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Sample records for penile small arteries

  1. Involvement of large-conductance Ca(2+) -activated K(+) channels in both nitric oxide and endothelium-derived hyperpolarization-type relaxation in human penile small arteries

    DEFF Research Database (Denmark)

    Király, István; Pataricza, János

    2013-01-01

    Large-conductance Ca(2+) -activated K(+) channels (BKC a ), located on the vascular smooth muscle, play an important role in regulation of vascular tone. In penile corpus cavernosum tissue, opening of BKC a channels leads to relaxation of corporal smooth muscle, which is essential during erection; however, there is little information on the role of BKC a channels located in penile vascular smooth muscle. This study was designed to investigate the involvement of BKC a channels in endothelium-dependent and endothelium-independent relaxation of human intracavernous penile arteries. In human intracavernous arteries obtained in connection with transsexual operations, change in isometric force was recorded in microvascular myographs, and endothelium-dependent [nitric oxide (NO) and endothelium-derived hyperpolarization (EDH)-type] and endothelium-independent (NO-donor) relaxations were measured in contracted arteries. In penile small arteries contracted with phenylephrine, acetylcholine evoked NO- and EDH-type relaxations, which were sensitive to iberiotoxin (IbTX), a selective blocker of BKC a channels. Iberiotoxin also inhibited relaxations induced by a NO-donor, sodium nitroprusside. NS11021, a selective opener of BKC a channels, evoked pronounced relaxations that were inhibited in the presence of IbTX. NS13558, a BKC a -inactive analogue of NS11021, failed to relax human penile small arteries. Our results show that BKC a channels are involved in both NO- and EDH-type relaxation of intracavernous penile arteries obtained from healthy men. The effect of a selective opener of BKC a channels also suggests that direct activation of the channel may be an advantageous approach for treatment of impaired endothelium-dependent relaxation often associated with erectile dysfunction.

  2. Involvement of large-conductance Ca(2+) -activated K(+) channels in both nitric oxide and endothelium-derived hyperpolarization-type relaxation in human penile small arteries.

    Science.gov (United States)

    Király, István; Pataricza, János; Bajory, Zoltán; Simonsen, Ulf; Varro, András; Papp, Julius Gy; Pajor, Lászlo; Kun, Attila

    2013-07-01

    Large-conductance Ca(2+) -activated K(+) channels (BKC a ), located on the vascular smooth muscle, play an important role in regulation of vascular tone. In penile corpus cavernosum tissue, opening of BKC a channels leads to relaxation of corporal smooth muscle, which is essential during erection; however, there is little information on the role of BKC a channels located in penile vascular smooth muscle. This study was designed to investigate the involvement of BKC a channels in endothelium-dependent and endothelium-independent relaxation of human intracavernous penile arteries. In human intracavernous arteries obtained in connection with transsexual operations, change in isometric force was recorded in microvascular myographs, and endothelium-dependent [nitric oxide (NO) and endothelium-derived hyperpolarization (EDH)-type] and endothelium-independent (NO-donor) relaxations were measured in contracted arteries. In penile small arteries contracted with phenylephrine, acetylcholine evoked NO- and EDH-type relaxations, which were sensitive to iberiotoxin (IbTX), a selective blocker of BKC a channels. Iberiotoxin also inhibited relaxations induced by a NO-donor, sodium nitroprusside. NS11021, a selective opener of BKC a channels, evoked pronounced relaxations that were inhibited in the presence of IbTX. NS13558, a BKC a -inactive analogue of NS11021, failed to relax human penile small arteries. Our results show that BKC a channels are involved in both NO- and EDH-type relaxation of intracavernous penile arteries obtained from healthy men. The effect of a selective opener of BKC a channels also suggests that direct activation of the channel may be an advantageous approach for treatment of impaired endothelium-dependent relaxation often associated with erectile dysfunction. PMID:23414060

  3. Penile angiography and superselective embolization therapy in arterial priapism

    International Nuclear Information System (INIS)

    Purpose: To report feasibility, benefit and complications of penile angiography and superselective penile embolization in arterial priapism. Materials and Methods: Four consecutive patients (aged 28, 29, 40 and 49 years), who underwent penile angiography for arterial priapism (high-flow priapism) within a four-year period, were identified by a keyword search of our radiology information system. One patient had sustained a direct penile trauma (severe blow to the erected penis) and three patients suffered from recurrent spontaneous priapism. All patients had previously undergone corporeal aspiration and noradrenaline injection to achieve detumescence. Two patients had one or several unsuccessful spongiocavernous shunt procedures. Results: In three of the four patients, superselective pudendal and penile angiography demonstrated pathologic arteriocavernous shunting. In two of the three patients, superselective embolization using a coaxial micro-catheter was attempted. In one of the two patients, the cavernous artery became spastic before embolization material was actually injected, inducing immediate and lasting detumescence. In the other patient, unilateral Gelfoam embolization led to immediate detumescence but the priapism recurred 12 hours after the procedure. A subsequent contralateral Gelfoam embolization was successful. Erectile function was preserved in all cases. No procedure-related complications occurred. Conclusion: Our experience supports the prevailing opinur experience supports the prevailing opinion found in the current literature that superselective coaxial embolization constitutes the treatment of choice in patients with high-flow priapism. Prognosis is good with high probability of preserving the erectile function. (orig.)

  4. Flow-Evoked Vasodilation Is Blunted in Penile Arteries from Zucker Diabetic Fatty Rats

    DEFF Research Database (Denmark)

    SchjØrring, Olav; Kun, Attila

    2012-01-01

    Introduction.? Endothelium-derived relaxing factors such as nitric oxide (NO), prostanoids, and endothelium-derived hyperpolarizing factor (EDHF) are thought to play an important role in vasodilation of penile arteries. Aim.? The present study investigated the mechanisms involved in flow- and acetylcholine-induced vasodilation in penile arteries, and whether acetylcholine- and flow-mediated vasodilation is altered in Zucker diabetic fatty (ZDF) rats, a model of type 2 diabetes. Moreover, it was addressed whether enhanced myogenic tone may explain impaired flow-evoked vasodilation in arteries from ZDF rats. Methods.? Penile dorsal arteries obtained from lean control and ZDF rats were suspended in a pressure myograph, and flow- and acetylcholine-evoked vasodilation was measured as changes in arterial diameter. Main Outcome Measure.? Changes in penile arterial diameter. Results.? Incubation with an inhibitor of NO synthase, asymmetric dimethyl-L-arginine (ADMA), and of cyclooxygenase, indomethacin, reduced acetylcholine but not flow-evoked vasodilation in penile arteries, while both responses were abolished by endothelial cell removal. Iberiotoxin, a blocker of large-conductance calcium-activated K(+) (BK(Ca) ) channels, inhibited flow-evoked vasodilation. Flow-evoked vasodilation was reduced in arteries from ZDF rats in the absence, but not in the presence, of indomethacin plus ADMA. Elevation of intraluminal pressure increased myogenic tone, which was reduced in arteries from ZDF rats. Conclusion.? The present findings show that flow evokes endothelium-dependent EDHF-type vasodilation involving BK(Ca) channels in penile arteries. Flow-evoked vasodilation is reduced and only of EDHF-type in penile arteries from type 2 diabetic rats suggesting modulation of this pathway may restore endothelial function and preserve erection in diabetes. Schjørring O, Kun A, Flyvbjerg A, Kirkeby HJ, Jensen JB, and Simonsen U. Flow-evoked vasodilation is blunted in penile arteries from Zucker diabetic fatty rats. J Sex Med **;**:**-**.

  5. Correlation between penile cavernosal artery blood flow and retinal vascular findings in arteriogenic erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Ahmed M Emarah

    2010-09-01

    Full Text Available Ahmed M Emarah1, Shawky M El-Haggar2, Ihab A Osman2, Abdel Wahab S Khafagy21Departments of Ophthalmology, 2Andrology and Sexology, Cairo University Hospital, EgyptObjectives: Arteriogenic erectile dysfunction (ED is a target organ disease of atherosclerosis, and therefore might be a predictor of systemic atherosclerosis. Being systemic, it might be possible to evaluate the extent of atherosclerosis from retinal vascular findings. We investigated the possible correlation between penile cavernosal artery blood flow and retinal vascular findings in patients with arteriogenic ED.Patients and methods: Sixty patients with ED were divided according to the peak systolic velocity (PSV in their penile cavernosal arteries into two groups; Group A included 30 patients with PSV less than 25 cm/sec, and Group B included 30 patients with PSV more than 35 cm/sec. Blood flow in the penile cavernosal artery was measured with color Doppler ultrasonography. All patients were assessed by ocular fundus examination under amydriatic conditions to evaluate retinal vascular atherosclerotic changes using Hyman’s classification.Results: Evidence of retinal vascular atherosclerotic changes was found in 19 patients (63.3% in Group A and in 10 patients (33.3% in Group B.Conclusions: Our study confirms the possibility of predicting penile arterial vascular status in patients with ED from their retinal vascular findings by using amydriatic simple, practical funduscopy.Keywords: erectile dysfunction, atherosclerosis, retinal vascular atherosclerosis

  6. Penile size and the 'small penis syndrome'.

    Science.gov (United States)

    Wylie, Kevan R; Eardley, Ian

    2007-06-01

    The male is often troubled by concerns that his penis is not large enough to satisfy his partner or himself. He is ashamed to have others view his penis, especially in the flaccid state. Such concerns might be unfounded in reality and might be a presentation of social anxiety or some other clinical problem, such as erectile dysfunction. Concern over the size of the penis, when such concern becomes excessive, might present as the 'small penis syndrome', an obsessive rumination with compulsive checking rituals, body dysmorphic disorder, or as part of a psychosis. However, it is often a worry that can be described as within the normal experience of many men. Various potential causal factors are considered. A thorough assessment, normalizing the worry and then exploring the treatment options in detail with the man, is essential to allow the matter to be consolidated satisfactorily within the male ego. PMID:17355371

  7. Microsurgical reimplantantion of a self-amputated penis with anastomosis of a single deep dorsal penile artery: Case report

    Directory of Open Access Journals (Sweden)

    Necati Gürbüz

    2009-01-01

    Full Text Available Microsurgical penile reimplantation was performed in a 24 years old man with chronic schizophrenia after a complete penile self-amputation. Urethra, corpora cavernosa and right deep dorsal penile artery were anastomosed microsurgically 6 hours after trauma. Skin necrosis on postoperative day 4 and distal urethral defect at the end of the first week developed. Necrotic tissues were debrided and a free skin graft was laid on the defect. During long-term follow-up, there was a distal urethral defect which was 1.5 cm in length, the sensation was decreased on distal penile shaft and glans and penile length was also shortened. The patient had morning erections, but he has not attempted sexual intercourse. We have observed rigid erection continuing for 10 minutes with combined injection stimulation test.

  8. Revascularization surgery for penile calciphylaxis.

    Science.gov (United States)

    Akai, Atsushi; Okamoto, Hiroyuki; Shigematsu, Kunihiro; Miyata, Tetsuro; Watanabe, Toshiaki

    2013-12-01

    Calciphylaxis, a systemic disorder seen in 1%-4% of patients with end-stage renal disease, is a cause of penile ischemic gangrene. We present a case of successful revascularization surgery for penile calciphylaxis. An arterial bypass to the deep dorsal penile vein relieved the rest pain and stopped expansion of the gangrenous lesion. PMID:23571078

  9. Evolution of penile prosthetic devices.

    Science.gov (United States)

    Le, Brian; Burnett, Arthur L

    2015-03-01

    Penile implant usage dates to the 16th century yet penile implants to treat erectile dysfunction did not occur until nearly four centuries later. The modern era of penile implants has progressed rapidly over the past 50 years as physicians' knowledge of effective materials for penile prostheses and surgical techniques has improved. Herein, we describe the history of penile prosthetics and the constant quest to improve the technology. Elements of the design from the first inflatable penile prosthesis by Scott and colleagues and the Small-Carrion malleable penile prosthesis are still found in present iterations of these devices. While there have been significant improvements in penile prosthesis design, the promise of an ideal prosthetic device remains elusive. As other erectile dysfunction therapies emerge, penile prostheses will have to continue to demonstrate a competitive advantage. A particular strength of penile prostheses is their efficacy regardless of etiology, thus allowing treatment of even the most refractory cases. PMID:25763121

  10. Evolution of penile prosthetic devices

    Science.gov (United States)

    Burnett, Arthur L.

    2015-01-01

    Penile implant usage dates to the 16th century yet penile implants to treat erectile dysfunction did not occur until nearly four centuries later. The modern era of penile implants has progressed rapidly over the past 50 years as physicians' knowledge of effective materials for penile prostheses and surgical techniques has improved. Herein, we describe the history of penile prosthetics and the constant quest to improve the technology. Elements of the design from the first inflatable penile prosthesis by Scott and colleagues and the Small-Carrion malleable penile prosthesis are still found in present iterations of these devices. While there have been significant improvements in penile prosthesis design, the promise of an ideal prosthetic device remains elusive. As other erectile dysfunction therapies emerge, penile prostheses will have to continue to demonstrate a competitive advantage. A particular strength of penile prostheses is their efficacy regardless of etiology, thus allowing treatment of even the most refractory cases. PMID:25763121

  11. Comparison of digital subtraction angiography, CT angiography, and ultrasonic doppler examination in the evaluation of penile arterial lesions

    International Nuclear Information System (INIS)

    CT angiography reconstructed by a multidetector-row helical CT scanner is a newly developed form of imaging. We compared CT angiography and ultrasonic Doppler examination with digital subtraction angiography (DSA) in the diagnosis of arterial lesion. Eighteen patients with arteriogenic erectile dysfunction (ED) underwent color Doppler study DSA, and CT angiography after providing informed consent. The CT angiography images were obtained by a multidetector-row helical CT scanner, Asteion TSX021A (TOSHIBA). We injected prostaglandin E1 into the penile cavernous body, and then rapidly infused nonionic contrast medium into the antecubital vein. DSA and CT angiography images of the bilateral internal pudendal arteries and cavernous arteries were examined for stenotic lesions or occlusion. We also compared the peak systolic blood flow velocity in the cavernous artery measured by color Doppler ultrasound with CT angiography and DSA. The CT anigography and color Doppler studies were performed on an outpatient basis, but DSA required hospitalization. In the 36 internal pudendal arteries, DSA represented 22 normal arteries and 14 stenosis or occlusions. CT angiography showed 15 normal arteries and 21 occlusions. For the diagnosis of stenosis or occlusion in the internal pudendal artery, the CT angiography image had a good agreement, with a sensitivity of 1.00, specificity of 0.68, and accuracy of 0.81. For diagnosis in the cavernous artery, CT angiography image also vernous artery, CT angiography image also showed a good agreement with DSA; however, the quality of the images of fine arteries was better in the DSA images. The inferior view and internal view of the pelvis in CT angiography were helpful for visulaizing the internal pudendal artery, especially at the pubic bone. There was insufficient correlation between peak systolic blood flow velocity and DSA findings. There were no serious complications involved in either examination. CT angiography has not yet reached the same level as DSA in the evaluation of fine arteries. However, CT angiography can produced images sufficient for the diagnosis of arteriogenic ED with some advantages. We believe that with improvement, CT angiography will become an adequate replacement for DSA in the diagnosis of penile arterisl lision. (author)

  12. Penile abnormalities

    Directory of Open Access Journals (Sweden)

    Yunus Söylet

    2010-05-01

    Full Text Available Hypospadias is a congenital development anomaly of penis. The meatus is located in between glans penis and perineum. Frenulum is absent. The glans does not fuse on the ventral side. Ventral preputial development is incomplete. There is usually associated a variable degree of chordee. Hypospadias is classifed according to level of meatus. Severe hypospadias and chordee, bilateral undescended testis, small penis may be the signs of a sexual development disorder and further diagnostic evaluation is indicated. Circumcision without repair of hypospadias is contraindicated. Surgical correction of hypospadias should be completed by 15 months of age. Epispadias, penile agenesis, diphallia, penile torsion, penoscrotal fusion, concealed penis, micropenis, priapism and penoscrotal transposition are the other penile anomalies. This section is basically written for the diagnosis of penile anomalies and associated malformations, timing of surgery and to give take home messages for the pediatricians. Surgical correction of penile anomalies requires experiences in the field of pediatric urology and it is performed by Pediatric Surgeons and Pediatric Urologists. (Turk Arch Ped 2010; 45 Suppl: 94-9

  13. Penile angiography and superselective embolization therapy in arterial priapism; Penisangiographie und superselektive Embolisationstherapie bei high-flow Priapismus

    Energy Technology Data Exchange (ETDEWEB)

    Dinkel, H.P.; Triller, J. [Inst. fuer Diagnostische Radiologie, Inselspital, Univ. Bern (Switzerland); Hochreiter, W. [Urologische Klinik, Inselspital, Univ. Bern (Switzerland)

    2003-08-01

    Purpose: To report feasibility, benefit and complications of penile angiography and superselective penile embolization in arterial priapism. Materials and Methods: Four consecutive patients (aged 28, 29, 40 and 49 years), who underwent penile angiography for arterial priapism (high-flow priapism) within a four-year period, were identified by a keyword search of our radiology information system. One patient had sustained a direct penile trauma (severe blow to the erected penis) and three patients suffered from recurrent spontaneous priapism. All patients had previously undergone corporeal aspiration and noradrenaline injection to achieve detumescence. Two patients had one or several unsuccessful spongiocavernous shunt procedures. Results: In three of the four patients, superselective pudendal and penile angiography demonstrated pathologic arteriocavernous shunting. In two of the three patients, superselective embolization using a coaxial micro-catheter was attempted. In one of the two patients, the cavernous artery became spastic before embolization material was actually injected, inducing immediate and lasting detumescence. In the other patient, unilateral Gelfoam embolization led to immediate detumescence but the priapism recurred 12 hours after the procedure. A subsequent contralateral Gelfoam embolization was successful. Erectile function was preserved in all cases. No procedure-related complications occurred. Conclusion: Our experience supports the prevailing opinion found in the current literature that superselective coaxial embolization constitutes the treatment of choice in patients with high-flow priapism. Prognosis is good with high probability of preserving the erectile function. (orig.) [German] Ziel: Untersuchung der Interventionsmoeglichkeiten bei arteriellem (high-flow) Priapismus durch endovaskulaere superselektive Embolisation der Penisarterien. Methode: Alle innerhalb eines Vierjahreszeitraums (1/99-5/2002) wegen Priapismus zur Angiographie zugewiesenen Patienten wurden erfasst. Eine elektronische RIS-Abfrage ergab vier Maennern im Alter von 28, 29, 40 und 49 Jahren. Bei einem Patienten lag anamnestisch ein peniles Trauma vor; bei drei Patienten bestand ein spontaner, rezidivierender Priapismus. Bei allen Patienten wurden zunaechst eine kavernoese Blutaspiration und intrakavernoese Noradrenalininjektionen durchgefuehrt, um eine Detumeszenz zu erreichen. Zwei Patienten hatten zuvor eine oder mehrere frustrane kavernosospongioese Shuntprozeduren. Ergebnisse: Bei drei von vier Maennern wurde angiographisch eine pathologische arterio-kavernoese Hyperperfusion nachgewiesen. Zwei Patienten wurden durch superselektive Embolisation behandelt. Dabei kam es allerdings in einem Fall vor der Einbringung des Embolisats zu einem spastischen Verschluss der A. profunda penis (A. cavernosa), wodurch umgehend eine dauerhafte Detumeszenz erzielt wurde. Bei einem weiteren Patienten wurde die A. profunda penis rechts mit Gelfoam embolisiert, wodurch die Detumeszenz erreicht wurde; am Folgetag kam es zu einem Rezidiv, das durch kontralaterale arteriokavernoese Hyperperfusion bedingt war und mit einer linksseitigen Teilembolisation erfolgreich behandelt wurde. Postinterventionell blieb die Erektionsfaehigkeit jeweils vollstaendig erhalten. Schlussfolgerung: Unsere Erfahrungen bestaetigen die in der Literatur vorherrschende Meinung, dass die transarterielle Katheterembolisation als Therapieverfahren der Wahl beim arteriellen Priapismus betrachtet werden darf. Die Prognose des arteriellen Priapismus ist gut bei hoher Chance des volstaendigen Erhalts der erektilen Funktion. (orig.)

  14. Calciphylaxis: Temporal Artery Calcification Preceding Widespread Skin Lesions and Penile Necrosis

    OpenAIRE

    Shah, Manzoor A.; Roppolo, Michael W.

    2012-01-01

    Temporal artery calciphylaxis has rarely been described in chronic kidney disease patients on dialysis. We report a case of 72-year-old Caucasian man with multiple comorbidities and end-stage renal disease on dialysis who presented with temporal artery calcification leading to bilateral loss of vision followed by extensive skin lesions including one on glans penis. While on peritoneal dialysis, he developed anterior ischemic optic neuropathy, had no improvement on high dose steroids, and temp...

  15. Penile prostheses

    OpenAIRE

    Bettocchi, Carlo; Palumbo, Fabrizio; Spilotros, Marco; Palazzo, Silvano; Saracino, Gabriele A.; Martino, Pasquale; Battaglia, Michele; Selvaggi, Francesco P.; Ditonno, Pasquale

    2010-01-01

    Penile prosthesis implantation is recognized as a valid option to obtain an artificial erection satisfactory for sexual intercourse in those patients in which a pharmacological approach is contraindicated or ineffective. Penile prostheses are subbject to continuous development and they are achieving ever better mechanical reliability and safety. The devices are divided into two g...

  16. Penile embryology and anatomy.

    Science.gov (United States)

    Yiee, Jenny H; Baskin, Laurence S

    2010-01-01

    Knowledge of penile embryology and anatomy is essential to any pediatric urologist in order to fully understand and treat congenital anomalies. Sex differentiation of the external genitalia occurs between the 7th and 17th weeks of gestation. The Y chromosome initiates male differentiation through the SRY gene, which triggers testicular development. Under the influence of androgens produced by the testes, external genitalia then develop into the penis and scrotum. Dorsal nerves supply penile skin sensation and lie within Buck's fascia. These nerves are notably absent at the 12 o'clock position. Perineal nerves supply skin sensation to the ventral shaft skin and frenulum. Cavernosal nerves lie within the corpora cavernosa and are responsible for sexual function. Paired cavernosal, dorsal, and bulbourethral arteries have extensive anastomotic connections. During erection, the cavernosal artery causes engorgement of the cavernosa, while the deep dorsal artery leads to glans enlargement. The majority of venous drainage occurs through a single, deep dorsal vein into which multiple emissary veins from the corpora and circumflex veins from the spongiosum drain. The corpora cavernosa and spongiosum are all made of spongy erectile tissue. Buck's fascia circumferentially envelops all three structures, splitting into two leaves ventrally at the spongiosum. The male urethra is composed of six parts: bladder neck, prostatic, membranous, bulbous, penile, and fossa navicularis. The urethra receives its blood supply from both proximal and distal directions. PMID:20602076

  17. Penile Trauma

    Science.gov (United States)

    ... of penile injuries each year. How Does the Penis Normally Work? Male Reproductive Organs Medical Illustration Copyright © ... All rights reserved The main roles of the penis are to carry urine and sperm out of ...

  18. Erectile dysfunction after radiotherapy for prostate cancer and radiation dose to the penile structures: A critical review

    International Nuclear Information System (INIS)

    Erectile dysfunction (ED) is a common sequela after external beam radiotherapy and brachytherapy for prostate cancer. There are several structures in the vicinity of the prostate that are critical to erectile function and that receive a substantial radiation dose: neurovascular bundles (NVBs), internal pudendal arteries (IPAs), accessory pudendal arteries, corpora cavernosa and the penile bulb. Most reports analyzing the correlation between radiation dose to these structures and radiation-induced ED are limited by the small number of patients analyzed in each study. So far, there is no evidence for a role of the NVBs in radiation-induced ED. There are no reports on the IPAs, based on reduced arterial flow in the penis. Several studies show contradicting results on the corpora cavernosa, which house the erectile tissue required for erection. There are contradicting reports on the penile bulb, although studies with more patients tend not to find any correlation. Sparing of the penile bulb to improve potency-preservation is not sufficiently supported by the current literature. If sparing of the penile bulb is achieved by reducing the margin for the apex, an oncological risk is taken, while it is uncertain whether this will improve potency-preservation

  19. Chronic penile strangulation

    Directory of Open Access Journals (Sweden)

    Lopes Roberto I

    2003-01-01

    Full Text Available Chronic penile strangulation is exceedingly rare with only 5 cases previously reported. We report an additional case of progressive penile lymphedema due to chronic intermittent strangulation caused by a rubber band applied to the penile base for 6 years. A 49-year-old man presented incapacity to exteriorize the glans penis. For erotic purposes, he had been using a rubber-enlarging band placed in the penile base for 6 years. With chronic use, he noticed that his penis swelled. Physical examination revealed lymphedema of the penis, phimosis and a stricture in the penile base. The patient was submitted to circumcision and the lymphedema remained stable 10 months postoperatively. Chronic penile incarceration usually causes penile lymphedema and urinary disturbance. Treatment consists of removal of foreign devices and surgical treatment of lymphedema.

  20. Chronic penile strangulation

    Scientific Electronic Library Online (English)

    Roberto I, Lopes; Silvia I, Lopes; Roberto N, Lopes.

    2003-08-01

    Full Text Available Chronic penile strangulation is exceedingly rare with only 5 cases previously reported. We report an additional case of progressive penile lymphedema due to chronic intermittent strangulation caused by a rubber band applied to the penile base for 6 years. A 49-year-old man presented incapacity to ex [...] teriorize the glans penis. For erotic purposes, he had been using a rubber-enlarging band placed in the penile base for 6 years. With chronic use, he noticed that his penis swelled. Physical examination revealed lymphedema of the penis, phimosis and a stricture in the penile base. The patient was submitted to circumcision and the lymphedema remained stable 10 months postoperatively. Chronic penile incarceration usually causes penile lymphedema and urinary disturbance. Treatment consists of removal of foreign devices and surgical treatment of lymphedema.

  1. Sonographic evaluation of penile in patients with erectile dysfunction

    International Nuclear Information System (INIS)

    A review of the current state of knowledge is made on sonographic evaluation of penile in patients with erectile dysfunction. This sonography is developed with high resolution ultrasound on gray scale, combined with color Doppler ultrasonography; which the arteries of penile are examined before and during the erection. The penile ultrasonography has meant an important tool in the evaluation of specific patients who have submitted erectile dysfunction, particularly, in those with record of trauma and history of Peyronie's disease. In addition, through a sonographic evaluation has permitted to prove manifestations of the pathophysiological phenomena of the patient in order to establish their classification and guide their treatment

  2. 'Variant' angina: Evidence for small vessel coronary artery spasm

    International Nuclear Information System (INIS)

    A unique case of 'variant' angina pectoris has been observed in a patient with normal coronary arteries and typical chest pain appearing spontaneously at rest, and repeatedly provoked by ergonovine maleate (0.1 mg iv) associated with large transmural perfusion defects on 201TI-imaging (after ergonovine) and a marked increase in T wave voltage despite no demonstrable spasm of a major coronary artery after the same doses of ergonovine. While saline solution could not provoke chest pain and treatment with a beta-blocking agent increased the frequency of ischemic attacks, a calcium antangonist therapy reduced and eventually eliminated the attacks. Thus, this case provides evidence for yet another aspect of a 'variant' form of angina pectoris: small vessel coronary artery spasm. (orig.)

