue enhancement. For long-term presence of implants, timed supplementation can be used similar to that for fascial plasty. In complications such as mucosal necrosis of the glans penis, most cases occur from the use of non-HA gel or an unpurified form and misunderstanding of the management protocol for immediate side effects. Currently, GPA using injectable HA gel is not recommended in the International Society for Sexual Medicine guideline due to possible sensory loss. In a 5-year long-term follow-up of GPA by subcutaneous injection of HA gel, the residual volume of implants decreased by 15% of the maximal glandular circumference, but was still effective for alleviating the hypersensitivity of the glans penis in premature ejaculation patients. For efficacy in premature ejaculation, selection of appropriate candidates is the most important factor for success. GPA does not harm erectile function and is less invasive and irreversible compared to dorsal neurectomy. To refine the procedure, more interest and well-designed studies are required for the establishment of the procedure. PMID:26331121

Cross-sectional study examining four types of male penile and urethral "play".

PubMed

Rinard, Katherine; Nelius, Thomas; Hogan, LaMicha; Young, Cathy; Roberts, Alden E; Armstrong, Myrna L

2010-12-01

To provide further quantitative and qualitative evidence about men who insert foreign liquids and objects into their penis and/or urethra. As part of a larger, cross-sectional study examining men (n = 445) with genital piercings (GP), 2 questions inquired whether the respondents had penile tattoos and/or inserted other materials, such as fluids and foreign objects, into their penis and urethra. Four different practices have been described in the literature: embedding (a) foreign objects and/or (b) liquids subcutaneously into penile tissue, as well as inserting (c) liquids and/or (d) foreign objects into the urethra. In our study, 354 (78%) men with GP responded to the 2 questions; 85 (24%) replied affirmatively and 68 (80%) provided comments. Respondents coined their practices penile and/or urethral "play." Two respondents embedded metal balls into their penis, 1 at age 13 injected water for penis enlargement; 11 inserted liquids into the urethra, and 63 reported insertion of 32 different objects, frequently urethral sounds or "sounding" (n = 33/52%) were mentioned. Major motivation themes focused on sexual stimulation and experimentation. Penile tattoos (n = 14) were also reported, mainly for esthetics. Few complications or STDs were reported. Basic demographic assumptions of those who participate in these actions were challenged, and this study provides evidence of a wider distribution of men using penile or urethral play, and "sounding." Clinician awareness of these practices are important to obtain accurate health histories, manage genitourinary tract complications, as well as provide applicable patient education. Copyright © 2010 Elsevier Inc. All rights reserved.

Glans Penis Augmentation Using Hyaluronic Acid Gel as an Injectable Filler.

PubMed

Moon, Du Geon; Kwak, Tae Il; Kim, Je Jong

2015-08-01

Glans penis augmentation (GPA) has received little attention from experts despite the existence of a subset of patients who may be dissatisfied with a small glans or poor tumescence of the glans during erection. Recently, GPA using an injectable filler or implantation of a graft or filler has been developed. Despite a demanding injection technique and inevitable uneven undulation of the glandular surface, GPA using injectable hyaluronic acid (HA) gel is a novel and useful therapy and an effective and safe procedure for soft tissue enhancement. For long-term presence of implants, timed supplementation can be used similar to that for fascial plasty. In complications such as mucosal necrosis of the glans penis, most cases occur from the use of non-HA gel or an unpurified form and misunderstanding of the management protocol for immediate side effects. Currently, GPA using injectable HA gel is not recommended in the International Society for Sexual Medicine guideline due to possible sensory loss. In a 5-year long-term follow-up of GPA by subcutaneous injection of HA gel, the residual volume of implants decreased by 15% of the maximal glandular circumference, but was still effective for alleviating the hypersensitivity of the glans penis in premature ejaculation patients. For efficacy in premature ejaculation, selection of appropriate candidates is the most important factor for success. GPA does not harm erectile function and is less invasive and irreversible compared to dorsal neurectomy. To refine the procedure, more interest and well-designed studies are required for the establishment of the procedure.

[Longitudinal preputial pedicled flap urethroplasty for chordee of Donnahoo type IV].

PubMed

Zeng, Li; Shan, Wei; Yuan, Miao; Huang, Guizhen; Huang, Lugang

2012-11-01

To investigate the effectiveness of longitudinal preputial pedicled flap urethroplasty for chordee of Donnahoo IV type. Between June 1994 and October 2011, 30 patients with chordee (Donnahoo type IV) underwent longitudinal preputial pedicled flap urethroplasty. The patients' age ranged from 2 to 16 years (mean, 5.8 years). The morphology of the balanus-navicular fossa-external urethral orifice ranged normal; the penis length was 2.5-6.8 cm (mean, 4.3 cm); the penis bending angle was 35-70 degrees (mean, 40.1 degrees). Primary and secondary operation was 27 cases and 3 cases, respectively. The size of flap ranged from 1.5 cm x 1.3 cm to 4.0 cm x 2.0 cm. After correction, the penis length was 3.0-8.5 cm (mean, 6.6 cm); the penis bending angle was 0-10 degrees (mean, 1.2 degrees). All patients were followed up 6 months to 12 years (mean, 33 months). No recurrence, stabbing pain of the balanus, or foreign body sensation occurred during follow-up. Of them, 4 patients (13.33%) had urinary fistular, they had satisfactory results after the second operation; 2 patients (6.67%) had urethral stricture 1 month after operation, they also had satisfactory results after arethral dilatation. The other patients showed no scattering urinary flow and good direction without complication. Six patients had satisfactory sexual function after puberty without erection disorder, pain, or dyspareunia. Longitudinal preputial pedicled flap urethroplasty can achieve maximum utilization of prepuce and aesthetic and functional improvement with less complication, so it is a relatively ideal mean for treating chordee of Donnahoo type IV.

Successful medical treatment of glans ischemia after voluntary buprenorphine injection.

PubMed

Brecheteau, François; Grison, Pierre; Abraham, Pierre; Lebdai, Souhil; Kemgang, Steve; Souday, Vincent; Nedelcu, Cosmina; Culty, Thibaut; Larré, Stéphane; Azzouzi, Abdel Rahmene; Bigot, Pierre

2013-11-01

The diverted use of synthetic opioid buprenorphine by drug addicts can be responsible for serious ischemic and infectious complications, particularly in the case of intravenous injection. We present a case of serious glans ischemia after buprenorphine injection directly into the deep dorsal vein of the penis. Analysis using new medical imaging techniques and treatments is detailed below. A 26-year-old male drug addict presented with glans pain 4 days after self-injection of buprenorphine into the deep dorsal vein of the penis. The patient was apyretic and presented a urethral discharge. His glans was blue without discoloration on digital pressure. Additionally, his biologic and serologic tests were normal while bacteriology showed the presence of Enterobacter cloacae urethritis. After 48 hours of intravenous antibiotic treatment without improvement, a specific medical treatment using enoxaparin and ilomedin was initiated, with the assumption that there was an ischemic complication. Laser speckle contrast imaging allowed confirmation of the presence of distal penis ischemia and provided an accurate mapping of the ischemic zone. A 28-day treatment combining antibiotics, subcutaneous heparin at curative dose, antiplatelet drug, ilomedin, and hyperbaric oxygen therapy resulted in clinical improvement of the lesions with no functional complications. To date, no consensus exists on the proper diagnostic and treatment approach to severe glans ischemia due to buprenorphine injection into the deep dorsal vein of the penis. The results of laser speckle contrast imaging were of real interest during the process of diagnosis. In addition, the combination of ilomedin with hyperbaric oxygen therapy and anticoagulant and antiplatelet drugs appeared to be an effective therapy. © 2013 International Society for Sexual Medicine.

Effects of age and hypertension on α1-adrenoceptors in the major source arteries of the rat bladder and penis.

PubMed

Yono, Makoto; Tanaka, Takanori; Tsuji, Shigeki; Irie, Shin; Sakata, Yukikuni; Otani, Masayuki; Yoshida, Masaki; Latifpour, Jamshid

2011-11-16

α(1)-Adrenoceptors regulate blood pressure, regional vascular resistance and tissue blood flow. As aging and hypertension may impact pelvic arterial blood flow resulting in bladder and penile dysfunction, we investigated effects of age and hypertension on α(1)-adrenoceptors in the major source arteries of the rat bladder and penis. Using radioligand receptor binding, real-time reverse transcription-polymerase chain reaction (RT-PCR) and fluorescent microsphere infusion techniques, we compared 3 and 22-month-old male Fischer rats, and male normotensive Wistar-Kyoto (WKY) rats and spontaneously hypertensive rats (SHRs). Twenty-two-month-old rats and SHRs had significantly higher total α(1)-adrenoceptor density in the internal iliac artery and lower blood flow to the bladder and penis than 3-month-old and WKY rats, respectively. RT-PCR data showed an age and hypertension related increase in the expression of α(1B)-adrenoceptor mRNA in the internal iliac, vesical and internal pudendal arteries and a switch from α(1A) predominance in 3-month-old and WKY rats to α(1B)>α(1A) in 22-month-old rats and SHRs. Our data indicate the presence of age and hypertension related alterations in vascular α(1)-adrenoceptor subtype distribution and in blood flow to the rat bladder and penis. These findings suggest that pharmacological blockade of the vascular α(1B)-adrenoceptor, which could increase pelvic blood flow, may contribute to the improvement of bladder and penile dysfunctions in animal models for aging and hypertension. Copyright © 2011 Elsevier B.V. All rights reserved.

Histomorphology of the penis bone (Baculum) in the gray long-eared bat Plecotus austriacus (Chiroptera, Vespertilionidae).

PubMed

Herdina, Anna Nele; Herzig-Straschil, Barbara; Hilgers, Helge; Metscher, Brian D; Plenk, Hanns

2010-07-01

For the first time, the histomorphology of the penis bone of a bat (Plecotus austriacus) was examined in detail. From Plecotus austriacus, 14 whole penes and 11 isolated bacula were studied and compared to bacula of Plecotus auritus and Plecotus macrobullaris. The baculum was located on specimen microradiographs and in micro-CT images in the tip of the penis. Using serial semithin sections and surface-stained, undecalcified ground sections, the types of bone and other tissues constituting the baculum were examined by light microscopy. 3D reconstructions were generated from the serial semithin sections and from micro-CT images. The shaft and the proximal branches of the Y-shaped baculum form a tubular bone around a medullary cavity. Since the small diameter of this channel and the main lamellar bone around it resemble a Haversian canal, the baculum is equivalent to a single-osteon bone. Several oblique nutrient canals enter this medullary cavity in the shaft and branches. All ends of the baculum consist predominantly of woven bone. The collagen fiber bundles of the tunica albuginea of both corpora cavernosa insert via fibrocartilage into the woven bone of the branches. Thus, the microscopic structures support the hypothesis that the baculum functions as a stiffening element in the erect penis. In this study, several microscopic imaging techniques were evaluated for displaying the microscopic structures of the baculum. Specimen microradiography, but especially micro-CT proved to be suitable nondestructive methods for accurate and reproducible demonstration and comparison of the three-dimensional structures of the baculum in different bat species.

Metastatic prostate adenocarcinoma to the penis: a series of 29 cases with predilection for ductal adenocarcinoma.

PubMed

Ellis, Carla L; Epstein, Jonathan I

2015-01-01

Twenty-nine men with metastatic prostate adenocarcinoma to the penis were identified at our institution between 1993 and 2013. Of the 29 patients, 19 had a prior history of adenocarcinoma of the prostate, and 8 of those had ductal features in the primary lesion. Sixteen of 29 revealed ductal features in the metastasis. Seven of the 8 cases with ductal features in the primary had ductal features in the penile metastasis. Seven penile metastases were proven to be of prostatic origin solely by immunohistochemistry. Three cases were originally misdiagnosed as urothelial carcinoma upon review of the penile lesion. Other variant morphologies in the metastases included sarcomatoid carcinoma, small cell carcinoma, and adenosquamous carcinoma. In summary, prostate carcinoma involving the penis displays ductal features considerably more often than prostate cancer in general. Features that can cause difficulty in recognizing metastatic prostate adenocarcinoma to the penis include the unusual anatomic site for prostate cancer, poor differentiation, an increased prevalence of variant morphology, a long interval from the primary lesion, and, in some cases, no documented history of a primary prostatic lesion. Immunohistochemical analysis should be performed to rule out prostate carcinoma in penile/penile urethral tumors with morphology that differs from typical squamous or urothelial carcinoma. Even in the setting of metastatic disease, there is a critical need for an accurate diagnosis so that the appropriate therapy can be initiated, symptomatic relief can be provided, and long-term survival achieved in some cases, while at the same time avoiding penectomy for a misdiagnosis of a primary penile cancer.

Androgen-dependent and independent process of bone formation in the distal segment of Os penis in the rat.

PubMed

Murakami, R; Izumi, K; Yamaoka, I

1995-11-01

The distal segment of the os penis of the rat develops as a fibrocartilage which is replaced with non-lamellar bone by endochondral ossification after puberty. Development of the fibrocartilage and its calcification have been shown to be induced by androgens, but androgen-dependency of the endochondral ossification has not been studied in detail. In the present study, immature male rats of various ages were castrated and the ossification of the fibrocartilage of os penis was examined. In rats castrated at 6 weeks, when the fibrocartilage was scarcely calcified, ossification did not occur even at 24 weeks. When the castrated rats were treated with testosterone, ossification started before 12 weeks of age. In rats castrated at 8 weeks, when the fibrocartilage was heavily calcified, endochondral ossification was observed in some of the animals (5/7) at 24 weeks of age. The results of this study indicate that once the fibrocartilage is calcified, the endochondral ossification can take place without androgen, although the androgen can promote the process of ossification.

Men sexually interested in transwomen (MSTW): gendered embodiment and the construction of sexual desire.

PubMed

Weinberg, Martin S; Williams, Colin J

2010-07-01

This article extends research on transgenderism by providing a sociological study of men who are sexually interested in transwomen (MSTW; viz., genetic males who use estrogen to feminize their body but retain their penis). We conducted fieldwork in a bar catering to transwomen and the men who were sexually interested in them, and did on-the-spot interviews with the MSTW. We initially examined the nature of MSTW's sexual attraction to transwomen, followed by how this related to their sexual orientation identity. Using a sexual fields approach (Green, 2008), we first found how the ambience of the bar helped to create an erotic environment through a heightened sense of gender. Then, focusing on the theory of embodiment (Jackson & Scott, 2007), we saw how the MSTW constructed a unique sexual desire according to the sexual orientation identity they brought to the situation. Those who identified as "straight" tended to gloss that the transwoman had a penis, while the bisexually identified men were more likely to incorporate the transwoman's penis into the sexual experience.

[Reconstructive surgery of penile deformities and tissue deficiencies].

PubMed

Kelemen, Zsolt

2009-05-31

Penile deformities and tissue deficiencies can disturb sexual intercourse or make it impossible. The aim of the study is to summarize the different diseases according to their clinical appearance and pathological processes and to review operative methods and personal experiences. Surgical treatment of hypo- and epispadias is usually performed in childhood, but curvatures after unsuccessful operation can demand the reconstruction of urethra, skin and corpora cavernosa eventually. Peyronie's disease and curvature after penile fracture desire the reconstruction of tunica albuginea. Plaque surgery used to be performed with dermal, tunica vaginalis or venous grafts, but best results are obtained by shortening procedure on the contralateral side according to the Heinecke-Mikulitz principle. Tissue deficiencies and curvatures were observed after necrotic inflammatory processes, like Fournier's gangrene or chronic dermatitis. Skin defects were cured by flaps and grafts. Abscesses of penis, severe tissue defects and also curvatures were observed after intracavernous injection in cases of erectile dysfunction. Possibilities of reconstruction seem to be very poor. Oil granuloma of penis presents a new task for penile reconstruction. The best results of skin replacement were achieved by temporary embedding of the penis in scrotum.

Penile amputation and scrotal urethrostomy followed by chemotherapy in a dog with penile hemangiosarcoma.

PubMed

Bolfer, Luiz; Schmit, Joanna M; McNeill, Amy L; Ragetly, Chantal A; Bennett, R Avery; McMichael, Maureen

2015-01-01

A 7 yr old castrated male standard poodle weighing 25 kg was presented with a 5 day history of hematuria, dysuria, and the presence of a 2.5 cm, firm swelling within the prepuce. Abdominal radiographs revealed a soft-tissue mass on the distal prepuce and lysis of the cranial margin of the os penis. The patient was sedated and an ulcerated hemorrhagic mass was identified at the tip of the penis. The mass was diagnosed as hemangiosarcoma via incisional biopsy. A penile amputation with scrotal urethrostomy was performed followed by chemotherapy with doxorubicin.

Proximal Hypospadias

PubMed Central

Kraft, Kate H.; Shukla, Aseem R.; Canning, Douglas A.

2011-01-01

Hypospadias results from abnormal development of the penis that leaves the urethral meatus proximal to its normal glanular position. Meatal position may be located anywhere along the penile shaft, but more severe forms of hypospadias may have a urethral meatus located at the scrotum or perineum. The spectrum of abnormalities may also include ventral curvature of the penis, a dorsally redundant prepuce, and atrophic corpus spongiosum. Due to the severity of these abnormalities, proximal hypospadias often requires more extensive reconstruction in order to achieve an anatomically and functionally successful result. We review the spectrum of proximal hypospadias etiology, presentation, correction, and possible associated complications. PMID:21516286

Aggressive Angiomyxoma Involving Penis and Urethra - A Case Report.

PubMed

Damodaran, Shivashankar; Gengan, Devakannan; Walling, Sashi T

2017-07-01

Aggressive angiomyxoma is a rare benign mesenchymal stromal tumour, characterized by locally infiltrative nature and a tendency for recurrence. Only a few cases of penile involvement have been reported in the literature so far. We report a case of aggressive penile angiomyxoma in a sixty-two-year-old obese, diabetic male patient. He presented with obstructive lower urinary tract symptoms (LUTS) and diffuse enlargement of the penis and scrotum. He was managed with excision, reduction scrotoplasty, internal urethrotomy, followed by Leuprolide therapy for prevention of recurrence. He is on follow up for 20 months without recurrence and obstructive symptoms.

Squamous cell carcinoma of penis with bullous pemphigoid masquerading as lymphogranuloma venereum

PubMed Central

Venugopal, V.; Gnanaraj, Pushpa; Fernandes, S. D.; Narasimhan, Murali; Karthikeyan, Subashini; Rahul, Shwetha

2013-01-01

We report a case of a 60-year old unmarried male who presented with multiple ulcers and foul smelling discharge from the groin since 4 months and multiple tense bullae over the trunk of 1 month duration. Groove sign was present. Investigations for lymphogranuloma venereum (LGV) and other sexually transmitted diseases were negative. Histopathology from the ulcer in the groin and growth in the penis revealed squamous cell carcinoma (SCC). Skin biopsy of bulla was diagnostic of bullous pemphigoid (BP). We report a rare case of SCC masquerading as LGV with BP occurring as a paraneoplastic phenomenon. PMID:23919055

Penile strangulation by iron metal ring: A novel and effective method of management

PubMed Central

Paonam, Somorendro; Kshetrimayum, Nillachandra; Rana, Indrajit

2017-01-01

Penile strangulation by metal ring is a rare urological emergency situation which requires urgent decompression of the penis to avoid adverse effect. It is usually associated with an attempt to improve sexual act and/or to prolong erection. But sometimes, cutting of the ring to decompress the penis safely is a very difficult task particularly when the strangulating object is a hard metal object as in our case. Here, we present a case which was managed by cutting in a novel way with the help of dental micromotor with wheel shape bur. PMID:28216935

False fracture of the penis.

PubMed

Shah, Darshan K; Paul, Elliot M; Meyersfield, Sanford A; Schoor, Richard A

2003-06-01

Penile fracture is an uncommon, but well-described, entity that requires emergent treatment. The classic, "text-book" history, a blow to the erect penis accompanied by a "snap," pain, and immediate detumescence, is not universally present. We report 2 cases of "false" penile fracture, a condition that closely mimics "true" penile fracture. Perhaps the most distinguishing symptoms are the absence of the "snap" and gradual detumescence, both of which suggest false fracture but are not specific. It is our intention to bring this condition to the attention of general urologists who may see it in clinical practice and to guide them in its management.

[Cosmetic surgery of the male genitalia].

PubMed

Chevallier, D; Haertig, A; Faix, A; Droupy, S

2013-07-01

To describe the indications and results of techniques to change the appearance of the penis for aesthetic reasons. Provide recommendations concerning cosmetic surgery of the male genitalia. We have selected from Medline Database, articles published between 1990 and 2011. Forty articles have been selected excluding papers reporting populations less than five cases per type of procedure. There is no consensus on the size below which it is justifiable to accept or attempt to modify the size of the penis. Length of the penis in maximal tension less than 9.5 cm or 10 cm in erection can be considered as an acceptable limit, in a patient who suffers from it. The assessment of men asking for penile enlargement must include a psychosexological or psychiatric evaluation, looking for a dysmorphophobia or another psychiatric condition. Penile extenders under medical control must be the first-line treatment option for patient seeking penile lenghtening procedure when justified. In case of failure, three techniques can be used alone or in combination: penile lengthening by section of the suspensory ligaments and suprapubic skin advancement, lipectomy of Mons pubis and scrotal webbing section. The results are modest, the rate of complications significant and satisfaction low. Girth enlargement techniques by injection of autologous fat give inconsistent aesthetic results and satisfaction rates are low. All other techniques remain experimental. Cosmetic surgery of the penis is associated with a high risk of forensic exposure and surgery should be only proposed after a multidisciplinary consensus, followed by a time of reflection given to the patient after full disclosure. Applications for the purpose of reconstruction surgery after trauma or consequences of cancer treatment are justified. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Distinct subclassification of DRG neurons innervating the distal colon and glans penis/distal urethra based on the electrophysiological current signature

PubMed Central

Petruska, Jeffrey C.; Cooper, Brian Y.; Johnson, Richard D.