  3. Genetic fuzzy system predicting contractile reactivity patterns of small arteries

    DEFF Research Database (Denmark)

    Tang, J; Sheykhzade, Majid

    2014-01-01

    Monitoring of physiological surrogate end points in drug development generates dynamic time-domain data reflecting the state of the biological system. Conventional data analysis often reduces the information in these data by extracting specific data points, thereby discarding potentially useful information. We developed a genetic fuzzy system (GFS) algorithm that is capable of learning all information in time-domain physiological data. Data on isometric force development of isolated small arteries were used as a framework for developing and optimizing a GFS. GFS performance was improved by several strategies. Results show that optimized fuzzy systems (OFSs) predict contractile reactivity of arteries accurately. In addition, OFSs identified significant differences that were undetectable using conventional analysis in the responses of arteries between groups. We concluded that OFSs may be used in clustering or classification tasks as aids in the objective identification or prediction of dynamic physiological behavior.

  4. Superficial temporal artery to middle cerebral artery double bypass via a small craniotomy: technical note.

    Science.gov (United States)

    Yoshimura, Shinichi; Egashira, Yusuke; Enomoto, Yukiko; Yamada, Kiyofumi; Yano, Hirohito; Iwama, Toru

    2010-01-01

    Frontotemporal craniotomy is usually necessary to perform superficial temporal artery (STA)-middle cerebral artery (MCA) double bypass for cerebrovascular occlusive disease. This report describes a less invasive technique of double bypass through a small craniotomy with minimum skin incision. Thirty-four consecutive patients underwent an elective STA-MCA double bypass via a small craniotomy from January 2006 to October 2009. The parietal and frontal branches of the STA were divided through a minimum linear or y-shaped skin incision, and these branches were anastomosed to the supra- and infrasylvian portions of the MCA. No periprocedural complication such as subdural hematoma or cutaneous necrosis occurred. Postoperative cerebral angiography within 6 months showed that the bypasses were patent in all 34 patients. Double STA-MCA bypass via a small craniotomy might be less invasive, especially for patients at high risk for postoperative hemorrhagic complication or cutaneous necrosis. PMID:21030817

  5. Penil kalcifylaksi

    DEFF Research Database (Denmark)

    Kjaerskov, Mette Wanscher; Comstedt, Lisbeth Rosholm

    2009-01-01

    A 64-year-old diabetic man on peritoneal dialysis developed painful necrotic ulcers of the glans penis over a period of six months. On suspicion of atherosclerotic necrosis, a partial resection of his penis was performed. Histological examination showed calciphylaxis. This vasculopathy with calcification and intimal fibrosis in small blood vessels is mostly seen in patients with end-stage renal disease. The condition is characterized by painful livedoid and infiltrated plaques and ulcers. Involvement of the penis is rare, but probably underdiagnosed. Udgivelsesdato: 2009-May-25

  6. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... 32 J. FRANCOIS EID, MD: I do between 250 to 300 a year. 00:17:35 IRWIN ... last 300 penile prostheses. All of these were Titan three-piece penile prostheses, so what you’re ...

  7. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... the same – that is, placement of a penile prosthetic device in the two erection chambers of the ... the opportunity for infection, the most feared penile prosthetic complication. On my immediate left is Dr. Francois ...

  8. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... 00:10 ANNOUNCER: Over the next hour you’ll see a live panel discussion of penile implant ... could do that for penile implants, maybe we’ll decrease our infection rates.” And I started looking ...

  9. Calciphylaxis leading to penile necrosis.

    Science.gov (United States)

    Haider, Imran; Siddiqui, Muhammad; Naji, Wisam; Sheikh, Maria; Waqar, Ayesha

    2014-06-01

    Penile gangrene is a rare disease. It represents a poor prognostic sign in end stage renal disease (ESRD) patients and an indicator of metastatic vascular calcification. Pathogenesis of this life threatening condition is not clearly understood and treatment is also controversial. We describe the case of a 61-year-old man known to have diabetes mellitus, chronic renal failure on haemodialysis, who was complaining of worsening groin pain for 4 weeks. On examination dry gangrene of glans penis was noted. Cultures from the penis showed multiple organisms. Computed tomography (CT) showed diffuse calcification of external and internal iliac arteries. Later, he developed caciphylaxis of right anterior thigh. His overall condition did not improve in spite of adequate antibiotics and he was shifted to intensive care unit (ICU) where he required high doses of vasopressors. Clinically he kept deteriorating and passed away due to septic shock. PMID:25252499

  10. Penile metastasis from rectal carcinoma

    Directory of Open Access Journals (Sweden)

    Murhekar K

    2007-01-01

    Full Text Available Penile metastases are infrequent and often originate from genitor-urinary organs including bladder and prostate. In the present communication, we report an unusual case of penile metastasis from rectal adenocarcinoma. Though uncommon, this presentation is not unknown. A review of literature of penile metastases in colorectal cancers is also summarized here.

  11. Development of Small Diameter Nanofiber Tissue Engineered Arterial Grafts

    Science.gov (United States)

    Tara, Shuhei; Rocco, Kevin A.; Bagi, Paul S.; Yi, Tai; Udelsman, Brooks; Zhuang, Zhen W.; Cleary, Muriel; Iwakiri, Yasuko; Breuer, Christopher K.; Shinoka, Toshiharu

    2015-01-01

    The surgical repair of heart and vascular disease often requires implanting synthetic grafts. While synthetic grafts have been successfully used for medium-to-large sized arteries, applications for small diameter arteries (polylactic acid nanofibers with inner luminal diameter between 0.5 and 0.6 mm were surgically implanted as infra-renal aortic interposition conduits in 25 female C17SCID/bg mice. Twelve mice were given sham operations. Survival of mice with TEVG grafts was 91.6% at 12 months post-implantation (sham group: 83.3%). No instances of graft stenosis or aneurysmal dilatation were observed over 12 months post-implantation, assessed by Doppler ultrasound and microCT. Histologic analysis of explanted TEVG grafts showed presence of CD31-positive endothelial monolayer and F4/80-positive macrophages after 4, 8, and 12 months in vivo. Cells positive for ?-smooth muscle actin were observed within TEVG, demonstrating presence of smooth muscle cells (SMCs). Neo-extracellular matrix consisting mostly of collagen types I and III were observed at 12 months post-implantation. PCR analysis supports histological observations. TEVG group showed significant increases in expressions of SMC marker, collagen-I and III, matrix metalloproteinases-2 and 9, and itgam (a macrophage marker), when compared to sham group. Overall, patency rates were excellent at 12 months after implantation, as structural integrity of these TEVG. Tissue analysis also demonstrated vessel remodeling by autologous cell. PMID:25830942

  12. Radioisotope penile plethysmography: Technique for evaluating corpora cavernosal blood flow during early tumescence in patients with erectile dysfunction

    International Nuclear Information System (INIS)

    Radioisotope penile plethysmography is a new adaptation of technetium-labeled red blood cell imaging. It is designed to assess penile corpora cavernosal blood flow during early tumescence in patients with erectile dysfunction. Peak corporal flow rates and volume changes in the penis were analyzed and compared with arterial integrity (arteriography) and venous-sinusoidal competence (cavernosometry). Peak corporal flow rates correlated most accurately with arterial integrity (r =.01). No significant correlation was identified with venous leakage variables (r =.01) The significant correlation of peak corporal flow and arteriography suggests that radioisotope penile plethysmography may assist in the evaluation of arterial inflow disorders in patients with erectile dysfunction

  13. Overview of Contemporary Penile Rehabilitation Therapies

    Directory of Open Access Journals (Sweden)

    Run Wang

    2008-09-01

    Full Text Available Introduction. Post-prostatectomy erectile dysfunction affects a considerable number of men and is a significant quality of life issue. There has been a substantial amount of research on the treatment of post-prostatectomy ED, and now there is a rising interest in the concept of penile rehabilitation. The goal of penile rehabilitation is to moderate the destructive processes that occur after prostatectomy in order to preserve erectile function, either through spontaneous or assisted means. Methods. We reviewed published data and experiences of post-prostatectomy penile rehabilitation using regimented interventions of phosphodiesterase inhibitors, vacuum erectile device, and intracavernosal agents, and we present and analyze the research conducted. Results. These studies show improved objective and subjective clinical outcomes in regards to physical parameters, sexual satisfaction, and rates of spontaneous erections. Conclusion. These studies are often limited by small size, study period, and study design. There continues to be a need for large, randomized, placebo controlled trials with adequate followup to fully evaluate the efficacy and cost-effectiveness of the various proposed penile rehabilitation regiments before a clear standard can be established.

  14. Penile Corporeal Reconstruction during Difficult Placement of a Penile Prosthesis

    OpenAIRE

    Aboseif, Sherif R.; Kim, Dennis H; Timothy F. Lesser; Viet Q. Tran

    2008-01-01

    For some patients with impotence and concomitant severe tunical/corporeal tissue fibrosis, insertion of a penile prosthesis is the only option to restore erectile function. Closing the tunica over an inflatable penile prosthesis in these patients can be challenging. We review our previous study which included 15 patients with severe corporeal or tunical fibrosis who underwent corporeal reconstruction with autologous rectus fascia to allow placement of an inflatable penile prosthesis. At a mea...

  15. An HIV-negative penil Kaposi's sarcoma.

    Science.gov (United States)

    Demir, A; Temiz, Y; Bozkurt, S U; Erbarut, I; Ilker, Y

    2004-01-01

    Kaposi's sarcoma is a tumour of reticuloendothelial system. Non-epidemic Kaposi's sarcoma limited to the penile involvement should be aggressively treated because it is rarely associated with diffuse organ involvement localized surgical excision or small-field external beam or electron beam radiation has been effective. In this case, we presented a man 53 years old, who presents with a papular indolent lesion on the glans penis, which is reported as a Kaposi sarcoma after excision of the lesion. PMID:15787336

  16. Primary Undifferentiated Penile Sarcoma in Adolescence

    OpenAIRE

    Choi, Young Hoon; Kim, Hyeon Woo; Ahn, Jae Hyun; Hwang, Dae Sung; Lee, Jung Woo; Lee, Byung Ki; Jun, So Eun; Lim, Young Tak; Lee, Sang Don; Ha, Hong Koo

    2012-01-01

    We report a case of primary penile undifferentiated sarcoma. A 16-year-old adolescent man visited Pusan National University Hospital complaining of a painless mass on his penis that was increasing in size. Magnetic resonance images revealed a 5×5-cm mass and pathological examinations revealed small round cell sarcomas with neuroendocrine differentiation. The tumor, which had metastatic pulmonary nodules, was treated by tumorectomy and systemic chemotherapy. Thirty-four months after the initia...

  17. Pulsed and Color Doppler Sonographic Findings of Penile Mondor' Disease

    Energy Technology Data Exchange (ETDEWEB)

    Han, Hye Yeon; Chung, Dong Jin; Kim, Kum Won; Hwang, Cheol Mog [University of Konyang School of Medicine, Daejeon (Korea, Republic of)

    2008-04-15

    Penile Mondor's disease is a rare disease that's characterized by thrombosis in the dorsal vein of the penis. Doppler ultrasonography (US) clearly visualizes dorsal vein thrombosis and the associated hemodynamic alterations. Previous studies have demonstrated the typical color Doppler US findings of superficial dorsal vein thrombosis without the flow signals in this area, yet this is insufficient to understand the hemodynamics in penile Mondor's disease. We report here for the first time a cavernosal artery flow signal pattern in a penile Mondor's disease patient, in addition to its previously reported classic US findings. In conclusion, the Doppler US findings of thrombus without blood flow in the superficial dorsal vein and the low-flow, high resistance in the cavernosal artery may be suggestive of penile Mondor's disease.

  18. Management of penile fractures

    International Nuclear Information System (INIS)

    Objective was to present our experience with surgical and conservative management of penile fracture. This prospective study was carried out in the Urology and Nephrology Center, at Al-Thawra General and Teaching Hospital, Sana'a, Yemen from June 2003 to September 2007 and included 30 patients presenting with penile fracture. Diagnosis was made clinically in all our patients. Six patients with simple fracture were treated conservatively while 24 patients with more severe injuries were operated upon. Patient's age ranged from 24-52 years (mean 31.3 years) 46.7% of patients were under the age of 30 years and 56.7% were unmarried. Hard manipulation of the erect penis for example during masturbation was the most frequent mechanism of fracture in 53.3% of patients. Solitary tear was found in 22 patients and bilateral corporal tears associated with urethral injury were found in 2 patients. Corporal tears were saturated with synthetic absorbable sutures and urethral injury was repaired primarily. All operated patients described full erection with straight penis except 3 of the 8 patients who were managed by direct longitudinal incision, in whom mild curvature during erection was observed. The conservatively treated patients described satisfactory penile straightness and erection. The optimal functional and cosmetic results are achieved following immediate surgical repair of penis fracture. Good results can also be obtained in some selected patients with conservative managemelected patients with conservative management. (author)

  19. Penile abscess and necrotizing fasciitis secondary to neglected false penile fracture

    Directory of Open Access Journals (Sweden)

    Al-Reshaid Reshaid

    2010-01-01

    Full Text Available Penile infection and abscess formation have been described in association with priapism, cavernosography, intracavernosal injection therapy, trauma and penile prosthesis. We report a case of penile abscess and necrotizing fasciitis of penile skin in a 37-year-old male, presented 3 weeks after neglected false penile fracture.

  20. Complications of trans-bronchial arterial chemo-embolization for non-small cell lung cancer

    International Nuclear Information System (INIS)

    Objective: Retrospectively evaluate the incidence and correlative factors of complication of transcatheter bronchial arterial chemo-embolization for the treatment of non-small cell lung cancer. Methods: Transcatheter bronchial arterial embolization was performed in 135 cases of non-small cell lung cancer. Bronchial arterial angiograms were taken prior to confirm the blood supply route of the lesions. Chemo- embolization was then performed through the catheterized bronchial artery or the super-selected catheterized branches with co-axial technique. Chemotherapy was taken first with the perfusion of combined three drugs: carboplatin 300 mg, MMC 10-20 mg or Epirubicin 40-60 mg, 5-FU 1000 mg; and then followed by bronchial arterial embolization with gelfoam particles or lipiodol separately. Results: Complications happened in 5.9% cases, including 1 case of spinal medullary ischemia (0.7%), 5 cases of intercostal artery ischemic syndrome(3.7%), and 2 cases of pulmonary artery embolization(1.5%). All complications were relieved after one to four weeks treatment. Spinal medullary ischemic and intercostal ischemic syndrome occurred both in the cases of main bronchial arterial embolization. Spinal medullary ischemia and pulmonary arterial embolization only happened in patients embolized with lipiodol, while intercostal ischemic syndrome was seen in both gelfoam particles and lipiodol embolization. Conclusions: Transcatheter bronchial arterial embolization should be performed crterial embolization should be performed carefully. Super-selective catheterization with gelfoam particles is the method of choice to avoid potential ischemic complications. (authors)

  1. An update on penile reconstruction

    OpenAIRE

    Garaffa, Giulio; Raheem, Amr Abdel; Ralph, David John

    2011-01-01

    Penile reconstruction still represents a formidable challenge for the urologist. In this review, the most recent advances in penile reconstruction after trauma, excision of benign and malignant disease and in patients with micropenis, aphallia or female to male gender dysphoria are reported.

  2. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available MINIMALLY INVASIVE PENILE IMPLANT SURGERY CORAL GABLES HOSPITAL CORAL GABLES, FLORIDA March 26, 2007 00:00:10 ANNOUNCER: Over the next hour you’ll see a live panel discussion of penile implant surgery. For men with severe erectile dysfunction, the ...

  3. Radioisotope penile plethysmography: A technique for evaluating corpora cavernosal blood flow during early tumescence

    International Nuclear Information System (INIS)

    Radioisotope penile plethysmography is a nuclear medicine technique which assists in the evaluation of patients with erectile dysfunction. This technique attempts to noninvasively quantitate penile corpora cavernosal blood flow during early penile tumescence using technetium-99m-labeled red blood cells. Penile images and counts were acquired in a steady-state blood-pool phase prior to and after the administration of intracorporal papaverine. Penile counts, images, and time-activity curves were computer analyzed in order to determine peak corporal flow and volume changes. Peak corporal flow rates were compared to arterial integrity (determined by angiography) and venosinusoidal corporal leak (determined by cavernosometry). Peak corporal flow correlated well with arterial integrity (r = 0.91) but did not correlate with venosinusoidal leak parameters (r = 0.01). This report focuses on the methodology and the assumptions which form the foundation of this technique. The strong correlation of peak corporal flow and angiography suggests that radioisotope penile plethysmography could prove useful in the evaluation of arterial inflow disorders in patients with erectile dysfunction

  4. Does prolonged semi-erection in prepubertal high flow priapism result in increased penile size?

    OpenAIRE

    Awwad, Ziad M.

    2005-01-01

    ABSTRACT High flow priapism is a rare pathology resulting mainly from trauma to the perineum leading to arterial-lacunar fistula. Management includes arterial embolization using absorbable material, as well as conservative approach. In this case, the effect of prolonged semi-erection in prepubertal high flow priapism on increased penile size is discussed.

  5. Nucleotide hydrolytic activity of isolated intact rat mesenteric small arteries

    DEFF Research Database (Denmark)

    Juul, B; Lüscher, M E

    1991-01-01

    Segments of isolated intact rat mesenteric small arteries were incubated in physiological bicarbonate buffer in the presence of nano- to millimolar concentrations of ATP. ATP was hydrolysed, and when the vessel was transferred from one incubation to another, the enzyme activity was transferred with the vessel, consistent with the presence of an ecto-ATPase. The substrate, ATP, was shown to induce a modification of the hydrolytic activity which occurred the more rapidly the higher the concentration of ATP. The modified system hydrolysed ATP with a decreased substrate affinity. As the substrate induced a modification of the hydrolytic activity, steady-state velocity measurements for determination of kinetic parameters could not be obtained. Nevertheless, it was possible to compare the modification caused by ATP and UTP, and to compare the hydrolysis rates measured with [32P]ATP, [32P]UTP and [32P]GTP. It was concluded that the hydrolytic activity of the vessels did not distinguish between the nucleoside triphosphates (NTPs). In a histidine buffer, the activity was shown to be activated by micromolar concentrations of either Ca2+ or Mg2+, and not to be influenced by inhibitors of P-type, F-type and V-type ATPases. Functional removal of the endothelium before assay did not reduce the measured NTP hydrolysis. At millimolar concentrations of trinucleotide the hydrolysis rate was 10-15 mumol per min per gram of tissue or 0.11-0.17 mumol per min per 10(6) vascular smooth muscle cells. This value is equivalent to the maximal velocity obtained for the Ca2+ or Mg(2+)-dependent NTPase released to the medium upon 2 s of sonication of the vessels (Plesner, L., Juul, B., Skriver, E. and Aalkjaer, C. (1991) Biochim. Biophys. Acta 1067, 191-200). Comparing the characteristics of the released NTPase to the characteristics of the activity of the intact vessel, they showed a strong resemblance, but the substrate-induced modification of the enzyme was seen only in the intact preparation.

  6. Penile Corporeal Reconstruction during Difficult Placement of a Penile Prosthesis

    Directory of Open Access Journals (Sweden)

    Sherif R. Aboseif

    2008-11-01

    Full Text Available For some patients with impotence and concomitant severe tunical/corporeal tissue fibrosis, insertion of a penile prosthesis is the only option to restore erectile function. Closing the tunica over an inflatable penile prosthesis in these patients can be challenging. We review our previous study which included 15 patients with severe corporeal or tunical fibrosis who underwent corporeal reconstruction with autologous rectus fascia to allow placement of an inflatable penile prosthesis. At a mean follow-up of 18 months (range 12 to 64, all patients had a prosthesis that was functioning properly without evidence of separation, herniation, or erosion of the graft. Sexual activity resumed at a mean time of 9 weeks (range 8 to 10. There were no adverse events related to the graft or its harvest. Use of rectus fascia graft for coverage of a tunical defect during a difficult penile prosthesis placement is surgically feasible, safe, and efficacious.

  7. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... inflatable penile prosthesis consists of two cylinders, a reservoir, and pump, which are placed in the body ... the pump. The pump transfers fluid from the reservoir to the cylinders in the penis, inflating them. ...

  8. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... changing gloves. We will do that throughout the case. 00:11:37 IRWIN GOLDSTEIN, MD: You have ... there. How many specialists are doing penile prosthesis cases in the United States? 00:16:27 J. ...

  9. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... allows us to get an idea of how big the penis is before putting the implant. We ... minimally invasive penile implant. Any of the objective data that I’m going to give you today ...

  10. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... such as Viagra or Cialis. The inflatable penile prosthesis consists of two cylinders, a reservoir, and pump, ... in the body during surgery. To inflate the prosthesis, the man just presses on the pump. The ...

  11. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... Today we are thrilled to have two contemporary experts in penile implant surgery for the treatment of ... the corpora cavernosa of the penis – these two experts have advanced the surgery by using new, minimally ...

  12. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... of a penile prosthetic device in the two erection chambers of the corpora cavernosa of the penis – ... MD: And that is the lining of the erection material? 00:15:04 J. FRANCOIS EID, MD: ...

  13. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... of penile implant surgery. For men with severe erectile dysfunction, the condition generally cannot be treated by popular ... implant surgery for the treatment of men with erectile dysfunction. While technically the initial concept is still the ...

  14. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... Irwin Goldstein. I am Director, San Diego Sexual Medicine at Alvarado, San Diego, California. I am Editor-in-Chief of the Journal of Sexual Medicine . I’ve been involved in penile implant surgery ...

  15. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... MD: Wow, that’s fantastic. Okay, another question. The success rate of the inflatable penile prosthesis. 00:17: ... is better. So we want a functional – our goal is to have the patient be functional and ...

  16. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... normal sex life and has been an excellent treatment for hundreds of thousands of men for the ... contemporary experts in penile implant surgery for the treatment of men with erectile dysfunction. While technically the ...

  17. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... live panel discussion of penile implant surgery. For men with severe erectile dysfunction, the condition generally cannot ... body during surgery. To inflate the prosthesis, the man just presses on the pump. The pump transfers ...

  18. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... to have two orgasms each time they make love. Here you see me changing gloves. We will ... the penile implant will enable him to make love with or without a curved penis. So one ...

  19. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... prevention. And as you know, one of the issues with penile implants in the past was the ... a Peyronie’s case, where modeling is the potential issue. Now, since Bioflex isn’t surrounded by the ...

  20. Imaging of penile traumas - therapeutic implications

    Energy Technology Data Exchange (ETDEWEB)

    Bertolotto, Michele; Calderan, Loretta; Cova, Maria Assunta [Universita di Trieste, UCO di Radiologia, Trieste (Italy)

    2005-12-01

    Injury to the penis may result from penetrating or nonpenetrating trauma. Nonpenetrating injury to the erect penis can produce albugineal tear, intracavernous hematoma or extraalbugineal hematoma from rupture of the dorsal vessels. Nonpenetrating injury to the flaccid penis usually follows blunt perineal traumas producing extratunical or cavernosal haematomas, or cavernosal artery tear followed by high flow priapism. Differential diagnosis between albugineal tear and other penile injuries must be obtained as soon as possible, since early surgical repair of albugineal tear reduces significantly the rate of postraumatic curvature and fibrosis. Ultrasonography (US) is able to detect the exact site of the tear in most patients as an interruption of the thin echogenic line of the tunica albuginea. Other imaging techniques are rarely required in the clinical practice. Color Doppler US is the imaging modality of choice to evaluate patients with high flow priapism. Focal or diffuse cavernosal fibrosis can be identified with US as echogenic areas in the cavernosal bodies. Postraumatic erectile dysfunction can result from fibrotic changes, nerve and vascular impairment or both. Doppler evaluation of penile vasculature is required in young patients with postraumatic impotence before surgical revascularization procedures. (orig.)

  1. Imaging of penile traumas - therapeutic implications

    International Nuclear Information System (INIS)

    Injury to the penis may result from penetrating or nonpenetrating trauma. Nonpenetrating injury to the erect penis can produce albugineal tear, intracavernous hematoma or extraalbugineal hematoma from rupture of the dorsal vessels. Nonpenetrating injury to the flaccid penis usually follows blunt perineal traumas producing extratunical or cavernosal haematomas, or cavernosal artery tear followed by high flow priapism. Differential diagnosis between albugineal tear and other penile injuries must be obtained as soon as possible, since early surgical repair of albugineal tear reduces significantly the rate of postraumatic curvature and fibrosis. Ultrasonography (US) is able to detect the exact site of the tear in most patients as an interruption of the thin echogenic line of the tunica albuginea. Other imaging techniques are rarely required in the clinical practice. Color Doppler US is the imaging modality of choice to evaluate patients with high flow priapism. Focal or diffuse cavernosal fibrosis can be identified with US as echogenic areas in the cavernosal bodies. Postraumatic erectile dysfunction can result from fibrotic changes, nerve and vascular impairment or both. Doppler evaluation of penile vasculature is required in young patients with postraumatic impotence before surgical revascularization procedures. (orig.)

  2. Small arteries can be accurately studied in vivo, using high frequency ultrasound

    DEFF Research Database (Denmark)

    Nielsen, T H; Iversen, Helle Klingenberg

    1993-01-01

    We have validated measurements of diameters of the superficial temporal artery and other small arteries in man with a newly developed 20 MHz ultrasound scanner with A, B and M-mode imaging. The diameter of a reference object was 1.202 mm vs. 1.205 mm as measured by stereomicroscopy (nonsignificant). In vitro measurements of porcine carotid arteries could be reproduced with a mean interobserver difference of 0.008 mm, and the repeatability coefficient was 0.04 mm (1.4%). The frontal branch of the human superficial temporal artery (mean 1.24 mm) was measured with intraobserver repeatability coefficients of 0.18 mm (13.8%) to 0.31 mm (23.4%). The interobserver mean difference was 0.01 mm (0.69%) and the interobserver repeatability coefficient was 0.16 mm (11.1%). Pulsatile changes of the cross sectional area of the radial plus the ulnar artery averaged 0.93 mm2 compared to 0.63 mm2 by strain-gauge plethysmography (nonsignificant). Pulsations were 4.6% in the radial artery. We conclude that high frequency ultrasound provides an accurate and reproducible measure of the diameter of small and medium sized human arteries in vivo.

  3. Penile Epidermoid Cyst Consisted of Multiple Foci: A Case Report

    OpenAIRE

    Akiou Okumura; Kiyoshi Takagawa; Hideki Fuse

    2012-01-01

    Penile epidermoid cysts are uncommon, and a small number of cases have been reported worldwide. We present the first documented patient with a penile epidermoid cyst which consisted of multiple focuses. A 37-year-old man presented to our department with a chief complaint of an asymptomatic, soft mass in the ventral part of the penis. The mass was nontender, freely movable and measuring 3 cm within the dermis. MRI (magnetic resonance imaging) revealed a high signal intensity on both T1- and T2...

  4. Arterial oxygen saturation, COPD, and cerebral small vessel disease

    OpenAIRE

    van Dijk, E. J.; Vermeer, S.E.; Groot, J.C., de; van de Minkelis, J; Prins, N.D.; Oudkerk, M; Hofman, A.; Koudstaal, P.J.; Breteler, M.M.B.

    2004-01-01

    OBJECTIVE: To study whether lower arterial oxygen saturation (SaO(2)) and chronic obstructive pulmonary disease (COPD) are associated with cerebral white matter lesions and lacunar infarcts. METHODS: We measured SaO(2) twice with a pulse oximeter, assessed the presence of COPD, and performed MRI in 1077 non-demented people from a general population (aged 60-90 years). We rated periventricular white matter lesions (on a scale of 0-9) and approximated a total subcortical white matter lesion...

  5. P2X1 receptors mediate sympathetic postjunctional Ca2+ transients in mesenteric small arteries.

    Science.gov (United States)

    Lamont, Christine; Vial, C; Evans, R J; Wier, W G

    2006-12-01

    Brief, spatially localized Ca(2+) transients occur in the smooth muscle adjacent to perivascular nerves of small arteries during neurogenic contractions. We named these "junctional Ca(2+) transients" (jCaTs) and postulated that they arose from Ca(2+) entering smooth muscle cells through P2X(1) receptors activated by neurally released ATP. Nevertheless, the lack of potent, subtype-selective P2X-receptor antagonists made determining the exact molecular identity of the channels difficult. Here we used small, pressurized mesenteric arteries from P2X(1)-receptor-deficient mice (KO) to test the hypothesis that jCaTs arise from Ca(2+) entering the smooth muscle cell via P2X(1) receptors. In wild-type (WT) arteries, confocal microscopy of fluo-4 fluorescence during electrical field stimulation (EFS) of perivascular sympathetic nerves revealed jCaTs in the smooth muscle cells adjacent to the perivascular nerves, similar to those reported previously in rat arteries, and alpha-latrotoxin (2.5 nM) markedly increased the frequency of "spontaneous" jCaTs. In the KO arteries, however, neither EFS nor alpha-latrotoxin elicited any jCaTs. A potent P2X-receptor agonist, alpha,beta-methylene ATP (10.0 microM), elicited strong contractions and increased intracellular Ca(2+) concentration in WT arteries but elicited neither in KO arteries. A biphasic vasoconstriction in response to EFS was observed in WT arteries. In KO arteries, however, the initial rapid, transient component of the biphasic vasoconstriction was absent. The data support the hypothesis that jCaTs represent Ca(2+) that enters the smooth muscle cells through P2X(1) receptors activated by neurally released ATP and that this Ca(2+) is involved in the initial rapid component of the sympathetic neurogenic contraction. PMID:16920810

  6. Histomorphometric Evaluation of the Small Coronary Arteries in Rats Exposed to Industrial Noise

    Directory of Open Access Journals (Sweden)

    Ana Lousinha

    2015-05-01

    Full Text Available Morphological changes induced by industrial noise (IN have been experimentally observed in several organs. Histological observations of the coronary arteries showed prominent perivascular tissue and fibrosis among IN-exposed rats. The effects on the small arteries are unknown. Objective: To evaluate the histomorphometric changes induced by IN on rat heart small arteries. Methods: Twenty Wistar rats exposed to IN during a maximum period of seven months and 20 age-matched controls were studied. Hearts were transversely sectioned from ventricular apex to atria and a mid-ventricular fragment was selected for analysis. The histological images were obtained with an optical microscope using 400× magnifications. A total of 634 arterial vessels (298 IN-exposed and 336 controls were selected. The mean lumen-to-vessel wall (L/W and mean vessel wall-to-perivascular tissue (W/P ratios were calculated using image J software. Results: There were no differences between exposed and control animals in their L/W ratios (p = 0.687 and time variations in this ratio were non-significant (p = 0.110. In contrast, exposed animals showed lower W/P ratios than control animals (p < 0.001, with significant time variations (p = 0.004. Conclusions: Industrial noise induced an increase in the perivascular tissue of rat small coronary arteries, with significant development of periarterial fibrosis.

  7. Physiological outflow boundary conditions methodology for small arteries with multiple outlets: A patient-specific hepatic artery haemodynamics case study.

    Science.gov (United States)

    Aramburu, Jorge; Antón, Raúl; Bernal, Nebai; Rivas, Alejandro; Ramos, Juan Carlos; Sangro, Bruno; Bilbao, José Ignacio

    2015-04-01

    Physiological outflow boundary conditions are necessary to carry out computational fluid dynamics simulations that reliably represent the blood flow through arteries. When dealing with complex three-dimensional trees of small arteries, and therefore with multiple outlets, the robustness and speed of convergence are also important. This study derives physiological outflow boundary conditions for cases in which the physiological values at those outlets are not known (neither in vivo measurements nor literature-based values are available) and in which the tree exhibits symmetry to some extent. The inputs of the methodology are the three-dimensional domain and the flow rate waveform and the systolic and diastolic pressures at the inlet. The derived physiological outflow boundary conditions, which are a physiological pressure waveform for each outlet, are based on the results of a zero-dimensional model simulation. The methodology assumes symmetrical branching and is able to tackle the flow distribution problem when the domain outlets are at branches with a different number of upstream bifurcations. The methodology is applied to a group of patient-specific arteries in the liver. The methodology is considered to be valid because the pulsatile computational fluid dynamics simulation with the inflow flow rate waveform (input of the methodology) and the derived outflow boundary conditions lead to physiological results, that is, the resulting systolic and diastolic pressures at the inlet match the inputs of the methodology, and the flow split is also physiological. PMID:25934258

  8. New insights into the control of small artery function in human pregnancy and estrogen receptor beta knockout mice

    OpenAIRE

    Luksha, Leanid

    2007-01-01

    Background: Available data clearly indicates functional and morphological differences between small and large arteries, and observations from studies on large arteries may not be applicable to understand the physiology of small arteries (~200-300mum) that actively participate in the regulation of peripheral vascular resistance, blood pressure and flow to target organs. These events confer cardiovascular adaptation to normal pregnancy (NP), however they are disturbed in preec...

  9. Phalloplasty: A panacea for 46,XY disorder of sex development conditions with penile deficiency?

    Science.gov (United States)

    Callens, Nina; Hoebeke, Piet

    2014-01-01

    In cases of severe penile inadequacy, such as in pathological conditions involving penile amputation (e.g. penile cancer), or in 46,XY disorders of sex development with severe undervirilization or maldevelopment of the penis (e.g. idiopathic micropenis, cloacal exstrophy), standard (surgical) penile lengthening techniques do not provide patients with a phallus suitable for sexual intercourse. Genital dissatisfaction can lead to low self-esteem and psychosexual dysfunction. Therefore, phalloplasty, the gold standard in transgender surgery, may provide a possibility to achieve a satisfactory genital appearance and sexual function. Small series have reported cosmetically acceptable and erogenous sensate neophalli with incorporation of a neourethra to allow voiding in a standing position and with enough bulk to allow penile prosthesis insertion for pleasurable intercourse. Although early results seem promising, further publication of series with large numbers and longer follow-up is needed to evaluate to what extent phalloplasty improves physical and sexual outcomes. Complications are of particular concern because of associated scarring and loss of sensitive tissue. Without full preoperative workups assessing patients' expectations and reasons for undergoing surgery, they may still struggle with self/penile image and with psychological barriers for engaging in sexual activity. Recommendations for the psychosocial management of boys and men with penile deficiency are suggested. PMID:25247659

  10. Endothelium-derived Relaxing Factors of Small Resistance Arteries in Hypertension.

    Science.gov (United States)

    Kang, Kyu-Tae

    2014-09-01

    Endothelium-derived relaxing factors (EDRFs), including nitric oxide (NO), prostacyclin (PGI2), and endothelium-derived hyperpolarizing factor (EDHF), play pivotal roles in regulating vascular tone. Reduced EDRFs cause impaired endothelium-dependent vasorelaxation, or endothelial dysfunction. Impaired endothelium-dependent vasorelaxation in response to acetylcholine (ACh) is consistently observed in conduit vessels in human patients and experimental animal models of hypertension. Because small resistance arteries are known to produce more than one type of EDRF, the mechanism(s) mediating endothelium-dependent vasorelaxation in small resistance arteries may be different from that observed in conduit vessels under hypertensive conditions, where vasorelaxation is mainly dependent on NO. EDHF has been described as one of the principal mediators of endothelium-dependent vasorelaxation in small resistance arteries in normotensive animals. Furthermore, EDHF appears to become the predominant endothelium-dependent vasorelaxation pathway when the endothelial NO synthase (NOS3)/NO pathway is absent, as in NOS3-knockout mice, whereas some studies have shown that the EDHF pathway is dysfunctional in experimental models of hypertension. This article reviews our current knowledge regarding EDRFs in small arteries under normotensive and hypertensive conditions. PMID:25343007

  11. Does prolonged semi-erection in prepubertal high flow priapism result in increased penile size?

    International Nuclear Information System (INIS)

    High flow priapism is a rare pathology resulting mainly from trauma to the perineum leading to arteliar-lacunar fistula. Management includes arterial embolization using absorbable material, as well as conservative approach. In this case, the effect of prolonged semi-erection in prepubertal high flow priapism on increased penile size is discussed. (author)

  12. Synergism of diabetic and inflammatory culture conditions on reactivity of isolated small arteries

    DEFF Research Database (Denmark)

    Blædel, Martin Mads; Boonen, Harrie C.M.

    Background: Cardiovascular disease (CVD) is the manifestation of atherosclerosis, which has been linked to obesity, the metabolic syndrome (MS) and overt type 2 diabetes (T2DM). Vascular dysfunction has been proposed to precede atherosclerosis, and in addition, a correlation between vascular dysfunction and local vascular inflammation has been suggested. Aim: This study addresses the involvement of vascular risk factors of MS and T2DM such as elevated glucose, increased insulin levels, as well as selected cytokines on vascular contractile function. Methods: Small mesenteric resistance arteries isolated from 8 week old male SD rats were cultured for 21 hours in Endothelial Basal Medium (EBM-2) in petri dishes and in the absence or presence of either 30 mM D-glucose, 100 nM insulin, 100 ng/mL TNFa or any combination of these. Contractile reactivity of normalised arteries was then determined by wire myography as a response to cumulatively increasing concentrations of noradrenaline (NA). Results:21 hour culture of isolated mesenteric arteries significantly reduced the arteries maximal high potassium-induced contractile reactivity and increased the contractility to noradrenaline slightly. Arteries that had been incubated in the presence of either D-glucose, insulin, or TNFa alone, displayed unchanged sensitivity and max. responses to NA as compared to control conditions (21 hour incubation in EBM-2 only). However, when arteries were incubated in combinations of glucose, insulin or TNF-a, the NA-induced max. responses and sensitivity significantly increased. Conclusion: These results suggest that the continuous presence of inflammatory cytokines may significantly enhance hyperglycaemia and hyperinsulinaemia-induced changes in vascular reactivity of cultured small arteries. An increased vascular inflammatory status might therefore be pivotal for the development of CVD in diabetes.

  13. Bestrophin is important for the rhythmic but not the tonic contraction in rat mesenteric small arteries

    DEFF Research Database (Denmark)

    Broegger, Torbjoern; Jacobsen, Jens Christian Brings

    2011-01-01

    Aims We have previously characterized a cGMP-dependent Ca2+-activated Cl– current in vascular smooth muscle cells (SMCs) and have shown its dependence on bestrophin-3 expression. We hypothesize that this current is important for synchronization of SMCs in the vascular wall. In the present study, we aimed to test this hypothesis by transfecting rat mesenteric small arteries in vivo with siRNA specifically targeting bestrophin-3. Methods and results The arteries were tested 3 days after transfection in vitro for isometric force development and for intracellular Ca2+ in SMCs. Bestrophin-3 expression was significantly reduced compared with arteries transfected with mutated siRNA. mRNA levels for bestrophin-1 and -2 were also significantly reduced by bestrophin-3 down-regulation. This is suggested to be secondary to specific bestrophin-3 down-regulation since siRNAs targeting different exons of the bestrophin-3 gene had identical effects on bestrophin-1 and -2 expression. The transfection affected neither the maximal contractile response nor the sensitivity to norepinephrine and arginine-vasopressin. The amplitude of agonist-induced vasomotion was significantly reduced in arteries down-regulated for bestrophins compared with controls, and asynchronous Ca2+ waves appeared in the SMCs. The average frequency of vasomotion was not different. 8Br-cGMP restored vasomotion in arteries where the endothelium was removed, but oscillation amplitude was still significantly less in bestrophin-down-regulated arteries. Thus, vasomotion properties were consistent with those previously characterized for rat mesenteric small arteries. Data from our mathematical model are consistent with the experimental results. Conclusion This study demonstrates the importance of bestrophins for synchronization of SMCs and strongly supports our hypothesis for generation of vasomotion.

  14. Penile myiasis: a case report

    OpenAIRE

    Passos, M; Barreto, N; Varella, R; Rodrigues, G.; Lewis, D.

    2004-01-01

    We report a case of penile myiasis in a Brazilian man caused by the larva of Dermatobia hominis. Myiasis is a parasitic disease of humans and other vertebrates caused by larvae of several fly species. Although urinary myiasis is well recognised, infestation of the genital tissue is a rare occurrence. Once the diagnosis has been made, the treatment is usually straightforward and uncomplicated.

  15. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... specialists are doing penile prosthesis cases in the United States? 00:16:27 J. FRANCOIS EID, MD: I ... should be. Do you realize that across the United States there’s 300,000 breast implants a year? Across ...

  16. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... 300,000 breast implants a year? Across the world there’s only 16,000 penile implants. There’s something ... surgical procedures. And whenever you’re evaluating a new surgical technology or a new surgical procedure, you’ ...

  17. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available MINIMALLY INVASIVE PENILE IMPLANT SURGERY CORAL GABLES HOSPITAL CORAL GABLES, FLORIDA March 26, 2007 00:00:10 ANNOUNCER: Over the next hour you’ll see a live ... from sunny Florida. We are live in the Coral Gables Hospital in beautiful Coral Gables, Florida. My ...

  18. Comparison of colour coded Duplex sonography and selective penile pharmacoangiography for the evaluation of arteriogenic impotence

    International Nuclear Information System (INIS)

    42 patients with suspected vasculogenic impotence were examined via colour Duplex sonographie. Penile vascular anatomy was mapped and peak velocity was determined in both cavernosal arteries before and after intracorporeal injection of 15 mg papaverine and 0,5 mg regitine. In all patients the results could be compared with selective penile pharmacoangiography as the gold standard. In 34/42 patients colour Duplex sonography and angiography led to an identical evaluation of penile blood supply. 4 patients were classified false-negative and 4 patients false-positive. Sensitivity and specificity were calculated for each side separately. Sensitivity was 82.4% for left side angiogram and 83.3% for right side angiogram. Specificity was 88% for left side angiogram and 87.5% for right side angiogram. Peak flow velocity was significantly diminished in pathological angiograms. (orig.)

  19. A dynamic dual isotope radionuclear method of quantifying penile blood flow.

    Science.gov (United States)

    Kursh, E D; Jones, W T; Thompson, S; Nelson, D; Miraldi, F

    1992-06-01

    A new radionuclear method of quantifying arterial and venous blood flow of the penis is described. The technique is based on the simultaneous recording of the change in blood volume and venous outflow in the flaccid and erect states, which is produced pharmacologically. The change in penile blood volume is determined by measuring the change in the technetium-labeled red blood cell activity with time. Venous outflow is recorded with a xenon washout technique. The isotope data are used to compute arterial and venous flows with a complex computerized mathematical formula. Three basic blood flow patterns have been noted that distinguish normal patients from those with arterial insufficiency and venous leakage. The study is relatively easy and noninvasive to perform, and it appears to quantify penile blood flow accurately. PMID:1593681

  20. Epigenetic Mechanisms in Penile Carcinoma

    OpenAIRE

    Hellen Kuasne; Fabio Albuquerque Marchi; Silvia Regina Rogatto; Ilce Mara de Syllos Cólus

    2013-01-01

    Penile carcinoma (PeCa) represents an important public health problem in poor and developing countries. Despite its unpredictable behavior and aggressive treatment, there have only been a few reports regarding its molecular data, especially epigenetic mechanisms. The functional diversity in different cell types is acquired by chromatin modifications, which are established by epigenetic regulatory mechanisms involving DNA methylation, histone acetylation, and miRNAs. Recent evidence indicates ...

  1. Melanocortin Receptors, Melanotropic Peptides and Penile Erection

    OpenAIRE

    King, Stephen H.; Mayorov, Alexander V.; Balse-srinivasan, Preeti; Hruby, Victor J.; Vanderah, Todd W.; Wessells, Hunter

    2007-01-01

    Penile erection is a complex physiologic event resulting from the interactions of the nervous system on a highly specialized vascular organ. Activation of central nervous system melanocortinergic (MC) receptors with either endogenous or synthetic melanotropic ligands may initiate and/or facilitate spontaneous penile erection.

  2. Penile Epidermoid Cyst Consisted of Multiple Foci: A Case Report

    Directory of Open Access Journals (Sweden)

    Akiou Okumura

    2012-09-01

    Full Text Available Penile epidermoid cysts are uncommon, and a small number of cases have been reported worldwide. We present the first documented patient with a penile epidermoid cyst which consisted of multiple focuses. A 37-year-old man presented to our department with a chief complaint of an asymptomatic, soft mass in the ventral part of the penis. The mass was nontender, freely movable and measuring 3 cm within the dermis. MRI (magnetic resonance imaging revealed a high signal intensity on both T1- and T2-weighted images. Excision of the cyst was performed under local anesthesia. Macroscopically, the cut surface of the mass appeared to be full of a cheese-like material and the cyst consisted of multiple focuses. The cyst did not contain skin appendages. The pathological diagnosis was an epidermoid cyst of the penis. No recurrence has been noted in the year since the operation.

  3. Comparison of penile brachial index and penile arteriography

    International Nuclear Information System (INIS)

    Thirty patients complaining of erectile dysfunction were evaluated by measurement of the penile brachial index and arteriography. The PBIs were measured in five healthy controls. Half of the patients were studied in a vascular laboratory and the other half in a radiology-urology erectile dysfunction clinic. A poor correlation was found between PBI and arteriographic findings. No statistical difference was observed between the correlation coefficients for the two laboratory sites. Factors responsible for accurate and inaccurate assessments are discussed, and the process by which PBI measurements are obtained and their relationship to the physiology of erections is explained

  4. The evaluation of a small-diameter polysaccharide-based arterial graft in rats.

    Science.gov (United States)

    Chaouat, Marc; Le Visage, Catherine; Autissier, Aude; Chaubet, Frederic; Letourneur, Didier

    2006-11-01

    Cardiovascular diseases may require surgery such as arterial bypasses that are usually performed with synthetic PTFE and Dacron grafts with diameter above 6mm. For smaller diameter replacement, healthy vascular tissue from the patient is not always available to carry out this type of graft. The purpose of this study was to evaluate the effectiveness of a small-diameter polysaccharide-based scaffold as an alternative arterial replacement. Tubular polysaccharide-based grafts of 2 mm internal diameter were prepared and moulded by a cross-linking technique. Fifteen Wistar adult rats underwent infrarenal aortic bypass with these grafts using microsurgical techniques. Grafts withstood aortic blood pressure and exhibited physiological blood flow, as evaluated with ultrasound techniques and angiographies at 4 and 8 weeks post-surgery. Harvested grafts were morphologically evaluated by light microscopy and immunohistochemistry. Neointima formation at 8 weeks was evidenced through collagen deposition and smooth muscle-like cells circumferential growth on the luminal surface without intimal hyperplasia or aneurysm formation. In conclusion, we described a 2mm polysaccharide-based arterial material being investigated in vivo and demonstrating patency for up to 8 weeks post-surgery with neointima formation and absence of intimal hyperplasia. PMID:16857256

  5. Pulmonary Artery Agenesis Associated With Emphysema and Multiple Invasive Non-Small Cell Lung Cancers.

    Science.gov (United States)

    Makdisi, George; Edell, Eric S; Maleszewski, Joseph J; Molina, Julian R; Deschamps, Claude

    2015-06-01

    Pulmonary artery (PA) agenesis in the absence of associated cardiac abnormalities is a rare congenital abnormality. It may remain undiagnosed until adulthood when patients present with respiratory symptoms such as hemoptysis, dyspnea, repeated respiratory infections, or pulmonary hypertension. Herein we present a case of a 50-year-old woman who was found to have multiple, morphologically distinct non-small cell lung cancers in association with agenesis of the PA. This instance represents the fourth reported case of such association in the English literature. PMID:26046873

  6. Evoked and spontaneous purinergic junctional Ca2+ transients (jCaTs) in rat small arteries.

    Science.gov (United States)

    Lamont, Christine; Wier, W Gil

    2002-09-20

    Confocal microscopy of fluo-4 fluorescence in pressurized rat mesenteric small arteries subjected to low-frequency electrical field stimulation revealed Ca2+ transients in perivascular nerves and novel, spatially localized Ca2+ transients in adjacent smooth muscle cells. These muscle Ca2+ transients occur with a very brief latency to the stimulus pulse (most jCaTs. As expected from spontaneous neurotransmitter release, jCaTs also occur spontaneously, with characteristics identical to evoked jCaTs. Visualization of sympathetic neurotransmission shows that purinergic components dominate at low frequencies of sympathetic nerve fiber activation. PMID:12242262

  7. Effects of glucagon-like peptide-1 in diabetic rat small resistance arteries.

    Science.gov (United States)

    Bayram, Zeliha; Nacitarhan, Cahit; Ozdem, Sadi S

    2014-09-01

    We investigated the functional effects of glucagon-like peptide-1 [GLP-1(7-36)] and GLP-1(9-36) and the mechanism(s) playing a role in the effects of these agents in isolated small resistance arteries from control and diabetic rats. Cumulative concentrations of GLP-1(7-36) and GLP-1(9-36) produced concentration-dependent relaxations in endothelium-intact but not endothelium-denuded arteries that were significantly decreased in diabetic rats. GLP-1 receptor antagonist exendin(9-39) significantly inhibited responses to GLP-1 analogs. Nitric oxide/cyclic guanosine monophosphate pathway blockers, but not indomethacin, significantly decreased responses to GLP-1(7-36) or GLP-1(9-36) in control and diabetic rats. 4-Aminopyridine or glibenclamide incubation did not alter relaxations to GLP-1 analogs. GLP-1(7-36)- and GLP-1(9-36)-induced relaxations were blunted significantly and to similar extends by charybdotoxin and apamin combination in control and diabetic rats. Catalase did not affect, whereas superoxide dismutase (SOD) caused a significant increase in relaxations to GLP-1 analogs only in diabetic rats. We provided evidence about the relaxant effects of GLP-1(7-36) and GLP-1(9-36) in resistance arteries that were reduced in diabetic rats. Both calcium-activated potassium channels and endothelium played a major role in relaxations. Increment in certain reactive oxygen species and/or reduction in superoxide dismutase function might play a role in reduced relaxant responses of resistance arteries to GLP-1(7-36) and GLP-1(9-36) in diabetic rats. PMID:24887687

  8. Maternal smoking and impaired endothelium-dependent nitric oxide-mediated relaxation of uterine small arteries in vitro

    DEFF Research Database (Denmark)

    Andersen, Malene R; Uldbjerg, Niels

    2011-01-01

    Objective This study aimed to investigate the endothelium-dependent relaxation of uterine small arteries from pregnant nonsmokers, smokers, and ex-smokers who stopped smoking early in pregnancy. Study Design Uterine arteries were dissected from myometrial biopsies obtained during elective cesarean sections of 34 uncomplicated, singleton pregnancies, and the vascular function was assessed in a wire myograph for isometric recordings. Serum cotinine verified self-reported smoking; 15 were nonsmokers, 10 were smokers, and 9 were ex-smokers. Results Arteries from smokers and ex-smokers had reduced bradykinin-induced relaxation compared to arteries from nonsmokers (P < .05). The relaxation response to the nitric oxide donor sodium nitroprusside was similar in arteries from nonsmokers and smokers but was better in arteries from ex-smokers (P < .05). Conclusion The findings suggest that maternal smoking reduces endothelium-dependent nitric oxide–mediated relaxation in uterine small arteries andthat smoking cessation early in pregnancy does not fully abolish this deleterious effect, despite improvement in relaxation to nitroprusside.

  9. Hydrostatic Pressure Independently Increases Elastin and Collagen Co-expression in Small-diameter Engineered Arterial Constructs

    OpenAIRE

    Crapo, Peter M.; Wang, Yadong

    2011-01-01

    Prior studies have demonstrated that smooth muscle cell (SMC) proliferation, migration, and extracellular matrix production increase with hydrostatic pressure in vitro. We have engineered highly compliant small-diameter arterial constructs by culturing primary adult arterial SMCs under pulsatile perfusion on tubular, porous, elastomeric scaffolds composed of poly(glycerol sebacate) (PGS). This study investigates the effect of hydrostatic pressure on the biological and mechanical properties of...

  10. Penile gangrene in diabetes mellitus with renal failure: A poor prognostic sign of systemic vascular calciphylaxis

    OpenAIRE

    Agarwal, Mayank Mohan; Shrawan K. Singh; Mandal, Arup K

    2007-01-01

    Penile gangrene associated with chronic renal failure is very uncommon. A 52-year-old man with diabetes mellitus, diffuse atherosclerosis, ischemic cardiomyopathy and end-stage renal disease presented with blackening of distal penis for 10 days. His general condition was poor and gangrene of prepuce and glans was noted. Doppler and magnetic-resonance angiography revealed bilateral internal iliac artery obstruction. He underwent trocar suprapubic cystostomy and was planned for partial penectom...

  11. FRACTURAS DEL PENE / Penile fracture

    Scientific Electronic Library Online (English)

    Carmen, Zevallos M; Francisco M, González V; María José, Ruiz L; Fernando, Alarcón S.

    2014-08-01

    Full Text Available Introducción: La fractura del cuerpo cavernoso representa una urgencia urológica infrecuente pero grave, ya que la lesión de estructuras cercanas y una demora en su tratamiento suele generar complicaciones morfológicas y funcionales irreversibles. Casos clínicos: Registramos 5 casos de fractura pene [...] ana en nuestro hospital en el período 2008-2012, con afectación del cuerpo cavernoso derecho y hematoma asociado en todos ellos. La edad promedio fue de 33,5 (rango 26-44) años. Todos relataron los síntomas característicos excepto uno, que permaneció sin dolor. Se realizó una ecografía urgente en 3 casos para confirmar el diagnóstico y evaluar la extensión de la lesión. Los pacientes fueron intervenidos quirúrgicamente de urgencia, el postoperatorio transcurrió sin incidencias y actualmente todos se encuentran asintomáticos. Abstract in english Background: Penile fracture occurs when the erect penis is bent suddenly and forcefully, rupturing the tunica albuginea of one or both of the corpus cavernosum. A delay in its treatment may lead to functional and morphological sequelae. Case reports: We report five patients aged 26 to 44 years with [...] penile fracture and right corpus cavernosum involvement. All patients excepting one had felt pain. An emergency ultrasound was done in three cases to confirm the diagnosis and the extension of the lesion. All were operated, had an uneventful postoperative period and are currently asymptomatic.