2014-01-01

Spinal sensory neurons innervating visceral and mucocutaneous tissues have unique microanatomic distribution, peripheral modality, and physiological, pharmacological, and biophysical characteristics compared with those neurons that innervate muscle and cutaneous tissues. In previous patch-clamp electrophysiological studies, we have demonstrated that small- and medium-diameter dorsal root ganglion (DRG) neurons can be subclassified on the basis of their patterns of voltage-activated currents (VAC). These VAC-based subclasses were highly consistent in their action potential characteristics, responses to algesic compounds, immunocytochemical expression patterns, and responses to thermal stimuli. For this study, we examined the VAC of neurons retrogradely traced from the distal colon and the glans penis/distal urethra in the adult male rat. The afferent population from the distal colon contained at least two previously characterized cell types observed in somatic tissues (types 5 and 8), as well as four novel cell types (types 15, 16, 17, and 18). In the glans penis/distal urethra, two previously described cell types (types 6 and 8) and three novel cell types (types 7, 14, and 15) were identified. Other characteristics, including action potential profiles, responses to algesic compounds (acetylcholine, capsaicin, ATP, and pH 5.0 solution), and neurochemistry (expression of substance P, CGRP, neurofilament, TRPV1, TRPV2, and isolectin B4 binding) were consistent for each VAC-defined subgroup. With identification of distinct DRG cell types that innervate the distal colon and glans penis/distal urethra, future in vitro studies related to the gastrointestinal and urogenital sensory function in normal as well as abnormal/pathological conditions may be benefitted. PMID:24872531

Distinct subclassification of DRG neurons innervating the distal colon and glans penis/distal urethra based on the electrophysiological current signature.

PubMed

Rau, Kristofer K; Petruska, Jeffrey C; Cooper, Brian Y; Johnson, Richard D

2014-09-15

Spinal sensory neurons innervating visceral and mucocutaneous tissues have unique microanatomic distribution, peripheral modality, and physiological, pharmacological, and biophysical characteristics compared with those neurons that innervate muscle and cutaneous tissues. In previous patch-clamp electrophysiological studies, we have demonstrated that small- and medium-diameter dorsal root ganglion (DRG) neurons can be subclassified on the basis of their patterns of voltage-activated currents (VAC). These VAC-based subclasses were highly consistent in their action potential characteristics, responses to algesic compounds, immunocytochemical expression patterns, and responses to thermal stimuli. For this study, we examined the VAC of neurons retrogradely traced from the distal colon and the glans penis/distal urethra in the adult male rat. The afferent population from the distal colon contained at least two previously characterized cell types observed in somatic tissues (types 5 and 8), as well as four novel cell types (types 15, 16, 17, and 18). In the glans penis/distal urethra, two previously described cell types (types 6 and 8) and three novel cell types (types 7, 14, and 15) were identified. Other characteristics, including action potential profiles, responses to algesic compounds (acetylcholine, capsaicin, ATP, and pH 5.0 solution), and neurochemistry (expression of substance P, CGRP, neurofilament, TRPV1, TRPV2, and isolectin B4 binding) were consistent for each VAC-defined subgroup. With identification of distinct DRG cell types that innervate the distal colon and glans penis/distal urethra, future in vitro studies related to the gastrointestinal and urogenital sensory function in normal as well as abnormal/pathological conditions may be benefitted. Copyright © 2014 the American Physiological Society.

Penis Transplantation: First US Experience.

PubMed

Cetrulo, Curtis L; Li, Kai; Salinas, Harry M; Treiser, Matthew D; Schol, Ilse; Barrisford, Glen W; McGovern, Francis J; Feldman, Adam S; Grant, Michael T; Tanrikut, Cigdem; Lee, Jeffrey H; Ehrlichman, Richard J; Holzer, Paul W; Choy, Garry M; Liu, Raymond W; Ng, Zhi Yang; Lellouch, Alexandre G; Kurtz, Josef M; Austen, William G; Winograd, Jonathan M; Bojovic, Branko; Eberlin, Kyle R; Rosales, Ivy A; Colvin, Robert B; Ko, Dicken S C

2018-05-01

We describe the first successful penis transplant in the United States in a patient with a history of subtotal penectomy for penile cancer. Penis transplantation represents a new paradigm in restoring anatomic appearance, urine conduit, and sexual function after genitourinary tissue loss. To date, only 2 penis transplants have been performed worldwide. After institutional review board approval, extensive medical, surgical, and radiological evaluations of the patient were performed. His candidacy was reviewed by a multidisciplinary team of surgeons, physicians, psychiatrists, social workers, and nurse coordinators. After appropriate donor identification and recipient induction with antithymocyte globulin, allograft procurement and recipient preparation took place concurrently. Anastomoses of the urethra, corpora, cavernosal and dorsal arteries, dorsal vein, and dorsal nerves were performed, and also inclusion of a donor skin pedicle as the composite allograft. Maintenance immunosuppression consisted of mycophenolate mofetil, tacrolimus, and methylprednisolone. Intraoperative, the allograft had excellent capillary refill and strong Doppler signals after revascularization. Operative reinterventions on postoperative days (PODs) 2 and 13 were required for hematoma evacuation and skin eschar debridement. At 3 weeks, no anastomotic leaks were detected on urethrogram, and the catheter was removed. Steroid resistant-rejection developed on POD 28 (Banff I), progressed by POD 32 (Banff III), and required a repeat course of methylprednisolone and antithymocyte globulin. At 7 months, the patient has recovered partial sensation of the penile shaft and has spontaneous penile tumescence. Our patient reports increased overall health satisfaction, dramatic improvement of self-image, and optimism for the future. We have shown that it is feasible to perform penile transplantation with excellent results. Furthermore, this experience demonstrates that penile transplantation can be successfully performed with conventional immunosuppression. We propose that our successful penile transplantation pilot experience represents a proof of concept for an evolution in reconstructive transplantation.

Giant condyloma acuminata: Incidence among cases diagnosed as carcinoma of the penis

PubMed Central

Davies, Sylvia W.

1965-01-01

Twenty-four cases of giant condyloma acuminata were found among 100 cases diagnosed as carcinoma of the penis. One of the 24 tumours showed early malignant change. The characteristic histological pattern of giant condyloma consists of broad processes composed of prickle cells associated with little keratinization. The malignant condylomas show, in comparison, a loss of prickle cell preponderance, increased basal cell activity and frequent keratinization, or may present as a solid papillary epithelioma forming broad sheets of uniform cells with many mitoses. The incidence of malignant change in the giant condyloma and the relationship between the benign and malignant tumours are discussed. Images PMID:14276146

Penile Fracture Following a Fall in a 7-Year-Old Male.

PubMed

Meenakshi-Sundaram, Bhalaajee; Coco, Caitlin T; Furr, James R; Shaw, Marshall D; Frimberger, Dominic C

2017-08-01

We report a rare case of isolated penile fracture in a prepubescent male caused by an accidental fall. The patient presented with swelling and ecchymosis on the base of the penis and along the penile shaft. A flexible cystoscopy was performed, which did not reveal any concomitant urethral injury. The penis was degloved and the corporal tear was closed with absorbable suture. Due to the location of the injury, ventral mobilization of the urethra was required. The pathophysiology of penile fracture as well as the diagnosis and management of this rare injury are discussed in this report. Copyright © 2017 Elsevier Inc. All rights reserved.

Suckers and other bursal structures of Pomphorhynchus bulbocolli and Acanthocephalus dirus (Acanthocephala).

PubMed

Doyle, L R; Gleason, L N

1991-06-01

Accessory copulatory structures in the bursa of Pomphorhynchus bulbocolli include 2 suckers on the inner surface and bursal rays. A stylet was present in the penis of this species. Two suckers were present in the bursa of Acanthocephalus dirus, but bursal rays and a stylet in the penis were not observed. This is the first report of suckers present in the bursas of acanthocephalans. Copulatory cement caps and holes surrounded by a ring approximating the inner bursal diameter and not covered by a cap were present on the sides of some P. bulbocolli, indicating the possibility of hypodermic insemination in this species.

18F-FDG PET/CT Findings of Metastasis to Spongy Body of Penis From Urothelial Carcinoma of Bladder.

PubMed

Wang, Yan-li; Fang, Na; Zeng, Lei; Wu, Zeng-jie; Cui, Xin-jian

2016-05-01

The spongy body of the penis metastasis from other primary sites is a rare clinical entity. It is frequently associated with widespread metastatic disease and poor prognosis clinically. We report a case of a 61-year-old man with a previous history of cystectomy due to infiltrating urothelial carcinoma of the bladder 12 months ago and presented with penile shaft swelling pain and hematuria for 3 months. The restaging F-FDG PET/CT scan demonstrated a hypermetabolic mass at his penile shaft. This lesion was confirmed on phallectomy to be infiltrating urothelial carcinoma metastasis from the known primary bladder tumor.

Condoms: still the most popular contraceptive.

PubMed

Silverstone, T

1997-01-01

Condoms can be used as a barrier contraceptive and/or to protect against many sexually-transmitted diseases. They are easy to buy and use and free from medical risk. Carefully used, and used in conjunction with a spermicide, condoms have similar reliability to IUDs, progesterone-only pills and the diaphragm. The condom must be put on before the penis touches the vaginal area. The penis should not touch the vaginal area after the condom has been taken off. Oil-based products, eg baby oil, massage oil, lipstick, petroleum jelly, suntan oil, can damage the condom. If a lubricant is required, use one that is water-based.

Penile Traumatic Neuroma: A Late Complication of Penile Dorsal Neurotomy to Treat Premature Ejaculation.

PubMed

Park, Hyun Jun; Kim, Tae Nam; Baek, Seung Ryong; Lee, Kyung Min; Choi, Kyung-Un; Park, Nam Cheol

2016-09-01

Traumatic neuroma is a reactive process caused by the regeneration of an injured nerve that usually forms a nodular proliferation of small nerve bundles. Penile traumatic neuroma is rare; only a few cases related to circumcision have been reported. To report on a case of traumatic neuroma in the penis after selective dorsal neurotomy (SDN) to treat premature ejaculation. The penile traumatic neuroma was successfully removed by excision and confirmed by histopathology. A 55-year-old man who had had several painless, slow-growing nodules on his penis for 2 years presented to our hospital. He had no history of genital trauma, urinary tract infection, or penile surgery, except SDN to treat premature ejaculation. The nodules were excised and the final diagnosis was traumatic neuroma. No recurrence has been detected during 1 year of follow-up. The main complications of SDN are recurrence of premature ejaculation, pain or paresthesia on the glans penis, and erectile dysfunction. However, no traumatic neuroma has been reported as a complication. We report that a traumatic neuroma can occur after SDN. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

The Strong Protective Effect of Circumcision against Cancer of the Penis

PubMed Central

Morris, Brian J.; Gray, Ronald H.; Castellsague, Xavier; Bosch, F. Xavier; Halperin, Daniel T.; Waskett, Jake H.; Hankins, Catherine A.

2011-01-01

Male circumcision protects against cancer of the penis, the invasive form of which is a devastating disease confined almost exclusively to uncircumcised men. Major etiological factors are phimosis, balanitis, and high-risk types of human papillomavirus (HPV), which are more prevalent in the glans penis and coronal sulcus covered by the foreskin, as well as on the penile shaft, of uncircumcised men. Circumcised men clear HPV infections more quickly. Phimosis (a constricted foreskin opening impeding the passage of urine) is confined to uncircumcised men, in whom balanitis (affecting 10%) is more common than in circumcised men. Each is strongly associated with risk of penile cancer. These findings have led to calls for promotion of male circumcision, especially in infancy, to help reduce the global burden of penile cancer. Even more relevant globally is protection from cervical cancer, which is 10-times more common, being much higher in women with uncircumcised male partners. Male circumcision also provides indirect protection against various other infections in women, along with direct protection for men from a number of genital tract infections, including HIV. Given that adverse consequences of medical male circumcision, especially when performed in infancy, are rare, this simple prophylactic procedure should be promoted. PMID:21687572

20-year experience with iatrogenic penile injury.

PubMed

Amukele, Samuel A; Lee, Gene W; Stock, Jeffrey A; Hanna, Moneer K

2003-10-01

We review our experience with the management of iatrogenic penile injuries. Apart from circumcision, serious damage to the penis can occur following hypospadias repair, surgery for priapism or total loss of the penis following surgical repair of bladder exstrophy. A retrospective analysis of patients with iatrogenic penile amputation referred to us between 1980 and 2000 was undertaken. Causes of injury and choice of management were reviewed. Of the 13 cases treated during the 20-year period mechanism of primary injury was circumcision in 4, hypospadias repair in 6, priapism in 1, bladder exstrophy repair in 1 and penile carcinoma in 1. A variety of techniques were used for phallic reconstruction. Penile degloving, division of suspensory ligament and rotational skin flaps achieved penile augmentation and enhancement. Reasonable cosmesis and penile length were achieved in all cases. In indicated cases microsurgical phalloplasty was technically feasible. However long-term followup showed various complications including erosions from the use of a penile stiffener. The ultimate goal of reconstructive surgery is to have a penis with normal function and appearance. The management of penile injury requires a wide variety of surgical techniques that are tailored to the individual patient. Expedient penile reconstruction is successful and therapeutic delay is associated with complications.

Controversies of Sex Re-assignment in Genetic Males with Congenital Inadequacy of the Penis.

PubMed

Raveenthiran, Venkatachalam

2017-09-01

Sex assignment in 46XY genetic male children with congenital inadequacy of the penis (CIP) is controversial. Traditionally, children with penile length less than 2 cm at birth are considered unsuitable to be raised as males. They are typically re-assigned to female-sex and feminizing genitoplasty is usually done in infancy. However, the concept of cerebral androgen imprinting has caused paradigm shift in the philosophy of sex re-assignment. Masculinization of the brain, rather than length of the penis, is the modern criterion of sex re-assignment in CIP. This review summarizes the current understanding of the complex issue. In 46XY children with CIP, male-sex assignment appears appropriate in non-hormonal conditions such as idiopathic micropenis, aphallia and exstrophy. Female-sex re-assignment appears acceptable in complete androgen insensitivity (CAIS), while partial androgen insensitivity syndrome (PAIS) patients are highly dissatisfied with the assignment of either sex. Children with 5-alpha reductase deficiency are likely to have spontaneous penile lengthening at puberty. Hence, they are better raised as males. Although female assignment is common in pure gonadal dysgenesis, long-term results are not known to justify the decision.

Analysis of Knowledge Level in Brasilian Students about Human Papillomavirus Infection and Development of Penile Cancer

PubMed Central

Abdalla, George Kemil; Fajardo, Emanuella Francisco; Gomes, Bruno Belmonte Martinelli; Bianco, Thiago Mantello; Salge, Ana Karina Marques; de Carvalho, Eduardo Elias Vieira; Reis, Marlize Moura Dos; Abrahão, Dayana Pousa Siqueira; Abdalla, Douglas Reis

2017-01-01

Introduction: Human papillomavirus (HPV), belonging to the Papovavirida family, is the most prevalent sexually transmitted disease (STD) agent worldwide. In Brazil, it is estimated that there are 3-6 million people infected with HPV. Aim: The aim of this study was to evaluate the knowledge of young male students about penis cancer related to HPV infection. Methods: This exploratory and quantitative study was conducted to analyze answers of 242 male students attending a private college located in Uberaba city, Minas Gerais state, Brazil, during 2015. Results: Most of the 242 participants (88.8%) affirmed having started sexual life very early, the majority (79.3%) were currently married and 69.8% had a single sexual partner. Regardless of their knowledge about HPV virus and its relationship with penis cancer, our data showed a general lack of awareness of the participants. Conclusion: Our results suggest that despite efforts to propagate information about HPV infection and its relation to penis cancer, the level of knowledge of students is low. Because of that, it is important to improve the information spread by media, emphasizing prevention and treatment of HPV infection in men. PMID:28612588

Analysis of Knowledge Level in Brazilian Students about Human Papillomavirus Infection and Development of Penile Cancer

PubMed

Abdalla, George Kemil; Fajardo, Emanuella Francisco; Gomes, Bruno Belmonte Martinelli; Bianco, Thiago Mantello; Salge, Ana Karina Marques; Carvalho, Eduardo Elias Vieira de; Dos Reis, Marlize Moura; Abrahão, Dayana Pousa Siqueira; Abdalla, Douglas Reis

2017-05-01

Introduction: Human papillomavirus (HPV), belonging to the Papovavirida family, is the most prevalent sexually transmitted disease (STD) agent worldwide. In Brazil, it is estimated that there are 3-6 million people infected with HPV. Aim: The aim of this study was to evaluate the knowledge of young male students about penis cancer related to HPV infection. Methods: This exploratory and quantitative study was conducted to analyze answers of 242 male students attending a private college located in Uberaba city, Minas Gerais state, Brazil, during 2015. Results: Most of the 242 participants (88.8%) affirmed having started sexual life very early, the majority (79.3%) were currently married and 69.8% had a single sexual partner. Regardless of their knowledge about HPV virus and its relationship with penis cancer, our data showed a general lack of awareness of the participants. Conclusion: Our results suggest that despite efforts to propagate information about HPV infection and its relation to penis cancer, the level of knowledge of students is low. Because of that, it is important to improve the information spread by media, emphasizing prevention and treatment of HPV infection in men. Creative Commons Attribution License

Congenital megaprepuce: a 12-year experience (52 cases) of this specific form of buried penis.

PubMed

Rod, Julien; Desmonts, Alexis; Petit, Thierry; Ravasse, Philippe

2013-12-01

Congenital megaprepuce is a specific form of buried penis. Children affected by this malformation usually suffer from a subjective difficulty in voiding which is the main indication for early surgical correction. The aim of this study was to report a single center's 12-year experience in the treatment of megaprepuce in children, describing the surgical procedure we used to treat it and the results. We retrospectively reviewed the charts of all children who underwent congenital megaprepuce repair between January 1999 and August 2011 in our institution. Fifty-two children were operated during the study period. Our single surgical technique, not an original one, consists of fixing the penile shaft at the base of the penis, and widely reducing the inner prepuce. Four children (8%) underwent revision surgery but according to our criteria a very good result was observed in only 23 patients, and a less good but still acceptable result in 25 patients. Our 12-year experience in the surgical treatment of congenital megaprepuce demonstrated satisfying results from a safe and simple surgical technique, but to achieve the optimum result remains difficult. Copyright © 2012 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

[Penile dimensions in type 2 diabetes].

PubMed

Belousov, I I; Kogan, M I; Ibishev, H S; Vorobyev, S V; Khripun, I A; Gusova, Z R

2015-12-01

The current literature provides a wide range of publications on the anthropometry of the penis specifying the relationship between penile dimensions and sex hormones, weight, height and erectile function. But most of the studies involved healthy volunteers or young patients with erectile dysfunction. Our study was conducted in patients with type 2 diabetes. Penile measurements obtained in the present study were compared those of the average Russian man. The patients were divided into groups with preserved and impaired erectile function. Erectile function was also studied relative to the variability of penile dimensions. The effect of DM duration on erectile function was defined. Comparative analysis revealed the relationship between penile anatomical dimensions and erectile function. We studied the effect of type 2 diabetes on the anatomical dimensions and elasticity of the penis, established the relationship between penile dimensions and elasticity of the penis. The correlation between the severity of erectile dysfunction and serum testosterone levels on one side, and penile dimensions on the other was found. The effect of penile dimensions on erectile function in DM patients was also examined. Determining penile dimensions and their variability due to various pathological conditions or processes, may eventually lead to better result of ED management.

[Rupture of the albuginea of the corpora cavernosa].

PubMed

Dergamoun, Hamza; El Makhoukhi, Zayd El Boukili

2017-01-01

The fractures of the penis are rare in our context and are most often secondary to false penile fracture. A more common cause has been described in the countries of the Middle East where people interrupt the erection due to a violent bending of their penis called "Taqaandan". We here report the case of a 21-year old patient with no particular previous history, presenting to the emergency department at the Medical Center Avicenna with pain and deformation of the penis following "Taqaandan" manoeuvre. After having heard a click the patient felt pain and had violent detumescence without associated urinary problems, thus excluding urethral involvement. The image shows the classic "eggplant" appearance (A). Ultrasound confirmed the diagnosis of rupture of the albuginea of the corpus cavernosum, and the patient underwent surgery. A selective contralateral approach was used in order to avoid unnecessary dissection. After the evacuation of the haematoma, the fracture line was shown (B) and then fixed with reverse suture. The patient was discharged the day after surgery and was put under analgesic and antihormonal treatment. The patient went for a check-up after 2, 4 and 6 months and showed recovery of normal erectile function without cranking or fibrous plate.

[Magnetic resonance imaging of the penis. Its normal anatomy].

PubMed

Banchik, E L; Mineev, N I; Mitusov, V V; Dombrovskiĭ, V I; Kogan, M I

2012-01-01

To estimate the capabilities of magnetic resonance imaging (MRI) to identify penile anatomic structures and their topographic relationships. Penile MRI results were analyzed in 52 men of different ages who had no history, clinical, laboratory, and radiological data in favor of diseases of this organ. Penile imaging technology and its algorithm, including patient preparation and posi-tioning and a list of impulse sequences and their parameters, are proposed. Penile MRI and anatomy are described in detail; magnetic resonance signal characteristics of the main structural elements of the organ and its adjacent tissues on T1- and T2-weighted images are specified. The MRI morphometry results of the cavernous and spongy bodies, urethra, and penis as a whole, which agree well with the similar known literature data, are given. The investigation has provided evidence for the high informative value of the technique in recognizing the relatively small anatomic structures of the penis, which is comparable with that of the morphological study of a gross specimen of this organ, which in turn predetermines a further investigation of the capabilities of MRI to diagnose penile diseases and to estimate the quality of their treatment.

Interstitial radiation therapy for carcinoma of the penis using iridium 192 wires: the Henri Mondor experience (1970-1979)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mazeron, J.J.; Langlois, D.; Lobo, P.A.

1984-10-01

From 1970 to 1979, a group of 50 patients was treated for squamous cell carcinoma of the penis by interstitial irradiation using an afterloading technique and iridium 192 wires. The group included 9 patients with T1 tumors, 27 with T2 tumors, and 14 with T3 tumors. Forty-five patients presented with no metastatic inguinal nodes (NO), 3 patients with N1 nodes, and 2 patients had N3 nodes. After treatment, 11 patients (1 T1, 6 T2 and 4 T3) developed local recurrences. Three patients developed post-therapeutic necrosis which necessitated partial amputation in 2 cases. Eight patients developed post-therapeutic urethral stenosis, which requiredmore » surgical treatment in three of the cases. Twenty-one percent of the patients died of their disease. The authors advocate interstitial irradiation using iridium 192 wires for the treatment of non-infiltrating or moderately infiltrating squamous cell carcinoma of the penis in which the largest dimension does no exceed 4 cm. When regular follow-up can be assurred, it is reasonable to forgo prophylactic treatment of the inguinal nodes in patients presenting without groin metastasis.« less

Treatment of carcinoma of the penis by iridium 192 wire implant

DOE Office of Scientific and Technical Information (OSTI.GOV)

Daly, N.J.; Douchez, J.; Combes, P.F.