  12. Purinergic and adrenergic Ca2+ transients during neurogenic contractions of rat mesenteric small arteries.

    Science.gov (United States)

    Lamont, Christine; Vainorius, Enrikas; Wier, W Gil

    2003-06-15

    Contraction of small arteries is regulated by the sympathetic nervous system, but the Ca2+ transients during neurally stimulated contraction of intact small arteries have not yet been recorded. We loaded rat mesenteric small arteries with the fluorescent Ca2+ indicator fluo-4 and mounted them in a myograph that permitted simultaneous (i) high-speed confocal imaging of fluorescence from individual smooth muscle cells, (ii) electrical stimulation of perivascular nerves, and (iii) recording of isometric tension. Sympathetic neuromuscular transmission was achieved by electrical field stimulation (EFS) (frequency, 10 Hz; pulse voltage, 40 V; pulse duration, 0.2 ms) in the presence of capsaicin and scopolamine (to inhibit 'sensory' and cholinergic nerves, respectively). During the first 20 s of EFS, force rose to a small peak and then declined. During this time, junctional Ca2+ transients (jCaTs) were present at relatively high frequency. We have previously attributed jCaTs to influx of Ca2+ through post-junctional P2X receptors activated by ATP. Propagating asynchronous Ca2+ waves, previously associated with bath-applied alpha1-adrenoceptor agonists, were not initially present. During the next 2.5 min of EFS, force rose slowly, and asynchronous propagating Ca2+ waves appeared. The selective alpha1-adrenoceptor antagonist prazosin abolished both the slowly developing contraction and the Ca2+ waves, but reduced the initial transient contraction by only ~25 %. During 3 min of EFS in prazosin, the frequency of jCaTs declined markedly; at sites at which at least one jCaT occurred, the average probability of a jCaT was 0.008 +/- 0.002 pulse-1 in the first 20 s and 0.0007 +/- 0.0002 pulse-1 in the last 20 s. We suggest that (i) ATP released from sympathetic varicosities activates the initial, transient, contraction and the activator Ca2+ is derived largely from jCaTs, and (ii) sympathetically released noradrenaline (NA) activates the later, major contraction through mechanisms involving alpha1-adrenoceptors and which are associated with propagating Ca2+ waves. PMID:12740429

  13. Cuerpos extraños en pene / Penile foreign bodies

    Scientific Electronic Library Online (English)

    Héctor, Pastor Navarro; María José, Donáte Moreno; Pedro, Carríón López; Miguel, Segura Martín; Juan Gabriel, Lorenzo Romero; José María, Pastor Guzmán; J., Payá Berbegal; Saturnino, Lujan Marco; Julio, Virseda Rodríguez.

    2009-08-01

    Full Text Available Objetivo: Mostrar 8 casos de cuerpos extraños en pene. Métodos/Resultados: Realizamos una presentación fundamentalmente visual de variados artilugios o cuerpos extraños de ubicación peneana. Conclusiones: Raramente la existencia de cuerpos extraños peneanos se debe a accidentes. Los cuerpos extraños [...] en pene son colocados por muy diversas razones, destacando principalmente dentro de actividades eróticas o autoeróticas, pudiendo tener consecuencias desde leves, a casos en los que puede acabar en amputación peneana. Abstract in english Objective: To describe 8 cases of penile foreign bodies. Methods/Results: We provide an essentially visual overview of various objects or foreign bodies affecting the penis. Conclusions: The presence of penile foreign bodies is rarely due to an accident. These objects are placed for a wide variety o [...] f reasons, but primarily for erotic or self-arousal purposes. The consequences of penile foreign bodies can be mild or very severe, resulting in penile amputation.

  14. Cerebral small-resistance artery structure and cerebral blood flow in normotensive subjects and hypertensive patients

    International Nuclear Information System (INIS)

    The aim of this study was to prospectively investigate whether the structure of cerebral small-resistance arteries is related to cerebral perfusion parameters as measured with dynamic susceptibility-weighted contrast magnetic resonance imaging (DSC-MRI) in a selected cohort of hypertensive and normotensive patients. Ten hypertensive and 10 normotensive patients were included in the study. All patients underwent neurosurgical intervention for an intracranial tumor and were investigated with DSC-MRI at 1.5 T. Cerebral small-resistance arteries were dissected from a small portion of morphologically normal cerebral tissue and mounted on an isometric myograph for the measurement of the media-to-lumen (M/L) ratio. A quantitative assessment of cerebral blood flow (CBF) and volume (CBV) was performed with a region-of-interest approach. Correlation coefficients were calculated for normally distributed variables. The institutional review board approved the study, and informed consent was obtained from all patients. Compared with normotensive subjects, hypertensive patients had significantly lower regional CBF (mL/100 g/min) in the cortical grey matter (55.63 ± 1.90 vs 58.37 ± 2.19, p < 0.05), basal ganglia (53.34 ± 4.39 vs 58.22. ± 4.33, p < 0.05), thalami (50.65 ± 3.23 vs 57.56 ± 4.45, p < 0.01), subcortical white matter (19.32 ± 2.54 vs 22.24 ± 1.9, p < 0.05), greater M/L ratio (0.099 ± 0.013 vs 0.085 ± 0.012, p < 0.05), and lower microvessel density (1.66 ± 0.67 vs 2.52 ± 1.28, p < 0.05). A statistically significant negative correlation was observed between M/L ratio of cerebral arteries and CBF in the cortical grey matter (r = -0.516, p < 0.05), basal ganglia (r = -0.521, p < 0.05), thalami (r = -0.527 p < 0.05), and subcortical white matter (r = -0.612, p < 0.01). Our results indicate that microvascular structure might play a role in controlling CBF, with possible clinical consequences. (orig.)

  15. Cerebral small-resistance artery structure and cerebral blood flow in normotensive subjects and hypertensive patients

    Energy Technology Data Exchange (ETDEWEB)

    De Ciuceis, Carolina; Porteri, Enzo; Rizzoni, Damiano; Boari, Gianluca E.M.; Rosei, Enrico Agabiti [University of Brescia, Clinica Medica, Department of Clinical and Experimental Sciences, Brescia (Italy); Cornali, Claudio; Mardighian, Dikran; Fontanella, Marco M. [University of Brescia, Section of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Brescia (Italy); Pinardi, Chiara [Spedali Civili, Medical Physics Unit, Brescia (Italy); University of Brescia, Section of Neuroradiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Brescia (Italy); Rodella, Luigi F.; Rezzani, Rita [University of Brescia, Section of Anatomy, Department of Clinical and Experimental Sciences, Brescia (Italy); Gasparotti, Roberto [University of Brescia, Section of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Brescia (Italy); University of Brescia, Section of Neuroradiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Brescia (Italy)

    2014-12-15

    The aim of this study was to prospectively investigate whether the structure of cerebral small-resistance arteries is related to cerebral perfusion parameters as measured with dynamic susceptibility-weighted contrast magnetic resonance imaging (DSC-MRI) in a selected cohort of hypertensive and normotensive patients. Ten hypertensive and 10 normotensive patients were included in the study. All patients underwent neurosurgical intervention for an intracranial tumor and were investigated with DSC-MRI at 1.5 T. Cerebral small-resistance arteries were dissected from a small portion of morphologically normal cerebral tissue and mounted on an isometric myograph for the measurement of the media-to-lumen (M/L) ratio. A quantitative assessment of cerebral blood flow (CBF) and volume (CBV) was performed with a region-of-interest approach. Correlation coefficients were calculated for normally distributed variables. The institutional review board approved the study, and informed consent was obtained from all patients. Compared with normotensive subjects, hypertensive patients had significantly lower regional CBF (mL/100 g/min) in the cortical grey matter (55.63 ± 1.90 vs 58.37 ± 2.19, p < 0.05), basal ganglia (53.34 ± 4.39 vs 58.22. ± 4.33, p < 0.05), thalami (50.65 ± 3.23 vs 57.56 ± 4.45, p < 0.01), subcortical white matter (19.32 ± 2.54 vs 22.24 ± 1.9, p < 0.05), greater M/L ratio (0.099 ± 0.013 vs 0.085 ± 0.012, p < 0.05), and lower microvessel density (1.66 ± 0.67 vs 2.52 ± 1.28, p < 0.05). A statistically significant negative correlation was observed between M/L ratio of cerebral arteries and CBF in the cortical grey matter (r = -0.516, p < 0.05), basal ganglia (r = -0.521, p < 0.05), thalami (r = -0.527 p < 0.05), and subcortical white matter (r = -0.612, p < 0.01). Our results indicate that microvascular structure might play a role in controlling CBF, with possible clinical consequences. (orig.)

  16. Symptomatic intracranial metastasis in penile carcinoma

    OpenAIRE

    Moiyadi, Aliasgar V.; Tongaonkar, Hemant B.; Bakshi, Ganesh K.

    2010-01-01

    Distant metastases in penile cancers are rare, especially metachronous symptomatic intracranial metastasis. A middle-aged patient presented to us with an intracranial mass 2 years after being treated for penile cancer. Given the rarity of metastasis and the diagnostic dilemma along with the need for relief of neurological symptoms, it was excised and found to be a metastatic deposit. We discuss the case and review the relevant literature.

  17. Organ-Preserving Surgery for Penile Carcinoma

    OpenAIRE

    Martins, Francisco E.; Raul N. Rodrigues; Tomé M. Lopes

    2008-01-01

    Introduction. Penile carcinoma has traditionally been treated by either surgical amputation or radical radiotherapy, both associated with devastating anatomical, functional, and psychological impact on the patient's life. Innovative surgical techniques have focused on penile preservation in well-selected patients to minimize physical disfigurement and consequently maximize quality of life. The objective of this article is to define the current status of these organ-preser...

  18. Opening of Small and Intermediate Calcium-Activated Potassium Channels Induces Relaxation Mainly Mediated by Nitric-Oxide Release in Large Arteries and Endothelium-Derived Hyperpolarizing Factor in Small Arteries from Rat

    DEFF Research Database (Denmark)

    Stankevicius, Edgaras; Dalsgaard, T.

    2011-01-01

    This study was designed to investigate whether calcium-activated potassium channels of small (SK(Ca) or K(Ca)2) and intermediate (IK(Ca) or K(Ca) 3.1) conductance activated by 6,7-dichloro-1H-indole-2,3-dione 3-oxime (NS309) are involved in both nitric oxide (NO) and endothelium-derived hyperpolarizing factor (EDHF)-type relaxation in large and small rat mesenteric arteries. Segments of rat superior and small mesenteric arteries were mounted in myographs for functional studies. NO was recorded using NO microsensors. SK(Ca) and IK(Ca) channel currents and mRNA expression were investigated in human umbilical vein endothelial cells (HUVECs), and calcium concentrations were investigated in both HUVECs and mesenteric arterial endothelial cells. In both superior (similar to 1093 mu m) and small mesenteric (similar to 300 mu m) arteries, NS309 evoked endothelium- and concentration-dependent relaxations. In superior mesenteric arteries, NS309 relaxations and NO release were inhibited by both N(G),N(G)-asymmetric dimethyl-L-arginine (ADMA) (300 mu M), an inhibitor of NO synthase, and apamin (0.5 mu M) plus 1-[(2-chlorophenyl)diphenylmethyl]-1H-pyrazole (TRAM-34) (1 mu M), blockers of SK(Ca) and IK(Ca) channels, respectively. In small mesenteric arteries, NS309 relaxations were reduced slightly by ADMA, whereas apamin plus an IK(Ca) channel blocker almost abolished relaxation. Iberiotoxin did not change NS309 relaxation. HUVECs expressed mRNA for SK(Ca) and IK(Ca) channels, and NS309 induced increases in calcium, outward current, and NO release that were blocked by apamin and TRAM-34 or charybdotoxin. These findings suggest that opening of SK(Ca) and IK(Ca) channels leads to endothelium-dependent relaxation that is mediated mainly by NO in large mesenteric arteries and by EDHF-type relaxation in small mesenteric arteries. NS309-induced calcium influx appears to contribute to the formation of NO.

  19. Opening of small and intermediate calcium-activated potassium channels induces relaxation mainly mediated by nitric-oxide release in large arteries and endothelium-derived hyperpolarizing factor in small arteries from rat

    DEFF Research Database (Denmark)

    Stankevicius, Edgaras; Dalsgaard, Thomas

    2011-01-01

    This study was designed to investigate whether calcium-activated potassium channels of small (SK(Ca) or K(Ca)2) and intermediate (IK(Ca) or K(Ca)3.1) conductance activated by 6,7-dichloro-1H-indole-2,3-dione 3-oxime (NS309) are involved in both nitric oxide (NO) and endothelium-derived hyperpolarizing factor (EDHF)-type relaxation in large and small rat mesenteric arteries. Segments of rat superior and small mesenteric arteries were mounted in myographs for functional studies. NO was recorded using NO microsensors. SK(Ca) and IK(Ca) channel currents and mRNA expression were investigated in human umbilical vein endothelial cells (HUVECs), and calcium concentrations were investigated in both HUVECs and mesenteric arterial endothelial cells. In both superior (?1093 ?m) and small mesenteric (?300 ?m) arteries, NS309 evoked endothelium- and concentration-dependent relaxations. In superior mesenteric arteries, NS309 relaxations and NO release were inhibited by both N(G),N(G)-asymmetric dimethyl-l-arginine (ADMA) (300 ?M), an inhibitor of NO synthase, and apamin (0.5 ?M) plus 1-[(2-chlorophenyl)diphenylmethyl]-1H-pyrazole (TRAM-34) (1 ?M), blockers of SK(Ca) and IK(Ca) channels, respectively. In small mesenteric arteries, NS309 relaxations were reduced slightly by ADMA, whereas apamin plus an IK(Ca) channel blocker almost abolished relaxation. Iberiotoxin did not change NS309 relaxation. HUVECs expressed mRNA for SK(Ca) and IK(Ca) channels, and NS309 induced increases in calcium, outward current, and NO release that were blocked by apamin and TRAM-34 or charybdotoxin. These findings suggest that opening of SK(Ca) and IK(Ca) channels leads to endothelium-dependent relaxation that is mediated mainly by NO in large mesenteric arteries and by EDHF-type relaxation in small mesenteric arteries. NS309-induced calcium influx appears to contribute to the formation of NO.

  20. Surgical or conservative treatment of penile fracture

    Directory of Open Access Journals (Sweden)

    ?or?evi? D.

    2008-01-01

    Full Text Available Introduction: Penile fracture presents with rupture of corpora cavernosa. It is not rare but is remarkable. Treatment options are controversial. Aim: To establish the incidence, what are early and late complications in patients treated surgically or with conservative treatment options (prospective/retrospective and randomized analysis. To find out what therapy verified as superior. Material and method: The total of 32 patients with typical acute penile fracture were analyzed. The patients were between 20 and 56 years of age (Mean age 40+7.25 SD. A total of 11 patients that presented up to 48h after the rupture of tunica albuginea (34.37% were operated, while 9 patients (28.13% were conservatively treated. 12 patients (37.5% reported to andrology consulting room due to penile fibrous alterations and/or erectile dysfunction 6 to 14 months after the anamnesticaly established, typical penile fracture ("primary latent penile fracture". Both groups of patients were strictly clinically followed 3, 6, 9 and 12 months after the penile fracture. Eventual development of late complications (erectile dysfunction ED, penile curvature, induratio, caverno-urethral fistula and urethral stenosis was also recorded. Etiology of ED was investigated: anamnesticaly, by hormone and laboratory analysis, using penodynamic test (PGE1, Duplex Doppler echosonography, and dynamic cavernosography. Results: In the operated group of patients, (11 pts, 34.37% preserved erectile capacity was recorded and no penile deformity or plaque lesions on the site of suture, after the patients were recommended to have 4 weeks of sexual abstinence. The rupture of tunica albuginea was always transversal in relation to penile axis i.e. in relation to axial force against which the penis acts during the intercourse. The rupture is always on the basis or mid penile portion . Out of 21 (65.63% conservatively treated patients in 13 (61.9% plaque lesions (longitudinal diameter 2 cm was recorded, while sexual dysfunction was established in 13 patients (12 with ED and 1 patient with incapability for vaginal penetration. Evaluation of post therapeutical complications in relation to type of treatment, significantly higher frequency was recorded in the group of conservatively treated patients (p<0.01. Penile veno-oclusive dysfunction was registrated as significantly most frequent cause of ED (in 10 - 76.92% out of 13 patients. All patients with ED had palpable fibrous lesion similar to Peyrone’s plaque, while the degree of penile deviation correlated to the size of plaque lesion. Conclusion: The late complications of penile fracture were significantly more frequently recorded in the group of conservative treated patients (p< 0.01 which proves that this lesion presents as urgent urological entity. The penile rupture is always transversal, and most probable place of rupture is physiological penile curve since this is the site of weakened structural integrity.

  1. Clinical application of radiofrequency ablation combined with bronchial artery infusion of docetaxel in treating non-small cell lung cancer

    International Nuclear Information System (INIS)

    Objective: To discuss the clinical application of radiofrequency ablation combined with bronchial artery infusion of docetaxel in treating non-small cell lung cancer and to summarize the experience of using this therapy in clinical practice. Methods: Radiofrequency ablation was performed in twenty-one patients with lung cancer. The diagnosis was confirmed by CT-guided percutaneous needle biopsy or bronchoscopic biopsy in all patients. One week after radiofrequency ablation treatment, bronchial artery infusion of docetaxel was conducted. The therapeutic results were observed and evaluated. Results: After the treatment, the lesion's size was markedly reduced and the clinical symptoms were dramatically improved in all patients. Conclusion: Radiofrequency ablation combined with bronchial artery infusion of docetaxel is a safe, effective and simple technique with excellent therapeutic results for the treatment of non-small cell lung cancer. It is really worth popularizing this technique in clinical practice. (authors)

  2. Surgical Excision of Multiple Penile Syringomas With Scrotal Flap Reconstruction

    OpenAIRE

    Vaca, Elbert E.; Mundinger, Gerhard S.; Zelken, Jonathan A.; Erdag, Gulsun; Manahan, Michele A.

    2014-01-01

    Objective: Penile syringomas are rare lesions usually occurring in isolation. We report the excision and reconstruction of multiple synchronous penile shaft syringomas with local scrotal flaps. Methods: We report a rare case of excision of multiple penile syringomas and reconstruction with scrotal flaps in a 29-year-old man. Results: Penile syringomas were excised and reconstructed with scrotal flaps in a single-stage procedure. Conclusions: In addition to providing wound coverage, this recon...

  3. Successful Replantation of Amputated Penile Shaft following Industrial Injury

    Directory of Open Access Journals (Sweden)

    A Ariafar

    2010-09-01

    Full Text Available Penile amputation is an uncommon urological emergency. Although rare, traumatic amputation of penis is a challenging injury to treat. However, modern microsurgical reconstruction techniques have improved success rate of penile replantation and become the procedure of choice for managing these patients. Herein, we report on a case of penile amputation following an industrial accident.

  4. Characterisation of Ca2+ or Mg(2+)-dependent nucleoside triphosphatase from rat mesenteric small arteries

    DEFF Research Database (Denmark)

    Plesner, L; Juul, B

    1991-01-01

    When isolated rat mesenteric small arteries were submitted to 2 s of sonication, a nucleoside triphosphatase activity was released to the medium, mainly from the plasma membrane of the vascular smooth muscle cells. The activity was kinetically characterized: It hydrolysed ATP, UTP and GTP with the same substrate affinity and the same specific activity. CaATP, as well as MgATP were substrates for the enzyme with an apparent Km in the micromolar range. ATPase inhibitors: ouabain, vanadate, AlF4-, oligomycin and N-ethylmaleimide were without effect on the hydrolytic activity. Among other modifiers tested only N,N'-dicyclohexylcarbodiimide caused significant (greater than 30%) inhibition. In the presence of micromolecular concentrations of Ca2+ and Mg2+, small (less than 20 mM) concentrations of Na+, K+, Rb+, Cs+ and choline+, irrespective of the nature of the anion, activated the hydrolysis with an equilibrium ordered pattern, but concentrations of monovalent cation salts above 20 mM decreased the hydrolysis rate. No activation by monovalent cation salts was seen at millimolar concentrations of divalent cations and substrate. On the basis of the results a standard mixture is proposed, which allows a sensitive assay of the specific enzyme activity.

  5. Long-Term Results of Combined Tunica Albuginea Plication and Penile Prosthesis Implantation for Severe Penile Curvature and Erectile Dysfunction

    OpenAIRE

    Cormio, Luigi; Massenio, Paolo; Di Fino, Giuseppe; Lucarelli, Giuseppe; Mancini, Vito; Liuzzi, Giuseppe; Carrieri, Giuseppe

    2014-01-01

    Penile prosthesis implantation is the recommended treatment in patients with penile curvature and severe erectile dysfunction (ED) not responding to pharmacotherapy. Most patients with mild-to-moderate curvature can expect cylinder insertion to correct both ED and penile curvature. In patients with severe curvature and in those with persistent curvature after corporeal dilation and prosthesis placement, intraoperative penile “modelling” over the inflated prosthesis has been introduced as ...

  6. Bilateral multicystic renal dysplasia with potter sequence: A case with penile agenesis

    International Nuclear Information System (INIS)

    Hereditary renal adysplasia (HRA) is rare autosomal dominant condition. Patients have several other anomalies including Potter facies, thoracic, cardiac, and extremity deformities. The case present dysmorphic facial features such as hypertelorism, prominent epicanthic folds, a flat and broad nose, choanal stenosis, low set ears and a receding chin. He had femoral bowing, hypoplastic right tibia and agenesis of the right foot. He had rich and thin skin. He had also a dysplastic empty scrotum, penile agenesis, and anal atresia. The autopsy revealed pulmonary hypoplasia, ventricular septal defect, bilateral multicystic renal dysplasia, agenesis of ureter and bladder, intraabdominal testicles, and a single umbilical artery. The penile agenesis was first reported, and including the consanguinity in the parents might further delineate the bilateral multicystic HRA. Vater/caudal regression anomalies, Mullerian duct/aplasia, unilateral renal agenesis, and cervicothoracic somite anomalies association and Coloboma, heart anomaly, choanal atresia, retardation, retardation, genital and ear anomalies syndrome has been considered in differential diagnosis. (author)

  7. Simplified quantification of small animal [18F]FDG PET studies using a standard arterial input function

    International Nuclear Information System (INIS)

    Arterial input function (AIF) measurement for quantification of small animal PET studies is technically challenging and limited by the small blood volume of small laboratory animals. The present study investigated the use of a standard arterial input function (SAIF) to simplify the experimental procedure. Twelve [18F]fluorodeoxyglucose ([18F]FDG) PET studies accompanied by serial arterial blood sampling were acquired in seven male Sprague-Dawley rats under isoflurane anaesthesia without (every rat) and with additional (five rats) vibrissae stimulation. A leave-one-out procedure was employed to validate the use of a SAIF with individual scaling by one (1S) or two (2S) arterial blood samples. Automatic slow bolus infusion of [18F]FDG resulted in highly similar AIF in all rats. The average differences of the area under the curve of the measured AIF and the individually scaled SAIF were 0.11±4.26% and 0.04±2.61% for the 1S (6-min sample) and the 2S (4-min/43-min samples) approach, respectively. The average differences between the cerebral metabolic rates of glucose (CMRglc) calculated using the measured AIF and the scaled SAIF were 1.31±5.45% and 1.30±3.84% for the 1S and the 2S approach, respectively. The use of a SAIF scaled by one or (preferably) two arterial blood samples can serve as a valid substitute for individual AIF measurements to quantify [18F]FDG PET studies in rats. The SAIF approach minimises the lots. The SAIF approach minimises the loss of blood and should be ideally suited for longitudinal quantitative small animal [18F]FDG PET studies. (orig.)

  8. New stent design for use in small coronary arteries during percutaneous coronary intervention

    Directory of Open Access Journals (Sweden)

    Juan F Granada

    2010-10-01

    Full Text Available Juan F Granada1, Barbara A Huibregtse2, Keith D Dawkins21The Jack H Skirball Center for Cardiovascular Research, Cardiovascular Research Foundation, Columbia University Medical Center, New York, NY, USA; 2Boston Scientific Corporation, Natick, MA, USAAbstract: Patients with diabetes mellitus, of female gender, increased age, and/or with peripheral vascular disease often develop coronary stenoses in small caliber vessels. This review describes treatment of these lesions with the paclitaxel-eluting 2.25 mm TAXUS® Liberté® Atom™ stent. Given the same stent composition, polymer, antirestenotic drug (paclitaxel, and release kinetics as the first-generation 2.25 mm TAXUS® Express® Atom™ stent, the second-generation TAXUS Liberté Atom stent incorporates improved stent design characteristics, including thinner struts (0.0038 versus 0.0052 inches, intended to increase conformability and deliverability. In a porcine noninjured coronary artery model, TAXUS Liberté Atom stent implantation in small vessels demonstrated complete strut tissue coverage compared with the bare metal stent control, suggesting a similar degree of tissue healing between the groups at 30, 90, and 180 days. The prospective, single-armed TAXUS ATLAS Small Vessel trial demonstrated improved instent late loss (0.28 ± 0.45 versus 0.84 ± 0.57 mm, P < 0.001, instent binary restenosis (13.0% versus 38.1%, P < 0.001, and target lesion revascularization (5.8% versus 17.6%, P < 0.001 at nine months with the TAXUS Liberté Atom stent as compared with the bare metal Express stent control, with similar safety measures between the two groups. The TAXUS Liberté Atom also significantly reduced nine-month angiographic rates of both instent late loss (0.28 ± 0.45 versus 0.44 ± 0.61 mm, P = 0.03 and instent binary restenosis (13.0% versus 25.9%, P = 0.02 when compared with the 2.25 mm TAXUS Express Atom control. The observed reduction in target lesion revascularization with the TAXUS Liberté Atom compared with the TAXUS Express Atom at nine months (5.8% versus 13.7%, P = 0.02 was sustained through three years (10.0% versus 22.1%, P = 0.008 with similar, stable safety outcomes between the groups. In conclusion, these data confirm the safety and favorable performance of the TAXUS Liberté Atom stent in the treatment of small coronary vessels.Keywords: small vessel, paclitaxel, stent

  9. Epigenetic Mechanisms in Penile Carcinoma

    Directory of Open Access Journals (Sweden)

    Hellen Kuasne

    2013-05-01

    Full Text Available Penile carcinoma (PeCa represents an important public health problem in poor and developing countries. Despite its unpredictable behavior and aggressive treatment, there have only been a few reports regarding its molecular data, especially epigenetic mechanisms. The functional diversity in different cell types is acquired by chromatin modifications, which are established by epigenetic regulatory mechanisms involving DNA methylation, histone acetylation, and miRNAs. Recent evidence indicates that the dysregulation in these processes can result in the development of several diseases, including cancer. Epigenetic alterations, such as the methylation of CpGs islands, may reveal candidates for the development of specific markers for cancer detection, diagnosis and prognosis. There are a few reports on the epigenetic alterations in PeCa, and most of these studies have only focused on alterations in specific genes in a limited number of cases. This review aims to provide an overview of the current knowledge of the epigenetic alterations in PeCa and the promising results in this field. The identification of epigenetically altered genes in PeCa is an important step in understanding the mechanisms involved in this unexplored disease.

  10. KATP-channel-induced vasodilation is modulated by the Na,K-pump activity in rabbit coronary small arteries

    DEFF Research Database (Denmark)

    Glavind-Kristensen, Marianne; Matchkov, Vladimir

    2004-01-01

    The purpose of the study was to evaluate the importance of the Na,K-pump in relaxations induced by K(ATP)-channel openers in rabbit coronary small arteries. Arterial segments were mounted in myographs for recording of isometric tension. Whole-cell patch clamp was used to assess K(ATP)-channel currents in isolated smooth muscle cells from the arteries. In arteries preconstricted with the thromboxane A(2) analogue U46619 pinacidil and cromakalim induced concentration-dependent relaxations. In arteries preconstricted with potassium (124 mM) only high concentrations of pinacidil had a small relaxant effect. In arteries preconstricted with U46619 pinacidil-induced relaxations were unaffected by pretreatment with N(omega)-nitro-L-arginine (L-NNA) and only slightly reduced after mechanical removal of the endothelium. Pinacidil induced relaxations were not significantly affected by 1 microM glibenclamide. However, the relaxations were partly inhibited in potassium-free media and by 1 microM ouabain. In contrast, the concentration-dependent relaxation to cromakalim was partly blocked by 1 microM glibenclamide and partly by 1 microM ouabain and when both drugs were present the inhibition increased. Ouabain (1 microM) and glibenclamide (1 microM) each partly inhibited an ATP-sensitive current induced by pinacidil and cromakalim. In the presence of both inhibitors a greater inhibition was seen. When the solution in the patch pipette was sodium-free the current was reduced and ouabain had no effect. The study suggests that the relaxation to cromakalim and most likely pinacidil is mediated through opening of K(ATP) channels. Inhibition of the Na,K-pump, however, may change the local environment for the K(ATP) channels (i.e. increases the ATP/ADPratio and/or decreases the transmembrane potassium gradient), which partly prevents the activation of the K(ATP)-channel current.

  11. Digoxin inhibition of relaxation induced by prostacyclin and vasoactive intestinal polypeptide in small human placental arteries

    DEFF Research Database (Denmark)

    Maigaard, S; Forman, Axel

    1985-01-01

    Small chorionic plate arteries were obtained from human placentae following normal vaginal delivery. Tubal vascular preparations were dissected, mounted in organ baths, and their isometric tension was recorded. Digoxin (10(-6) M) caused a rise in basic tension, reaching a maximum of 17 per cent of contractions induced by potassium (124 mM) depolarization. Pretreatment with digoxin did not significantly influence the concentration-dependent contractile responses to 5-hydroxytryptamine and prostaglandin F2 alpha (PGF2 alpha). In preparations contracted with PGF2 alpha, cumulative addition of prostacyclin (PGI2) and vasoactive intestinal polypeptide (VIP) produced concentration dependent relaxations. Digoxin (10(-8) to 10(-6) M) inhibited and finally abolished these relaxant effects of PGI2 and VIP in a concentration-dependent fashion. Pretreatment by digoxin (10(-8) to 10(-6) M) diminished the relaxant effect of sodium nitroprusside, but the effect was less pronounced than that on PGI2- and VIP-induced relaxation. As PGI2 and VIP may be of importance for the maintenance of a low resistance of the fetal placental vascular bed, the finding that digoxin decreases the vasodilating effects of these agents might imply effects on placental resistance of cardiac glycosides when used in late human pregnancy.

  12. Advanced coronary artery calcification and cerebral small vessel diseases in the healthy elderly

    International Nuclear Information System (INIS)

    Coronary artery calcification (CAC) scores are widely accepted to predict risk of coronary heart diseases and are associated with atherosclerosis in other vasculatures. Cerebral small vessel diseases (SVDs), including white matter lesions (WML), silent lacunar infarction (SLI) and cerebral microbleeds (CMB), are considered to develop in conjunction with pro-atherogenic conditions, measured by CAC scores. Of 672 individuals aged ?65 years that underwent health screening, 312 subjects with brain magnetic resonance imagings (MRIs) were enrolled in this study. The distribution of baseline characteristics among individuals with or without MRIs was not different. Clinical and laboratory information was collected and CAC scores were measured using multi-detector computed tomography. Cerebral SVD were independently assessed by 2 raters who were unaware of the CAC scores. The prevalence of CAC (CAC>0) was 71.7% in men and 50.0% in women. The associations between moderate-to-extensive CAC (CAC score ?100) and WML (adjusted odds ratio and 95% confidence interval, 4.99 and 1.33-18.73), SLI (5.04 and 1.86-13.63) and CMB (6.07 and 1.54-23.94) remained significant after adjusting for relevant confounders. This study documents significant associations between CAC and cerebral SVDs. The findings suggest that SVDs in the brain and CAC in the heart may develop under similar systemic pathogenic processes. (author)

  13. Pulsative hematoma: A penile fracture complication

    Directory of Open Access Journals (Sweden)

    Nale ?or?e

    2007-01-01

    Full Text Available Background. 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. Case report. 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. Conclusion. 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.

  14. Penile and generalised calciphylaxis in peritoneal dialysis.

    Science.gov (United States)

    Sarkis, Edmond

    2015-01-01

    This is a rare case of penile and generalised calciphylaxis. We describe the case of a patient admitted to our hospital for septic shock and necrotic skin findings, end-stage renal disease on peritoneal dialysis. Skin findings turned out to be calciphyactic lesions. The patient was taken to the operating room for penile debridement and started on antibiotics. He was treated with sodium thiosulfate and switched to haemodialysis. Calciphylaxis is a rare disease in which the treatment is basically supportive. Further studies are needed to identify the risk factors, mechanisms of disease and treatment modalities. PMID:25883256

  15. Severe Penile Curvature following Otis Urethrotomy.

    Science.gov (United States)

    Karaguzel, Ersagun; Gur, Metin; Tok, Dogan S; Kazaz, Ilke O; Eren, Huseyin; Kutlu, Omer; Ozgur, Guner K

    2013-01-01

    Urethral stricture is a common urological pathology with a high recurrence rate after treatment. Urethral manipulations are among its main causes. In this paper, urethral stricture developed secondary to urethral catheterization and was treated with cold-knife internal urethrotomy and the Otis urethrotomy procedure. During the follow-up period, severe ventral penile curvature preventing sexual intercourse developed due to fibrosis of the corpus spongiosum and tunica albuginea of the penis. This ventral penile curvature was corrected with a separate operation using a tunica vaginalis flap harvested from the left scrotum. PMID:23585763

  16. VEGF immunoexpression in penile carcinoma

    Directory of Open Access Journals (Sweden)

    Antonio Carlos Pereira Martins

    2002-01-01

    Full Text Available OBJECTIVE: To investigate the vessel endothelial growth factor (VEGF as a risk factor in squamous cell carcinoma of the penis (SCCP. METHODS: Forty-seven patients with penile carcinoma were evaluated retrospectively. The mean age and standard deviation were 61.1±11.7 years. All of them were treated by penectomy and those with positive nodes underwent groin lymphadenectomy. Tumor grading was 35 G1 and 12 G2/3. Primary lesion stage was 24 pT1 and 23 pT2-4. Positive inguinal nodes were observed in 15 patients. Selected paraffin embedded sections were submitted to VEGF immunohistochemical analysis by the avidin-biotin-immunoperoxidase method with antigen retrieval. All slides were examined using an automatic analyzer system and the proportion of labeled cells in 10 high magnification power fields (400X were recorded in a blind analysis. RESULTS: Median (% labeling index was 2.3 in G1 versus 2.2 in G2/3 tumors (p=0.60, and 4.0 in pT1 versus 1.8 pT2-4 tumors (p=0.10. The respective data for pN0 patients was 2.8 and for pN+ was 2.1 (p=0.20. Survival curves showed no association with patients survival. CONCLUSION: In squamous cell carcinoma of the penis the VEGF immunoexpression has no association with tumor grade or stage, as well as with patient survival.

  17. Differences in sensitivity of rat mesenteric small arteries to agonists when studied as ring preparations or as cannulated preparations.

    OpenAIRE

    Buus, N. H.; VanBavel, E.; Mulvany, M. J.

    1994-01-01

    1. Pharmacological experiments on vascular tissue are normally performed on isometric ring or strip preparations. The aim of this study was to compare the isometric characteristics with the characteristics obtained if vessels were examined under the more physiologically appropriate isobaric condition. 2. Rat mesenteric small arteries were mounted either on two steel wires for isometric force measurement (wire-myograph) or cannulated for measurement of the internal diameter under isobaric cond...

  18. Traumatic avulsion of penile and scrotal skin.

    Science.gov (United States)

    Tripathi, F M; Sinha, J K; Bhattacharya, V; Bariar, L M

    1982-07-01

    Due to the use of high speed machinery in industry and the rapid mechanisation of agriculture an increasing number of avulsion injuries are being referred for treatment. This paper describes our experience in the management of ten patients with extensive traumatic avulsion of the penile and scrotal skin, treated by primary split-thickness skin grafting. PMID:6758901

  19. Longitudinal study of aortic isthmus Doppler in appropriately grown and small-for-gestational-age fetuses with normal and abnormal umbilical artery Doppler.

    LENUS (Irish Health Repository)

    Kennelly, M M

    2012-04-01

    To establish reference ranges using longitudinal data for aortic isthmus (AoI) Doppler indices in appropriate-for-gestational-age (AGA) fetuses and to document the longitudinal trends in a cohort of small-for-gestational-age (SGA) fetuses with normal umbilical artery Doppler and in fetuses with intrauterine growth restriction (IUGR) and abnormal umbilical artery Doppler.

  20. Amplitude-integrated electroencephalographic activity and middle cerebral artery Doppler flow measurements in preterm small for gestational age infants.

    Science.gov (United States)

    Kolsuz, Leyla Daban; Topcuoglu, Sevilay; Gursoy, Tugba; Karatekin, Güner; Ovali, H Fahri

    2015-03-01

    Amplitude-integrated encephalography (EEG) is frequently used in neonatal intensive care units to monitor brain functions. Its bedside application and easy interpretation are the most important features. Brain development of small for gestational age infants can be affected by intrauterine chronic hypoxia. The current study aimed to evaluate cerebral functions of small for gestational age infants by means of amplitude-integrated EEG. Thirty- to 34-week-old 22 small for gestational age and 27 appropriate for gestational age preterm infants were included in the study. The mode of delivery, gender, birth weight, and Apgar scores of the patients were recorded. Following middle cerebral artery mean velocity measurement with cranial Doppler at the 24th hour of birth, an amplitude-integrated EEG recording was performed on all infants, for a period of 4 to 24 hours. Small for gestational age infants had significantly higher middle cerebral artery mean velocity than appropriate for gestational age infants (21.09 ± 4.25 vs 17.8 ± 4.07; P = .029). The amplitude-integrated EEG recordings showed lower "lower border of quiet sleep" and total Burdjalov score in small for gestational age infants when compared with appropriate for gestational age infants (2.5 [1-3.25] µV vs 3 [2.75-4] µV; P = .04, 8 [6-10], 9 [9-11]; P = .04, respectively). Increased middle cerebral artery blood flow observed in small for gestational age infants might be a marker of chronic intrauterine hypoxia to which these infants were exposed. These infants demonstrated a more immature pattern of amplitude-integrated EEG. PMID:25296921

  1. Some pharmacological and elastic characteristics of isolated subcutaneous small arteries from patients with essential hypertension

    DEFF Research Database (Denmark)

    Thybo, N K; Mulvany, M J

    1996-01-01

    To investigate the elastic characteristics of the wall of isolated subcutaneous resistance arteries from patients with essential hypertension, the response of the vessels to endothelium-dependent and -independent vasodilators and the dependence on calcium.

  2. Penile Doppler ultrasound predicting cardiovascular disease in men with erectile dysfunction.

    Science.gov (United States)

    Gupta, Nikhil; Herati, Amin; Gilbert, Bruce R

    2015-03-01

    Cardiovascular disease is a major cause of morbidity and mortality in the USA. Traditional risk factors such as obesity, physical inactivity, and diet are used to screen for cardiovascular disease. However, these risk factors miss a significant population who are at risk for future cardiac events. Erectile dysfunction (ED) has many associated conditions in common with cardiovascular disease and has been shown to be an independent risk factor for cardiovascular. Measurements made on penile Doppler ultrasound (PDU), such as cavernosal artery peak systolic velocity (PSV), cavernosal artery intima-medial thickness, and the finding of cavernosal artery calcification, are indicators of generalized vascular disease. Thus, elements of PDU can identify men at higher risk for cardiovascular disease. This review outlines the proper technique for PDU and the literature supporting the use of PDU to predict cardiovascular disease in men with erectile dysfunction. PMID:25677231

  3. Histamine-dependent prolongation by aldosterone of vasoconstriction in isolated small mesenteric arteries of the mouse

    DEFF Research Database (Denmark)

    Schjerning, Jeppe; Uhrenholt, Torben R

    2013-01-01

    In arterioles, aldosterone counteracts the rapid dilatation ("recovery") following depolarization-induced contraction. The hypothesis was tested that this effect of aldosterone depends on COX-derived products and/or NOS inhibition. Recovery of the response to high K(+) was observed in mesenteric arteries of wild type and COX-2(-/-) mice but it was significantly diminished in preparations from eNOS(-/-) mice. Aldosterone pretreatment inhibited recovery from wild type and COX-2(-/-) mice. The NO-donor sodium nitroprusside (SNP) restored recovery in arteries from eNOS(-/-) mice and this was inhibited by aldosterone. Actinomycin-D abolished the effect of aldosterone indicating a genomic effect. The effect was blocked by indomethacin and by the COX-1 inhibitor valeryl salicylate but not by NS-398 (10(-6) mol/L) or the TP-receptor antagonist S18886 (10(-7) mol/L). The effect of aldosterone on recovery in arteries from wild type mice and the SNP-mediated dilatation in arteries from eNOS(-/-) mice was inhibited by the histamine H2 receptor antagonist cimetidine. RT-PCR showed expression of mast cell markers in mouse mesenteric arteries. The adventitia displayed granular cells positive for toluidine blue vital stain. Confocal microscopy of live mast cells showed loss of quinacrine fluorescence and swelling after aldosterone treatment indicating degranulation. RT-PCR showed expression of mineralocorticoid receptors in mesenteric arteries and in isolated mast cells. These findings suggest that aldosterone inhibits recovery by stimulation of histamine release from mast cells along mesenteric arteries. The resulting activation of H2 receptors decreases the sensitivity to NO of vascular smooth muscle cells. Aldosterone may chronically affect vascular function through paracrine release of histamine.

  4. Atypical penile Mondor's disease - involvement of the circumflex vein.

    Science.gov (United States)

    Arora, Rahul; Sonthalia, Sidharth; Gera, Tanu; Sarkar, Rashmi

    2015-04-01

    Mondor's disease is a rare condition characterised by superficial thrombophlebitis of subcutaneous veins, most commonly over the anterior chest wall. Penile Mondor's disease is rarer, arising out of thrombophlebitis of the penile veins. It typically involves the dorsal vein of the penis and presents with a cord-like indurated lesion with a beaded feel, palpable along the length of the involved vein. Though penile Mondor's disease involving the dorsal vein of the penis has been reported by many authors, we report a peculiar case of penile Mondor's disease in a 26-year-old sexually active man with thrombophlebitis of the circumflex vein of the penis with sparing of the dorsal vein. Diagnosis was confirmed on Doppler ultrasonography of the penile venous system. Despite exhaustive history taking, no cause could be elicited. The lesion completely subsided within three days with daily local hot fomentation. We propose the term 'atypical penile Mondor's disease' for such a case. PMID:24867818

  5. Isolated Penile Torsion in Brothers: A Case Report

    Directory of Open Access Journals (Sweden)

    Metin Gunduz

    2012-04-01

    Full Text Available Penile torsion can be congenital and associated with hypospadias and chordee, or can be acquired after circumcision. The incidence of isolated neonatal penile torsion was 1.7 to 27% in the literature. The majority were between 10 and deg; and 20 and deg;. Generally, torsion was to the left in cases. The techniques for correction of penile torsion described in the literature are penile de-gloving and reattaching of skin, resection of Buck's fascia incising the base of the penis and removing angular ellipses of corporeal tissue with subsequent plication of tunica, and dorsal dartos flap rotation in severe cases. In conclusion, penile torsion may be familial. Therefore, brothers should be examined carefully. The degloving and realignment technique is successful in isolated penile torsion. [Arch Clin Exp Surg 2012; 1(2.000: 122-124

  6. Arterial hypertension due to fructose ingestion: model based on intermittent osmotic fluid trapping in the small bowel

    Directory of Open Access Journals (Sweden)

    Kurbel Sven

    2010-06-01

    Full Text Available Abstract Based on recently reported data that fructose ingestion is linked to arterial hypertension, a model of regulatory loops involving the colon role in maintenance of fluid and sodium homeostasis is proposed. In normal digestion of hyperosmolar fluids, also in cases of postprandial hypotension and in patients having the "dumping" syndrome after gastric surgery, any hyperosmolar intestinal content is diluted by water taken from circulation and being trapped in the bowel until reabsorption. High fructose corn sirup (HFCS soft drinks are among common hyperosmolar drinks. Fructose is slowly absorbed through passive carrier-mediated facilitated diffusion, along the entire small bowel, thus preventing absorption of the trapped water for several hours. Here presented interpretation is that ingestion of hyperosmolar HFCS drinks due to a transient fluid shift into the small bowel increases renin secretion and sympathetic activity, leading to rise in ADH and aldosterone secretions. Their actions spare water and sodium in the large bowel and kidneys. Alteration of colon absorption due to hormone exposure depends on cell renewal and takes days to develop, so the momentary capacity of sodium absorption in the colon depends on the average aldosterone and ADH exposure during few previous days. This inertia in modulation of the colon function can make an individual that often takes HFCS drinks prone to sodium retention, until a new balance is reached with an expanded ECF pool and arterial hypertension. In individuals with impaired fructose absorption, even a higher risk of arterial hypertension can be expected.

  7. Arterial hypertension due to fructose ingestion: model based on intermittent osmotic fluid trapping in the small bowel.

    Science.gov (United States)

    Kurbel, Sven

    2010-01-01

    Based on recently reported data that fructose ingestion is linked to arterial hypertension, a model of regulatory loops involving the colon role in maintenance of fluid and sodium homeostasis is proposed.In normal digestion of hyperosmolar fluids, also in cases of postprandial hypotension and in patients having the "dumping" syndrome after gastric surgery, any hyperosmolar intestinal content is diluted by water taken from circulation and being trapped in the bowel until reabsorption. High fructose corn sirup (HFCS) soft drinks are among common hyperosmolar drinks. Fructose is slowly absorbed through passive carrier-mediated facilitated diffusion, along the entire small bowel, thus preventing absorption of the trapped water for several hours.Here presented interpretation is that ingestion of hyperosmolar HFCS drinks due to a transient fluid shift into the small bowel increases renin secretion and sympathetic activity, leading to rise in ADH and aldosterone secretions. Their actions spare water and sodium in the large bowel and kidneys. Alteration of colon absorption due to hormone exposure depends on cell renewal and takes days to develop, so the momentary capacity of sodium absorption in the colon depends on the average aldosterone and ADH exposure during few previous days. This inertia in modulation of the colon function can make an individual that often takes HFCS drinks prone to sodium retention, until a new balance is reached with an expanded ECF pool and arterial hypertension. In individuals with impaired fructose absorption, even a higher risk of arterial hypertension can be expected. PMID:20579372

  8. Acute penile pain and swelling in a 4-year-old child with Henoch-Schönlein purpura.

    Science.gov (United States)

    Tewary, Kishor Kumar; Khodaghalian, Bernadette; Narchi, Hassib

    2015-01-01

    Henoch-Schönlein purpura (HSP) is the most common vasculitis found in children. It usually affects the small vessels of the skin, joints, gastrointestinal tract and, more rarely, kidneys, brain, lungs and genitalia. Apart from classical presentation with purpuric rashes around buttocks and lower extremities, features such as arthralgia, abdominal pain, haematuria and proteinuria as well as scrotal swelling have been described in the literature. Penile involvement is rare and is not commonly described. We describe a child with HSP who developed penile involvement. We review the literature of all the cases reported in detail, in order to highlight useful clinical presentation, management and prognosis of this rare manifestation. PMID:25858918

  9. An Impulse Control Disorder Case with Penile Fracture and Trichotillomania

    OpenAIRE

    Cumurcu, Birgu?l Elbozan

    2007-01-01

    Penile fractures are classically described as presenting with rapid detumescence of an erection associated with blunt trauma. This clinical finding is due to a tear in the tunica albuginea surrounding the corpora cavernosum. In this study, we report and discuss a case of trichotillomania and penile bending impulse resulting in penile fracture, which was operated in the urology clinic. The possible psychological and psychiatric problems underlying the impulsive behavior are discussed, and the ...

  10. The effect of vacuum devices on penile hemodynamics

    International Nuclear Information System (INIS)

    External vacuum devices are being used increasingly for the management of erectile dysfunction. There is limited information regarding the effect of vacuum devices on penile blood flow and potential for ischemic penile injury. The penile xenon washout rate was measured before and after application of 2 vacuum systems in 15 subjects. Compared to flaccid state measurements the xenon washout rate did not change significantly with the Synergist Erection System but it was significantly reduced with the Osbon ErecAid System. However, the degree and duration of decrease in penile blood flow that may result in ischemic changes are unknown

  11. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... urethral catheter, we want to do it through small incision. Doing it quickly is also extremely important. ... deliver the scrotum and the penis through this small fenestration, and then with the same contaminated – or ...

  12. Microneurovascular reimplantation in a case of total penile amputation

    Directory of Open Access Journals (Sweden)

    Bhatt Yogesh

    2008-01-01

    Full Text Available Amputation of the penis is a rare condition reported from various parts of the world as isolated cases or small series of patients; the common aetiology is self-mutilating sharp amputation or an avulsion or crush injury in an industrial accident. A complete reconstruction of all penile structures should be attempted in one stage which provides the best chance for full rehabilitation of the patient. We report here a single case of total amputation of the penis, which was successfully reattached by using a microsurgical technique. After surgery, near-normal appearance and function including a good urine flow and absence of urethral stricture, capabilities of erection and near normal sensitivity were observed.

  13. Penile skin necrosis - complication following selfcircumcision.

    Science.gov (United States)

    Sagar, Jayesh; Sagar, Bethani; Shah, Dharmendra K

    2005-07-01

    Circumcision is one of the commonest operations performed throughout the world for ritual, traditional or medical reasons. Self-circumcision may lead to disastrous complications. There have been reports of the complications following use of the constricting devices for improved sexual performance and for auto-erotic intentions, but cases of self-circumcision leading to complications such as necrosis of the penile skin and strangulation of the penis are very rarely reported. This case represents penile skin necrosis in a 55-year-old white English man following an attempt at self-circumcision with a medically unapproved plastic device available in the market. He recovered after surgical debridement and treatment with antibiotics. PMID:16884600

  14. Penile gangrene due to calcific uremic arteriopathy

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    Bappa Adamu

    2011-06-01

    Full Text Available Calcific uremic arteriopathy (CUA is a rare but potentially life-threatening complication of end-stage renal disease (ESRD and secondary hyperparathyroidism. It typically presents with ischemic necrosis involving areas of adiposity in the body mainly the trunk, buttocks, or proximal extremity. Patients can also present with digital ischemia and more rarely penile gangrene. The pathogenesis of CUA is not yet clear but several putative factors, mainly hyperparathyroidism and related metabolic abnormalities are implicated. A number of conditions can mimic CUA clinically and should be differentiated from it. We present in the current study, a patient who presented with progressive penile gangrene and skin necrosis due to CUA. We review the current understanding of the pathogenesis, diagnosis/differential diagnosis, and management of this rare but potentially life-threatening complication of ESRD.

  15. Synergism of clinical evaluation and penile sonographic imaging in diagnosis of penile fracture: a case report

    Directory of Open Access Journals (Sweden)

    Bello Jibril

    2012-09-01

    Full Text Available Abstract Introduction Penile fracture is an uncommon urologic emergency, and is the traumatic rupture of the tunica albuginea covering the corpus cavernosa. This usually occurs following blunt trauma sustained during coitus, masturbation or self-manipulations to hide or suppress an erection. Clinical diagnosis can often be easily made with typical history and examination findings. However, the patient may present atypically and/or with a suspicion of associated urethral injury. The roles of various diagnostic investigations are being evaluated in these situations. Case presentation We report the case of a 31-year-old African man with penile fracture and suspected associated urethral injury that occurred after self-manipulations to hide an erection. Conclusions Penile ultrasound and sonourethrography provide useful additional diagnostic information to supplement clinical history and physical examination findings and can be performed easily, at low cost and with no delays to surgery.

  16. Clinicopathological features and histogenesis of penile cysts.

    Science.gov (United States)

    Lezcano, Cecilia; Chaux, Alcides; Velazquez, Elsa F; Cubilla, Antonio L

    2015-05-01

    Cysts arising in the penis are uncommon and can be found anywhere from the urethral meatus to the root of the penis involving glans, foreskin, or shaft. Median raphe cysts account for the majority of penile cystic lesions reported in the literature. As their name suggests, they arise on the ventral midline of the penis that extends from the urethral meatus to the scrotum and perineum. Proposed hypotheses for their origin as well as their diverse morphology are discussed. PMID:25701383

  17. Epidemiologic study on penile cancer in Brazil

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    Luciano A. Favorito

    2008-10-01

    Full Text Available OBJECTIVES: To assess epidemiologic characteristics of penile cancer in Brazil. MATERIALS AND METHODS: From May 2006 to June 2007, a questionnaire was distributed to all Brazilian urologists. Their patients' clinical and epidemiological data was analyzed (age, race, place of residence, history of sexually transmitted diseases, tobacco smoking, performance of circumcision, type of hospital service, as well as the time between the appearance of the symptoms and the diagnosis, the pathological characteristics of the tumor (histological type, degree, localization and size of lesion, stage of disease, the type of treatment performed and the present state of the patient. RESULTS: 283 new cases of penile cancer in Brazil were recorded. The majority of these cases occurred in the north and northeast (53.02% and southeast (45.54% regions. The majority of patients (224, or 78.96% were more than 46 years of age while only 21 patients (7.41% were less than 35 years of age. Of the 283 patients presenting penile cancer, 171 (60.42% had phimosis with the consequent impossibility to expose the glans. A prior medical history positive for HPV infection was reported in 18 of the 283 cases (6.36%. In 101 patients (35.68% tobacco smoking was reported. The vast majority of the cases (n = 207; 73.14% presented with tumors localized in the glans and prepuce. In 48 cases (16.96% the tumor affected the glans, the prepuce and the corpus penis; in 28 cases (9.89% the tumor affected the entire penis. The majority of the patients (n = 123; 75.26% presented with T1 or T2; only 9 patients (3.18% presented with T4 disease. CONCLUSION: Penile cancer is a very frequent pathology in Brazil, predominantly affecting low income, white, uncircumcised patients, living in the north and northeast regions of the country.