1982-07-01

Since 1971, a group of 22 adult patients with squamous cell carcinoma of the penis have been treated by iridium 192 wire implants. There were 6 T1 tumors, 14 T2 tumors and 2 T3; only one patient (T3) presented with local failure after implant. Local necrosis occurred in 2 patients without local tumoral recurrence, but was sufficient enough to warrant amputation. Thus 19/22 (86%) patients were locally cured with penile conservation. In these patients the most frequent posttherapeutic complication is chronic urethral stenosis (9/19 patients, 47%) requiring repeated instrumental dilations. Four patients presented with initial inguinal mestastatic nodes; only onemore » was cured by radiosurgical treatment. Among patients without metastatic nodes at the time of diagnosis, none had delayed metastatic nodes. Three patients died of nodal evolution, 5 patients died of intercurrent disease without evidence of disease and 14 are now alive and NED. It appears that iridium 192 wire implant is the most effective conservative treatment of invasive squamous cell carcinoma of the penis; however, these results confirm that no particular treatment is required for inguinal nodal areas for patients who initially present with no disease.« less

Urethral anatomy and semen flow during ejaculation

NASA Astrophysics Data System (ADS)

Kelly, Diane

2016-11-01

Ejaculation is critical for reproductive success in many animals, but little is known about its hydrodynamics. In mammals, ejaculation pushes semen along the length of the penis through the urethra. Although the urethra also carries urine during micturition, the flow dynamics of micturition and ejaculation differ: semen is more viscous than urine, and the pressure that drives its flow is derived primarily from the rhythmic contractions of muscles at the base of the penis, which produce pulsatile rather than steady flow. In contrast, Johnston et al. (2014) describe a steady flow of semen through the crocodilian urethral groove during ejaculation. Anatomical differences of tissues associated with mammalian and crocodilian urethral structures may underlie these differences in flow behavior.

Cellular effects of tributyltin (TBT) on the penis epithelium cells of prosobranchs ( Hinia reticulata and Ocinebrina aciculata)

NASA Astrophysics Data System (ADS)

Brick, M.; Deutsch, U.; Fioroni, P.

1996-09-01

Cytopathological effects on organelles of penis epithelium cells were investigated in prosobranchs that had been exposed for two weeks to three months to high TBT-concentrations in artificial seawater. TBT exposure damaged cell organelles, such as mitochondria, Golgi dictyosomes, endoplasmatic reticulum, and injured the cell membranes. In addition, atypical intercellular spaces were observed between the cells of the epithelial layer. Further cell alterations included the increase of residual bodies within the cells as well as structural changes of the basal lamina. The ultrastructural changes were compared with cell alterations of specimens which had been collected in a polluted environment on the coast of Brittany (France).

Superficial Dorsal Venous Rupture of the Penis: False Penile Fracture That Needs to be Treated as a True Urologic Emergency.

PubMed

Truong, Hong; Ferenczi, Basil; Cleary, Ryan; Healy, Kelly A

2016-11-01

A 38-year-old man with history of repaired penile fracture presented with rapid detumescence, penile pain, and ecchymosis during vaginal sexual intercourse concerning for recurrent fracture. Surgical exploration revealed ruptured superficial dorsal vein of the penis, which was subsequently ligated. Patients with traumatic penile vascular injuries often present with clinical features indistinguishable from a true penile fracture. Gradual detumescence and an absence of characteristic popping sound may indicate a vascular injury but they cannot safely rule out a true penile fracture. Both true and false penile fractures require emergent surgical exploration and repair to prevent long-term complications. Copyright © 2016 Elsevier Inc. All rights reserved.

Mondor's disease of the penis following a long-haul flight.

PubMed

Day, S; Bingham, J S

2005-07-01

Mondor's disease of the penis, otherwise known as superficial thrombophlebitis (STP) or thrombosis of the dorsal vein, is an under-reported benign condition, the aetiology of which is poorly understood. It is characterized by a sudden, indurated swelling of the vein, often occurring after vigorous sexual activity. We report a case of Mondor's disease occurring 24 h following a 15-h flight. This gentleman also reported a history of STP of his left lower limb varicose veins following a similar-length flight three years previously. In the absence of any other clear predisposing factor, we propose long-haul flight as an important factor contributing to the development of dorsal vein thrombosis.

Morphological effects of tributyltin (TBT) in vitro on the genital system of the mesogastropoda Littorina littorea (Prosobranchia)

NASA Astrophysics Data System (ADS)

Deutsch, U.; Brick, M.

1993-02-01

This ultrastructural study investigates the pathological changes in the penial, the sperm groove and the glandular cushion epithelium in male Littorina littorea (Mesogastropoda) related to TBT (tributyltin) contamination. The results are compared with those on Ocinebrina aciculata (Neogastropoda), which shows a wide range of cell changes in the penis epithelia of male and imposex affected females. The investigation of the different penis epithelia of L. littorea revealed that the cells analysed show a low sensibility towards TBT. The cells display normal metabolism. Certain atypical structures like swelling microvilli and cristae which tend to lie parallel to the long axis in the mitochondria, were detected as pathological effects.

Development of the External Genitalia: Perspectives from the Spotted Hyena (Crocuta crocuta)

PubMed Central

Cunha, Gerald R.; Risbridger, Gail; Wang, Hong; Place, Ned J.; Grumbach, Mel; Cunha, Tristan J.; Weldele, Mary; Conley, Al J.; Barcellos, Dale; Agarwal, Sanjana; Bhargava, Argun; Drea, Christine; Hammond, Geoffrey L.; Siiteri, Penti; Coscia, Elizabeth M.; McPhaul, Michael J; Baskin, Laurence S.; Glickman, Stephen E.

2014-01-01

This review/research paper summarizes data on development of the external genitalia of the spotted hyena, a fascinating mammal noted for extreme masculinization of the female external genitalia. The female spotted hyena is the only extant mammal that mates and gives birth through a pendulous penis-like clitoris. Our studies indicate that early formation of the phallus in both males and females is independent of androgens; indeed the phallus forms before the fetal testes or ovaries are capable of synthesizing androgens. Likewise, pre- and postnatal growth in length of the penis and clitoris is minimally affected by “androgen status”. Nonetheless, several internal morphologies, as well as external surface features of the phallus, are androgen-dependent and thus account for dimorphism between the penis and clitoris. Finally, estrogens play a critical role in penile and clitoral development, specifying the position of the urethral orifice, determining elasticity of the urethral meatus, and facilitating epithelial-epithelial fusion events required for proper formation of the distal urethra/urogenital sinus and prepuce. Accordingly, prenatal inhibition of estrogen synthesis via administration of letrozole (an aromatase inhibitor) leads to malformations of the glans as well as the prepuce (hypospadias). The effects of prenatal androgens, anti-androgens and impaired estrogen synthesis correlated with the tissue expression of androgen and estrogen receptors. PMID:24582573

Quantitative analysis of development and aging of genital corpuscles in glans penis of the rat.

PubMed

Shiino, Mizuho; Hoshi, Hideo; Kawashima, Tomokazu; Ishikawa, Youichi; Takayanagi, Masaaki; Murakami, Kunio; Kishi, Kiyoshi; Sato, Fumi

2015-02-01

The aim of the present postnatal developmental study was to determine densities of unique genital corpuscles (GCs) in glans penis of developing and aged rats. GCs were identified as corpuscular endings consisting of highly branched and coiled axons with many varicosities, which were immunoreactive for protein gene product 9.5. In addition, GCs were immunoreactive for calcitonin gene-related peptide and substance P, but not for vasoactive intestinal polypeptide and neuropeptide Y. GCs were not found in the glans penis of 1 week old rats. Densities of GCs were low at 3 weeks, significantly increased at 5 and 10 weeks, reached the peak of density at 40 weeks, and tended to decrease at 70 and 100 weeks. Sizes of GCs were small in 3 weeks old rats, increased at 5 and 10 weeks, reached the peak-size at 40 weeks and reduced in size at 70 and 100 weeks. Considering sexual maturation of the rat, the results reveal that GCs of the rat begins to develop postnatal and reaches to the peak of their development after puberty and continues to exist until old age, in contrast to prenatal and early postnatal development of other sensory receptors of glabrous skin. Copyright © 2014 Elsevier Ltd. All rights reserved.

Endocrine regulation and sexual differentiation of avian copulatory sexually selected characters.

PubMed

Brennan, Patricia L R; Adkins-Regan, Elizabeth

2014-10-01

Reproductive specializations in birds have provided intriguing model systems to better understand the role of endocrine mechanisms that regulate phenotype expression and the action of sexual selection. A comparative approach can elucidate how endocrine systems associated with control of sexual differentiation, sexual maturation, and reproductive physiology and behavior have diversified. Here we compare the copulatory sexually selected traits of two members of the galloanseriform superfamily: quail and ducks. Japanese quail have a non-intromittent penis, and they have evolved a unique foam gland that is known to be involved in post-copulatory sexual selection. In contrast, ducks have maintained a large intromittent penis that has evolved via copulatory male-male competition and has been elaborated in a sexually antagonistic race due to sexual conflict with females over mating. These adaptations function in concert with sex-specific and, in part, species-specific behaviors. Although the approaches to study these traits have been different, exploring the differences in neuroendocrine regulation of sexual behavior, development and seasonality of the foam gland and the penis side by side, allow us to suggest some areas where future research would be productive to better understand the evolution of novelty in sexually selected traits. Copyright © 2014 Elsevier Ltd. All rights reserved.

The role of the illusion in the construction of erotic desire: narratives from heterosexual men who have occasional sex with transgender women.

PubMed

Reback, Cathy J; Kaplan, Rachel L; Bettcher, Talia M; Larkins, Sherry

2016-08-01

Little is known about men's sexual desire for and erotic attraction to male-to-female transgender women. To better understand how erotic desire is constructed, this study examined the narratives of a sample of heterosexual men who had had an occasional sexual encounter with a transgender woman. Open-ended qualitative interviews were conducted with 16 heterosexual men who reported at least one sexual encounter with a transgender woman in the previous 12 months. Using principles of Grounded Theory, three themes emerged: (1) the erotic desire that transpired from a transgender woman's construction of her femininity, (2) the sexual act that dictated the specific navigation of a transgender woman's penis and (3) the sexual dissonance that resulted from being a heterosexually identified man having sex with a partner who had a penis. These themes reflected how the participants defined and negotiated their sexual encounters, both psychologically through their understanding of sex with a transgender woman with a penis, and physically through the navigation of specific sex acts. The role of the 'illusion' was central to the meaning and construction of erotic desire. These narratives provided another framework for continuing discourse on the complexity of erotic desire.

The Role of the Illusion in the Construction of Erotic Desire: Narratives from Heterosexual Men Who Have Occasional Sex with Transgender Women

PubMed Central

Reback, Cathy J.; Kaplan, Rachel L.; Bettcher, Talia M.; Larkins, Sherry

2016-01-01

Little is known about men’s sexual desire for and erotic attraction to male-to-female transgender women. This study examined the narratives of a sample of heterosexual men who had an occasional sexual encounter with a transgender woman to better understand how erotic desire was constructed. Open-ended qualitative interviews were conducted with 16 heterosexual men who reported at least one sexual encounter with a transgender woman in the previous 12 months. Using the principles of Grounded Theory, three themes emerged: (1) the erotic desire that transpired from a transgender woman’s construction of her femininity; (2) the sexual act that dictated specific navigation of a transgender woman’s penis; and, (3) the sexual dissonance that resulted from being a heterosexually identified man having sex with a partner who had a penis. These themes reflected how the participants defined and negotiated their sexual encounters, both psychologically through their understanding of sex with a transgender woman with a penis, and physically through the navigation of specific sex acts. The role of the ‘illusion’ was central in the meaning and construction of erotic desire. These narratives provided another framework for the continuing discourse on the complexity of erotic desire. PMID:26967172

Treatment with CB2 Agonist JWH-133 Reduces Histological Features Associated with Erectile Dysfunction in Hypercholesterolemic Mice

PubMed Central

Fraga-Silva, Rodrigo Araujo; Costa-Fraga, Fabiana Pereira; Faye, Younouss; Savergnini, Silvia Quintao; Lenglet, Sébastien; Mach, François; Steffens, Sabine; Stergiopulos, Nikolaos; Souza dos Santos, Robson Augusto; da Silva, Rafaela Fernandes

2013-01-01

Hypercholesterolemia is one of the most important risk factors for erectile dysfunction, mostly due to the impairment of oxidative stress and endothelial function in the penis. The cannabinoid system might regulate peripheral mechanisms of sexual function; however, its role is still poorly understood. We investigated the effects of CB2 activation on oxidative stress and fibrosis within the corpus cavernosum of hypercholesterolemic mice. Apolipoprotein-E-knockout mice were fed with a western-type diet for 11 weeks and treated with JWH-133 (selective CB2 agonist) or vehicle during the last 3 weeks. CB2 receptor expression, total collagen content, and reactive oxygen species (ROS) production within the penis were assessed. In vitro corpus cavernosum strips preparation was performed to evaluate the nitric oxide (NO) bioavailability. CB2 protein expression was shown in cavernosal endothelial and smooth muscle cells of wild type and hypercholesterolemic mice. Treatment with JWH-133 reduced ROS production and NADPH-oxidase expression in hypercholesterolemic mice penis. Furthermore, JWH-133 increased endothelial NO synthase expression in the corpus cavernosum and augmented NO bioavailability. The decrease in oxidative stress levels was accompanied with a reduction in corpus cavernosum collagen content. In summary, CB2 activation decreased histological features, which were associated with erectile dysfunction in hypercholesterolemic mice. PMID:24302957

Surgical management of morbidity due to lymphatic filariasis: the usefulness of a standardized international clinical classification of hydroceles.

PubMed

Capuano, G P; Capuano, C

2012-03-01

The objective of this work is to evaluate the usefulness of a standardized clinical classification of hydroceles in lymphatic filariasis endemic countries to guide their surgical management. 64 patients with hydroceles were operated in 2009-2010, in Level II hospitals (WHO classification), during two visits to Fiji, by the same mobile surgical team. The number of hydroceles treated was 83. We developed and evaluated a much needed clinical classification of hydroceles based on four criteria: Type (uni/bilateral); Side (left/right); Stage of enlargement of the scrotum rated from I to VI; Grade of burial of the penis rated from 0 to 4. It lead to the conclusion that 1) A Stage I or II hydrocele, associated with Grade 0 or 1 penis burial could be considered a "Simple Hydrocele". The surgical treatment is simple with no anticipated early complication. WHO Level II of health care structure seems adapted. 2) A Stage III or IV hydrocele associated with Grade 2, 3 or 4 penis burial could be considered a "Complicated Hydrocele". The operation is longer, more complicated and the possibility of occurrence of complications seems greater. A level III health care facility would be more adapted under the normal functioning of the health system. We conclude that a standardized clinical classification of hydroceles based on the Stage of enlargement of the scrotum and the Grade of burial of the penis appears to be a useful tool to guide the decision about the level of care and the surgical technique required. We use the same classification for penoscrotal lymphoedema. A decision tree is presented for the management of hydroceles in lymphatic filariasis endemic countries which could usefully complement the "Algorithm for management of scrotal swelling" proposed by WHO in 2002. An international classification system of hydroceles would also allow standardization and facilitate study design and comparisons of their results.

Sex-related penile fracture with complete urethral rupture: A case report and review of the literature.

PubMed

Garofalo, Marco; Bianchi, Lorenzo; Gentile, Giorgio; Borghesi, Marco; Vagnoni, Valerio; Dababneh, Hussam; Schiavina, Riccardo; Franceschelli, Alessandro; Romagnoli, Daniele; Colombo, Fulvio; Corcioni, Beniamino; Golfieri, Rita; Brunocilla, Eugenio

2015-09-30

To present the management of a patient with partial disruption of both cavernosal bodies and complete urethral rupture and to propose a non-systematic review of literature about complete urethral rupture. MATERIAL AND METHOD - CASE REPORT: A 46 years old man presented to our emergency department after a blunt injury of the penis during sexual intercourse. On physical examination there was subcutaneous hematoma extending over the proximal penile shaft with a dorsal-left sided deviation of the penis and urethral bleeding. Ultrasound investigation showed an hematoma in the ventral shaft of the penis with a discontinuity of the tunica albuginea of the right cavernosal corporum. The patient underwent immediate emergency surgery consisted on evacuation of the hematoma, reparation the partial defect of both two cavernosal bodies and end to end suture of the urethra that resulted completely disrupted. The urethral catheter was removed at the 12-th postoperative day without voiding symptoms after a retrograde urethrography. 6 months postoperatively the patients was evaluated with uroflowmetry demonstrating a max flow rate of 22 ml/s and optimal functional outcomes evaluated with validated questionnaires. 8 months after surgery the patients was evaluated by dynamic magnetic resonance (MRI) of the penis showing only a little curvature on the left side of the penile shaft. Penile fracture is an extremely uncommon urologic injury with approximately 1331 reported cases in the literature till the years 2001. To best of our knowledge from 2001 up today, 1839 more cases have been reported, only in 159 of them anterior urethral rupture was associated and in only 22 cases a complete urethral rupture was described. In our opinion, in order to prevent long term complications, in case of clinical suspicion of penile fracture, especially if it is associated to urethral disruption, emergency surgery should be the first choice of treatment.

Epithelioid sarcoma of the penis: a case report.

PubMed

Colombo, Fulvio; Franceschelli, Alessandro; Schiavina, Riccardo; Gentile, Giorgio; Passaretti, Giovanni; Martorana, Giuseppe

2013-11-01

Epithelioid sarcoma of the penis is a slowly growing soft tissue neoplasm that rarely arises from the penis. The aim of this case is to describe this rare pathology and to underline the importance of differential diagnosis with benign diseases such as Peyronie's disease. We report the case of a 20-year-old man who referred the onset of a progressive left dorsolateral penile curvature (about 60°) started 3 years before. The patient was evaluated with two US examinations that revealed two sites of tunical thickening with normal hemodynamic evaluation. The physical examination demonstrated a dorsal fibrotic plaque of about 2.5 cm. A juvenile form of Peyronie's Disease was diagnosed, and the patient was scheduled for surgical treatment (plaque's incision/excision and grafting). Intraoperative appearance showed that the great part of the left cavernous body was substituted by a very tough tissue which deeply involved the erectile tissue; intraoperative frozen section was suspicious for mesenchymal epithelioid neoplasm. In order to obtain definitive histological analysis and collect proper informed consent, we preferred to proceed with our original project, applying a dual graft (buccal mucosa and allograft dermal matrix) to cover the wide excised area. The final histological report confirmed the diagnosis of epithelioid sarcoma. Postoperative CT and MRI, at 3 and 6 months from surgery, were negative for metastases. The patient underwent radical intervention after 6 months. Epithelioid sarcoma of the penis and Peyronie's Disease can present with similar clinical findings although they obviously entail a different clinical progress. Since the diagnosis of neoplasm can be established only by the pathologist on biopsy specimen, in cases of unusual clinical presentation of Peyronie's disease (especially in young men suffering from a fast-growing penile induration), an early histological assessment should be performed to avoid the possibility of misdiagnosis in case of this poor-prognosis disease and to assure the definitive diagnosis. © 2012 International Society for Sexual Medicine.

Mechanistic link between erectile dysfunction and systemic endothelial dysfunction in type 2 diabetic rats

PubMed Central

Musicki, Biljana; Hannan, Johanna L.; Lagoda, Gwen; Bivalacqua, Trinity J.; Burnett, Arthur L.

2016-01-01

Men with type 2 diabetes mellitus (T2DM) and erectile dysfunction (ED) have greater risk of cardiovascular events than T2DM men without ED, suggesting ED as a predictor of cardiovascular events in diabetic men. However, molecular mechanisms underlying endothelial dysfunction in the diabetic penis explaining these clinical observations are not known. We evaluated whether the temporal relationship between ED and endothelial dysfunction in the systemic vasculature in T2DM involves earlier redox imbalance and endothelial nitric oxidase synthase (eNOS) dysfunction in the penis than in the systemic vasculature, such as the carotid artery. Rats were rendered T2DM by high-fat diet for 2 weeks, followed by an injection with low-dose streptozotocin. After 3 weeks, erectile function (intracavernosal pressure) was measured and penes and carotid arteries were collected for molecular analyses of eNOS uncoupling, protein S-glutathionylation, oxidative stress (4-hydroxy-2-nonenal, 4-HNE), protein expression of NADPH oxidase subunit gp91phox, endothelium-dependent vasodilation in the carotid artery, and non-andrenergic, non-cholinergic (NANC) mediated cavernosal relaxation. Erectile response to electrical stimulation of the cavernous nerve and NANC mediated cavernosal relaxation were decreased (p<0.05), while relaxation of the carotid artery to acetylcholine was not impaired in T2DM rats. eNOS monomerization, protein expressions of 4-HNE and gp91phox, and protein S-glutathionylation, were increased (p<0.05) in the penis, but not in the carotid artery, of T2DM compared to nondiabetic rats. In conclusion, redox imbalance, increased oxidative stress by NADPH oxidase, and eNOS uncoupling, occur early in T2DM in the penis, but not in the carotid artery. These molecular changes contribute to T2DM ED, while vascular function in the systemic vasculature remains preserved. PMID:27153512

Correlative 3D-imaging of Pipistrellus penis micromorphology: Validating quantitative microCT images with undecalcified serial ground section histomorphology.

PubMed

Herdina, Anna Nele; Plenk, Hanns; Benda, Petr; Lina, Peter H C; Herzig-Straschil, Barbara; Hilgers, Helge; Metscher, Brian D

2015-06-01

Detailed knowledge of histomorphology is a prerequisite for the understanding of function, variation, and development. In bats, as in other mammals, penis and baculum morphology are important in species discrimination and phylogenetic studies. In this study, nondestructive 3D-microtomographic (microCT, µCT) images of bacula and iodine-stained penes of Pipistrellus pipistrellus were correlated with light microscopic images from undecalcified surface-stained ground sections of three of these penes of P. pipistrellus (1 juvenile). The results were then compared with µCT-images of bacula of P. pygmaeus, P. hanaki, and P. nathusii. The Y-shaped baculum in all studied Pipistrellus species has a proximal base with two club-shaped branches, a long slender shaft, and a forked distal tip. The branches contain a medullary cavity of variable size, which tapers into a central canal of variable length in the proximal baculum shaft. Both are surrounded by a lamellar and a woven bone layer and contain fatty marrow and blood vessels. The distal shaft consists of woven bone only, without a vascular canal. The proximal ends of the branches are connected with the tunica albuginea of the corpora cavernosa via entheses. In the penis shaft, the corpus spongiosum-surrounded urethra lies in a ventral grove of the corpora cavernosa, and continues in the glans under the baculum. The glans penis predominantly comprises an enlarged corpus spongiosum, which surrounds urethra and baculum. In the 12 studied juvenile and subadult P. pipistrellus specimens the proximal branches of the baculum were shorter and without marrow cavity, while shaft and distal tip appeared already fully developed. The present combination with light microscopic images from one species enabled a more reliable interpretation of histomorphological structures in the µCT-images from all four Pipistrellus species. © 2015 Wiley Periodicals, Inc.

Erect penile dimensions in a cohort of 778 Middle Eastern men: establishment of a nomogram.

PubMed

Habous, Mohamad; Tealab, Alaa; Williamson, Ben; Binsaleh, Saleh; El Dawy, Sherif; Mahmoud, Saad; Abdelwahab, Osama; Nassar, Mohammed; Mulhall, John P; Veale, David; Muir, Gordon

2015-06-01

Accurate data regarding the size of the erect penis are of great importance to several disciplines working with male patients, but little high-quality research exists on the subject, particularly in different ethnic groups and for erect penis size. The aim of this study was to create a nomogram of erect penile dimensions in a large sample of Middle Eastern men. A retrospective cohort study of 778 men (mean age 43.7; range 20-82) attending urological outpatient clinics in Saudi Arabia was conducted. Exclusion criteria were age under 18 years, a presenting complaint of small or short penis, Peyronie's disease or complaint of congenital curvature, clinical hypogonadism, and previous penile surgery or trauma. Three erect penile dimensions following induction of erection using intracavernosal injection of Quadrimix. Mean patient body mass index (BMI) was 29.09 (standard deviation [SD] 5.76). The mean suprapubic skin-to-penile tip erect length was 12.53 cm (SD 1.93); the mean erect length from the symphysis pubis to the penile tip was 14.34 cm (SD 1.86); and the mean erect shaft circumference was 11.50 cm (SD 1.74). A nomogram was constructed and statistical analysis performed, demonstrating a weak negative correlation between BMI and erect penile length measured from the suprapubic skin (r = -0.283, P < 0.000) but not from bone to tip, and a weak negative correlation between age and both erect penile length measurements (skin to tip r = -0.177, P < 0.0005; bone to tip r = -0.099, P = 0.006). A nomogram for Middle Eastern men can be used as a standard when advising men with small penis anxiety. The importance of measuring erect size and allowing for infra-pubic fat interference in measurement is emphasized. We envisage that this tool can be used to educate and reassure concerned men about the size of their penises. © 2015 International Society for Sexual Medicine.

Bent Penis

MedlinePlus

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A common presentation to an uncommon disease. Penile Mondor's disease: a case report and literature review.

PubMed

Walsh, John C; Poimboeuf, Sabré; Garvin, Daniel S

2014-01-01

Penile Mondor's disease, or superficial thrombophlebitis of the dorsal vein of the penis, is a relatively uncommon but potentially anxiety-inducing self-limiting condition that should be easily recognizable by any primary care practitioner. It typically presents with a cord-like mass and pain to the dorsal penis and has a myriad of causes, including trauma, excessive sexual activity, excessive exercise, or malignancy. Although Penile Mondor's disease is typically a clinical diagnosis, Doppler ultrasound is the initial imaging modality of choice if there is question or doubt about the diagnosis. Accurate diagnosis and reassurance about the condition's benign and self-limiting nature assuages most patients' fears. Treatment is primarily symptomatic but may vary depending on possible underlying disease processes.

Regional lymph node staging using lymphotropic nanoparticle enhanced magnetic resonance imaging with ferumoxtran-10 in patients with penile cancer.

PubMed

Tabatabaei, Shahin; Harisinghani, Mukesh; McDougal, W Scott

2005-09-01

We evaluated lymphotropic nanoparticle enhanced magnetic resonance imaging (LNMRI) with ferumoxtran-10 in determining the presence of regional lymph node metastases in patients with penile cancer. Seven patients with squamous cell carcinoma of the penis underwent LNMRI. All patients subsequently underwent groin dissection and the nodal images were correlated with histology. We found that LNMRI had sensitivity, specificity, and positive and negative predictive values of 100%, 97%, 81.2% and 100%, respectively, in predicting the presence of regional lymph node metastases in patients with penile cancer. Lymph node scanning using LNMRI accurately predicts the pathological status of regional lymph nodes in patients with cancer of the penis. LNMRI may accurately triage patients for regional lymphadenectomy.

A bone fide atypical fibroxanthoma of penis.

PubMed

Cuomo, Roberto; Addesso, Maria; Altieri, Roberto; D'Antonio, Antonio

2014-10-01

Malignant mesenchymal tumors of the penis are very rare and they have vascular origin. We present a case of a 71-year-old man with a painless nodule of 2.0 cm in diameter located in the penile foreskin. There was no history of urinary or sexually transmitted disease. An excisional biopsy revealed a markedly pleomorphic sarcoma resembling atypical fibroxanthoma (AFX) associated with a squamous cell carcinoma in situ. The patient refused a wide re-excision and was free of disease after 36 months. Because the different therapeutic management and prognosis, differential diagnosis should be made with sarcomatoid squamous cell carcinoma and melanoma: A diagnosis of AFX or malignant fibrous histiocytoma may be considered only after the complete exclusion of these two entities.

A new surgical method for penile girth enhancement.

PubMed

Li, Xiaoge; Tao, Ling; Cao, Chuan; Shi, Haishan; Li, Le; Chen, Liang; Li, Shirong

2015-01-01

We developed a new surgical model of penile girth enhancement in dog, with minimal damage, fewer complications, and high success rate, to enable the experimental investigation of penile implants. We obtained materials for penile girth enhancement by processing the pericardium and blood vessel wall collected from pigs. Incisions were made at the penile bulb for the implantation of the materials, and facilitate observation and data collection, based on the anatomical features of dog's penis. We measured the girth of the flaccid penis before and after the operation, and erectile function at 1-month postoperation. In addition to evaluation of recovery from the incision and local pathological changes, ultrasonic examination was performed to monitor the long-term changes associated with implantation. The mean girth of the flaccid penis significantly increased from 7.37±0.40 cm before the operation, to 8.70±0.56 cm postoperation. Dogs resumed normal mating at 1 month after the operation, without any significant change in the mating time. Ultrasonic examination clearly illustrated the implants, and helped in the measurement of the distance between the materials and the baculum. Chinese Rural dog is a promising animal model for penile girth enhancement surgery. The findings demonstrated that surgical implantation into penile bulb was associated with less damage, faster postoperative recovery, and higher success. For the first time, ultrasonic examination provided objective data on the surgical outcomes of penile girth enhancement.

Augmentation Phalloplasty With Autologous Dermal Fat Graft in the Treatment of "Small Penis".

PubMed

Xu, Lisi; Zhao, Muxin; Chen, Wen; Li, Yangqun; Yang, Zhe; Ma, Ning; Wang, Weixin; Feng, Jun; Liu, Qiyu; Ma, Tong

2016-02-01

Our objective is to report on the efficacy and safety of dermal fat graft in augmentation phalloplasty performed on patients who presented complaining of "small penis," and evaluate the cosmetic and psychological outcomes of it. From April 2010 and January 2015, 23 Chinese adult patients aged 18 to 33 years (average, 23 years) with subjective perception of small penis were included; all who requested an increase in the penile dimension underwent penile elongation (suprapubic skin advancement-ligamentolysis) and girth enhancement by dermal fat graft. Besides objective measurement, Male Genital Image Scale was used to facilitate selection of patients and evaluate the outcome, respectively. The change and shrinkage of the dermal fat strips was evaluated by ultrasound examination and computed tomography. No major complications or erection deficiencies occurred during the postoperative follow-up period. After 6 months, the mean flaccid length was increased by 2.27 ± 0.54 cm, whereas the mean flaccid circumference gain was 1.67 ± 0.46 cm. Significant improvement of genital satisfaction was reported during the follow-up. The shrinkage of dermal fat strips was inconspicuous, and no curvature was observed due to fibrosis. With strict patient selection, this procedure is proved to be a plausible and reasonable option for patients with penile dysmorphophobia. Also, it provides a potential alternative procedure to current dominant methods and promotes the aesthetic results with penile lengthening.

Erection capability is potentiated by long-term sildenafil treatment: role of blood flow-induced endothelial nitric-oxide synthase phosphorylation.

PubMed

Musicki, Biljana; Champion, Hunter C; Becker, Robyn E; Liu, Tongyun; Kramer, Melissa F; Burnett, Arthur L

2005-07-01

Despite demonstrated clinical efficacy of sildenafil for the temporary treatment of erectile dysfunction, the possibility that sildenafil used long-term durably augments erectile ability remains unclear. We investigated whether continuous long-term administration of sildenafil at clinically relevant levels to aged rats "primes" the penis for improved erectile ability and involves nitric oxide (NO) or RhoA/Rho-kinase signaling pathways. In aged, but not young rats, sildenafil prolonged erection and increased the protein expressions of phosphorylated endothelial NO synthase (eNOS) at serine-1177 and phosphorylated Akt at serine-473 in penes. Only in the young rat penis, protein expressions of phosphodiesterase-5 and phosphomyosin phosphatase target subunit 1, a marker of Rho-kinase activity, were increased by sildenafil. Sildenafil inhibited phosphodiesterase-5 activity in penes of young and aged rats coincident with assayed free plasma levels of the drug equivalent to clinically therapeutic measurements. We conclude that erectile ability can be enhanced under preconditions of erectile impairment by long-term inhibition of phosphodiesterase-5 and that the effect is mediated by Akt-dependent eNOS phosphorylation. The lack of erectile ability enhancement in young rats by long-term phosphodiesterase-5 inhibition may relate to restrained NO signaling by phosphodiesterase-5 up-regulation, lack of incremental Akt and eNOS phosphorylation, and heightened Rho-kinase signaling in the penis.

Long-term persistence of human papillomavirus in the skin of the glans penis of elderly men above 80 years of age.

PubMed

Kitamura, Tadaichi; Suzuki, Motofumi; Koyama, Yasuhiro; Shigehara, Kazuyoshi

2018-05-01

Investigations of human papillomavirus (HPV) in the glans penis are scarce, especially with regard to its natural history. To elucidate HPV prevalence among Japanese men attending urological clinics, 798 adult participants were recruited consecutively and stratified into groups by age based on 10-year intervals. The overall HPV prevalence among the participants was 24.8%, with 15.5% positive for high-risk HPV and 9.3% infected with other HPVs. The HPV positivity rate was sustained in those over 80 years of age at nearly the same level as those in the younger age groups. We also determined the age at last sexual intercourse of 15 HPV-positive participants in the 80+ years age group. In addition, six participants positive for HPV were re-examined for HPV and all showed nearly the same HPV types as those identified in their first examinations. The difference between the age at the first test and the age of last intercourse was 8.3 ± 6.2 years. Except for the elderly group who reported sexual intercourse within the previous year, the duration was 10.0 ± 5.1 years. Our data suggest an HPV persistence of at least eight years. Further investigation is necessary to elucidate the long-term persistence of HPV infection in the glans penis.

Pelvic magnetic resonance imaging angioanatomy of the arterial blood supply to the penis in suspected prostate cancer patients.

PubMed

Thai, Cao Tan; Karam, Ibrahim Michel; Nguyen-Thi, Phi Linh; Lefèvre, Frédéric; Hubert, Jacques; Felblinger, Jacques; Eschwège, Pascal

2015-05-01

To describe the internal pudendal artery (IPA) and accessory pudendal artery (APA) detected by magnetic resonance (MR) angiography to help surgeons to find and preserve them during radical prostatectomy (RP). Constrast-enhanced MR 3.0 T angiography of the pelvis were performed in 111 male patients suspected diagnosis of prostate cancer (PCa), and describe the penile arterial blood supply. There are three patterns of the arterial blood supply to the penis (IPA and/or APA) accounting for 51.4%, 46.8% and 1.8% of cases, respectively. About the accessory pudendal artery (APA): 54/111 (48.6%) patients had APA with five different branching patterns, they were type I (APA bilateral symmetry): 17 (31.5%); type II (APA bilateral asymmetry): 1 (1.9%); type III (APA unilateral lateral): 13 (24%); type IV (APA unilateral apical): 21 (38.9%); type V (APA unilateral mix): 2 (3.7%). APA origin were from inferior epigastric artery (IEA): 7 (9.5%); from inferior vesical artery (IVA): 32 (43.2%); from obturator artery (OA): 35 (47.3%). A precise angioanatomic evalutation of arteries destined to the penis by MR angiography pre-operation for male pelvic organs will help surgeons to preserve them and contributes to reduce the erectile dysfunction after these procedures. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

[Replacement of plaque by buccal mucosa in the treatment of Peyronieś disease: a report of 27 cases].

PubMed

Liu, Ben; Zhu, Xuan-Wen; Zhong, Da-Chuan; Shen, Bo-Hua; Jiang, Hai; Xie, Li-Ping

2009-01-01

To evaluate the clinical results of the replacement of plaque by buccal mucosa in the treatment of Peyronie's disease. We performed surgical replacement of the plaque by free autograft of buccal mucosa on 27 patients with Peyronie's disease, ranging in age from 24 to 72 years (mean 53), varying in disease course between 1 and 13 years, with a penile curvature angle of 30 degrees - 80 degrees in erection. Of the total number, 15 patients had the plaque located in the dorsal root, 6 in the dorsal shaft, 3 in the subcoronal shaft and 3 in the ventral shaft of the penis; 24 had 1 plaque, 2 had 2 and 1 had 3, ranging in size from 0.7 cm x 0.7 cm to 1.6 cm x 1.0 cm. Satisfactory results were achieved in all the cases, with no such complications as hematoma, infection, oral numbness, and tightness of the mouth. Of the 24 cases that were followed up for 0.5 to 7 years, complete straightening of the penis was achieved in 21, slight residual curvature (< 15 degrees) was noted in 3, a little shortening of the penis (< 1 cm) in 2, and erectile pain in 3. Buccal mucosa, with a stable elasticity and no shrinkage, can be recommended for wide use in the surgical treatment of Peyronie's disease.

Lorcaserin

MedlinePlus

... a condition that affects the shape of the penis such as angulation, cavernosal fibrosis, or Peyronie's disease; ... than 4 hours discharge from the breast breast enlargement in males Lorcaserin may cause other side effects. ...

Withdrawal Method (Coitus Interruptus)

MedlinePlus

Withdrawal method (coitus interruptus) Overview The withdrawal method of contraception, also known as coitus interruptus, is the practice of withdrawing the penis from the vagina and away from a woman's external ...

Male Infertility

MedlinePlus

... ejaculation occurs when semen enters the bladder during orgasm instead of emerging out the tip of the penis. Various health conditions can cause retrograde ejaculation, including diabetes, spinal injuries, medications, and surgery of ...

Scrotal Masses

MedlinePlus

... the most likely cause. Varicocele. This is the enlargement of the veins within the scrotum that carry ... that carries semen from the testicle to the penis. This painful condition cuts off blood to the ...

Dislocation of the penis: a rare complication after traumatic pelvic injury

PubMed Central

Lim, Mei Chin; Srinivasan, Sivasubramanian; Teh, Hui Seong; Teo, Chang Peng Colin

2015-01-01

Traumatic injury to the male external genitalia is frequently encountered, but acute traumatic dislocation of the penile structure is extremely rare, with only a few reports found in the literature. We herein report the case of a 21-year-old man who sustained blunt trauma to the pelvis following a motor vehicle accident, and had features suspicious of penile dislocation. With the use of computed tomography and bedside ultrasonography, a diagnosis of penile dislocation was made, which was subsequently confirmed intraoperatively. Immediate surgical intervention via gentle manipulation of the penile tissue back to its native position was performed in order to restore normal anatomy. The exact mechanism of penile dislocation is not known. However, circumferential laceration around the foreskin causing degloving injury of the penis is suggested in our patient. PMID:25640107

[Penile Tuberculosis : A Case Report].

PubMed

Imanaka, Takahiro; Nomura, Hironori; Tsujimura, Go; Ko, Yoko; Kinjyo, Takanori; Yoshioka, Iwao; Takada, Shingo; Yahata, Yoko; Mizutani, Tetsu

2017-04-01

A 66-year-old man presented with a chief complaint of glans penis pain, induration, and discharge of pus. He was prescribed a course of antibiotics, but the condition persisted despite treatment. Thus, we differrentially diagnosed the patient with penile tuberculosis and pyoderma gangrenosum, and performed a biopsy of the penis. The biopsy result was thickening of the horny layer epidermis with only a foreign body granuloma composed of inflammatory cells, and did not lead to a definitive diagnosis. Thoraca-abdominal computed tomography revealed axillary lymphadenopathy with necrosis. Suspecting tuberculosis lymphadenitis, we performed T-spot and QuantiFERONtests. The result was T-spot negative and QuantiFERONpositive, so we diagnosed the patient with penile tuberculosis, and started antituberculosis medication. In about half a year after the start of treatment the symptoms subsided, and lymphadenopathy showed reduction.

Fournier's gangrene of the penis in a 12-year-old patient secondary to phimosis.

PubMed

Ward, Luther; Eisenson, Daniel; Fils, Jean-Louis

2016-12-01

We report a case of Fournier's gangrene in a 12-year-old boy from St. Boniface Hospital in Fond-des-Blancs, Haiti. Fournier's gangrene, a fulminant necrotizing fasciitis of the penis and scrotum, is a rare and life-threatening infection that requires hospitalization, broad-spectrum antibiotics, and surgical debridement.1-3 It is usually associated with impaired cellular immunity due to systemic disorders such as diabetes and liver disease.4,5 This patient had none of those risk factors, but had severe, longstanding phimosis, for which circumcision had been recommended many years before. This case illustrates how lack of access to basic surgical care for an easily treatable condition leads to advanced presentation of a severe disease process. [Full article available at http://rimed.org/rimedicaljournal-2016-12.asp].

Carcinoma of penis. Review of cases treated by surgery and radiation therapy 1960-1977

DOE Office of Scientific and Technical Information (OSTI.GOV)

Krieg, R.M.; Luk, K.H.

1981-08-01

Cases of squamous cell carcinoma of the penis treated by surgery and radiation therapy at Moffitt Hospital, University of California, and Mount Zion Hospital and Medical Center are reviewed. Only cases followed for more than three years or with autopsy findings are presented. For the primary lesion, over-all surgical control rate locally was 15/17 or 88 per cent. Over-all control rate with radiation therapy alone was 9/12 (75 per cent), and with surgical salvage 11/12 (92 per cent). Radiation therapy appears to be the treatment of choice for early stage lesions, reserving surgery for salvage. Prophylactic ilioinguinal lymph node dissectionmore » for N0 lesions is not warranted. The role of chemotherapy needs further investigation.« less

Site-specific human papillomavirus infection in adolescent men who have sex with men (HYPER): an observational cohort study.

PubMed

Zou, Huachun; Tabrizi, Sepehr N; Grulich, Andrew E; Hocking, Jane S; Bradshaw, Catriona S; Cornall, Alyssa M; Morrow, Andrea; Prestage, Garrett; Law, Matthew G; Garland, Suzanne M; Chen, Marcus Y; Fairley, Christopher K

2015-01-01

Men who have sex with men (MSM) have an increased risk of anogenital human papilomavirus (HPV) infection, which can lead to HPV-related anogenital lesions such as warts, anal intraepithelial neoplasia, and anal cancer. Some of these HPV types are preventable with vaccines. We aimed to describe the incidence of anal, penile, and oral HPV infection, and to estimate the site-specific transmission probability per partner, for teenage MSM. In our observational cohort study, we enrolled teenage MSM (aged 16-20 years) with low sexual exposure and a low prevalence of HPV in Melbourne (VIC, Australia). At baseline, 3, 6, and 12 months, we took a swab from the anal canal, and participants self-collected a swab from the penis and an oral rinse. Our primary outcome was definite and probable incident HPV infection of the anus, penis, or mouth at any time in the 12 months from baseline, assessed through the presence of HPV DNA. We defined definite incident HPV infection as the same HPV type detected more than once from the same site in men who had a negative HPV test at baseline. We defined probable incident HPV infection as only one positive test. We estimated the probability of HPV transmission per partner using HPV prevalence in MSM with a similar age to partners of men in our cohort. This study is registered at the Australian New Zealand Clinical Trials Registry and ClinicalTrials.gov, numbers ACTRN12611000857909 and NCT01422356. We enrolled 200 MSM aged 16-20 years (median 19 years [IRQ 18-20; range 16-20]) between Sept 20, 2010, and Aug 24, 2012. Over the 12 month follow-up period, we detected 48 definite (107 possible) HPV infections in the anus, ten definite (34 possible) HPV infections on the penis, and no definite (six possible) infections in the mouth. Definite incidence rate per 100 person-years for any anal HPV infection was 57 (95% CI 46-68), and for any anal HPV type in the quadrivalent vaccine was 33 (23-44). Definite incidence rate per 100 person-years for any penile HPV was 12 (6-21) and for any HPV type in the quadrivalent vaccine was 5 (1-12). Estimated probabilities of HPV transmission from the penis to the anus were significantly higher than were those from the anus to the penis (p<0·05 for all HPV types in the quadrivalent vaccine). High incidence rates suggest that the vaccination coverage in MSM will need to be high. The transmission estimates will inform HPV modelling. Merck. Copyright © 2015 Elsevier Ltd. All rights reserved.

Loratadine and Pregnancy

MedlinePlus

... with several limitations suggested a small risk for hypospadias (a condition where the opening of the penis ... risk of any type of birth defect, including hypospadias. Also, studies involving infants with hypospadias did not ...

Immunoelectrophoresis - urine

MedlinePlus

Immunoglobulin electrophoresis - urine; Gamma globulin electrophoresis - urine; Urine immunoglobulin electrophoresis; IEP - urine ... A clean-catch urine sample is needed. The clean-catch method is used to prevent germs from the penis or vagina from getting ...

Self catheterization - male

MedlinePlus

... insert your catheter: Wash your hands well with soap and water. Collect your supplies, including your catheter ( ... penis with Betadine (an antiseptic cleaner), a towelette, soap and water, or baby wipes the way your ...

Sperm release pathway

MedlinePlus Videos and Cool Tools

... organs include the testes, epididymis, urethra, vas deferens, prostate gland, seminal vesicle, and penis. The testes are ... ducts toward the urethra, passing first by the prostate gland, where a milky fluid is added to ...

Penis Pump

MedlinePlus

... health conditions and any medications you take, including herbal supplements. This will help prevent potential problems. Side effects ... testicles or prostate What medications you take , including herbal supplements What erectile dysfunction treatments you've tried and ...