  18. Management of Penile Fracture and its Outcome

    International Nuclear Information System (INIS)

    Objective: To describe the management and outcome of patients with penile fracture. Study Design: Case series. Place and Duration of Study: Department of Urology and Renal Transplantation, Jinnah Hospital, Lahore, from March 2008 to March 2011. Methodology: Sixteen patients presenting with clinical findings / history of penile fracture were included in this study. Diagnosis was made on the basis of history and clinical findings. Surgical exploration and repair was done on the same day. In all patients, a subcoronal circumferential degloving incision was made. Rent location and dimensions management and postoperative complication were noted. Postoperatively, erection was suppressed for 4 - 5 days. All patients were discharged with advice of avoidance of sex for about 8 weeks. Patients were followed-upto 6 months. Results: Majority of the patients (87.5%) were married and 13 (81.25%) were aged 18 - 45 years. The typical findings recorded in 100.0% patients were erection at time of fracture, detumescence, swelling and ecchymosis. Audible crackling sound and pain was present in 13 (81.25%) patients. Ten (62.5%) patients had rent in the proximal part of penile shaft and right lateral tear was present in 11 (68.75%) patients. Blood clots were evacuated and closure of rent was done with vicryl 2/0 (interrupted stitches). 100.0% patients had uneventful recovery with only 3 (18.75%) patients developed right chordae of erect penis after treatment. All (100.0%) patients were potent and without any problem of erection. Conclusion: Penile fracture is under-reported. A trauma to erect penis is essential to cause fracture. Surgical exploration and repair is the treatment of choice. (author)

  19. Epidemiologic study on penile cancer in Brazil

    Scientific Electronic Library Online (English)

    Luciano A., Favorito; Aguinaldo C., Nardi; Mario, Ronalsa; Stenio C., Zequi; Francisco J. B., Sampaio; Sidney, Glina.

    2008-10-01

    Full Text Available OBJECTIVES: To assess epidemiologic characteristics of penile cancer in Brazil. MATERIALS AND METHODS: From May 2006 to June 2007, a questionnaire was distributed to all Brazilian urologists. Their patients' clinical and epidemiological data was analyzed (age, race, place of residence, history of se [...] xually transmitted diseases, tobacco smoking, performance of circumcision, type of hospital service), as well as the time between the appearance of the symptoms and the diagnosis, the pathological characteristics of the tumor (histological type, degree, localization and size of lesion, stage of disease), the type of treatment performed and the present state of the patient. RESULTS: 283 new cases of penile cancer in Brazil were recorded. The majority of these cases occurred in the north and northeast (53.02%) and southeast (45.54%) regions. The majority of patients (224, or 78.96%) were more than 46 years of age while only 21 patients (7.41%) were less than 35 years of age. Of the 283 patients presenting penile cancer, 171 (60.42%) had phimosis with the consequent impossibility to expose the glans. A prior medical history positive for HPV infection was reported in 18 of the 283 cases (6.36%). In 101 patients (35.68%) tobacco smoking was reported. The vast majority of the cases (n = 207; 73.14%) presented with tumors localized in the glans and prepuce. In 48 cases (16.96%) the tumor affected the glans, the prepuce and the corpus penis; in 28 cases (9.89%) the tumor affected the entire penis. The majority of the patients (n = 123; 75.26%) presented with T1 or T2; only 9 patients (3.18%) presented with T4 disease. CONCLUSION: Penile cancer is a very frequent pathology in Brazil, predominantly affecting low income, white, uncircumcised patients, living in the north and northeast regions of the country.

  20. Penile skin necrosis - complication following selfcircumcision.

    OpenAIRE

    Sagar, Jayesh; Sagar, Bethani; Shah, Dharmendra K.

    2005-01-01

    Circumcision is one of the commonest operations performed throughout the world for ritual, traditional or medical reasons. Self-circumcision may lead to disastrous complications. There have been reports of the complications following use of the constricting devices for improved sexual performance and for auto-erotic intentions, but cases of self-circumcision leading to complications such as necrosis of the penile skin and strangulation of the penis are very rarely reported. This case represen...

  1. Penile Calciphylaxis in End Stage Renal Disease

    OpenAIRE

    Fulvio Floccari; Moreno Malaguti; Giovanni Otranto; Antonio Gorini; Luca Di Lullo; Vincenzo Barbera; Alberto Santoboni

    2013-01-01

    Calciphylaxis, better described as “Calcific uremic arteriolopathy” (CUA), involves about 1–4% of hemodialysis patients all around the world with high mortality rates. We describe a rare clinical case of CUA in peritoneal dialysis patient associated with urological disease. Penile calciphylaxis represents rare clinical complication, and an early diagnosis and multidisciplinary approach are requested. Pathogenesis is still unclear, and therapeutic approaches need more long-term clinical ...

  2. Severe Penile Curvature following Otis Urethrotomy

    OpenAIRE

    Ersagun Karaguzel; Metin Gur; Tok, Dogan S.; Kazaz, Amp X. Lke O.; Huseyin Eren; Omer Kutlu; Ozgur, Guner K.

    2013-01-01

    Urethral stricture is a common urological pathology with a high recurrence rate after treatment. Urethral manipulations are among its main causes. In this paper, urethral stricture developed secondary to urethral catheterization and was treated with cold-knife internal urethrotomy and the Otis urethrotomy procedure. During the follow-up period, severe ventral penile curvature preventing sexual intercourse developed due to fibrosis of the corpus spongiosum and tunica albuginea of the penis. Th...

  3. Epidemiologic study on penile cancer in Brazil

    OpenAIRE

    Favorito, Luciano A.; Aguinaldo C. Nardi; Mario Ronalsa; Stenio de C. Zequi; Francisco J.B Sampaio; Sidney Glina

    2008-01-01

    OBJECTIVES: To assess epidemiologic characteristics of penile cancer in Brazil. MATERIALS AND METHODS: From May 2006 to June 2007, a questionnaire was distributed to all Brazilian urologists. Their patients' clinical and epidemiological data was analyzed (age, race, place of residence, history of sexually transmitted diseases, tobacco smoking, performance of circumcision, type of hospital service), as well as the time between the appearance of the symptoms and the diagnosis, the pathological ...

  4. Idiopathic mucosal penile squamous papillomas in dogs.

    Science.gov (United States)

    Cornegliani, Luisa; Vercelli, Antonella; Abramo, Francesca

    2007-12-01

    A new papillomatous clinical entity is described affecting the penile mucosa of dogs. The animals, 11 male dogs of different breeds, ageing from 6 to 13 years, were presented for genital mass and occasional haematuria. Surgical incision of the prepuce skin of the anaesthetized dogs showed the presence of single pedunculated, soft, pink-red, cauliflower-like masses arising from the penile mucosa, with diameter ranging from 2 to 8 cm. In all cases, histopathological examination of the excised masses showed normal epithelial differentiation with digitiform expansion of all the layers and elongated rete ridges slanted towards the periphery of the lesion. Evidence of ballooning degeneration or basophilic intranuclear inclusion bodies was not found. Both immunohistochemistry and polymerase chain reaction techniques failed to reveal papillomavirus. According to the histological World Health Organization classification of papillomatous lesions and due to the lack of evidence of a viral origin the masses were identified as idiopathic mucosal penile squamous papillomas. Urinary problems resolved after surgical excision, haematuria was therefore considered secondary to ulceration of the papillated masses. PMID:17991162

  5. Organ-Preserving Surgery for Penile Carcinoma

    Directory of Open Access Journals (Sweden)

    Tomé M. Lopes

    2008-11-01

    Full Text Available Introduction. Penile carcinoma has traditionally been treated by either surgical amputation or radical radiotherapy, both associated with devastating anatomical, functional, and psychological impact on the patient's life. Innovative surgical techniques have focused on penile preservation in well-selected patients to minimize physical disfigurement and consequently maximize quality of life. The objective of this article is to define the current status of these organ-preserving surgical options for penile carcinoma. Materials and Methods. An extensive review of the Pubmed literature was performed to find articles discussing only reconstructive surgery which have contributed significantly to change traditional, frequently mutilating treatments, to develop less disfiguring surgery, and to improve patients' quality of life over the last two decades. Results. Several articles were included in this analysis in which a major contribution to the change in therapy was thought to have occurred and was documented as beneficial. Some articles reported novel techniques of less-mutilating surgery involving different forms of glans reconstruction with the use of flaps or grafts. The issue of safe surgical margins was also addressed. Conclusion. The development of less-disfiguring techniques allowing phallus preservation has reduced the negative impact on functional and cosmetic outcomes of amputation without sacrificing oncological objectives in appropriately selected patients based on stage, grade, and location of the tumour. Until more prospective studies are available and solid evidence is documented, organ preservation should be offered with caution.

  6. Simultaneous Surgical Treatment of Non-small Cell Lung Cancer and Off-pump Coronary Artery bypass Grafting

    Directory of Open Access Journals (Sweden)

    Yi ZHANG

    2009-04-01

    Full Text Available Background and objective Patients with resectable lung cancer and unstable coronary heart disease are at high risks of postoperative death or severe cardioovascular complications. They always pose a therapeutic challenge for thoracic surgeons. The aim of this study is to summarize clinical experience of radical lung resection for cancer with simultaneous off-pump coronary artery bypass grafting. Methods Seven patients who suffered from non small cell lung cancer concomitant arrhythmia, unstable angina and recent history of myocardial infarction had been carried out simultaneous radical lobectomy and off-pump coronary artery bypass grafting. Preoperative 6 patients had been confirmed to be misfit for either coronary arterioplasty or stent implanting by performing the coronary angiography. One patient had undergone stenting before the lung cancer had been diagnosed. The procedure through median sternotomy performed offpump coronary artery bypass grafting preceded lobectomy and mediastinal lymphadenectomy. Left upper lobectomy was performed in 2 patients, right upper lobectomy was performed in 1 patient, right upper and middle lobectomy was performed in one patient, video thoracoscopy assisted left lower lobectomy was performed in 1 patient, right lower lobectomy was performed in 2 patients. Results There was no death of patient in hospital, however, a patient died 7th month postoperatively because of cerebrovascular accident. Atrial fibrillation was observed postoperatively in 1 patient. Five patients were diagnosed as squamous cell lung cancer by pathology examination, and 2 patients were adenocarcinoma. Follow-up ranging from 2 months to 59 monthswas available for these patients postoperatively. None of the patients showed evidence of angina and myocardial infarction after surgery. In one patient, who underwent left superior lobectomy, local recurrence was found at 19 months after surgery. Conclusion In selected patients, simultaneous radical lung resection and off-pump coronary artery bypass grafting is a safe and effective treatment when unstable coronary heart disease and lung cancer coexist. The therapeutic strategy may decrease the incidence of postoperative complications.

  7. Sentinel Node Biopsy in Penile Cancer: Case Report

    International Nuclear Information System (INIS)

    A case that illustrates the benefits of lymphatic mapping in penile cancer with sentinel nodes to detect lymphgammagraphy groin. This is a patient of 48 years who consulted the urology department for evaluation after partial penile amputation require at another institution by the appearance of a histologically confirmed lesion in the glans penis as Squamous Cell Carcinoma

  8. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... and then we will proceed to making an opening, an incision in the skin. We’re changing ... actually slip the prosthesis through the tight, small opening. We’re dilating the penis hydraulically. This allows ...

  9. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... we prepare the skin, we isolate the urethral catheter, we want to do it through small incision. ... contaminated gloves, we’ll put in a Foley catheter and then we will proceed to making an ...

  10. Distribution of mesenteric cranial artery in the small intestine of Procyon cancrivorus (Cuvier, 1798 (Mammalia, Procyonidae - doi: 10.4025/actascibiolsci.v32i2.5839 Distribution of mesenteric cranial artery in the small intestine of Procyon cancrivorus (Cuvier, 1798 (Mammalia, Procyonidae - doi: 10.4025/actascibiolsci.v32i2.5839

    Directory of Open Access Journals (Sweden)

    Kleber Fernando Pereira

    2010-05-01

    Full Text Available The mesenteric artery is a high caliber vessel dependent on the abdominal artery, right below the emergence of the vessels destined for the liver and stomach. The present study aimed to describe the behavior of the arterial vessel in the small intestine of the crab-eating raccoon (Procyon cancrivorus. The animals were collected on highways (roadkill. Cannulation of the abdominal aorta, perfusion with warmed water (40°C and stained latex injection (Neoprene 450, Dupont do Brasil and Sulvinil stain, Glassuret S.A were performed, followed by formaldehyde fixation (10%. The dissection and photographic documents (Sony Cyber-shot, 8.1 megapixels made it possible to systemize the arteries and define the vascular patterns of the viscera. It was verified that the mesenteric cranial artery supports the entire jejune and the mesenteric portion of the ileum. Next to the mesenteric border, it becomes an anastomosis forming vascular arches from where straight arteries leave, supplying the mesenteric portion and sometimes also the jejunal anti-mesenteric portion. The artery that irrigates the ileum comes up as a branch of the cranial mesenteric artery. Anatomic knowledge of the vascular pattern of the crab-eating raccoon (Procyon cancrivorus is of fundamental importance for researches regarding the arterial distribution of the intestine considering anatomic variances.The mesenteric artery is a high caliber vessel dependent on the abdominal artery, right below the emergence of the vessels destined for the liver and stomach. The present study aimed to describe the behavior of the arterial vessel in the small intestine of the crab-eating raccoon (Procyon cancrivorus. The animals were collected on highways (roadkill. Cannulation of the abdominal aorta, perfusion with warmed water (40°C and stained latex injection (Neoprene 450, Dupont do Brasil and Sulvinil stain, Glassuret S.A were performed, followed by formaldehyde fixation (10%. The dissection and photographic documents (Sony Cyber-shot, 8.1 megapixels made it possible to systemize the arteries and define the vascular patterns of the viscera. It was verified that the mesenteric cranial artery supports the entire jejune and the mesenteric portion of the ileum. Next to the mesenteric border, it becomes an anastomosis forming vascular arches from where straight arteries leave, supplying the mesenteric portion and sometimes also the jejunal anti-mesenteric portion. The artery that irrigates the ileum comes up as a branch of the cranial mesenteric artery. Anatomic knowledge of the vascular pattern of the crab-eating raccoon (Procyon cancrivorus is of fundamental importance for researches regarding the arterial distribution of the intestine considering anatomic variances.

  11. Thrombophlebitis of the penile superficial vein, penile mondor's disease: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sang Hyun; Kim, Young Hwa; Kim, Doo Sang; Shin, Hyung Chul; Bae, Won Kyung; Kim, Il Young [Soonchunhyang University, Chunan (Korea, Republic of); Kim, Hyun Cheol [Kyung-Hee University, Seoul (Korea, Republic of)

    2007-07-15

    Mondor's disease is commonly known as thrombophlebitis of the superficial vein in the breast, and this disease occurs rarely in the penis. Despite extensive information about the clinical presentation and course of this disease, imaging findings for this disease are limited. We report gray scale and power Doppler sonographic findings of penile Mondor's disease.

  12. Thrombophlebitis of the penile superficial vein, penile mondor's disease: a case report

    International Nuclear Information System (INIS)

    Mondor's disease is commonly known as thrombophlebitis of the superficial vein in the breast, and this disease occurs rarely in the penis. Despite extensive information about the clinical presentation and course of this disease, imaging findings for this disease are limited. We report gray scale and power Doppler sonographic findings of penile Mondor's disease

  13. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... the implant and I’ve made my corporotomy too big, I can put a nice superficial suture in ... percent. 01:01:35 PAUL PERITO, MD: Will fail every five years, so most ... you were saying about it being too small. The longer you wait to get this ...

  14. Penile fracture: experience in 56 cases

    Directory of Open Access Journals (Sweden)

    Koifman Leandro

    2003-01-01

    Full Text Available OBJECTIVE: The aim of this work is to report the diagnostic and therapeutic options for 55 patients with clinical diagnosis of penile fracture. MATERIALS AND METHODS: The patients were retrospectively assessed between 1982 and 2002. The primary diagnostic evaluation method for 55 patients (56 fractures was clinical history and physical exam. Ten (17.8% cases required complementary exams. Ultrasound (US was performed in 2 cases, and magnetic resonance imaging (MRI in 1 case. Retrograde urethrocystogram was performed in suspicious urethral injury, which happened for 7 patients. RESULTS: Of 56 assessed cases, 49 (89.5% were submitted to surgical exploration, and only 7 were conservatively conducted. Surgical treatment was performed in 48 patients (49 fractures, in these cases, 47 (95.9% presented tunica albuginea disruption and solely 2 (4.1% evidenced lesion of dorsal vein. Ultrasonography confirmed disruption of tunica albuginea in 1 (50% case, and in the other it was not possible to determinate the origin of the lesion, and the patient was submitted to surgical exploration, which confirmed the condition. MRI was used only in 1 case, confirming the lesion. Among 7 patients submitted to conservative management, until now, 3 (42.8% required surgical intervention to correct penile chordee. CONCLUSIONS: Penile fracture is an entity of eminently clinical diagnosis, which management should be surgical and immediate, avoiding thus complications related to erectile dysfunction. When suspecting an associated urethral injury, Urethrocystogram is recommended. In cases where there is diagnostic uncertainty, ultrasound and/or MRI may be used to reveal the condition.

  15. Penile brachytherapy: Results for 49 patients

    International Nuclear Information System (INIS)

    Purpose: To report results for 49 men with squamous cell carcinoma (SCC) of the penis treated with primary penile interstitial brachytherapy at one of two institutions: the Ottawa Regional Cancer Center, Ottawa, and the Princess Margaret Hospital, Toronto, Ontario, Canada. Methods and Materials: From September 1989 to September 2003, 49 men (mean age, 58 years; range, 22-93 years) had brachytherapy for penile SCC. Fifty-one percent of tumors were T1, 33% T2, and 8% T3; 4% were in situ and 4% Tx. Grade was well differentiated in 31%, moderate in 45%, and poor in 2%; grade was unspecified for 20%. One tumor was verrucous. All tumors in Toronto had pulsed dose rate (PDR) brachytherapy (n = 23), whereas those in Ottawa had either Iridium wire (n 22) or seeds (n = 4). Four patients had a single plane implant with a plastic tube technique, and all others had a volume implant with predrilled acrylic templates and two or three parallel planes of needles (median, six needles). Mean needle spacing was 13.5 mm (range, 10-18 mm), mean dose rate was 65 cGy/h (range, 33-160 cGy/h), and mean duration was 98.8 h (range, 36-188 h). Dose rates for PDR brachytherapy were 50-61.2 cGy/h, with no correction in total dose, which was 60 Gy in all cases. Results: Median follow-up was 33.4 months (range, 4-140 months). At 5 years, actuarial overall survival was 78.3% and cause-specific survival 90.0%. Four men died of penile cancer, and 6 died of other causes with no evidence of recurrence. Th causes with no evidence of recurrence. The cumulative incidence rate for never having experienced any type of failure at 5 years was 64.4% and for local failure was 85.3%. All 5 patients with local failure were successfully salvaged by surgery; 2 other men required penectomy for necrosis. The soft tissue necrosis rate was 16% and the urethral stenosis rate 12%. Of 8 men with regional failure, 5 were salvaged by lymph node dissection with or without external radiation. All 4 men with distant failure died of disease. Of 49 men, 42 had an intact and tumor-free penis at last follow-up or death. The actuarial penile preservation rate at 5 years was 86.5%. Conclusions: Brachytherapy is an effective treatment for T1, T2, and selected T3 SCC of the penis. Close follow-up is mandatory because local failures and many regional failures can be salvaged by surgery

  16. Surgical Management of a Locally Advanced Symptomatic Recurrence of Penile Sarcoma Secondary to Prostate Brachytherapy

    Scientific Electronic Library Online (English)

    Tariq S., Hakky; Patrick, Espiritu; Alejandro R., Rodriguez; Nicholas, Gould; Philippe E., Spiess.

    2013-04-01

    Full Text Available Background The surgical management of patients with symptomatic metastatic or locally advanced recurrences involving the penis remains poorly characterized. The aim of the present abstract and video is to detail our experience in the surgical management of a specific patient with a locally advanced [...] symptomatic recurrence of penile sarcoma secondary to prostate cancer treated with primary brachytherapy. Materials and Methods A 70 year old male patient initially treated for localized prostate cancer with interstitial brachytherapy at an outside facility developed an unfortunate secondary malignancy consisting of a locally advanced penile sarcoma involving as well the prostate and base of the bladder. Despite our best efforts to control his pain, he developed a very symptomatic local recurrence with a secondary penile abscess and purulent periurethral drainage. At this time, it was felt a surgical resection consisting of a total penectomy, urethrectomy, cystoprostatectomy, and ileal conduit urinary diversion would be the best option for local cancer control in this particular patient. Results The patient underwent the surgical resection without any complications as illustrated in this surgical video, with a jejunal intestinal mass identified at the time of surgery which was resected with a primary bowel anastomosis performed. The patient was discharged from hospital uneventfully with his symptomatic local recurrence being successfully managed and the patient no longer requiring oral narcotics for pain control. The pathological report confirmed a locally advanced sarcoma involving the penile, prostate, and bladder which was resected with negative surgical margins and the jejunal mass was confirmed to represent a small bowel sarcoma metastatic site. Conclusion As highlighted in the present video, the treatment of a symptomatic sarcoma local recurrence contiguously involving the penis can be successfully managed provided the patient is informed of the potential morbidity and psychosocial implications imparted by performing a total penectomy and adjacent organ resection.

  17. Surgical Management of a Locally Advanced Symptomatic Recurrence of Penile Sarcoma Secondary to Prostate Brachytherapy

    Directory of Open Access Journals (Sweden)

    Tariq S. Hakky

    2013-04-01

    Full Text Available Background The surgical management of patients with symptomatic metastatic or locally advanced recurrences involving the penis remains poorly characterized. The aim of the present abstract and video is to detail our experience in the surgical management of a specific patient with a locally advanced symptomatic recurrence of penile sarcoma secondary to prostate cancer treated with primary brachytherapy. Materials and Methods A 70 year old male patient initially treated for localized prostate cancer with interstitial brachytherapy at an outside facility developed an unfortunate secondary malignancy consisting of a locally advanced penile sarcoma involving as well the prostate and base of the bladder. Despite our best efforts to control his pain, he developed a very symptomatic local recurrence with a secondary penile abscess and purulent periurethral drainage. At this time, it was felt a surgical resection consisting of a total penectomy, urethrectomy, cystoprostatectomy, and ileal conduit urinary diversion would be the best option for local cancer control in this particular patient. Results The patient underwent the surgical resection without any complications as illustrated in this surgical video, with a jejunal intestinal mass identified at the time of surgery which was resected with a primary bowel anastomosis performed. The patient was discharged from hospital uneventfully with his symptomatic local recurrence being successfully managed and the patient no longer requiring oral narcotics for pain control. The pathological report confirmed a locally advanced sarcoma involving the penile, prostate, and bladder which was resected with negative surgical margins and the jejunal mass was confirmed to represent a small bowel sarcoma metastatic site. Conclusion As highlighted in the present video, the treatment of a symptomatic sarcoma local recurrence contiguously involving the penis can be successfully managed provided the patient is informed of the potential morbidity and psychosocial implications imparted by performing a total penectomy and adjacent organ resection.

  18. Penile Involvement and Henoch-Schönlein Purpura: A Case Report

    Directory of Open Access Journals (Sweden)

    Önder YAVA?CAN

    2012-01-01

    Full Text Available Henoch-Schönlein purpura (HSP, characterized by non-thrombocytopenic purpura accompanied by arthritis/arthralgia, gastrointestinal and genitourinary system involvement is the most common vasculitis in childhood. Associated penile involvement is very rare in patients with genitourinary system involvement. We report a 4.5 year-old boy with penile involvement and arthritis after a shortduration remission of HSP. Prednisolone (1mg/kg/day, orally and conservative measures resulted in complete recovery within five days. In conclusion, steroid treatment could be administered in HSP children with penile involvement although controversial.

  19. Activation of endothelial and epithelial KCa2.3 calcium-activated potassium channels by NS309 relaxes human small pulmonary arteries and bronchioles

    DEFF Research Database (Denmark)

    Kroigaard, C.; Dalsgaard, T.

    2012-01-01

    BACKGROUND AND PURPOSE Small (KCa2) and intermediate (KCa3.1) conductance calcium-activated potassium channels (KCa) may contribute to both epithelium- and endothelium-dependent relaxations, but this has not been established in human pulmonary arteries and bronchioles. Therefore, we investigated the expression of KCa2.3 and KCa3.1 channels, and hypothesized that activation of these channels would produce relaxation of human bronchioles and pulmonary arteries. EXPERIMENTAL APPROACH Channel expression and functional studies were conducted in human isolated small pulmonary arteries and bronchioles. KCa2 and KCa3.1 currents were examined in human small airways epithelial (HSAEpi) cells by whole-cell patch clamp techniques. RESULTS While KCa2.3 expression was similar, KCa3.1 protein was more highly expressed in pulmonary arteries than bronchioles. Immunoreactive KCa2.3 and KCa3.1 proteins were found in both endothelium and epithelium. KCa currents were present in HSAEpi cells and sensitive to the KCa2.3 blocker UCL1684 and the KCa3.1 blocker TRAM-34. In pulmonary arteries contracted by U46619 and in bronchioles contracted by histamine, the KCa2.3/ KCa3.1 activator, NS309, induced concentration-dependent relaxations. NS309 was equally potent in relaxing pulmonary arteries, but less potent in bronchioles, than salbutamol. NS309 relaxations were blocked by the KCa2 channel blocker apamin, while the KCa3.1 channel blocker, charybdotoxin failed to reduce relaxation to NS309 (0.011 mu M). CONCLUSIONS AND IMPLICATIONS KCa2.3 and KCa3.1 channels are expressed in the endothelium of human pulmonary arteries and epithelium of bronchioles. KCa2.3 channels contributed to endo- and epithelium-dependent relaxations suggesting that these channels are potential targets for treatment of pulmonary hypertension and chronic obstructive pulmonary disease.

  20. Penile herpes zoster: an unusual location for a common disease

    Scientific Electronic Library Online (English)

    Milan, Bjekic; Milica, Markovic; Sandra, Sipetic.