Penis pain

MedlinePlus

... Priapism. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology . 11th ed. Philadelphia, ... disease. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology . 11th ed. Philadelphia, ...

Original technique for penile girth augmentation through porcine dermal acellular grafts: results in a 69-patient series.

PubMed

Alei, Giovanni; Letizia, Piero; Ricottilli, Francesco; Simone, Pierfranco; Alei, Lavinia; Massoni, Francesco; Ricci, Serafino

2012-07-01

Although different techniques for augmentation phalloplasty have been reported in the medical literature, this issue is still highly controversial, and none of the proposed procedures has been unanimously approved. The aim of this study is to describe an innovative surgical technique for penile girth augmentation with porcine dermal acellular grafts, through a small transverse incision at the penile base, along the penopubic junction. Between 2000 and 2009, 104 patients were referred to our institution for penile enhancement. After a preoperative psychosexual consultation and a general medical assessment, 69 patients were deemed suitable good candidates for surgery. The average penis circumference was measured at the mid-length of the penis and was 8.1 cm (5.4-10.7 cm) and 10.8 cm (6.5-15.8 cm) during flaccidity and erection, respectively. All patients received penile augmentation with porcine dermal acellular grafts. Results evaluation of an innovative technique for penile girth augmentation through exogenous porcine grafts and small penobubic incision. Postoperative measurements were performed at 6 and 12 months. At the 1-year follow-up, the average penis circumference was 11.3 cm (8.2-13.2 cm, 3.1 cm mean increase) during flaccidity and 13.2 cm (8.8-14.5 cm, 2.4 cm mean increase) during erection. No major complications occurred in the series. Minor complications were resolved with conservative treatment within 3 weeks. Sexual activity was resumed from 1 to 2 months after surgery. The psychosexual impact of the operation was beneficial in the majority of cases. Penile girth enlargement with acellular dermal matrix grafts has several advantages over augmentation with autogenous dermis-fat grafts: the elimination of donor site morbidity and a significantly shorter operation time. With this approach, through a short dorsal incision at the base of the penis, the scar is concealed in a crease covered by pubic hair and thus hardly visible. © 2012 International Society for Sexual Medicine.

Precocious puberty

MedlinePlus

... period (menstruation) Mature outer genitals In boys, precocious puberty is when any of the following develop before age 9: Armpit or pubic hair Growth of the testes and penis Facial hair, often first on the upper lip ...

Paraphimosis

MedlinePlus

... done correctly, prevents this condition. Images Male reproductive anatomy References Elder JS. Anomalies of the penis and urethra. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016: ...

Cancer in Patients With Gabapentin (GPRD)

ClinicalTrials.gov

2017-06-06

Pain, Neuropathic; Epilepsy; Renal Pelvis Cancer; Pancreatic Cancer; Breast Cancer; Nervous System Cancer; Chronic Pancreatitis; Stomach Cancer; Renal Cell Carcinoma; Diabetes; Bladder Cancer; Bone and Joint Cancer; Penis Cancer; Anal Cancer; Cancer; Renal Cancer

Penis-Enlargement Products: Do They Work?

MedlinePlus

... found mixed results in safety, effectiveness and patient satisfaction. At best, surgery such as division of the ... of Sexual Medicine. 2014;11:1856. Velten J. Satisfaction guaranteed? How individual, partner, and relationship factors impact ...

Penile enlargement with methacrylate injection: is it safe?

PubMed

Torricelli, Fabio Cesar Miranda; Andrade, Enrico Martins de; Marchini, Giovanni Scala; Lopes, Roberto Iglesias; Claro, Joaquim Francisco Almeida; Cury, Jose; Srougi, Miguel

2013-01-01

CONTEXT Penis size is a great concern for men in many cultures. Despite the great variety of methods for penile augmentation, none has gained unanimous acceptance among experts in the field. However, in this era of minimally invasive procedure, injection therapy for penile augmentation has become more popular. Here we report a case of methacrylate injection in the penis that evolved with penile deformity and sexual dysfunction. This work also reviews the investigation and management of this pathological condition. CASE REPORT A 36-year-old male sought medical care with a complaint of penile deformity and sexual dysfunction after methacrylate injection. The treatment administered was surgical removal. Satisfactory cosmetic and functional results were reached after two months. CONCLUSIONS There is a need for better structured scientific research to evaluate the outcomes and complication rates from all penile augmentation procedures.

MRI of the penis

PubMed Central

Kirkham, A

2012-01-01

MRI of the penis is an expensive test that is not always superior to clinical examination or ultrasound. However, it shows many of the important structures, and in particular the combination of tumescence from intracavernosal alprostadil, and high-resolution T2 sequences show the glans, corpora and the tunica albuginea well. In this paper we summarise the radiological anatomy and discuss the indications for MRI. For penile cancer, it may be useful in cases where the local stage is not apparent clinically. In priapism, it is an emerging technique for assessing corporal viability, and in fracture it can in most cases make the diagnosis and locate the injury. In some cases of penile fibrosis and Peyronie's disease, it may aid surgical planning, and in complex pelvic fracture may replace or augment conventional urethrography. It is an excellent investigation for the malfunctioning penile prosthesis. PMID:23118102

Patient with bilateral breast enlargement and hypospadias.

PubMed

Ali, A A; Ahmed, T; Rashid, M M

2009-01-01

A 20 year old man was admitted in the surgical unit of Dhaka Medical College Hospital on August 2007 presented with Hypospadias & underdeveloped penis from childhood, gradual enlargement of both breasts for the last 10 years, absence of axillary and pubic hair from puberty & painful swelling of both testes for the last 3 years. The patient was regarded as a female upto the age of 10 years. He has got no voice change since puberty. On examination he had average body built, there was bilateral gynaecomastia, hypospadias, rudimentary penis & absence of pubic and axillary hair. His testosterone level, serum prolactin level, serum progesterone level, serum estradiol level was done. Cytology on buccal smear done and ultrasonography revealed no ovary and uterus. Ultimately patient was diagnosed as a case of androgen insensitivity syndrome (AIS). The case is reported for clinical awareness & to share our experience.

The Evidence of Imposex in Turbo sp. from Ujungpiring Waters of Jepara

NASA Astrophysics Data System (ADS)

Nuraini, RAT; Hartati, R.; Endrawati, H.; Widianingsih; Rachma, MJ; Mahendrajaya, RT

2018-02-01

Imposex is an endocrine disruption syndrome, in which females of marine gastropods develop sexual characteristics of males (penis and/or vas deferens). This syndrome is caused by tributyltin (TBT) or triphenyltin (TPT), toxic organotin compounds found in naval paints used as antifouling system in boats and artificial structures. The main objective of this study was to assess the incidence and severity of imposex in Turbosp.A hundred individus of Turbo sp was collected from Ujung Piring waters of Jepara, and observed for their sex and imposex. The results showed that the ratio male and female was 1.13 : 1, and the frequency of imposex females was 64.58%. The relative penis size were longer in imposex female than in male. The possibility of pollution was clearly shown from high evidence of imposex female.

MRI of the penis.

PubMed

Kirkham, A

2012-11-01

MRI of the penis is an expensive test that is not always superior to clinical examination or ultrasound. However, it shows many of the important structures, and in particular the combination of tumescence from intracavernosal alprostadil, and high-resolution T(2) sequences show the glans, corpora and the tunica albuginea well. In this paper we summarise the radiological anatomy and discuss the indications for MRI. For penile cancer, it may be useful in cases where the local stage is not apparent clinically. In priapism, it is an emerging technique for assessing corporal viability, and in fracture it can in most cases make the diagnosis and locate the injury. In some cases of penile fibrosis and Peyronie's disease, it may aid surgical planning, and in complex pelvic fracture may replace or augment conventional urethrography. It is an excellent investigation for the malfunctioning penile prosthesis.

Primary Undifferentiated Pleomorphic Sarcoma of the Penis

PubMed Central

Yoo, Hyung Sun; Satti, Suma

2017-01-01

Background: Primary penile sarcoma is a rare disease that affects men of all ages. Different subtypes of primary penile sarcoma exist, with the rarest being pleomorphic sarcoma. Delays in presentation and diagnosis of primary penile sarcoma have been reported because of its benign-appearing presenting features and rarity. If penile sarcoma is left untreated, the clinical consequence is metastasis that is fatal in most cases. Case Report: We report an extremely rare case of undifferentiated pleomorphic sarcoma of the penis in a 59-year-old patient who initially presented with a slow-growing penile nodule. The tumor was surgically excised, but the patient experienced local recurrence and, despite receiving chemotherapy and surgery, died of metastatic disease 15 months after initial presentation. Conclusion: Vigilance regarding biopsy and intervention for penile nodules may lead to early diagnosis and improved clinical outcomes. PMID:29230132

[Mondor's disease of penis: A case report].

PubMed

Marsaudon, E; Legal, C; Gayoux, D; Weber, O

2016-09-01

Mondor's disease is a rare superficial thrombophlebitis, historically involving the thoracic venous system of women. However, it can occur in both gender and all over the skin. We report a 40-year-old man with type one diabetes who presented with a thrombosis of the superficial dorsal vein of the penis that he treated as a fungal infection. Treatment with non-steroidal anti-inflammatory drugs and low molecular weight heparin contributed to a favorable outcome in 2 weeks. Pathogenesis and treatment of Mondor's disease remain incompletely dominated. Some predisposing factors have been highlighted in the literature. It might be interesting to add diabetes, due to its frequent pelvic problems leading to a potential venous inflammatory trigger. Copyright © 2015 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Morphology of the external genitalia of the adult male and female mice as an endpoint of sex differentiation

PubMed Central

Weiss, Dana A.; Rodriguez, Esequiel; Cunha, Tristan; Menshenina, Julia; Barcellos, Dale; Chan, Lok Yun; Risbridger, Gail; Baskin, Laurence; Cunha, Gerald

2013-01-01

Adult external genitalia (ExG) are the endpoints of normal sex differentiation. Detailed morphometric analysis and comparison of adult mouse ExG has revealed 10 homologous features distinguishing the penis and clitoris that define masculine vs. feminine sex differentiation. These features have enabled the construction of a simple metric to evaluate various intersex conditions in mutant or hormonally manipulated mice. This review focuses on the morphology of the adult mouse penis and clitoris through detailed analysis of histologic sections, scanning electron microscopy, and three-dimensional reconstruction. We also present previous results from evaluation of “non-traditional” mammals, such as the spotted hyena and wallaby to demonstrate the complex process of sex differentiation that involves not only androgen-dependent processes, but also estrogen-dependent and hormone-independent mechanisms. PMID:21893161

[Tongue, trachea, abdominal wall, uterus, and penis allografts. More details on some other clinical applications of vascularized composite tissue allotransplantation].

PubMed

Petit, F

2007-10-01

The first hand and face allografts opened a new era in medicine history: a time when allotransplantation and reconstructive surgery coupled their principles. Their success and their development made composite tissue allotransplantation (CTA) a clinical reality for our speciality. Although still recent and limited, experience from this new surgical practice will widen with feedback from the first clinical cases and with experience gained from more clinical cases, more anatomical areas, more type of allografts, more surgical techniques, more immunosuppressive regimens. Tongue, trachea, abdominal wall, uterus, penis allotransplantations have been performed, contemporarily. Whatever the future and the benefits for the selected patients might have been, reports from these - un- and misknown - cases contribute to a better knowledge of CTA, its therapeutic potential, its limits, its challenges.

A new surgical method for penile girth enhancement

PubMed Central

Li, Xiaoge; Tao, Ling; Cao, Chuan; Shi, Haishan; Li, Le; Chen, Liang; Li, Shirong

2015-01-01

Objective: We developed a new surgical model of penile girth enhancement in dog, with minimal damage, fewer complications, and high success rate, to enable the experimental investigation of penile implants. Methods: We obtained materials for penile girth enhancement by processing the pericardium and blood vessel wall collected from pigs. Incisions were made at the penile bulb for the implantation of the materials, and facilitate observation and data collection, based on the anatomical features of dog’s penis. We measured the girth of the flaccid penis before and after the operation, and erectile function at 1-month postoperation. In addition to evaluation of recovery from the incision and local pathological changes, ultrasonic examination was performed to monitor the long-term changes associated with implantation. Results: The mean girth of the flaccid penis significantly increased from 7.37±0.40 cm before the operation, to 8.70±0.56 cm postoperation. Dogs resumed normal mating at 1 month after the operation, without any significant change in the mating time. Ultrasonic examination clearly illustrated the implants, and helped in the measurement of the distance between the materials and the baculum. Conclusion: Chinese Rural dog is a promising animal model for penile girth enhancement surgery. The findings demonstrated that surgical implantation into penile bulb was associated with less damage, faster postoperative recovery, and higher success. For the first time, ultrasonic examination provided objective data on the surgical outcomes of penile girth enhancement. PMID:26379868

Caspase-3 dependent nitrergic neuronal apoptosis following cavernous nerve injury is mediated via RhoA and ROCK activation in major pelvic ganglion.

PubMed

Hannan, Johanna L; Matsui, Hotaka; Sopko, Nikolai A; Liu, Xiaopu; Weyne, Emmanuel; Albersen, Maarten; Watson, Joseph W; Hoke, Ahmet; Burnett, Arthur L; Bivalacqua, Trinity J

2016-07-08

Axonal injury due to prostatectomy leads to Wallerian degeneration of the cavernous nerve (CN) and erectile dysfunction (ED). Return of potency is dependent on axonal regeneration and reinnervation of the penis. Following CN injury (CNI), RhoA and Rho-associated protein kinase (ROCK) increase in penile endothelial and smooth muscle cells. Previous studies indicate that nerve regeneration is hampered by activation of RhoA/ROCK pathway. We evaluated the role of RhoA/ROCK pathway in CN regulation following CNI using a validated rat model. CNI upregulated gene and protein expression of RhoA/ROCK and caspase-3 mediated apoptosis in the major pelvic ganglion (MPG). ROCK inhibitor (ROCK-I) prevented upregulation of RhoA/ROCK pathway as well as activation of caspase-3 in the MPG. Following CNI, there was decrease in the dimer to monomer ratio of neuronal nitric oxide synthase (nNOS) protein and lowered NOS activity in the MPG, which were prevented by ROCK-I. CNI lowered intracavernous pressure and impaired non-adrenergic non-cholinergic-mediated relaxation in the penis, consistent with ED. ROCK-I maintained the intracavernous pressure and non-adrenergic non-cholinergic-mediated relaxation in the penis following CNI. These results suggest that activation of RhoA/ROCK pathway mediates caspase-3 dependent apoptosis of nitrergic neurons in the MPG following CNI and that ROCK-I can prevent post-prostatectomy ED.

The penis: a new target and source of estrogen in male reproduction.

PubMed

Mowa, C N; Jesmin, S; Miyauchi, T

2006-01-01

In the past decade, interest and knowledge in the role of estrogen in male reproduction and fertility has gained significant momentum. More recently, the cellular distribution and activity of estrogen receptors (alpha and beta)(ER) and aromatase (estrogen synthesis) has been reported in the penis, making the penis the latest "frontier" in the study of estrogen in male reproduction. ER and aromatase are broadly and abundantly expressed in various penile compartments and cell types (erectile tissues, urethral epithelia, vascular and neuronal cells), suggesting the complexity and significance of the estrogen-ER system in penile events. Unraveling this complexity is important and will require utilization of the various resources that are now at our disposal including, animal models and human lacking or deficient in ER and aromatase and the use of advanced and sensitive techniques. Some of the obvious areas that require our attention include: 1) a comprehensive mapping of ER-alpha and -beta cellular expression in the different penile compartments and subpopulations of cells, 2) delineation of the specific roles of estrogen in the different subpopulations of cells, 3) establishing the relationship of the estrogen-ER system with the androgen-androgen receptor system, if any, and 4) characterizing the specific penile phenotypes in human and animals lacking or deficient in estrogen and ER. Some data generated thus far, although preliminary, appear to challenge the long held dogma that, overall, androgens have a regulatory monopoly of penile development and function.

Visualization of Penile Suspensory Ligamentous System Based on Visible Human Data Sets

PubMed Central

Chen, Xianzhuo; Wu, Yi; Tao, Ling; Yan, Yan; Pang, Jun; Zhang, Shaoxiang; Li, Shirong

2017-01-01

Background The aim of this study was to use a three-dimensional (3D) visualization technology to illustrate and describe the anatomical features of the penile suspensory ligamentous system based on the Visible Human data sets and to explore the suspensory mechanism of the penis for the further improvement of the penis-lengthening surgery. Material/Methods Cross-sectional images retrieved from the first Chinese Visible Human (CVH-1), third Chinese Visible Human (CVH-3), and Visible Human Male (VHM) data sets were used to segment the suspensory ligamentous system and its adjacent structures. The magnetic resonance imaging (MRI) images of this system were studied and compared with those from the Visible Human data sets. The 3D models reconstructed from the Visible Human data sets were used to provide morphological features of the penile suspensory ligamentous system and its related structures. Results The fundiform ligament was a superficial, loose, fibro-fatty tissue which originated from Scarpa’s fascia superiorly and continued to the scrotal septum inferiorly. The suspensory ligament and arcuate pubic ligament were dense fibrous connective tissues which started from the pubic symphysis and terminated by attaching to the tunica albuginea of the corpora cavernosa. Furthermore, the arcuate pubic ligament attached to the inferior rami of the pubis laterally. Conclusions The 3D model based on Visible Human data sets can be used to clarify the anatomical features of the suspensory ligamentous system, thereby contributing to the improvement of penis-lengthening surgery. PMID:28530218

Comparative effects of neonatal diethylstilbestrol on external genitalia development in adult males of two mouse strains with differential estrogen sensitivity

PubMed Central

Mahawong, Phitsanu; Sinclair, Adriane; Li, Yi; Schlomer, Bruce; Rodriguez, Esequiel; Ferretti, Max M.; Liu, Baomai; Baskin, Laurence S.; Cunha, Gerald R.

2014-01-01

The effect of neonatal exposure to diethylstilbestrol (DES), a potent synthetic estrogen, was examined to evaluate whether the CD-1 (estrogen insensitive, outbred) and C57 (estrogen sensitive, inbred) mouse strains differ in their response to estrogen disruption of male ExG differentiation. CD-1 and C57BL/6 litters were injected with sesame oil or DES (200 ng/g/5μl in sesame oil vehicle) every other day from birth to day 10. Animals were sacrificed at the following time points: birth, 5, 10 and 60 days postnatal. Neonatally DES-treated mice from both strains had many ExG abnormalities that included the following: (a) severe truncation of the prepuce and glans penis, (b) an abnormal urethral meatus, (c) ventral tethering of the penis, (d) reduced os penis length and glans width, (e) impaired differentiation of cartilage, (f) absence of urethral flaps, and (g) impaired differentiation of erectile bodies. Adverse effects of DES correlated with the expression of estrogen receptors within the affected tissues. While the effects of DES were similar in the more estrogen-sensitive C57BL/6 mice versus the less estrogen-sensitive CD-1 mice, the severity of DES effects was consistently greater in C57BL/6 mice. We suggest that many of the effects of DES, including the induction of hypospadias, are due to impaired growth and tissue fusion events during development. PMID:25449353

Visualization of Penile Suspensory Ligamentous System Based on Visible Human Data Sets.

PubMed

Chen, Xianzhuo; Wu, Yi; Tao, Ling; Yan, Yan; Pang, Jun; Zhang, Shaoxiang; Li, Shirong

2017-05-22

BACKGROUND The aim of this study was to use a three-dimensional (3D) visualization technology to illustrate and describe the anatomical features of the penile suspensory ligamentous system based on the Visible Human data sets and to explore the suspensory mechanism of the penis for the further improvement of the penis-lengthening surgery. MATERIAL AND METHODS Cross-sectional images retrieved from the first Chinese Visible Human (CVH-1), third Chinese Visible Human (CVH-3), and Visible Human Male (VHM) data sets were used to segment the suspensory ligamentous system and its adjacent structures. The magnetic resonance imaging (MRI) images of this system were studied and compared with those from the Visible Human data sets. The 3D models reconstructed from the Visible Human data sets were used to provide morphological features of the penile suspensory ligamentous system and its related structures. RESULTS The fundiform ligament was a superficial, loose, fibro-fatty tissue which originated from Scarpa's fascia superiorly and continued to the scrotal septum inferiorly. The suspensory ligament and arcuate pubic ligament were dense fibrous connective tissues which started from the pubic symphysis and terminated by attaching to the tunica albuginea of the corpora cavernosa. Furthermore, the arcuate pubic ligament attached to the inferior rami of the pubis laterally. CONCLUSIONS The 3D model based on Visible Human data sets can be used to clarify the anatomical features of the suspensory ligamentous system, thereby contributing to the improvement of penis-lengthening surgery.

Primary tuberculosis of glans penis after intravesical Bacillus Calmette Guerin immunotherapy.

PubMed

Sharma, V K; Sethy, P K; Dogra, P N; Singh, Urvashi; Das, P

2011-01-01

A 55-year-old male with carcinoma in situ of urinary bladder was treated with weekly intravesical injections of Bacillus Calmette Guerin (BCG) vaccine. Three days after the sixth injection, he developed low grade fever and multiple grouped punched out, 2-3 mm ulcers around meatus and corona glandis. In addition, multiple, firm, indurated, nontender papules and few deeper nodules were present on the proximal part of glans penis, along with bilateral enlarged, matted and nontender inguinal lymph nodes. There was no history suggestive of sexually transmitted diseases and high risk behavior. Chest X-ray was within normal limits, and Mantoux, Venereal Disease Research Laboratory (VDRL) and HIV antibody tests were negative. The biopsy from the penile ulcer revealed epithelioid cell granuloma with Langhans giant cells. Fine needle aspiration cytology from the lymph node also revealed epithelioid cell granuloma and acid fast bacilli on Ziehl Neelsen's stain. The tissue biopsy grew Mycobacterium tuberculosis. The BCG immunotherapy was stopped and patient was treated with four drug antitubercular therapy with isoniazid, rifampicin, ethambutol, and pyrazinamide in standard daily doses along with pyridoxine. The edema resolved and the ulcers started healing within 2 weeks, and at 6 weeks after starting antitubercular therapy almost complete healing occurred. To the best of our knowledge, we describe the first case of an Indian patient with BCG induced primary tuberculosis of penis after immunotherapy for carcinoma urinary bladder and review the previously described cases to increase awareness of this condition in dermatologists and venereologists.

Rapid discrimination and determination of antibiotics drugs in plastic syringes using near infrared spectroscopy with chemometric analysis: Application to amoxicillin and penicillin.

PubMed

Lê, Laetitia Minh Mai; Eveleigh, Luc; Hasnaoui, Ikram; Prognon, Patrice; Baillet-Guffroy, Arlette; Caudron, Eric

2017-05-10

The aim of this study was to investigate near infrared spectroscopy (NIRS) combined to chemometric analysis to discriminate and quantify three antibiotics by direct measurement in plastic syringes.Solutions of benzylpenicillin (PENI), amoxicillin (AMOX) and amoxicillin/clavulanic acid (AMOX/CLAV) were analyzed at therapeutic concentrations in glass vials and plastic syringes with NIR spectrometer by direct measurement. Chemometric analysis using partial least squares regression and discriminative analysis was conducted to develop qualitative and quantitative calibration models. Discrimination of the three antibiotics was optimal for concentrated solutions with 100% of accuracy. For quantitative analysis, the three antibiotics furnished a linear response (R²>0.9994) for concentrations ranging from 0.05 to 0.2 g/mL for AMOX, 0.1 to 1.0 MUI/mL for PENI and 0.005 to 0.05 g/mL for AMOX/CLAV with excellent repeatability (maximum 1.3%) and intermediate precision (maximum of 3.2%). Based on proposed models, 94.4% of analyzed AMOX syringes, 80.0% of AMOX/CLAV syringes and 85.7% of PENI syringes were compliant with a relative error including the limit of ± 15%.NIRS as rapid, non-invasive and non-destructive analytical method represents a potentially powerful tool to further develop for securing the drug administration circuit of healthcare institutions to ensure that patients receive the correct product at the right dose. Copyright © 2017 Elsevier B.V. All rights reserved.

Testicular Cancer

MedlinePlus

... of skin behind the penis. You can get cancer in one or both testicles. Testicular cancer mainly affects young men between the ages of ... undescended testicle Have a family history of the cancer Symptoms include pain, swelling, or lumps in your ...

Everything You Wanted to Know about Puberty (For Teens)

MedlinePlus

... may experience something called nocturnal emissions (or wet dreams), when the penis becomes erect while a guy ... contains sperm. That's why they're called wet dreams — they happen when you're sleeping and your ...

Erectile Dysfunction: MedlinePlus Health Topic

MedlinePlus

... Men's Health (Hormone Health Network) Also in Spanish Sex and the Man With Cancer (American Cancer Society) Also in Spanish Specifics Bent Penis (Mayo Foundation for Medical Education and Research) Videos and Tutorials Simultaneous Inflatable Penile Prosthesis (IPP) and ...

Penis Health: Identify and Prevent Problems

MedlinePlus

... might make this condition more likely. Changes in libido. Reduced desire for sex (libido) can be due to several conditions, including a ... or even depression. Significant and abrupt increases in libido, particularly in older men, might be due to ...

SURGICAL TREATMENT AND COMPLICATIONS OF PENILE FRACTURES

PubMed Central

Kulovac, Benjamin; Aganović, Damir; Junuzović, Dželaludin; Prcić, Alden; Hadžiosmanović, Osman; BazardžAnović, Mustafa; Hodžić, Harun

2007-01-01

Paper goal is to determine complications after urgent surgical treatment of patient with penile fractures, by using circumferential-degloving technique (degloving penile skin to root of penis). In period between 1998-2006 year, 23 patients have been treated as urgent cases with clinically proven penis fracture, age between 18 and 35. Patients were treated in 3 medical centers in Bosnia and Herzegovina(Sarajevo, Tuzla and Zenica). All 23 (100%) patients were injured during sexual intercourse. In the case of 20 (86,9%) patients partial rupture of corpus cavernosum was verified. Two (8,6%) patients had a complete rupture of urethra and it was primary sutured. In 22 cases (95,6%) spontaneous erection appeared, and in the case of 2 (8,6%) patients penile curvature was verified. Urgent surgical treatment is the best therapy choice, which enables preservation of erection in great number of cases in patients with penile fracture. PMID:17489766

Anatomic Basis for Penis Transplantation: Cadaveric Microdissection of Penile Structures.

PubMed

Tiftikcioglu, Yigit Ozer; Erenoglu, Cagil Meric; Lineaweaver, William C; Bilge, Okan; Celik, Servet; Ozek, Cuneyt

2016-06-01

We present a cadaveric dissection study to investigate the anatomic feasibility of penile transplantation. Seventeen male cadavers were dissected to reveal detailed anatomy of the dorsal neurovascular structures including dorsal arteries, superficial and deep dorsal veins, and dorsal nerves of the penis. Dorsal artery diameters showed a significant decrease from proximal to distal shaft. Dominance was observed in one side. Deep dorsal vein showed a straight course and less decrease in diameter compared to artery. Dorsal nerves showed proximal branching pattern. In a possible penile transplantation, level of harvest should be determined according to the patient and the defect, where a transgender patient will receive a total allograft and a male patient with a proximal penile defect will receive a partial shaft allograft. We designed an algorithm for different levels of penile defect and described the technique for harvest of partial and total penile transplants.

Penile Mondor's disease after anterolateral retroperitoneal approach for lumbar fracture.

PubMed

Dobran, Mauro; Benigni, Roberta; Nasi, Davide; Cantoro, Daniele

2017-11-01

This is a rare case of thrombosis of the dorsal vein of the penis (Mondor's disease) occurred after an anterior-lateral retroperitoneal approach for a vertebral stabilisation in thoracolumbar vertebral fracture. Potential causes are traumatism, neoplasms, excessive sexual activity or abstinence. Although penile Mondor's disease is a clinical diagnosis, ultrasound imaging is the gold standard to confirm it. In the reported case, 1 week after neurosurgical retroperitoneal procedure of vertebral stabilisation, the patient complained of a painful cord-like mass midshaft of penis. The diagnosis was made by clinical evaluation and ultrasound images. After 2 weeks of therapy with enoxaparin sodium, the patient recovered. The authors report this case evaluating the possible correlation between the anterior-lateral retroperitoneal approach and the development of the rare Mondor's disease. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Physiology of male sexual function.

PubMed

deGroat, W C; Booth, A M

1980-02-01

The male sexual response cycle consists of excitement, plateau, orgasm, and resolution. The initial event, penile erection, is produced by arteriolar dilatation and increased blood flow to the erectile tissue of the penis. Erection is a reflex response initiated by visual, olfactory, or imaginative stimuli impinging upon supraspinal centers or by genital stimulation that in turn activates spinal reflex mechanisms. Sacral parasympathetic and thoracolumbar sympathetic nerves provide the efferent vasodilator input to the penis. Parasympathetic nerves also stimulate secretion from the seminal vesicles and prostate and Cowper's glands during the plateau phase. The orgasmic phase is characterized by seminal emission and ejaculation and the accompanying sensations. Emission of semen into the urethra depends on sympathetic nerves that elicit contractions of smooth muscles in the vas deferens, seminal vesicles, and prostate. Rhythmic contractions of striated muscle (bulbocavernosus and ischiocavernosus) generated by efferent pathways in the pudendal nerve eject semen from the urethra.

Phantom penis: historical dimensions.

PubMed

Wade, Nicholas J; Finger, Stanley

2010-10-01

Interest in sensations from removed body parts other than limbs has increased with modern surgical techniques. This applies particularly to operations (e.g., gender-changing surgeries) that have resulted in phantom genitalia. The impression given in modern accounts, especially those dealing with phantoms associated with penis amputation, is that this is a recently discovered phenomenon. Yet the historical record reveals several cases of phantom penises dating from the late-eighteenth century and the early-nineteenth century. These cases, recorded by some of the leading medical and surgical figures of the era, are of considerable historical and theoretical significance. This is partly because these phantoms were associated with pleasurable sensations, in contrast to the loss of a limb, which for centuries had been associated with painful phantoms. We here present several early reports on phantom penile sensations, with the intent of showing what had been described and why more than 200 years ago.

Persistence of Polydimethylsiloxane Condom Lubricants.

PubMed

Tottey, Leah S; Coulson, Sally A; Wevers, Gerhard E; Fabian, Laura; McClelland, Heather; Dustin, Mickayla

2018-05-14

Polydimethylsiloxane (PDMS) is commonly used to lubricate condoms. The detection of PDMS on swabs from complainants can be used to support an allegation of sexual assault. Previous research has focused on establishing analytical techniques for detecting PDMS. This research examined the persistence of PDMS on the penis, in the vagina, in the mouth, and on skin. The longest PDMS detection times were 20 h on the penis, 35 h in the vagina, and 52 h on skin. PDMS was detected up to 4 h in the mouth if the participant did not eat or drink and up to 9 h if the participant slept. PDMS was not detected in the mouth after eating or drinking. The presence of biological fluids had no detrimental effect on the analysis. Aqueous extraction of swabs for DNA did not remove any significant amount of PDMS; hence, swab remains could be subsequently analyzed for PDMS. © 2018 American Academy of Forensic Sciences.

Hypospadias anatomy: Elastosonographic evaluation of the normal and hypospadic penis.

PubMed

Camoglio, Francesco Saverio; Bruno, Costanza; Zambaldo, Silvia; Zampieri, Nicola

2016-08-01

Hypospadias is one of the most common congenital anomalies in childhood. The aim of this study is to apply elastosonography on normal and hypospadic penis to verify the structural differences in tissues composition and stiffness. We analyzed medical chart of patients treated at our Institution for hypospadias during the period December 2005 and December 2014 (group 1). Other two groups were enrolled for this study: group 2- patients with hypospadias waiting for surgery and group 3-patients without hypospadias. Inclusion and exclusion criteria were created; all patients underwent penile ultrasound and elastosonography. Elastographic index of elasticity was defined as soft, medium-hard or hard. We assigned the value 1 to soft tissue, 2 and 3 to medium-hard and hard respectively. During the study period 294 patients were treated for hypospadias. After reviewing medical chart 115 patients were considered for analysis (group 1). 22 patients were enrolled in group 2 and 38 patients were enrolled in group 3. Group 1: 7 proximal hypospadias, 29 penile hypospadias, 79 distal hypospadias. Patients with hypospadias had malformation also at corpus spongiosum and cavernosum respect to controls. Elastography showed a corpus spongiosum stiffness defined as medium-hard or hard in all cases of the pathologic group and soft in all the subjects of the control group (p < 0.05). Elastosonography showed how the hypospadia anatomy is deeply altered, even in an anatomical area far from meatal abnormality: corpus spongiosum in hypospadic penis seems to be globally stiffer and less elastic and cavernous corpora are less developed. Copyright © 2016 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

The value of magnetic resonance imaging in the diagnosis of penile fracture.

PubMed

Guler, Ibrahim; Ödev, Kemal; Kalkan, Havva; Simsek, Cihan; Keskin, Suat; Kilinç, Mehmet

2015-01-01

We studied the use of magnetic resonance imaging in the diagnosis of penile fracture. Between 1997 and 2012, fifteen patients (age range 17-48 years, mean age 37 years) with suspected penile fracture underwent MRI examinations. Ten patients were injured during sexual intercourse, whereas four patients were traumatized by non-physiological bending of the penis during self manupilation, one patient was traumatized falling from the bed. Investigations were performed with 1.5 T MR unit. With the patient in the supine position, the penis was taped against the abdominal wall and surface coil was placed on the penis. All patients were studied with axial, coronal, sagittal precontrast and postcontrast T1-weighted TSE(TR/TE:538/13 msn) and T2-weighted TSE(5290/110 msn) sequences. All patient underwent surgical exploration. The follow-up ranged from 3 months to 72 months. Clinically all patients showed normal healing process without complications. In 11 patients a shortening and thickening of tunica albuginea was observed. Three patients have post traumatic erectile disfunction. In all patient corpus cavernosum fractures were clearly depicted on a discontinuity of the low signal intensity of tunica albuginea. These findings were most evident on T1WI and also depicted on T2W sequences. Images obtained shortly after contrast medium administration showed considerable enhancement only in rupture site. Subcutaneous extratunical haematoma in all patients were also recognizable on T2 WI. MRI findings were confirmed at surgery. Magnetic resonance imaging is of great value for the diagnosis of penile fracture. Furthermore this method is well suited for visualising the post-operative healing process.

Redundant prepuce increases the odds of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).

PubMed

Zhao, Yu-Yang; Xu, Dong-Liang; Zhao, Fu-Jun; Han, Bang-Min; Shao, Yi; Zhao, Wei; Xia, Shu-Jie

2014-01-01

Some published evidence has revealed that the dendritic cells can interact with pathogens that exist in the inner foreskin. This information provides a new vision that pathogens could play a role through the redundant prepuce; numerous studies have failed to find pathogens in prostates of patients who had chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). However, no studies have reported an association between foreskin length and CP/CPPS. Hence, we conducted a retrospective case-control study of clinical data from 322 CP/CPPS patients (case group) and 341 nonCP/CPPS patients (control group). Demographic characteristics, lifestyle factors, and foreskin lengths were collected and analyzed. Multivariate logistic regression was adopted to calculate the odds of foreskin length for CP/CPPS. According to the multivariate logistic regression results, when the foreskin length covered up more than half of the glans penis, the odds for CP/CPPS were higher with an increased foreskin (odds ratio (OR): 1.66, 95% confidence interval (CI): 1.04-2.66). In comparison, when the glans penis was completely covered by the foreskin, the OR value increased to 1.86 (95% CI, 1.2-2.88). The study results showed an association between foreskin length and the odds of CP/CPPS. When the foreskin length covered up more than half of the glans penis, there were greater odds for CP/CPPS. This possible mechanism might result from interaction between pathogens and DCs in the inner foreskin, consequently activating T-cells to mediate allergic inflammation in the prostate and producing the autoimmunizations causing CP/CPPS.

Total phallic reconstruction using radial forearm free flap after iatrogenic penile amputation.

PubMed

Angulo, J C; Arance, I; Gómez-Llorens, C; Esquinas, C; Gómez-Martín, C; Fernández-Cañamaque, J L

2017-09-01

The iatrogenic loss of the penis is a rare situation. We present a challenging case of deferred total penile reconstruction in a genetic male. A 57-year-old man with the loss of the penis due to a penile abscess and necrosis secondary to penile curvature surgery. The reconstruction was performed over several operations using a radial forearm free flap (RFFF) and placement of a customised inflatable prosthesis a year later. During the first operation, the penile abscess was drained, the necrotic residues were debrided and placement of hypogastric drainage. Seven weeks later, phalloplasty was performed with RFFF and a tube-in-tube neourethra was constructed. Multiple microsurgical anastomosis was performed, and the donor site was coated with a skin graft from the thigh of partial thickness. The surgery lasted 10hours and had the complication of hair growth in the neourethra, which required mechanical endoscopic depilation on repeated occasions. The patient regained penile sensitivity. Eighteen months after the phalloplasty, a Zephyr single-body inflatable prosthesis (Geneva, Switzerland) was implanted, using the tunica albuginea of the proximal corpus cavernosum. The patient was satisfied with the aesthetics and urinary and sensory function. Four months later, the patient is gaining confidence to consider penetration. Despite the risk of postoperative complications and the need for multiple operations, phallic reconstruction with RFFF and the placement of a customised prosthetic implant can improve urinary and sexual function secondary to the loss of the penis. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Penile Improvement Protocol in Postoperative Management of Patients Undergoing Metoidioplasty.

PubMed

Cohanzad, Shahryar

2016-12-01

To introduce a postoperative protocol to optimize the final size of the penis in patients undergoing metoidioplasty. Fourteen patients with the mean age of 29.3 years (8-40 ± 11.7), ten female transsexuals (46 xx karyotype) and four with 5-alpha-reductase deficiency syndrome (5ARDS) who had undergone extensive metoidioplasty entered a penile improvement protocol (PIP) between 2007 and 2015 at a specialized clinic in a general hospital in Tehran, Iran. Subjects were thoroughly instructed, rehearsed on the protocol and closely followed for 24 weeks. Written informed consent was obtained from all participants. We adapted a popular device, the so-called penile traction device, to accommodate the size of the neo-penis. All patients achieved an increase in their penile length with a mean of 28.42 mm (21-47 ± 6.86). Two subjects developed penile bruises and edema during the protocol implementation. No significant procedural complications were detected in the remaining 12 participants. PIP can be an effective step in increasing the size of the neo-penis in patients who have undergone metoidioplasty. We suggest this procedure to be seriously considered in postoperative management of well-informed and motivated patients to improve the final penile length and function in this population. Larger studies are needed to further validate this protocol. This journal requires that the authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Toxic Hazards Research Unit

DTIC Science & Technology

1977-09-01

greatly enlarged . Histologic examination of the neoplastic tissue growth was per- formed and a diagnosis made of reticulum cell sarcoma of multi...Guinea Pig Venipuncture femoral vein Venipuncture penis Dental exam Rodent Venipuncture tail vein Orbital sinus bleeding Heart Mark rodent using toe

Inflammation of the Penis

MedlinePlus

... Pill Identifier Commonly searched drugs Aspirin Metformin Warfarin Tramadol Lactulose Ranitidine News & Commentary Recent News Afib and Weight AHA: Using Electricity to Test Your Risk for Heart Failure Close Siblings Can Ease the Pain of Family Conflict Don't Turn Into a ...

Health Care for College Students

MedlinePlus

... diet. Don't Ignore These Symptoms. Call the Student Health Service Right Away If You Have: A fever of 102°F (39°C) or higher A headache and a stiff neck Pain with urination An unusual discharge from your penis ...

Chlamydia Infections

MedlinePlus

... include Abnormal vaginal discharge, which may have a strong smell A burning sensation when urinating Pain during intercourse If the infection spreads, you might get lower abdominal pain, pain during sex, nausea, or fever. Symptoms in men include Discharge from your penis A burning sensation ...

How to Handle Abuse

MedlinePlus

... hurting or harming someone) might have frightened the boy or girl into staying quiet. No matter what the abuser ... suit or underwear: breasts, vagina, and bottom for girls, and penis and bottom for boys. If an adult or another kid touches a ...

Genetics Home Reference: intrauterine growth restriction, metaphyseal dysplasia, adrenal hypoplasia congenita, and ...

MedlinePlus

... associated with IMAGe syndrome occur only in affected males. They include an unusually small penis (micropenis), undescended ... The condition has been diagnosed more often in males than in females, probably because females do not ...

Titanium pigmentation. An electron probe microanalysis study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dupre, A.; Touron, P.; Daste, J.

1985-05-01

A patient had an unusual pigmentary disease induced by titanium dioxide. The use of a topical cream containing titanium dioxide caused a xanthomalike appearance on the patient's penis. Electron probe microanalysis was valuable in establishing the cause of this balanitis.

Effect of penile-extender device in increasing penile size in men with shortened penis: preliminary results.

PubMed

Nikoobakht, Mohammadreza; Shahnazari, Alireza; Rezaeidanesh, Maedeh; Mehrsai, Abdolrasoul; Pourmand, Gholamreza

2011-11-01

It has been suggested that the application of penile-extender devices increases penile length and circumference. However, there are a few scientific studies in this field. The aim of this study was to assess the efficacy of a penile-extender (Golden Erect(®) , Ronas Tajhiz Teb, Tehran, Iran) in increasing penile size. This prospective study was performed on subjects complaining about "short penis" who were presented to our clinic between September 15, 2008 and December 15, 2008. After measuring the penile length in flaccid and stretched forms and penile circumference, patients were instructed to wear Golden Erect(®) , 4-6 hours per day during the first 2 weeks and then 9 hours per day until the end of the third month. The subjects were also trained how to increase the force of the device during determined intervals. The patients were visited at the end of the first and third months, and penile length and circumference were measured and compared with baseline. The primary end point of the study was changes in flaccid and stretched penile lengths compared with the baseline size during the 3 months follow-up. Twenty-three cases with a mean age of 26.5 ± 8.1 years entered the study. The mean flaccid penile length increased from 8.8 ± 1.2 cm to 10.1 ± 1.2 cm and 10.5 ± 1.2 cm, respectively, in the first and third months of follow-up, which was statistically significant (P < 0.05). Mean stretched penile length also significantly increased from 11.5 ± 1.0 cm to, respectively, 12.4 ± 1.3 cm and 13.2 ± 1.4 cm during the first and second follow-up (P < 0.05). No significant difference was found regarding proximal penile girth. However, it was not the same regarding the circumference of the glans penis (9.3 ± 0.86 cm vs. 8.8 ± 0.66 cm, P < 0.05). Our findings supported the efficacy of the device in increasing penile length. Our result also suggested the possibility of glans penis girth enhancement using penile extender. Performing more studies is recommended. © 2010 International Society for Sexual Medicine.

Sex Education: Talking to Toddlers and Preschoolers about Sex

MedlinePlus

... age 3 or 4, children often realize that boys and girls have different genitals. As natural curiosity kicks in, ... a penis? Try a simple explanation, such as, "Boys' bodies and girls' bodies are made differently." Why do you have ...

Female condom becomes available nationwide.

PubMed

1995-01-01

Between May 1993 and August 1994, only family planning and sexually transmitted disease (STD) clinics had the female condom available. The manufacturer is using a print and educational campaign to market the female condom. The print campaigns provide a toll-free number for consumers and health care providers. The educational component consists of community outreach programs for public health, family planning clinics, and university health centers. The single-use soft polyurethane sheath has a flexible ring at the closed end, which is used to insert the condom and holds it over the cervix. A flexible ring is at the outer end; it holds the condom over the labia. The female condom is prelubricated and comes with a bottle of lubricant. Adding extra lubricant on the penis or the inside of the condom can prevent invagination of the outer ring, the penis entering the vagina instead of the condom, or the condom riding the penis. The 1-year failure rate is 25% for average use and 5.1% for perfect use. Correct and consistent use determines the female condom's ability to protect against STDs and HIV. The female condom helps women protect themselves against pregnancy and STDs/HIV when their male partner refuses to use a latex condom. Since it is visible outside the vagina, some women might still find it difficult to negotiate its use. Drawbacks of the female condom are that it is cumbersome and challenges our traditional gender roles and ideas about sexuality. Education addressing how women feel about themselves, their sexuality, and their relationships is needed to increase female condom use and acceptance. Some couples prefer the female condom over the male condom because it is roomier and because the polyurethane creates a better sensation than latex.