    2011-12-01

    Full Text Available Herpes zoster is a common dermatological condition which affects up to 20% of the population, most frequently involving the thoracic and facial dermatomes with sacral lesions occurring rarely and only a few reported cases of penile shingles. Case report: We report two cases of unusual penile clinica [...] l presentations of varicella zoster virus infection in immunocompetent men. The patients presented with grouped clusters of vesicles and erythema on the left side of penile shaft and posterior aspect of the left thigh and buttock, involving s2-s4 dermatomes. The lesions resolved quickly upon administration of oral antiviral therapy. Conclusion: Penile herpes zoster should not be overlooked in patients with unilateral vesicular rash.

  1. Penile rehabilitation after radical prostatectomy : what the evidence really says

    DEFF Research Database (Denmark)

    Fode, Mikkel; Ohl, Dana A

    2013-01-01

    The pathophysiology of erectile dysfunction after radical prostatectomy (RP) is believed to include neuropraxia, which leads to temporarily reduced oxygenation and subsequent structural changes in penile tissue. This results in veno-occlusive dysfunction, therefore, penile rehabilitation programmes focus on tissue oxygenation. Animal studies support the use of phosphodiesterase type 5 inhibitors (PDE5Is) after cavernous nerve damage but results from human studies are contradictory. The largest study to date found no long-term effect of either daily or on-demand PDE5I administration after RP compared with placebo. The effects of prostaglandin and vacuum erection devices are questionable and high-quality studies are lacking. Better documentation for current penile rehabilitation and/or better rehabilitation protocols are needed. One must be careful not to repeat the statement that penile rehabilitation improves erectile function after RP so many times that it becomes a truth even without the proper scientific backing.

  2. Penile Prosthesis Implantation for Treatment of Postpriapism Erectile Dysfunction

    OpenAIRE

    Jalal, Akbar A.; Durazi, Mohammed H.

    2008-01-01

    Introduction: Our aim was to evaluate the procedure and outcome of penile prosthesis surgery in the treatment of men with postpriapism erectile dysfunction. Materials and Methods: During the period between 1997 and 2004, a total of 17 patients with postpriapism erectile dysfunction underwent penile prosthesis implantation at our institution. Prosthesis implantation was done electively 6 to 18 months after priapism, when the patients presented with erectile dysfunction. Of the prosthesis im...

  3. Clinical Neuroanatomy and Neurotransmitter-Mediated Regulation of Penile Erection

    OpenAIRE

    Jung, Junyang; Jo, Hyun Woo; Kwon, Hyunseob; Jeong, Na Young

    2014-01-01

    Erectile dysfunction (ED) has an adverse impact on men's quality of life. Penile erection, which is regulated by nerves that are innervated into the erectile tissue, can be affected by functional or anatomical trauma of the perineal region, including specific structures of the penis, causing ED. Penile erection is neurologically controlled by the autonomic nervous system. Therefore, it is of utmost importance to understand the neurogenic structure of the erectile tissue and the types of neuro...

  4. Traumatic degloving lesion of penile and scrotal skin

    Directory of Open Access Journals (Sweden)

    Luiz A. Zanettini

    2005-06-01

    Full Text Available Avulsions of penile and scrotal skin are uncommon events and are caused mainly by accidents with industrial machines and agricultural machine belts. We report the case of a 30-year old patient with avulsion and traumatic degloving of the penile and scrotal skin, with exposure of the cavernous bodies, spongy body, and testes due to an industrial machine accident. Reconstruction was performed in steps, achieving a satisfactory esthetic result, normal voiding and reestablished sexual function.

  5. Angiosarcoma of penis: Case report of an aggressive penile cancer.

    Science.gov (United States)

    Priyadarshi, Vinod; Goel, Hemant Kumar; Chakrabarty, Debashish; Pal, Dilip Kumar

    2015-01-01

    Angiosarcoma is a very rare mesenchymal tumor of penis. Though extremely unusual, it should be considered in the differential diagnosis in patients presenting with a penile growth or a localized subcutaneous penile lesions as they are very aggressive and there is a high chance of recurrence. One such case is reported here, which was aggressively treated with total penectomy and the patient did not show any recurrence in 2 years of follow-up. PMID:25837261

  6. Intracavernosal metaraminol for treatment of intraoperative penile erection.

    OpenAIRE

    Tsai, S. K.; Hong, C. Y.

    1990-01-01

    Four patients developed penile erection when regional anaesthesia was induced with spinal block. In another patient, penile erection developed during fentanyl-induced general anaesthesia. Injection of metaraminol into corpus cavernosum successfully achieved detumescence in all these patients. The dose of metaraminol ranged from 10 to 25 micrograms, much less than that required for the treatment of vasodilator-induced priapism. Intracavernosal injection of metaraminol is a simple, effective an...

  7. Penile Microbiota and Female Partner Bacterial Vaginosis in Rakai, Uganda

    OpenAIRE

    Liu, Cindy M; Hungate, Bruce A; Tobian, Aaron A. R.; Ravel, Jacques; PRODGER, Jessica L.; Serwadda, David; Kigozi, Godfrey; Ronald M. Galiwango; NALUGODA, Fred; Keim, Paul; Wawer, Maria J; Price, Lance B.; GRAY, RONALD H.

    2015-01-01

    Bacterial vaginosis (BV) is a common vaginal bacterial imbalance associated with risk for HIV and poor gynecologic and obstetric outcomes. Male circumcision reduces BV-associated bacteria on the penis and decreases BV in female partners, but the link between penile microbiota and female partner BV is not well understood. We tested the hypothesis that having a female partner with BV increases BV-associated bacteria in uncircumcised men. We characterized penile microbiota composition and densit...

  8. Penile Agenesis: Report on 8 Cases and Review of Literature

    OpenAIRE

    Alireza Mirshemirani; Ahmad Khaleghnejad; Hoshang Pourang; Naser Sadeghian; Mohsen Rouzrokh; Shadab Salehpour

    2009-01-01

    Background:Penile agenesis (PA) is an extremely rare anomaly with profound urological and psychological consequences. The opening of the urethra could be either over the pubis or at any point on perineum or most frequently in anterior wall of the rectum. The aim of treatment is an early female gender assignment and feminizing reconstruction of the perineum. Case(s) Presentation:We report 8 cases of penile agenesis with urination and defecation through the rectum, apparently normal scrotum, bi...

  9. Arteriographic findings and erectile function in men with occlusive arterial disease in the legs

    International Nuclear Information System (INIS)

    A series of 56 men under 70 years of age were examined with conventional aortography because of arterial insufficiency in the legs, as well as an evaluation of their sexual function. The aortograms were evaluated with respect to the penile blood supply, and related to potency and penile blood pressure. Patients with bilateral occlusions or occlusion on one side and stenosis on the other in the penile blood supply had a statistical significant higher impotence rate and lower penile blood pressure index than patients without visible lesions on the arteriograms. It is concluded that the conventional aortography only will give a rough estimate of the erectile function, but it may be of some value in predicting the effect on the potency of a reconstructive vascular operation in the aorto-iliac area. (orig.)

  10. Penile length-somatometric parameters relationship in healthy Egyptian men.

    Science.gov (United States)

    Shalaby, M E; Almohsen, A E-R M; El Shahid, A R; Abd Al-Sameaa, M T; Mostafa, T

    2015-05-01

    This study aimed to assess the penile length-somatometric parameters relationship in healthy Egyptian men. Two thousand physically normal men (22-40 years) were subjected to measurement of stretched penile length, glans penis, testis size, index finger, weight, height, span, body mass index (BMI), waist circumference, hip circumference and waist/hip ratio. The mean stretched penile length of the studied subjects was 13.84 ± 1.35 cm (range 12-19 cm), and the mean glans penis length was 2.6 ± 0.4 cm (range 1.7-3.8 cm). Penile length demonstrated positive significant correlation with glans penis length, index finger length, BMI and significant negative correlation with waist/hip ratio. On the other hand, penile length demonstrated nonsignificant correlation with age, weight, height, waist circumference, span or testicular size. It is concluded that the penile length-somatometric parameters relationship in healthy Egyptian men is mostly related to glans penis and index finger lengths. PMID:24698122

  11. New stent design for use in small coronary arteries during percutaneous coronary intervention

    OpenAIRE

    Granada, Juan F.; Huibregtse, Barbara A.; Dawkins, Keith D.

    2010-01-01

    Juan F Granada1, Barbara A Huibregtse2, Keith D Dawkins21The Jack H Skirball Center for Cardiovascular Research, Cardiovascular Research Foundation, Columbia University Medical Center, New York, NY, USA; 2Boston Scientific Corporation, Natick, MA, USAAbstract: Patients with diabetes mellitus, of female gender, increased age, and/or with peripheral vascular disease often develop coronary stenoses in small caliber vessels. This review describes treatment of these lesions with the paclitaxel-elu...

  12. Effects of a long-term treatment with aliskiren or ramipril on structural alterations of subcutaneous small-resistance arteries of diabetic hypertensive patients.

    Science.gov (United States)

    De Ciuceis, Carolina; Savoia, Carmine; Arrabito, Emanuele; Porteri, Enzo; Mazza, Monica; Rossini, Claudia; Duse, Sarah; Semeraro, Francesco; Agabiti Rosei, Claudia; Alonzo, Alessandro; Sada, Lidia; La Boria, Elisa; Sarkar, Annamaria; Petroboni, Beatrice; Mercantini, Paolo; Volpe, Massimo; Rizzoni, Damiano; Agabiti Rosei, Enrico

    2014-10-01

    Structural alterations of subcutaneous small-resistance arteries are associated with a worse clinical prognosis in hypertension and non-insulin-dependent diabetes mellitus. The effects of the direct renin inhibitor aliskiren on microvascular structure were never previously evaluated. Therefore, we investigated the effects of aliskiren in comparison with those of an extensively used angiotensin-converting enzyme inhibitor, ramipril, on peripheral subcutaneous small-resistance artery morphology, retinal arteriolar structure, and capillary density in a population of patients with non-insulin-dependent diabetes mellitus. Sixteen patients with mild essential hypertension and with a previous diagnosis of non-insulin-dependent diabetes mellitus were included in the study. Patients were then randomized to 1 of the 2 active treatments (aliskiren 150 mg once daily, n=9; or ramipril 5 mg once daily, n=7). Each patient underwent a biopsy of the subcutaneous fat from the gluteal region, an evaluation of retinal artery morphology (scanning laser Doppler flowmetry), and capillary density (capillaroscopy), at baseline and after 1 year of treatment. Subcutaneous small arteries were dissected and mounted on a pressurized micromyograph, and the media-to-lumen ratio was evaluated. A similar office blood pressure-lowering effect and a similar reduction of the wall-to-lumen ratio of retinal arterioles were observed with the 2 drugs. Aliskiren significantly reduced media-to-lumen ratio of subcutaneous small-resistance arteries, whereas ramipril-induced reduction of media to lumen ratio was not statistically significant. No relevant effect on capillary density was observed. In conclusion, treatment with aliskiren or ramipril was associated with a correction of microvascular structural alterations in patients with non-insulin-dependent diabetes mellitus. PMID:24980672

  13. A Novel Tool to Predict the Cosmetic Outcome after Circumcision: Penile Visibility Index

    OpenAIRE

    Ilker Akyol; Hasan Soydan; Hasan Kocoglu; Ferhat Ates; Kenan Karademir; Kadir Baykal

    2014-01-01

    Objectives: We aimed to evaluate the circumcision status and complications, and the value of penile visibility index in predicting circumcision complications among elementary school children. Patients and Methods: Elementary school students were evaluated with physical exam in terms of circumcision complications. Visible penile length/stretched penile length ratio was calculated for each subject and recorded as penile visibility index (PVI). Data were assessed with SPSS...

  14. Therapeutic efficacy of Traditional Vein Chemotherapy and Bronchial Arterial Infusion Combining with CIKs on ? Stage Non-small Cell Lung Cancer

    Directory of Open Access Journals (Sweden)

    Guangqiang ZHAO

    2009-09-01

    Full Text Available Background and objective The therapeutic efficacy of late lung-cancer was very poor, and cytokine-induced killer cells (CIK were paid more attention to treat non-small cell lung cancer (NSCLC. The aim of this study is to get insight into the role of bronchial arterial infusion bronchial arterial infusion (BAI plus CIK about NSCLC by comparing therapeutic efficacy among BAI, traditional vein chemotherapy and BAI plus CIK, for late NSCLC. Methods A total of 120 patients were enrolled in this study, dividing randomly into three groups: bronchial arterial infusion (BAI, traditional vein chemotherapy and BAI plus CIK. Clinical effects and side effects were estimated after two period of therapy. Results The effective rate (CR+PR% of combined group is higher than the traditional vein chemotherapy group (66.67%, n=39 and there are significant differences (?2=4.721, P=0.03; The side effect of rate of BAI plus CIK group is significantly lower than the traditional vein chemotherapy group, and so did the non-bone marrow inhibition side effects (P < 0.05. The tumor progression rate (PD% of bronchial arterial infusion (BAI group is higher than combined group (?2=4.287, P=0.038. There was no difference between the traditional vein chemotherapy group and combined group (?2=0.082, P=0.775. Conclusion Bronchial Artery Infusion combined with cytokine-induced killer cells is an ideal, safety, effective comprehensive treatment method for late stage lung cancer.

  15. Serum YKL-40 and uterine artery Doppler – a prospective cohort study, with focus on preeclampsia and small-for-gestational-age

    DEFF Research Database (Denmark)

    Gybel-Brask, Dorte; HØgdall, Estrid

    2014-01-01

    OBJECTIVE: To test if serum YKL-40 is increased in women developing preeclampsia or small-for-gestational age fetuses. We also assessed the association between uterine artery pulsatility index, notching and serum YKL-40 levels. DESIGN: Prospective cohort study. SETTING: A primary referral unit for obstetric ultrasound. POPULATION: A total of 1214 unselected pregnant women enrolled at nuchal translucency examination between 11(+3) and 13(+6) weeks of gestation. METHODS: All women had ultrasound and blood sample collection at the nuchal translucency scan, a 20-week malformation scan and 25-week and 32-week fetal growth examinations. Uterine artery Doppler was assessed and outcome was registered from medical records. MAIN OUTCOME MEASURES: Preeclampsia, hypertension, small-for-gestational age. RESULTS: Serum YKL-40 was associated with increasing maternal age (p < 0.0001), body mass index (p = 0.0002), primiparity (p = 0.0003), and hypertension (p = 0.015). Serum YKL-40 increased from 12 to 20 weeks and decreased from 20-25 and 25-32 weeks of gestation. No association was found between preeclampsia and serum YKL-40. Small-for-gestational-age at birth was significantly associated with a 5.4% increase in serum YKL-40 at 32 weeks of gestation (95% CI 1.5-9.3, p = 0.005). An association was found between uterine artery pulsatility index at 32 weeks and small-for-gestational age (p = 0.0015) but not between YKL-40 and uterine artery notching (p = 0.83). CONCLUSIONS: Serum YKL-40 was not associated with preeclampsia. Increasing serum YKL-40 was related to maternal age, body mass index and small-for-gestational age and may reflect an exaggerated inflammatory response.

  16. Serum YKL-40 and uterine artery Doppler -- a prospective cohort study, with focus on preeclampsia and small-for-gestational-age

    DEFF Research Database (Denmark)

    Gybel-Brask, Dorte; HØgdall, Estrid

    2014-01-01

    OBJECTIVE: To test if serum YKL-40 is increased in women developing preeclampsia or small-for-gestational age fetuses. We also assessed the association between uterine artery pulsatility index, notching and serum YKL-40 levels. DESIGN: Prospective cohort study. SETTING: A primary referral unit for obstetric ultrasound. POPULATION: A total of 1214 unselected pregnant women enrolled at nuchal translucency examination between 11(+3) and 13(+6) weeks of gestation. METHODS: All women had ultrasound and blood sample collection at the nuchal translucency scan, a 20-week malformation scan and 25-week and 32-week fetal growth examinations. Uterine artery Doppler was assessed and outcome was registered from medical records. MAIN OUTCOME MEASURES: Preeclampsia, hypertension, small-for-gestational age. RESULTS: Serum YKL-40 was associated with increasing maternal age (p < 0.0001), body mass index (p = 0.0002), primiparity (p = 0.0003), and hypertension (p = 0.015). Serum YKL-40 increased from 12 to 20 weeks and decreased from 20-25 and 25-32 weeks of gestation. No association was found between preeclampsia and serum YKL-40. Small-for-gestational-age at birth was significantly associated with a 5.4% increase in serum YKL-40 at 32 weeks of gestation (95% CI 1.5-9.3, p = 0.005). An association was found between uterine artery pulsatility index at 32 weeks and small-for-gestational age (p = 0.0015) but not between YKL-40 and uterine artery notching (p = 0.83). CONCLUSIONS: Serum YKL-40 was not associated with preeclampsia. Increasing serum YKL-40 was related to maternal age, body mass index and small-for-gestational age and may reflect an exaggerated inflammatory response.

  17. Penile length is normal in most men seeking penile lengthening procedures.

    OpenAIRE

    GONTERO, Paolo

    2002-01-01

    Concerns over penile size and a desire for a longer penis are common in the male population. The number of male patients seeking an andrological consultation for the problem of 'short penis' is increasing. We looked at the numbers of patients presenting to a University andrology clinic over a 2-y period and correlated their perceived penis size with the accepted norms. Sixty-seven patients were evaluated with a median age of 27 (range 16-55) complaining of 'short penis' and requesting surgica...

  18. Potassium and calcium channel gene expression in small arteries in porcine and rat models of diet-induced obesity (Poster)

    DEFF Research Database (Denmark)

    Jensen, Lars JØrn; Salomonsson, Max

    Obesity is an increasing problem worldwide leading to cardiovascular morbidity. Only limited information exists on the transcriptional regulation of arterial K+ and Ca2+ channels in obesity. We quantified, by real-time PCR, mRNA expression of K+ channels and L-type Ca2+ channels (LTCC) in small mesenteric (MA), middle cerebral (MCA), and left coronary arteries (LCA) of lean vs. obese rats and minipigs. Male Sprague Dawley rats were fed a high-fat (FAT; N=5), high-fructose (FRUC; N=7), high-fat/high-fructose (FAT/FRUC; N=7) or standard diet (STD; N=7-11) for 28 Weeks. FAT and FAT/FRUC became obese, whereas FRUC and STD were lean. Systolic blood pressure (SBP) averaged over 14 weeks was increased (P<0.001) in FRUC and FAT/FRUC but not in FAT. Kir, Kv1.2, Kv1.5, and Kv7.4 channels were up-regulated in FAT, whereas SKca and IKca channels were down-regulated in FAT/FRUC (P<0.05). There were no transcriptional changes in FRUC. Castrated male Göttingen minipigs with or without diabetes were fed a diet rich in fat, cholesterol and fructose (OB+DIAB; N=3 vs. OB; N=2, respectively) or a standard diet (STD; N=3) for 22-45 weeks. Body weight, total body fat content and plasma triglyceride levels were increased in OB and OB+DIAB. BKca, IKca, SKca and/or LTCC mRNA was up-regulated in LCA from OB and OB+DIAB (n.s.). Expression of BKca mRNA was increased, whereas IKca mRNA decreased in MCA from OB (n.s.). SKca mRNA was decreased in MA from OB (n.s.). Diet-induced obesity in rats and minipigs lead to complex changes in K+ and Ca2+ channel gene expression, which, in rats, did not seem to be linked with changes in SBP. These transcriptional changes may lead to disturbances in microvascular flow patterns in obesity.

  19. A dual-radioisotope technique for the evaluation of penile blood flow during tumescence.

    Science.gov (United States)

    Miraldi, F; Nelson, A D; Jones, W T; Thompson, S; Kursh, E D

    1992-01-01

    A technique is described for concomitant study of both arterial and venous penile blood flow during tumescence. Dual-isotope acquisition is started after labeling red cells in vivo with 99mTc. Xenon-133 in saline is then injected into the corpus cavernosum followed with vasoactive drugs to induce an erection. The resulting xenon and technetium time-activity curves are inputs for a one-compartment model. In 14 subjects, the average peak arterial flow rate (PAF) for normal males was calculated as 13.0 +/- 1.28 ml/min (avg +/- s.d.) compared to 16.1 +/- 5.14 and 5.02 +/- 1.78 ml/min for patients with venous leak (VL) or arterial insufficiency (AI), respectively. Peak venous flows (PVF) were 4.25 +/- 1.17, 12.1 +/- 3.75, and 3.78 +/- 1.00 ml/min for normal, VL and AL respectively. Al patients have significantly lower PAF than normal (p = 0.002) or VL patients (p = 0.018), and VL patients had significantly higher PVF than normal (p = 0.012) or Al (p = 0.018). The technique may be helpful in the study of impotence. PMID:1730993

  20. Clinicopathological features of carcinoma of the distal penile urethra.

    Science.gov (United States)

    Corbishley, Catherine M; Rajab, Ramzi M; Watkin, Nicholas A

    2015-05-01

    Distal urethral carcinomas are very rare and are similar in their pathology and behaviour to tumours of the glans penis and foreskin. Similarly they are associated with penile intraepithelial neoplasia (PeIN) of both differentiated and undifferentiated types. Current management is mainly surgical, but increasingly involves specialist penile-preserving techniques. Handling and dissection of the specimens is broadly the same as other primary penile tumours. The prognosis of distal urethral lesions is believed to be worse than penile tumours and better than prostatic urethral tumours, but the evidence is sparse. The staging system for urethral tumours does not distinguish between proximal and distal, apart from prostatic urethra, and has led to much confusion in the literature. Although the subtypes of tumours seen in the distal urethra are the same as those on the glans and foreskin, there is an increased proportion of basaloid squamous carcinoma and malignant melanoma whereas the majority of tumours seen in the proximal and prostatic urethra are of urothelial origin. In future, distal urethral tumours should be separately designated with site-specific staging/TNM and reporting system and pathologically classified in the same way as penile and foreskin tumours. Ultimately, this will improve the quality of data and produce evidence to inform management. PMID:25656527

  1. Penile lymphoscintigraphy for sentinel node identification

    Energy Technology Data Exchange (ETDEWEB)

    Valdes Olmos, R.A.; Hoefnagel, C.A. [Netherlands Cancer Inst., Amsterdam (Netherlands). Dept. of Nuclear Medicine; Tanis, P.J.; Jansen, L.; Nieweg, O.E. [Netherlands Cancer Inst., Amsterdam (Netherlands). Dept. of Surgery; Meinhardt, W.; Horenblas, S. [Netherlands Cancer Inst., Amsterdam (Netherlands). Dept. of Urology

    2001-05-01

    Lymphoscintigraphy for sentinel node (SN) identification has been extensively validated in breast cancer and melanoma. The aim of this study was to evaluate the findings of lymphoscintigraphy for SN identification in carcinoma of the penis. Lymphoscintigraphy was performed in 74 consecutive patients (mean age 62.2 years, range 28-87 years) with clinically lymph node-negative squamous cell carcinoma of the penis (stage T2 or greater). Following local anaesthesia by xy-locaine 10% spray, technetium-99m nanocolloid (mean dose 64.8 MBq, range 40-131 MBq) in a volume of 0.3-0.4 ml was injected intradermally around the tumour. Shortly after injection, a 20-min dynamic study was performed with a dual-head gamma camera; subsequently, static anterior and lateral images were obtained at 30 min and 2 h using simultaneous cobalt-57 flood source transmission scanning. {sup 57}Co-assisted skin marking defined SN location for gamma probe/blue dye-guided biopsy, which was performed the next day. The SN visualization rate was 97% (72/74). Lymphatic drainage was bilateral in 81% of the cases (58/72), exclusively to the left groin in 13% (9/72) and only to the right groin in 6%. Bilateral lymph node drainage was synchronous in 38% (22/58) and asynchronous in 62% (in 18 patients the initial route was the left groin, and in the other 18, the right groin). Visualization before 30 min occurred in 66 patients (93%), in 64 of them (88%) already during the dynamic study. A total of 173 SNs were visualized (85 in the right groin, 88 in the left groin). Pitfalls were caused by inguinal skin contamination during injection (four patients) and intracavernous administration (one patient). At surgery, a total of 161 SNs were identified and removed. Sixteen patients (22%) had a tumour-positive SN and underwent standard regional lymph node dissection subsequently. During follow-up (median 28 months, range 3-74 months), two patients with a negative SN developed lymph node metastases in the mapped basin. It is concluded that penile lymphoscintigraphy is a valid and well-tolerated method for lymphatic mapping and SN identification. Although bilateral early inguinal drainage is the most frequent pattern, late imaging is recommended principally in patients with initial unilateral drainage in order to exclude delayed lymph node filling in the contralateral groin. SN identification may lead to a more accurate staging and avoid extensive lymph node dissection in the majority of patients with penile carcinoma. (orig.)

  2. Activation of endothelial and epithelial K(Ca) 2.3 calcium-activated potassium channels by NS309 relaxes human small pulmonary arteries and bronchioles

    DEFF Research Database (Denmark)

    Kroigaard, Christel; Dalsgaard, Thomas

    2012-01-01

    BACKGROUND AND PURPOSE: Small (K(Ca) 2) and intermediate (K(Ca) 3.1) conductance calcium-activated potassium channels (K(Ca) ) may contribute to both epithelium- and endothelium-dependent relaxations, but this has not been established in human pulmonary arteries and bronchioles. Therefore, we investigated the expression of K(Ca) 2.3 and K(Ca) 3.1 channels, and hypothesized that activation of these channels would produce relaxation of human bronchioles and pulmonary arteries. EXPERIMENTAL APPROACH: Channel expression and functional studies were conducted in human isolated small pulmonary arteries and bronchioles. K(Ca) 2 and K(Ca) 3.1 currents were examined in human small airways epithelial (HSAEpi) cells by whole-cell patch clamp techniques. RESULTS: While K(Ca) 2.3 expression was similar, K(Ca) 3.1 protein was more highly expressed in pulmonary arteries than bronchioles. Immunoreactive K(Ca) 2.3 and K(Ca) 3.1 proteins were found in both endothelium and epithelium. K(Ca) currents were present in HSAEpi cells and sensitive to the K(Ca) 2.3 blocker UCL1684 and the K(Ca) 3.1 blocker TRAM-34. In pulmonary arteries contracted by U46619 and in bronchioles contracted by histamine, the K(Ca) 2.3/ K(Ca) 3.1 activator, NS309, induced concentration-dependent relaxations. NS309 was equally potent in relaxing pulmonary arteries, but less potent in bronchioles, than salbutamol. NS309 relaxations were blocked by the K(Ca) 2 channel blocker apamin, while the K(Ca) 3.1 channel blocker, charybdotoxin failed to reduce relaxation to NS309 (0.01-1?µM). CONCLUSIONS AND IMPLICATIONS: K(Ca) 2.3 and K(Ca) 3.1 channels are expressed in the endothelium of human pulmonary arteries and epithelium of bronchioles. K(Ca) 2.3 channels contributed to endo- and epithelium-dependent relaxations suggesting that these channels are potential targets for treatment of pulmonary hypertension and chronic obstructive pulmonary disease.