Effects of Icariside II on Corpus Cavernosum and Major Pelvic Ganglion Neuropathy in Streptozotocin-Induced Diabetic Rats

PubMed Central

Bai, Guang-Yi; Zhou, Feng; Hui, Yu; Xu, Yong-De; Lei, Hong-En; Pu, Jin-Xian; Xin, Zhong-Cheng

2014-01-01

Diabetic erectile dysfunction is associated with penile dorsal nerve bundle neuropathy in the corpus cavernosum and the mechanism is not well understood. We investigated the neuropathy changes in the corpus cavernosum of rats with streptozotocin-induced diabetes and the effects of Icariside II (ICA II) on improving neuropathy. Thirty-six 8-week-old Sprague-Dawley rats were randomly distributed into normal control group, diabetic group and ICA-II treated group. Diabetes was induced by a one-time intraperitoneal injection of streptozotocin (60 mg/kg). Three days later, the diabetic rats were randomly divided into 2 groups including a saline treated placebo group and an ICA II-treated group (5 mg/kg/day, by intragastric administration daily). Twelve weeks later, erectile function was measured by cavernous nerve electrostimulation with real time intracorporal pressure assessment. The penis was harvested for the histological examination (immunofluorescence and immunohistochemical staining) and transmission electron microscopy detecting. Diabetic animals exhibited a decreased density of dorsal nerve bundle in penis. The neurofilament of the dorsal nerve bundle was fragmented in the diabetic rats. There was a decreased expression of nNOS and NGF in the diabetic group. The ICA II group had higher density of dorsal nerve bundle, higher expression of NGF and nNOS in the penis. The pathological change of major pelvic nerve ganglion (including the microstructure by transmission electron microscope and the neurite outgrowth length of major pelvic nerve ganglion tissue cultured in vitro) was greatly attenuated in the ICA II-treated group (p < 0.01). ICA II treatment attenuates the diabetes-related impairment of corpus cavernosum and major pelvic ganglion neuropathy in rats with Streptozotocin-Induced Diabetes. PMID:25517034

Increased penile expression of transforming growth factor and elevated systemic oxidative stress in rabbits with chronic partial bladder outlet obstruction.

PubMed

Lin, W-Y; Chang, P-J; Lin, Y-P; Wu, S-B; Chen, C-S; Levin, R M; Wei, Y-H

2012-02-01

There is a growing body of evidence to support the direct link between obstructive bladder dysfunction and erectile dysfunction (ED). However, there have been few pathophysiological studies to determine the relationship between lower urinary tract syndrome (LUTS) and ED. As the transforming growth factor-β1 (TGF-β1) that induces the synthesis of collagen in the penile tissues is critical for the development of ED, the first aim of this study was to investigate the expression of TGF-β1 in the penis from male rabbits with chronic partial bladder outlet obstruction (PBOO). Besides, it has been suggested that oxidative stress plays a significant role in the pathophysiological mechanism of ED. Thus, the second aim of this study was to further investigate whether the urinary or serum oxidative stress markers are involved in chronic PBOO-induced penile dysfunction. A total of 16 male New Zealand White rabbits were separated equally into four groups: a control group and PBOO groups obstructed for 2, 4 and 8 weeks respectively. Using the RT-PCR and Western blot analysis, a progressive increase of TGF-β1 in penis was found at 2, 4 and 8 weeks after obstruction. Moreover, the biomarkers for oxidative stress or oxidative damage were significantly detected in the penis of rabbits after PBOO, which include the enhancement of 8-hydroxy-2'-deoxyguanosine (8-OHdG) in urine and plasma, plasma malondialdehyde (MDA) and total antioxidant capacity (TAC), as well as reduction of glutathione (GSH). On the basis of our results, the increase of TGF-β1 and elevated systemic oxidative stress may play key roles to contribute to penile dysfunction after chronic PBOO. © 2011 The Authors. International Journal of Andrology © 2011 European Academy of Andrology.

The value of magnetic resonance imaging in the diagnosis of penile fracture

PubMed Central

Guler, Ibrahim; Ödev, Kemal; Kalkan, Havva; Simsek, Cihan; Keskin, Suat; Kilinç, Mehmet

2015-01-01

Purpose We studied the use of magnetic resonance imaging in the diagnosis of penile fracture. Materials and Methods Between 1997 and 2012, fifteen patients (age range 17-48 years, mean age 37 years) with suspected penile fracture underwent MRI examinations. Ten patients were injured during sexual intercourse, whereas four patients were traumatized by non-physiological bending of the penis during self manupilation, one patient was traumatized falling from the bed. Investigations were performed with 1.5T MR unit. With the patient in the supine position, the penis was taped against the abdominal wall and surface coil was placed on the penis. All patients were studied with axial, coronal, sagittal precontrast and postcontrast T1-weighted TSE(TR/TE:538/13 msn) and T2-weighted TSE(5290/110 msn) sequences. All patient underwent surgical exploration. The follow-up ranged from 3 months to 72 months. Clinically all patients showed normal healing process without complications. In 11 patients a shortening and thickening of tunica albuginea was observed. Three patients have post traumatic erectil disfunction. Results In all patient corpus cavernosum fractures were clearly depicted on a discontinuity of the low signal intensity of tunica albuginea. These findings were most evident on T1WI and also depicted on T2W sequences. Images obtained shortly after contrast medium administration showed considerable enhancement only in rupture site. Subcutaneous extratunical haematoma in all patients were also recognizable on T2 WI. MRI findings were confirmed at surgery. Conclusions Magnetic resonance imaging is of great value for the diagnosis of penile fracture. Furthermore this method is well suited for visualising the post-operative healing process PMID:26005975

Percutaneous Perineal Electrostimulation Induces Erection: Clinical Significance in Patients With Spinal Cord Injury and Erectile Dysfunction

PubMed Central

Shafik, Ahmed; Shafik, Ali A; Shafik, Ismail A; Sibai, Olfat El

2008-01-01

Objectives: Approximately one third to one half of the penis is embedded in the pelvis and can be felt through the scrotum and in the perineum. The main arteries and nerves enter the penis through this perineal part of the penis, which seems to represent a highly sensitive area. We investigated the hypothesis that percutaneous perineal stimulation evokes erection in patients with neurogenic erectile dysfunction. Methods: Percutaneous electrostimulation of the perineum (PESP) with synchronous intracorporeal pressure (ICP) recording was performed in 28 healthy volunteers (age 36.3 ± 7.4 y) and 18 patients (age 36.6 ± 6.8 y) with complete neurogenic erectile dysfunction (NED). Current was delivered in a sine wave summation fashion. Average maximal voltages and number of stimulations delivered per session were 15 to 18 volts and 15 to 25 stimulations, respectively. Results: PESP of healthy volunteers effected an ICP increase (P < 0.0001), which returned to the basal value upon stimulation cessation. The latent period recorded was 2.5 ± 0.2 seconds. Results were reproducible on repeated PESP in the same subject but with an increase of the latent period. Patients with NED recorded an ICP increase that was lower (P < 0.05) and a latent period that was longer (P < 0.0001) than those of healthy volunteers. Conclusion: PESP effected ICP increase in the healthy volunteers and patients with NED. The ICP was significantly higher and latent period shorter in the healthy volunteers than in the NED patients. PESP may be of value in the treatment of patients with NED, provided that further studies are performed to reproduce these results. PMID:18533410

Urethral advancement in hypospadias with a distal division of the corpus spongiosum: outcome in 158 cases.

PubMed

Thiry, S; Gorduza, D; Mouriquand, P

2014-06-01

Outcome of urethral mobilization and advancement (Koff procedure) in hypospadias with a distal division of the corpus spongiosum and redo cases with distal urethral failure. From January 1999 to November 2012, 158 children with a distal hypospadias (115 primary cases and 43 redo cases) underwent surgical repair using the Koff technique with a median age at surgery of 21 months (range, 12-217 months). Mean follow-up was 19 months (median, 14 months). Thirty patients (19%) presented with a complication (13.9% in primary cases and 32.5% in redo surgery) mostly at the beginning of our experience. Meatal stenosis was the most common one (3.5% in primary case, 6% overall). Ventral curvature (>10°), which is considered as a possible long-term iatrogenic complication of the Koff procedure, was not found in patients with fully grown penis except in one redo patient who had, retrospectively, an inadequate indication for this type of repair. Of 158 patients, 33 reached the age of puberty (>14 years old) with a mean follow-up of 34 months, only one presented with a significant ventral curvature. Urethral mobilization and advancement is a reasonable alternative for anterior hypospadias and distal fistula repair in selected cases. It has two major advantages compared to other techniques: it avoids any urethroplasty with non-urethral tissue and eliminates dysplastic tissues located beyond the division of the corpus spongiosum, which may not grow at the same pace as the rest of the penis. Significant iatrogenic curvature in fully grown penis is not supported by this series. Copyright © 2013 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Sexually Monomorphic Maps and Dimorphic Responses in Rat Genital Cortex.

PubMed

Lenschow, Constanze; Copley, Sean; Gardiner, Jayne M; Talbot, Zoe N; Vitenzon, Ariel; Brecht, Michael

2016-01-11

Mammalian external genitals show sexual dimorphism [1, 2] and can change size and shape upon sexual arousal. Genitals feature prominently in the oldest pieces of figural art [3] and phallic depictions of penises informed psychoanalytic thought about sexuality [4, 5]. Despite this longstanding interest, the neural representations of genitals are still poorly understood [6]. In somatosensory cortex specifically, many studies did not detect any cortical representation of genitals [7-9]. Studies in humans debate whether genitals are represented displaced below the foot of the cortical body map [10-12] or whether they are represented somatotopically [13-15]. We wondered what a high-resolution mapping of genital representations might tell us about the sexual differentiation of the mammalian brain. We identified genital responses in rat somatosensory cortex in a region previously assigned as arm/leg cortex. Genital responses were more common in males than in females. Despite such response dimorphism, we observed a stunning anatomical monomorphism of cortical penis and clitoris input maps revealed by cytochrome-oxidase-staining of cortical layer 4. Genital representations were somatotopic and bilaterally symmetric, and their relative size increased markedly during puberty. Size, shape, and erect posture give the cortical penis representation a phallic appearance pointing to a role in sexually aroused states. Cortical genital neurons showed unusual multi-body-part responses and sexually dimorphic receptive fields. Specifically, genital neurons were co-activated by distant body regions, which are touched during mounting in the respective sex. Genital maps indicate a deep homology of penis and clitoris representations in line with a fundamentally bi-sexual layout [16] of the vertebrate brain. Copyright © 2016 Elsevier Ltd. All rights reserved.

Long-Term Results of Brachytherapy for Carcinoma of the Penis Confined to the Glans (N- or NX)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Crevoisier, Renaud de; Slimane, Khemais; Sanfilippo, Nicholas

2009-07-15

Purpose: To analyze the results of exclusive interstitial low-dose-rate brachytherapy (BT) for squamous cell carcinoma (SCC) of the penis, strictly confined to the glans. Methods and Materials: A total of 144 patients with SSC of the glans penis were treated with BT. Inguinal nodal dissection was performed in 19% of patients (all N-). After circumcision, BT was performed using the hypodermic needle technique. Median iridium length per patients was 24 cm (range, 4-108) and median dose was 65 Gy (range, 37-75). Median treated volume was 22 cm{sup 3} (range, 5-110) and median reference isodose rate was 0.4 Gy/h (range, 0.2-1.2).more » Results: Median follow-up was 5.7 years (range, 0.5-29). The 10-year penile recurrence, inguinal lymph node recurrence, and inguinal nodal metastasis rates were: 20% (CI 95%, 11-29), 11% (CI 95%, 5-17), and 6% (CI 95%, 2-10), respectively. After salvage treatment, 86% patients with local failure were in a complete remission at last follow-up. The 10-year probability of avoiding penile surgery (for complication or local recurrence) was 72% (CI 95%, 62-82). The 10-year cancer-specific survival rate was 92% (CI 95%, 87-97). Diameter of tumor significantly increased the risk of recurrence (p = 0.02). The 10-year painful ulceration and stenosis risk rates were: 26% (CI 95%, 17-35) and 29% (CI 95%, 18-40), respectively. Seven patients required excision for necrosis. Treated volume and reference isodose rate significantly increased the risk of complications. Conclusion: BT is an effective conservative treatment for SCC confined to the glans. Salvage local treatment is effective. Dose rate should be limited to decrease toxicity.« less

Isolation and identification of female DNA on postcoital penile swabs.

PubMed

Cina, S J; Collins, K A; Pettenati, M J; Fitts, M

2000-06-01

After sexual assault, cells originating from the assailant may be recovered from the victim. Through polymerase chain reaction (PCR)-based technology, positive scientific identification of the assailant may be made from these cells. Described is a prospective study describing a method for positively identifying cells from a female sex partner obtained from postcoital swabs of the penis of the male sex partner. Swabs were taken from the penis of a man at 1- to 24-hour intervals after coitus. DNA was isolated from each swab through standard organic extraction methods. The presence of female DNA was detected using the gender-specific amelogenin marker. Extracted DNA was amplified for eight different genetic loci using the Promega PowerPlex kit (Promega) and Amplitaq Gold (Perkin Elmer). Amplified samples were electrophoresed on precast sequencing gels (Hitachi) and were analyzed fluorescently using Hitachi's FMBIO 2 fluorescent scanner and software. Each sample obtained from a penile swab or condom was compared to male and female buccal controls. Female DNA was isolated from all postcoital penile swabs as determined by exclusive amplification of the X-chromosome specific 212 base pair amelogenin marker. In all cases, scientific identification of the female DNA from the swabs was determined by coamplification of eight STR loci (PowerPlex) and was compared to female and male control profiles. Cells shed from a female victim during sexual intercourse can be retrieved from the penis of a male offender after sexual intercourse during a 1- to 24-hour postcoital interval. DNA can be extracted from these cells and can be used to scientifically identify the female sexual participant through PCR-based technology. It is suggested that penile swabs be taken from alleged perpetrators of sexual assaults to associate them with a female victim.

Development of the penis during the human fetal period (13 to 36 weeks after conception).

PubMed

Gallo, Carla B M; Costa, Waldemar S; Furriel, Angelica; Bastos, Ana L; Sampaio, Francisco J B

2013-11-01

We analyzed the development of the area of the penis and erectile structures (corpora cavernosa and corpus spongiosum) and the thickness of the tunica albuginea during the fetal period (13 to 36 weeks after conception) in humans to establish normative patterns of growth. We studied 56 male human fetuses at 13 to 36 weeks after conception. We used histochemical and morphometric techniques to analyze the parameters of total penile area, area of corpora cavernosa, area of corpus spongiosum, and thickness of tunica albuginea in the dorsal and ventral regions using ImageJ software (National Institutes of Health, Bethesda, Maryland). Between 13 and 36 weeks after conception the area of the penis varies from 0.95 to 24.25 mm2. The area of the corpora cavernosa varies from 0.28 to 9.12 mm2, and the area of the corpus spongiosum varies from 0.14 to 3.99 mm2. The thickness of the tunica albuginea varies from 0.029 to 0.296 mm in the dorsal region and from 0.014 to 0.113 mm in the ventral region of the corpora cavernosa. We found a strong correlation between the total penile area, corpora cavernosa and corpus spongiosum with fetal age (weeks following conception). The growth rate was more intense during the second trimester (13 to 24 weeks of gestation) compared to the third trimester (25 to 36 weeks). Tunica albuginea thickness also was strongly correlated with fetal age and this structure was thicker in the dorsal vs ventral region. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Risk of Damage to the Somatic Innervation of the Penis during the AdVanceProcedure: An Anatomical Study.

PubMed

Hogewoning, Cornelis R C; Elzevier, Henk W; Pelger, Rob C M; Bekker, Milou D; DeRuiter, Marco C

2015-08-01

One of the methods to treat post radical prostatectomy stress urinary incontinence is the AdVance (American Medical Systems, Minnetonka, MN, USA) male sling procedure. During this procedure, the somatic innervation of the penis may be at risk for injury. Six AdVance procedures were performed in six donated bodies at the Anatomy and Embryology Department of the Leiden University Medical Centre. The pelves were dissected and the shortest distance between the sling and the dorsal nerve of the penis (DNP) was documented. The aim of this study was to describe the anatomical relation between the AdVance male sling and penile nerves based on the dissection of six adult male pelves. The AdVance male sling procedure was conducted in six donated male bodies. After placement, the pelves were dissected and the shortest distance between sling and the DNP was documented. The main outcome measure was the distance between the AdVance male sling and the DNP. The mean distance of the sling to the DNP was 4.1 mm and was found situated directly next to the nerve (distance 0 mm) in 4 out of 12 (33%) hemipelves. The distance of the sling to the obturator neurovascular bundle was 30 mm or more in all six bodies. Damage to the DNP caused by the AdVance male sling procedure appears to be an extremely rare complication, which has not been described in current literature. The proximity of the AdVance to the DNP could, however, pose a risk that should be taken into consideration by physicians and patients when opting for surgery. © 2015 International Society for Sexual Medicine.

Morphological and histological characters of penile organization in eleven species of molossid bats.

PubMed

Comelis, Manuela T; Bueno, Larissa M; Góes, Rejane M; Taboga, S R; Morielle-Versute, Eliana

2018-04-01

The penis is the reproductive organ that ensures efficient copulation and success of internal fertilization in all species of mammals, with special challenges for bats, where copulation can occur during flight. Comparative anatomical analyses of different species of bats can contribute to a better understanding of morphological diversity of this organ, concerning organization and function. In this study, we describe the external morphology and histomorphology of the penis and baculum in eleven species of molossid bats. The present study showed that penile organization in these species displayed the basic vascular mammalian pattern and had a similar pattern concerning the presence of the tissues constituting the penis, exhibiting three types of erectile tissue (the corpus cavernosum, accessory cavernous tissue, and corpus spongiosum) around the urethra. However, certain features varied among the species, demonstrating that most species are distinguishable by glans and baculum morphology and glans histological organization. Major variations in glans morphology were genus-specific, and the greatest similarities were shared by Eumops species and N. laticaudatus. The greatest interspecific similarities occurred between M. molossus and M. rufus and between Eumops species. Save for M. molossus and M. rufus, morphology of the baculum was species-specific; and in E. perotis, it did not occur in all specimens, indicating that it is probably under selection. In the histological organization, the most evident differences were number of septa and localization of the corpora cavernosa. In species with a baculum (Molossus, Eumops and Nyctinomops species), the corpora cavernosa predominantly occupied the dorsal region of the penile glans and is associated with the proximal (basal) portion of the baculum. In species that do not have a baculum (Cynomops, Molossops and Neoplatymops species), the corpora cavernosa predominantly occupied the ventro-lateral region of the glans. Copyright © 2018 Elsevier GmbH. All rights reserved.

The possible protective effects of dipyridamole on ischemic reperfusion injury of priapism

PubMed Central

Karaguzel, Ersagun; Bayraktar, Cemil; Kutlu, Omer; Yulug, Esin; Mentese, Ahmet; Okatan, Ali Ertan; Colak, Fatih; Ozer, Serap; O.Kazaz, Ilke

2016-01-01

ABSTRACT Purpose To investigate the protective effects against ischemia reperfusion injury of dipyridamole in a model of induced priapism in rats. Materials and Methods Twenty-four male Sprague-Dawley rats were divided into four groups, control, P/R, P/R+DMSO and P/R+D. 3ml blood specimens were collected from vena cava inferior in order to determine serum MDA, IMA, TAS, TOS and OSI values, and penile tissue was taken for histopathological examination in control group. Priapism was induced in P/R group. After 1h, priapism was concluded and 30 min reperfusion was performed. In P/R+DMSO group 1ml/kg DMSO was administered intraperitoneally 30 min before reperfusion, while in P/R+D group 10mg/kg dipyridamole was administered intraperitoneally 30 min before reperfusion. Blood and penis specimens were collected after the end of 30 min reperfusion period. Sinusoidal area (µm2), tears in tunica albuginea and injury parameters in sinusoidal endothelium of penis were investigated. Results Histopathological examination revealed no significant changes in term of sinusoidal area. A decrease in tears was observed in P/R+D group compared to P/R group (p<0.05). Endothelial injury decreased in P/R+D group compared to P/R group (p>0.05). There were no significant differences in MDA and IMA values between groups. A significant increase in TOS and OSI values was observed in P/R+D group compared to P/R group. A significant decrease in TAS levels was observed in P/R+D group compared to the P/R group. Conclusions The administration of dipyridamole before reperfusion in ischemic priapism model has a potential protective effect against histopathological injury of the penis. PMID:27136481

Nitric oxide synthase gene transfer for erectile dysfunction in a rat model.

PubMed

Chancellor, M B; Tirney, S; Mattes, C E; Tzeng, E; Birder, L A; Kanai, A J; de Groat, W C; Huard, J; Yoshimura, N

2003-05-01

To determine whether over-expression of nitric oxide synthase (NOS) in the corpus cavernosum of the penis improves erectile function, as NO is an important transmitter for genitourinary tract function, mediating smooth muscle relaxation and being essential for penile erection. The inducible form of the enzyme NOS (iNOS) was introduced into the corpus cavernosum of adult Sprague-Dawley rats (250-300 g) by injecting a solution of plasmid, adenovirus or adenovirus-transduced myoblast cells (adeno-myoblasts). Plasmid, adenovirus and adeno-myoblasts encoding the expression of the beta-galactosidase reporter gene were also injected into rats. Throughout the corpora cavernosum there was expression of beta-galactosidase after injecting each of the three solutions. Maximum staining was greatest for adeno-myoblast, then adenovirus and then plasmid. The mean (sd) basal intracavernosal pressure (ICP) of iNOS-treated animals (adenovirus and adeno-myoblast) increased to 55 (23) cmH2O, compared with naive animals with a basal ICP of 5 (6) cmH2O (P = 0.001). Stimulating the cavernosal nerve (15 Hz, 1.5 ms, 10-40 V, 1 min) resulted in a doubling of the ICP (adenovirus and adeno-myoblast) from the basal level of the iNOS-treated animals. Direct in situ measurement of NO showed the release of 1-1.3 micro mol/L in the adeno-myoblast penis. Myoblast-mediated gene therapy was more successful for delivering iNOS into the corpus cavernosum than direct adenovirus injection or plasmid transfection. Surprisingly, implanting muscle cells into the penis is not only feasible but also beneficial. Gene therapy for NOS may open new avenues of treatment for erectile dysfunction. Control of NOS expression would be necessary to prevent priapism.

Knockout AR in Prostate

DTIC Science & Technology

2006-10-01

enlarged ventral prostates, we evaluated fertility. We found that there were no significant differences in litter-size when either WT or pes-ARKO males...prostate (DLP), ventral prostate (VP) all lobes of prostate (Pr), testes (T), glans penis (Pe); *Pɘ.05, ***Pɘ.001. PI: Chang, Chawnshang 7

21 CFR 884.5320 - Glans sheath.

Code of Federal Regulations, 2010 CFR

2010-04-01

... the entire shaft of the penis. It is indicated only for the prevention of pregnancy and not for the prevention of sexually-transmitted diseases. (b) Classification. Class III (premarket approval). (c) Date premarket approval application (PMA) or notice of completion of a product development protocol (PDP) is...

Arteriovenous Patterns in Beaked Whales

DTIC Science & Technology

2014-09-30

clear picture of the vascular anatomy in beaked whale heads that will enhance our understanding of the basic biology of beaked whales and act as a...erectile tissue, strikingly similar to the morphology of the corpus cavernosum of the mammalian penis . Connective tissue lining the nasal passage is

Rape and the Serial Rapist

DTIC Science & Technology

1993-12-01

contact with the female genitalia. Fellatio. Taking of the penis into the mouth. Incest. Sexual relations between persons who are too closely...34over half were victims of incest. All incestuous experiences occurred before puberty [5 to 10 years of age], and the majority of the experiences wore

What Are the Symptoms of Puberty, Precocious Puberty, and Delayed Puberty?

MedlinePlus

... puberty include: Growth of pubic and other body hair Growth spurt Breast development Onset of menstruation (after puberty ... of pubic hair, other body hair, and facial hair Enlargement of testicles and penis Muscle growth Growth spurt Acne Deepening of the voice Precocious ...

Computational Embryology and Predictive Toxicology of Hypospadias (SOT)

EPA Science Inventory

Hypospadias, one of the most common birth defects in human male infants, is a condition in which the urethral opening is misplaced along ventral aspect of the penis. We developed an Adverse Outcome Pathway (AOP) framework and computer simulation that describes the pathogenesis of...

'Batman excision' of ventral skin in hypospadias repair, clue to aesthetic repair (point of technique).

PubMed

Hoebeke, P B; De Kuyper, P; Van Laecke, E

2002-11-01

In the hypospadiac penis the ventral skin is poorly developed, while dorsal skin is redundant. The classical Byars' flaps are a way to use the excess dorsal skin to cover the penile shaft. The appearance after Byars' flaps however is not natural. We use a more natural looking skin allocation with superior aesthetic results. The clue in this reconstruction is an inverted triangle shaped excision of ventral skin expanding over the edges of the hooded prepuce (which makes it look like Batman). After excision of the ventral skin it is possible to close the penile skin in the midline, thus mimicking the natural raphe. In case of preputial reconstruction the excised ventral skin makes the prepuce look more natural. The trend of further refining aesthetic appearance of the hypospadiac penis often neglects the penile skin reconstruction. A technique is presented by which the total penile appearances after surgery ameliorates due to better skin reconstruction.

Neo-phalloplasty with re-innervated latissimus dorsi free flap: a functional study of a novel technique.

PubMed

Ranno, R; Veselý, J; Hýza, P; Stupka, I; Justan, I; Dvorák, Z; Monni, N; Novák, P; Ranno, S

2007-01-01

Twenty two patients with gender dysphoria underwent neo-phalloplasties using a novel technique. Latissimus dorsi musculocutaneus re-innervated free flap was used to allow voluntary rigidity of the neo-penis. From the first 22 patients, 18 have obtained motoric function of reconstructed penis; the "paradox erection" was obtained. 14 patients came for examination after a follow-up period of mean 26.4 months. We evaluated the motility and shape changes of neo-phallus measuring its different size and dimension during relax and muscle contraction. The range of neo-phallus length in relaxed position was between 7 and 17 cm (mean 12.2 cm), its circumference in the same position had a range between 13 and 20 cm (mean 13.7 cm). All patients were able to contract the muscle with an average length reduction of 3.08 cm and an average circumference enlargement of 4 cm. In this study, the dimensions and motility were quantified demonstrating the neo-phallus function and size changes during sexual intercourse.

Risk factors for bacterial contamination during boar semen collection.

PubMed

Goldberg, Ana Maria G; Argenti, Laura E; Faccin, Jamil E; Linck, Lídia; Santi, Mônica; Bernardi, Mari Lourdes; Cardoso, Marisa R I; Wentz, Ivo; Bortolozzo, Fernando P

2013-10-01

The aim of this study was to evaluate the influence of multiple factors on bacterial contamination in 213 ejaculates from four boar studs. Semen contamination by aerobic mesophiles increased in ejaculates where the preputial fluid flowed into the collection container, collection glove was dirty, preputial hair was long (>1.0 cm), the collection lasted >7 min and boars were older than 18 months. An increase in coliforms occurred when preputial fluid dripped into the collection container, collections lasted >7 min or when penis escaped during collection. Semen contamination increased when two or more factors related to hygiene (poor hygiene of the boar, dirty preputial ostium, large preputial diverticulum, long preputial hair, dirty gloves, preputial liquid trickling from the hand of the technician into the semen container and penis escaping) were present. A vigilant protocol of collection must be followed to minimize bacterial contamination, especially avoiding dripping of preputial liquid into the semen container. Copyright © 2013 Elsevier Ltd. All rights reserved.

Gross anatomy and ultrasonographic images of the reproductive system of the Malayan tapir (Tapirus indicus).

PubMed

Lilia, K; Rosnina, Y; Abd Wahid, H; Zahari, Z Z; Abraham, M

2010-12-01

The Malayan tapir (Tapirus indicus) is the largest among the four tapir species and is listed as an endangered species. Ultrasound examination and description of the external anatomy of the female reproductive system of three adult females were performed, whereas the internal anatomy was investigated in necropsied samples of four adult females and one subadult female. Descriptions of the male external genitalia were conducted on one adult male. Gross examination revealed the presence of a bicornuate uterus. The uterine cervix is firm and muscular with projections towards its lumen, which is also evident on ultrasonography. The elongated and relatively small ovaries, which have a smooth surface, could not be imaged on ultrasonography, due to their anatomical position. The testes are located inside a slightly pendulous scrotum that is sparsely covered with soft, short hairs. The penis has one dorsal and two lateral penile projections just proximal to the glans penis. © 2010 Blackwell Verlag GmbH.

Low-Intensity Shock Wave Therapy and Its Application to Erectile Dysfunction

PubMed Central

Lei, Hongen; Liu, Jing; Li, Huixi; Wang, Lin; Xu, Yongde; Tian, Wenjie; Lin, Guiting

2013-01-01

Although phosphodiesterase type 5 inhibitors (PDE5Is) are a revolution in the treatment of erectile dysfunction (ED) and have been marketed since 1998, they cannot restore pathological changes in the penis. Low-energy shock wave therapy (LESWT) has been developed for treating ED, and clinical studies have shown that LESWT has the potential to affect PDE5I non-responders with ED with few adverse effects. Animal studies have shown that LESWT significantly improves penile hemodynamics and restores pathological changes in the penis of diabetic ED animal models. Although the mechanisms remain to be investigated, recent studies have reported that LESWT could partially restore corpus cavernosum fibromuscular pathological changes, endothelial dysfunction, and peripheral neuropathy. LESWT could be a novel modality for treating ED, and particularly PDE5I non-responders with organic ED, in the near future. However, further extensive evidence-based basic and clinical studies are needed. This review intends to summarize the scientific background underlying the effect of LESWT on ED. PMID:24459653

Low-intensity shock wave therapy and its application to erectile dysfunction.

PubMed

Lei, Hongen; Liu, Jing; Li, Huixi; Wang, Lin; Xu, Yongde; Tian, Wenjie; Lin, Guiting; Xin, Zhongcheng

2013-12-01

Although phosphodiesterase type 5 inhibitors (PDE5Is) are a revolution in the treatment of erectile dysfunction (ED) and have been marketed since 1998, they cannot restore pathological changes in the penis. Low-energy shock wave therapy (LESWT) has been developed for treating ED, and clinical studies have shown that LESWT has the potential to affect PDE5I non-responders with ED with few adverse effects. Animal studies have shown that LESWT significantly improves penile hemodynamics and restores pathological changes in the penis of diabetic ED animal models. Although the mechanisms remain to be investigated, recent studies have reported that LESWT could partially restore corpus cavernosum fibromuscular pathological changes, endothelial dysfunction, and peripheral neuropathy. LESWT could be a novel modality for treating ED, and particularly PDE5I non-responders with organic ED, in the near future. However, further extensive evidence-based basic and clinical studies are needed. This review intends to summarize the scientific background underlying the effect of LESWT on ED.

Fournier's Gangrene due to Masturbation in an Otherwise Healthy Male.

PubMed

Heiner, Jason D; Eng, Katisha D; Bialowas, Todd A; Devita, Diane

2012-01-01

Fournier's gangrene is a rare and often fulminant necrotizing fasciitis of the perineum and genital region frequently due to a synergistic polymicrobial infection. This truly emergent condition is typically seen in elderly, diabetic, or otherwise immune-compromised individuals. Here, we report an unusual case of Fournier's gangrene due to excessive masturbation in an otherwise healthy 29-year-old male who presented to the emergency department complaining of two days of fever, vomiting, and diffuse myalgias. Upon further questioning, he also endorsed severe scrotal pain and swelling and frequent masturbation with soap as a lubricant resulting in recurrent penile erythema and minor skin abrasions. Examination of the patient's perineum was consistent with Fournier's gangrene and included significant erythema, edema, and calor of the penis and scrotum with a large malodorous eschar. He was given intravenous antibiotics and immunoglobulin and promptly underwent three surgical debridements of the scrotum and penis with split-thickness skin grafting. Complications from excessive masturbation are exceedingly rare, but as this case illustrates, they can be life threatening.

Fournier's Gangrene due to Masturbation in an Otherwise Healthy Male

PubMed Central

Heiner, Jason D.; Eng, Katisha D.; Bialowas, Todd A.; Devita, Diane

2012-01-01

Fournier's gangrene is a rare and often fulminant necrotizing fasciitis of the perineum and genital region frequently due to a synergistic polymicrobial infection. This truly emergent condition is typically seen in elderly, diabetic, or otherwise immune-compromised individuals. Here, we report an unusual case of Fournier's gangrene due to excessive masturbation in an otherwise healthy 29-year-old male who presented to the emergency department complaining of two days of fever, vomiting, and diffuse myalgias. Upon further questioning, he also endorsed severe scrotal pain and swelling and frequent masturbation with soap as a lubricant resulting in recurrent penile erythema and minor skin abrasions. Examination of the patient's perineum was consistent with Fournier's gangrene and included significant erythema, edema, and calor of the penis and scrotum with a large malodorous eschar. He was given intravenous antibiotics and immunoglobulin and promptly underwent three surgical debridements of the scrotum and penis with split-thickness skin grafting. Complications from excessive masturbation are exceedingly rare, but as this case illustrates, they can be life threatening. PMID:23326701

Structural and functional investigations of the murine cavernosal nerve: a model system for serial spatio-temporal study of autonomic neuropathy.

PubMed

Schaumburg, Herbert H; Zotova, Elena; Cannella, Barbara; Raine, Cedric S; Arezzo, Joseph; Tar, Moses; Melman, Arnold

2007-04-01

To illustrate the ultrastructural fibre composition of the rat cavernosal nerve at serial levels, from its origin in the main pelvic ganglion to its termination in the corpus cavernosum of the distal penile shaft, and to develop a technique that permits repeated electrophysiological recording from the fibres that form the cavernosal nerve distinct from the axons of the dorsal nerve of the penis (DNP). For the light microscope and ultrastructural studies, Sprague-Dawley rats were anaesthetized and the pelvic organs and lower limbs were perfused with glutaraldehyde through the distal aorta. Tissue samples were embedded in epoxy resin and prepared for light and electron microscopy. Frozen tissue was used for the immunohistochemical studies and sections were stained with rabbit anti-nitric oxide synthetase 1 (NOS1). For the electrophysiology, anaesthetized rats were used in sterile conditions. Nerve conduction velocity for the cavernosal nerve was assessed from a point 2 mm below the main (major) pelvic ganglion after stimulating the nerve at the crus penis; multi-unit averaging techniques were used to enhance the recording of slow-conduction activity. Recordings from the DNP were obtained over the proximal shaft after stimulation at the base of the penis. Step-serial sections of the cavernosal nerve revealed numerous ganglion cells in the initial segments and gradually fewer myelinated fibres at distal levels. At the point of crural entry, the nerve contained almost exclusively unmyelinated axons. As it descended the penile shaft, the nerve separated into small fascicles containing only one to four axons at the level of the distal shaft. In the corpus cavernosum, vesicle-filled presynaptic axon preterminals were close to smooth muscle fibres, but did not seem to be in direct contact. Immunohistochemical evaluation of NOS1 activity showed intense staining of the fibres of the DNP and most of the neurones in the main pelvic ganglion. There was also scattered NOS1 activity in the nerve bundles of the corpus cavernosum. Electrophysiology identified activity in C fibres on the cavernosal nerve and in Aalpha-Adelta fibres in the DNP. These results show that it is possible to perform integrated cavernosal pressure monitoring and ultrastructural and electrophysiological studies in this model. These yielded accurate data about the erectile status of the penis, and the state of unmyelinated and myelinated fibres in the DNP and cavernosal nerves of the same animal. This study provides a useful template for future studies of experimental diabetic autonomic neuropathy.

Black stone - a natural remedy for premature ejaculation and performance enhancement, or maybe not?

PubMed

Bush, Carly; O'Farrell, Nigel

2014-08-01

We describe the use of a non-prescribed aid (Black stone) for premature ejaculation that resulted in a chemical burn on the penis with an appearance similar to severe balanitis. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

The Prospects for Security Sector Reform in Tunisia: A Year After the Revolution

DTIC Science & Technology

2012-09-01

included.86 This single, easily accessible, and searchable resource for all laws and amendments pertaining to the secu- rity sector greatly enhances ...Reform of the Peni - tentiary System,” Geneva Centre for the Democratic Control of Armed Forces, DCAF-Tunisie, October 5, 2011, available from dcaf

What Gay, Bisexual and Other Men Who Have Sex with Men Need to Know about Sexually Transmitted Diseases

MedlinePlus

... receptive anal sex (been a “bottom”) in the past year; Chlamydia and gonorrhea of the penis if you ... a “top”) or received oral sex in the past year; Gonorrhea of the throat if you’ve performed ...

A case of penile gnathostomiasis in Thailand.

PubMed

Nitidandhaprabhas, P; Sirimachan, S; Charnvises, K

1978-11-01

A living young adult female Gnathostoma spinigerum 1.9 cm in length was extracted from a perforating hole on the left laterodorsal aspect of the proximal part of the inflamed glans penis of a 3-year-old Thai boy, the first such case to be recorded in the literature.

Learning the Language of Difference: The Dictionary in the High School.

ERIC Educational Resources Information Center

Willinsky, John

1987-01-01

Reports on dictionaries' power to misrepresent gender. Examines the definitions of three terms (clitoris, penis, and vagina) in eight leading high school dictionaries. Concludes that the absence of certain female gender-related terms represents another instance of institutionalized silence about the experience of women. (MM)

Orgasm During Intercourse: A Treatment Strategy for Women

ERIC Educational Resources Information Center

Zeiss, Antonette M.; And Others

1977-01-01

A six-step treatment program for women who are inorgasmic during intercourse is described. Teaches women to associate orgasms brought on by manual clitoral stimulation with arousing thoughts about intercourse and vaginal containment of a dildo. Learning is generalized to vaginal containment of the partner's penis and thrusting movements. (Author)

East Europe Report, Political, Sociological and Military Affairs, No. 2197

DTIC Science & Technology

1983-09-13

the secrets of someone else’s ideological penis . In- cidentally, those people are wrong who have already written about how Dr Muhic projects his...highly esteemed puberty potential and I take the liberty to recommend something to him. That is, it would be good if he turned to more serious

Gender Dysphoria and Sexual Abuse: A Case Report.

ERIC Educational Resources Information Center

Zucker, Kenneth J.; Kuksis, Myra

1990-01-01

A case report is presented in which an 11-year-old boy's desire to be a girl and to have his penis removed are shown to follow the initiation of sexual contact by his older brother. The boy's early history of moderate femininity may have made him vulnerable to gender identity conflict. (JDD)

ON THE SO-CALLED LATE OR THERAPEUTICAL RADIONECROSIS (in Italian)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Piemonte, M.

1960-01-01

Anatomical and clinical characteristics of the alteration known as late or therapeutical necrosis are reviewed and the most characteristical aspects of this alteration in various anatomical sites are discussed. Radionecroses of the tongue, of the palate, of the skin, of the uterus cervix, of the vulva, and of the penis are illustrated. (auth)

Exposed: Phallic Protections, Shame and Damaged Parental Objects

ERIC Educational Resources Information Center

Cregeen, Simon

2009-01-01

Using ideas derived from Dana Birksted-Breen ("Phallus, penis and mental space," "International Journal of Psycho-Analysis," 77: 649-57, 1996), this article explores the clinical experience with "Tommy," a young boy who suffered multiple traumas and neglect. Birksted-Breen describes a phallic state of mind, which, amongst other things, serves to…

A mixed infection of syphilis and chancroid.

PubMed

Lundquist, C D

1984-02-01

The clinical differentiation between a hard chancre and a soft chancre is well known to dermatologists. We present a patient with both a hard and a soft chancre developing on the penis. Thorough investigational studies should be made of all patients with venereal disease to determine whether more than one venereal disease is present.

Laser irradiation of penile blood as treatment of sexual dysfunctions

NASA Astrophysics Data System (ADS)

Koultchavenia, Ekaterina V.; Khomyakov, Victor T.

2001-05-01

40-60% of the men of average age suffer from the violations of sexual functions. Impotence doesn't make direct threat to life; nevertheless this disease essentially reduces quality of life, and consequently deserves the most steadfast attention. There are many methods of treatment of erectile dysfunction. However they are connected with a reception of medicines, which is expensive and has a number of contraindications, or with invasive procedures, or with surgical intervention, that also not always is desirable. We have developed the original device permitting to cause passive erection by creation of a local decompression. The second stage is the effect by an infrared laser radiation (denseness of a potency 4.2 mWt/sm2, continuous radiation with length of a wave 0.89 microns, exposition 5 minutes) on erection glans penis. We observed 24 patients with the complaints on insufficient erection (18), premature ejaculation (6); 2 patients in addition presented the complaint on small sizes of the penis. Age of the patients was 24-46 years, on the average 34.3 years. All have received treatment from 15 sessions in day.

[Hypertrophic adipose tissue transplantation secondary to a lipopenisculpture].

PubMed

Moullot, P; Nguyen, P-S; Philandrianos, C; Casanova, D

2014-10-01

Reconstruction of the penile skin requires a functional and esthetically perfect result, combining a high degree of skin elasticity to allow regular erections and a satisfactory cosmetic appearance. Demand for cosmetic surgery penile augmentation continues to increase for several years. The surgical technique most commonly used is now widening and lengthening lipopenisculpture (LPS), combining an adipocyte graft to a section of the suspensory ligament of the penis. A patient who underwent LPS presented several years after a major hypertrophy of the adipocyte graft, making it impossible to have sexual activities, imposing to perform liposuction. This liposuction was being complicated by necrosis of the penile skin. Reconstruction was required and consisted of an unexpanded thin skin graft associated with artificial dermis. Through technical adaptation of the skin graft on the erect penis, the use of artificial dermis and external stabilization by negative pressure therapy, reconstruction of the penile skin provides excellent aesthetic and functional results. Finally, it is rarely reported in the literature complications of lipofilling like alteration of the aesthetic result after weight gain. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Reconstruction of deformities resulting from penile enlargement surgery.

PubMed

Alter, G J

1997-12-01

More than 30 patients presented for reconstruction of penile deformities secondary to penile enlargement surgery performed by other physicians. Lengthening was performed by releasing the suspensory ligament of the penis and advancing pubic skin with a V-Y advancement flap. Girth was increased by injecting autologous fat. Specific complaints relating to the lengthening procedure involve hypertrophic and/or wide scars, a proximal penile hump from a thick, hair-bearing V-Y flap, and a low hanging penis. Complications relating to autologous fat injections include disappearance of fat, penile lumps and nodules, and shaft deformities. The repair of these deformities is described. From 1994 through October 1996, 19 men underwent 24 various combinations of reconstructive operations, such as scar revisions, V-Y advancement flap reversal, and removal of fat nodules and asymmetrical fat deposits. Penile appearance and function were improved. Complications include 1 hematoma requiring drainage, minor wound complications and 1 inadequately reversed V-Y flap. The methods of various repairs are discussed, including reconstructive limitations, timing and staging. Significant improvement can be achieved with proper reconstruction of penile deformities.

Penile length and circumference: an Indian study.

PubMed

Promodu, K; Shanmughadas, K V; Bhat, S; Nair, K R

2007-01-01

Apprehension about the normal size of penis is a major concern for men. Aim of the present investigation is to estimate the penile length and circumference of Indian males and to compare the results with the data from other countries. Results will help in counseling the patients worried about the penile size and seeking penis enlargement surgery. Penile length in flaccid and stretched conditions and circumference were measured in a group of 301 physically normal men. Erected length and circumference were measured for 93 subjects. Mean flaccid length was found to be 8.21 cm, mean stretched length 10.88 cm and circumference 9.14 cm. Mean erected length was found to be 13.01 cm and erected circumference was 11.46 cm. Penile dimensions are found to be correlated with anthropometric parameters. Insight into the normative data of penile size of Indian males obtained. There are significant differences in the mean penile length and circumference of Indian sample compared to the data reported from other countries. Study need to be continued with a large sample to establish a normative data applicable to the general population.

Taxonomic revision of the species of Parvanachis Radwin, 1968 (Gastropoda: Columbellidae) from the Gulf of Panama.

PubMed

de Maintenon, Marta J

2014-01-07

Species of Parvanachis Radwin, 1968 collected from the Gulf of Panama are anatomically characterized and taxonomically revised. Six species are reported to occur in the region: P. pygmaea (Sowerby, 1832), P. pardalis (Hinds, 1843), P. diminuta (C.B. Adams, 1852), P. albonodosa (Carpenter, 1857), P. milium (Dall, 1916), and P. dalli Bartsch, 1931. Of these six, three are confirmed as described. P. milium was not found in new collections or the previous survey collection and may be more common further south. P. dalli is a synonym of P. pygmaea; and P. albonodosa (auct.) is renamed, because the type material represents a different species. Two new species are described, P. dichroma and P. adamsi. P. pardalis, based on anatomy and shell and radular morphology, is referred to the genus Anachis, and Costoanachis nigricans (Sowerby, 1844), based on anatomy and shell morphology, is transferred to Parvanachis. The resulting seven species of Parvanachis constitute two groups; one (including the type species) with smaller shells and a simple penis morphology, and a group of four larger species with more complex penis morphology.