  3. In vivo high-resolution structural imaging of large arteries in small rodents using two-photon laser scanning microscopy

    Science.gov (United States)

    Megens, Remco T. A.; Reitsma, Sietze; Prinzen, Lenneke; Oude Egbrink, Mirjam G. A.; Engels, Wim; Leenders, Peter J. A.; Brunenberg, Ellen J. L.; Reesink, Koen D.; Janssen, Ben J. A.; Ter Haar Romeny, Bart M.; Slaaf, Dick W.; van Zandvoort, Marc A. M. J.

    2010-01-01

    In vivo (molecular) imaging of the vessel wall of large arteries at subcellular resolution is crucial for unraveling vascular pathophysiology. We previously showed the applicability of two-photon laser scanning microscopy (TPLSM) in mounted arteries ex vivo. However, in vivo TPLSM has thus far suffered from in-frame and between-frame motion artifacts due to arterial movement with cardiac and respiratory activity. Now, motion artifacts are suppressed by accelerated image acquisition triggered on cardiac and respiratory activity. In vivo TPLSM is performed on rat renal and mouse carotid arteries, both surgically exposed and labeled fluorescently (cell nuclei, elastin, and collagen). The use of short acquisition times consistently limit in-frame motion artifacts. Additionally, triggered imaging reduces between-frame artifacts. Indeed, structures in the vessel wall (cell nuclei, elastic laminae) can be imaged at subcellular resolution. In mechanically damaged carotid arteries, even the subendothelial collagen sheet (~1 ?m) is visualized using collagen-targeted quantum dots. We demonstrate stable in vivo imaging of large arteries at subcellular resolution using TPLSM triggered on cardiac and respiratory cycles. This creates great opportunities for studying (diseased) arteries in vivo or immediate validation of in vivo molecular imaging techniques such as magnetic resonance imaging (MRI), ultrasound, and positron emission tomography (PET).

  4. Double disruption of ?2A- and ?2C-adrenoceptors induces endothelial dysfunction in mouse small arteries: role of nitric oxide synthase uncoupling.

    Science.gov (United States)

    Couto, Gisele K; Davel, Ana P; Brum, Patrícia C; Rossoni, Luciana V

    2014-10-01

    Knockout mice lacking both ?2A- and ?2C-adrenergic receptors (?2A/?2C-ARKO) provide a model for understanding the mechanisms underlying the deleterious effects of sympathetic hyperactivity on the cardiovascular system. Thus, in the present study we investigated the vascular reactivity of large and small arteries of ?2A/?2C-ARKO mice. Aorta and mesenteric small arteries (MSAs) from 7-month-old male ?2A/?2C-ARKO mice and congenic C57BL6/J mice (wild-type, WT) were studied. In the aorta, noradrenaline- and serotonin-induced contraction was similar between groups, but in MSAs there was an increase in agonist-induced contraction in ?2A/?2C-ARKO compared with WT. The l-NAME effect was reduced in MSAs of ?2A/?2C-ARKO mice compared with WT mice, as was basal NO evaluated by a 4,5-diaminofluorescein diacetate probe. Increased total endothelial nitric oxide synthase (eNOS) protein expression was observed in MSAs from ?2A/?2C-ARKO mice, while the dimer/monomer ratio of eNOS was decreased. Mesenteric small arteries from ?2A/?2C-ARKO mice showed an increase in ethidium bromide-positive nuclei, indicating oxidative stress, which was attenuated by incubation with l-NAME. The sympathetic hyperactivity present in ?2A/?2C-ARKO mice alters vascular reactivity only in certain types of arteries. Moreover, after chronic sympathetic hyperactivity, uncoupling eNOS may be a significant source of superoxide anion and reduced NO bioavailability in small vessels, increasing the contractile tone. PMID:25037566

  5. Small dense LDL particles--a predictor of coronary artery disease evaluated by invasive and CT-based techniques: a case-control study

    DEFF Research Database (Denmark)

    Toft-Petersen, Anne P; Hansen, Hans-Henrik Tilsted

    2011-01-01

    Coronary angiography is the current standard method to evaluate coronary atherosclerosis in patients with suspected angina pectoris, but non-invasive CT scanning of the coronaries are increasingly used for the same purpose. Low-density lipoprotein (LDL) cholesterol and other lipid and lipoprotein variables are major risk factors for coronary artery disease. Small dense LDL particles may be of particular importance, but clinical studies evaluating their predictive value for coronary atherosclerosis are few.

  6. Comparison of Blood Velocity Measurements between Ultrasound Doppler and Accelerated Phase-Contrast MR Angiography in Small Arteries with Disturbed Flow

    OpenAIRE

    Jiang, Jingfeng; Strother, Charles; Johnson, Kevin; Baker, Sara; Consigny, Dan; Wieben, Oliver; Zagzebski, James

    2011-01-01

    Ultrasound Doppler (UD) velocity measurements are commonly used to quantify blood flow velocities in vivo. The aim of our work was to investigate the accuracy of in vivo spectral Doppler measurements of velocity waveforms. Waveforms were derived from spectral Doppler signals and corrected for intrinsic spectral broadening errors by applying a previously published algorithm. The method was tested in a canine aneurysm model by determining velocities in small arteries (3-4 mm diameter) near the ...

  7. Necrosis cutánea y peneana inducidas por warfarina / [title language=en]Warfarin-induced skin and penile necrosis

    Scientific Electronic Library Online (English)

    Alfredo, Pinzón; Catalina, Arias; Ana María, Cárdenas.

    2012-09-01

    Full Text Available Presentamos el caso de un hombre adulto mayor con múltiples episodios de trombosis venosa y arterial en diferentes localizaciones, quien desarrolló necrosis cutánea extensa y peneana pocos días después del uso de un antagonista de vitamina K (warfarina). Como parte del estudio de trombofilia se obse [...] rvó deficiencia de proteína C y S. (Acta Med Colomb 2012; 37: 142-146). Abstract in english We present the case of an elderly man with multiple episodes of venous and arterial thrombosis in different locations, who developed extensive skin and penile necrosis few days after the use of a vitamin K antagonist (warfarin). As part of the thrombophilia study, we observed protein C and S deficie [...] ncy. (Acta Med Colomb 2012; 37: 142-146).

  8. Necrosis cutánea y peneana inducidas por warfarina [title language=en]Warfarin-induced skin and penile necrosis

    Directory of Open Access Journals (Sweden)

    Alfredo Pinzón

    2012-09-01

    Full Text Available Presentamos el caso de un hombre adulto mayor con múltiples episodios de trombosis venosa y arterial en diferentes localizaciones, quien desarrolló necrosis cutánea extensa y peneana pocos días después del uso de un antagonista de vitamina K (warfarina. Como parte del estudio de trombofilia se observó deficiencia de proteína C y S. (Acta Med Colomb 2012; 37: 142-146.We present the case of an elderly man with multiple episodes of venous and arterial thrombosis in different locations, who developed extensive skin and penile necrosis few days after the use of a vitamin K antagonist (warfarin. As part of the thrombophilia study, we observed protein C and S deficiency. (Acta Med Colomb 2012; 37: 142-146.

  9. Henoch-Schonlein purpura: ultrasonography of scrotal and penile involvement.

    Science.gov (United States)

    Lim, Youngsik; Yi, Boem Ha; Lee, Hae Kyung; Hong, Hyun Sook; Lee, Min Hee; Choi, Seo-Youn; Park, Jae Ock

    2015-04-01

    Testicular or scrotal involvement has been reported in children with Henoch-Schonlein purpura (HSP), but there are very few reports on penile involvement. We report the initial and follow-up ultrasonographic findings of scrotal and penile involvement of HSP in a 5-year-old boy. On ultrasonography, scrotal soft tissue thickening and epididymal swelling with increased vascularity were noted, and on the penis, a focal mass-like lesion appeared on the dorsal surface of the distal penis, having a hypoechoic mass-like appearance without visible vascular flow on a Doppler study. After 2 days of treatment, follow-up ultrasonography showed normal scrotum and penis with a resolved soft tissue mass-like lesion. Therefore, we think that HSP ultrasonographic findings involving the scrotum and penis might help to diagnose scrotal and penile involvement in a case of HSP and to avoid unnecessary medication and/or surgical procedures. PMID:25541068

  10. Penile lesion from gunshot wound: a 43-case experience

    Directory of Open Access Journals (Sweden)

    Cavalcanti Andre G.

    2006-01-01

    Full Text Available OBJECTIVE: To demonstrate the main aspects of diagnosis, treatment and follow-up of 43 patients with gunshot wounds to the penis. MATERIALS AND METHODS: The location of the lesion, the presence of associated lesions, the performance of complementary exams, surgical treatment, postoperative complications and long term follow-up of 43 patients with penile lesions from gunshot wounds were retrospectively analyzed. RESULTS: Of 43 cases assessed, 41 were submitted to surgical exploration (95.3% and 2 were submitted to conservative treatment (4.7%. We found penile lesions involving the corpus cavernosum in 37 cases; the remaining 4 patients presented no lesions involving the corpus cavernosum, urethra or testicles but did in the superficial structures. Ten cases presented an association with testicular lesions and 14 cases association with anterior urethral lesions. CONCLUSION: Penile lesions from gunshot wounds should be treated with immediate surgical intervention. In exceptional situations featuring superficial lesions only conservative treatment may be applied.

  11. Metachronous penile metastasis from rectal cancer after total pelvic exenteration

    Directory of Open Access Journals (Sweden)

    Satoru Inoue

    2012-01-01

    Full Text Available Despite its abundant vascularization and extensive circulatory communication with neighboring organs, metastases to the penis are a rare event. A 57-year-old male, who had undergone total pelvic exenteration for rectal cancer sixteen months earlier, demonstrated an abnormal uptake within his penis by positron emission tomography/computed tomography. A single elastic nodule of the middle penis shaft was noted deep within Bucks fascia. No other obvious recurrent site was noted except the penile lesion. Total penectomy was performed as a curative resection based on a diagnosis of isolated penile metastasis from rectal cancer. A histopathological examination revealed an increase of well differentiated adenocarcinoma in the corpus spongiosum consistent with his primary rectal tumor. The immunohistochemistry of the tumor cells demonstrated positive staining for cytokeratin 20 and negative staining for cytokeratin 7, which strongly supported a diagnosis of penile metastasis from the rectum. The patient is alive more than two years without any recurrence.

  12. Effects of ATP and UTP on [Ca2+]i, membrane potential and force in isolated rat small arteries

    DEFF Research Database (Denmark)

    Juul, B; Plesner, L

    2011-01-01

    We have investigated excitation-contraction coupling mechanisms associated with the activation of purinoceptors and putative pyrimidinoceptors by assessing the effects of ATP and UTP on cytoplasmic Ca2+ activity ([Ca2+]i), membrane potential (Em) and force in rat mesenteric small arteries. UTP induced a sustained concentration-dependent contractions, closely associated with concentration-dependent increases in [Ca2+]i. Superfusion with 0.1 mM UTP caused a sustained depolarisation of 12 +/- 1 mV (SE, n = 8). In Ca(2+)-free medium, the increase in [Ca2+]i and the contraction obtained with UTP (1 mM) were both transient and were inhibited by prior exposure to noradrenaline (NA). In vessels depolarised with KCl, UTP caused no change in Em, but a sustained increase in force and a transient increase in [Ca2+]i were induced, leading to an increased force/[Ca2+]i ratio. Similar effects on [Ca2+]i, Em and force were observed with ATP; but the effect of ATP on force was transient, whereas the effect on [Ca2+]i and Em declined only slowly. There was no crosstachyphylaxis between the responses to ATP and UTP: in the presence of 1 mM of either, the other drug induced contractions in low concentrations, as if they acted through distinct receptors. The results suggest that both UTP and probably ATP release intracellular Ca2+, possibly from the stores emptied by NA. The sustained response to UTP appears to be due to an influx of extracellular Ca2+. UTP but not ATP was found to enhance the force-generating effect of [Ca2+]i.

  13. Use of penile extender device in the treatment of penile curvature as a result of Peyronie's disease. Results of a phase II prospective study

    OpenAIRE

    TIZZANI, Alessandro; GONTERO, Paolo

    2009-01-01

    NTRODUCTION: Pilot experiences have suggested that tension forces exerted by a penile extender may reduce penile curvature as a result of Peyronie's disease. AIM: To test this hypothesis in a Phase II study using a commonly marketed brand of penile extender. METHODS: Peyronie's disease patients with a curvature not exceeding 50 degrees with mild or no erectile dysfunction (ED) were eligible. Fifteen patients were required to test the efficacy of the device assuming an effect...

  14. Tadalafil rehabilitation therapy preserves penile size after bilateral nerve sparing radical retropubic prostatectomy

    Scientific Electronic Library Online (English)

    Ozgu, Aydogdu; Mehmet Ilker, Gokce; Berk, Burgu; Sumer, Baltaci; Onder, Yaman.

    2011-06-01

    Full Text Available OBJECTIVE: To evaluate the change in penile size r bilateral nerve sparing retropubic radical prostatectomy (BNSRRP) and possible effect of Tadalafil. MATERIALS AND METHODS: A total of 65 patients underwent BNSRRP and they were evaluated prospectively for a whole year of follow-up . The patients wer [...] e randomized to control without rehabilitation (Group 1) or Tadalafil rehabilitation group (Group 2). The patients were evaluated at months 3, 6 and 12 postoperatively for erectile function, penile measurements (flaccid penile length, penile length at maximum erection, penile circumference at flaccid status, and penile circumference at maximum erection), penile abnormalities and general health status. Statistical analysis was performed by Chi-Square test and significance was defined as p value

  15. Detection of neuroendocrine tumours in the small intestines using contrast-enhanced multiphase Ga-68 DOTATOC PET/CT: the potential role of arterial hyperperfusion

    International Nuclear Information System (INIS)

    Interpretation of small intestinal neuroendocrine tumours (NETs) by Ga-68 DOTATOC PET/CT can be difficult. The potential benefit of arterial hyperperfusion for the detection of NETs was evaluated. Between 2006 and 2009, 320 consecutive Ga-68 DOTATOC PET/CT examinations, performed for NETs, revealed 40 lesions suggesting intestinal NETs in 25 patients. Two groups of lesions were distinguished: epigastric lesions evaluable in the arterial and venous CT scan (Group 1) and hypogastrial lesions evaluable in the venous CT scan only (Group 2). Lesions were jointly rated by two radiologists and a nuclear medicine physician. Maximum standard uptake values (SUVmax) of lesions and background were assessed. The reference standard was histology (available for 28 lesions) or follow-up (for a mean of 22.9 months). PET detected all suspicious lesions but was false positive in 3 lesions. In Group 1 the arterial scan performed significantly better than the venous scan (p = 0.008). Diagnostic performance was better in Group 1 than in Group 2 (p < 0.001). SUVmax of true positive lesions were significantly higher than background SUVmax (p < 0.001) and SUVmax of false positive lesions (p = 0.005). The arterial phase of multiphase Ga-68 DOTATOC PET/CT might improve the localization of intestinal NETs and, thereby, improve the overall diagnostic accuracy of this modality in the assessment of intestinal NETs by adding information about lesion perfusion not available when only venous CT is performed

  16. Penile metastasis from rectal cancer by PET/CT.

    Science.gov (United States)

    Alzayed, Mohammed Fahad; Artho, Giovanni; Nahal, Ayoub; Hickeson, Marc

    2015-04-01

    It is extremely rare for rectal tumors to metastasize to the penis, and when it occurs, it is associated with poor prognosis. The appearance of penile metastasis from rectal primary tumor on PET imaging has not been widely reported. We report a case of a 70-year-old man with previous history of treated stage III adenocarcinoma of the rectum 26 months ago. The restaging 18F-FDG PET/CT scan demonstrated a hypermetabolic mass at the base of his penile shaft. This lesion was confirmed on core biopsy to be a metastatic adenocarcinoma of colorectal origin consistent with the known primary rectal tumor. PMID:25546188

  17. Penile metastasis from rectum cancer primarily interpreted as Peyronie's disease

    DEFF Research Database (Denmark)

    BrØnserud, Majken Munk; SØrensen, Flemming Brandt

    2015-01-01

    We report an unusual case of penile metastasis derived from a rectal adenocarcinoma, which was first interpreted as Peyronie's disease. The patient had a single palpable mass in the penile shaft within the corpus cavernosum, with no ulceration or pain in the area. Two years earlier he had been treated for rectal cancer with neoadjuvant radiation therapy and abdomino-perineal resection. The mass in the penis later turned out to be a manifestation of widespread metastatic disease. The patient lived three years after discovery of metachronous metastases in penis and lungs.

  18. A new technique for early detection of portal vein and arterial thromboses. Indwelling mesenteric venous catheterization and relevance to small bowel transplantation.

    Science.gov (United States)

    Yamataka, A; Kawamoto, S; Ishikawa, M; Lancaster, J F; Miyano, T; Lynch, S V

    1993-09-01

    The aim of this study was to ascertain whether, in an animal model, continuous monitoring of mesenteric venous pressure (MVP) via an indwelling mesenteric venous catheter could assist in early detection of thrombosis of the portal vein (PVT) and superior mesenteric artery (SMAT). The role of portography via the catheter was also studied in confirming these complications. An animal model of PVT and SMAT was developed in pigs. At laparotomy, a 20-cm jejunal loop was isolated and a heparin-coated catheter was inserted into a mesenteric vein of the isolated jejunum and connected to a pressure transducer. Conditions of PVT were simulated by progressive occlusion of the portal vein (PV) using a silastic tourniquet and those of SMAT by superior mesenteric artery (SMA) clamping. MVPs (mm Hg) were found to significantly increase with all degrees of PV occlusion (P SMAT and may be useful in the monitoring of the therapy for these complications after small bowel transplantation. PMID:8212141

  19. siRNA-induced in vivo downregulation of L-type calcium channels in rat small mesenteric arteries.

    DEFF Research Database (Denmark)

    Matchkov, Vladimir; Larsen, Per

    2008-01-01

    Ca2+ entry via L-type voltage-gated Ca2+ channels (Cav1.2) is a key factor in regulation of excitation-contraction coupling in smooth muscle cells (SMCs). Previous gene deletion studies have provided insight into the critical role of the pore-forming ?1C subunit in regulation of blood pressure. Homozygous knockout is, however, lethal but this limitation can be overcome by transient downregulation with small interference (siRNA). A specific downregulation of gene expression with siRNA can be a helpful tool in investigations of proteins in the vascular bed. The 1st to 3rd order branches of the mesenteric artery of anestisized Wistar rats were transfected with siRNAs targeting different exons of the ?1C gene or with control non-related siRNAs. The effect of transfection was analyzed after 3 and 10 days using quantitative PCR and immunohistochemistry. The functional effects of transfection were studied using isometric myography. Specific transfection downregulates mRNA of Cav1.2 by 93±2% within 3 days but the mRNA level recovered 10 days after transfection (110±13 % of the control level). Immunohistochemistry identified reduced Cav1.2 expression in the arteries transfected with siRNA directed against Cav1.2 ? subunit. Surprisingly, normalized internal diameter of Cav1.2 downregulated arteries was significant reduced by 33±10% (n=7) vs. arteries transfected with non-related siRNA. The maximal force development to K+-depolarization was significantly reduced (by 72±10%, n=6). The responses to noradrenaline, vasopressin and caffeine were also suppressed in Cav1.2 downregulated arteries. The reduced force development was accompanied with reduced nifedipine sensitive [Ca2+]i increase. The responses to K+-depolarization and agonist-stimulation in arteries transfected with siRNA directed against ?1C were upregulated in comparison with the controls 10 days after transfection. This upregulation was not, however, nifedipine-sensitive. Using in vivo transfection of arteries with siRNA we demonstrated the importance of Cav1.2 for vascular structure and reactivity and its tight coupling with other cellular Ca2+ handling processes.

  20. Penile torsion correction by diagonal corporal plication sutures

    Directory of Open Access Journals (Sweden)

    Brent W. Snow

    2009-02-01

    Full Text Available Penile torsion is commonly encountered. It can be caused by skin and dartos adherence or Buck’s fascia attachments. The authors suggest a new surgical approach to solve both problems. If Buck’s fascia involvement is demonstrated by artificial erection then a new diagonal corporal plication suture is described to effectively solve this problem.

  1. Penile length of newborns and children in Surakarta, Indonesia

    Directory of Open Access Journals (Sweden)

    Annang Giri Moelyo

    2013-03-01

    Full Text Available Background Penile length is a factor for assessing abnormalities in external genitalia. To diagnose micropenis, a condition in which penile length is 36 weeks newborns were 1.88 (SD 0.14 cm and 2.37 (SD 0.26 cm, respectively. The mean penile lengths by age groupings were as follows: 0-<6 months, 2.67 (SD 0.58 cm; 6-<12 months, 2.67 (SD 0.58 cm; 1-<3 years, 2.80 (SD 0.84 cm; 3-<5 years, 3.50 (SD 0.55 cm; 5-<7 years, 3.50 (SD 0.71 cm; 7-<9 years, 3.85 (SD 0.53 cm; 9-<11 years, 4.50 (SD 0.71 cm; 11-<13 years, 4.63 (SD 1.13 cm; 13-<15 years, 5.53 (SD 1.45 cm; and 15-18 years, 6.16 (SD 1.19 cm.Conclusion Normal penile length in boys in Surakarta is smaller than the normal range reference currently in use.

  2. Penile length of newborns and children in Surakarta, Indonesia

    Directory of Open Access Journals (Sweden)

    Annang Giri Moelyo

    2013-03-01

    Full Text Available Background Penile length is a factor for assessing abnormalities in external genitalia. To diagnose micropenis, a condition in which penile length is 36 weeks newborns were 1.88 (SD 0.14 cm and 2.37 (SD 0.26 cm, respectively. The mean penile lengths by age groupings were as follows: 0-<6 months, 2.67 (SD 0.58 cm; 6-<12 months, 2.67 (SD 0.58 cm; 1-<3 years, 2.80 (SD 0.84 cm; 3-<5 years, 3.50 (SD 0.55 cm; 5-<7 years, 3.50 (SD 0.71 cm; 7-<9 years, 3.85 (SD 0.53 cm; 9-<11 years, 4.50 (SD 0.71 cm; 11-<13 years, 4.63 (SD 1.13 cm; 13-<15 years, 5.53 (SD 1.45 cm; and 15-18 years, 6.16 (SD 1.19 cm. Conclusion Normal penile length in boys in Surakarta is smaller than the normal range reference currently in use. [Paediatr Indones. 2013;53:65-9.].

  3. Penile torsion correction by diagonal corporal plication sutures

    Scientific Electronic Library Online (English)

    Brent W., Snow.

    2009-02-01

    Full Text Available Penile torsion is commonly encountered. It can be caused by skin and dartos adherence or Buck’s fascia attachments. The authors suggest a new surgical approach to solve both problems. If Buck’s fascia involvement is demonstrated by artificial erection then a new diagonal corporal plication suture is [...] described to effectively solve this problem.

  4. Dysfunctional penile cholinergic nerves in diabetic impotent men

    International Nuclear Information System (INIS)

    Impotence in the diabetic man may be secondary to a neuropathic condition of the autonomic penile nerves. The relationship between autonomic neuropathy and impotence in diabetes was studied in human corporeal tissue obtained during implantation of a penile prosthesis in 19 impotent diabetic and 15 nondiabetic patients. The functional status of penile cholinergic nerves was assessed by determining their ability to accumulate tritiated choline (34), and synthesize (34) and release (19) tritiated-acetylcholine after incubation of corporeal tissue with tritiated-choline (34). Tritiated-choline accumulation, and tritiated-acetylcholine synthesis and release were significantly reduced in the corporeal tissue from diabetic patients compared to that from nondiabetic patients (p less than 0.05). The impairment in acetylcholine synthesis worsened with the duration of diabetes (p less than 0.025). No differences in the parameters measured were found between insulin-dependent (11) and noninsulin-dependent (8) diabetic patients. The ability of the cholinergic nerves to synthesize acetylcholine could not be predicted clinically with sensory vibration perception threshold testing. It is concluded that there is a functional penile neuropathic condition of the cholinergic nerves in the corpus cavernosum of diabetic impotent patients that may be responsible for the erectile dysfunction

  5. Penile torsion correction by diagonal corporal plication sutures

    OpenAIRE

    Snow, Brent W.

    2009-01-01

    Penile torsion is commonly encountered. It can be caused by skin and dartos adherence or Buck’s fascia attachments. The authors suggest a new surgical approach to solve both problems. If Buck’s fascia involvement is demonstrated by artificial erection then a new diagonal corporal plication suture is described to effectively solve this problem.

  6. Congenital fistula of the penile urethra: A case report

    Directory of Open Access Journals (Sweden)

    Tunc Ozdemir

    2014-04-01

    Full Text Available Urethral fistulous opening to the penile shaft with or without chordee is extremely rare. Here, a 4-year-old boy with congenital urethral fistula is reported. English literature was reviewed for the former similar cases. Historical analysis showed that no appropriate nomenclature occurred for this isolated anomaly.

  7. Anatomical evaluation of penile venous system by CT cavernosography in patients with erectile dysfunction and venous leakage

    Directory of Open Access Journals (Sweden)

    P Famili

    2012-11-01

    Full Text Available Background: Erectile dysfunction is an important problem in men and an organic cause is found in about 50% of cases. When a vasculogenic etiology is suspected, imaging assessments are of great help. Cavernosography is traditionally recognized as an imaging modality for evaluation of venous leakage in men with impotency. We employed CT cavernosography as a novel technique for demonstrating penile venous anatomy and leaking veins.Methods: In the present case series study, we recruited 45 patients with erectile dysfunction by convenient sampling at Hazrat Rasoul Akram Hospital in Tehran, Iran, during one year (1390. The patients had previously been diagnosed with venous incompetency by Doppler study. After intracavernosal injection of prostaglandin E1, we injected sterile normal saline into the corpora cavernosa to achieve penile erection. Later, we injected contrast media into the corpus cavernosum, which was followed by CT scan of the penis and pelvic area to show the venous anatomy and leakage sites.Results: The mean age of the patients was 35.8±8.9 years. 36 (80% patients had venous leakage in crural veins, 27 (60% in cavernosal veins, 27 (60% in circumflex veins, 24 (52.3% in urethral veins, 21 (46.7% in deep dorsal vein, 3 (6.7% in para-arterial veins and 3 (6.7% in corpus spongiosum. Conclusion: The results of this study show the high prevalence of venous leakage in patients referring for erectile dysfunction. Moreover, CT cavernosography was shown to be a useful method for evaluating penile venous system and its related leakage sites which are important for surgical planning.

  8. Penile Microbiota and Female Partner Bacterial Vaginosis in Rakai, Uganda

    Science.gov (United States)

    Hungate, Bruce A.; Tobian, Aaron A. R.; Ravel, Jacques; Prodger, Jessica L.; Serwadda, David; Kigozi, Godfrey; Galiwango, Ronald M.; Nalugoda, Fred; Keim, Paul; Wawer, Maria J.; Price, Lance B.; Gray, Ronald H.

    2015-01-01

    ABSTRACT Bacterial vaginosis (BV) is a common vaginal bacterial imbalance associated with risk for HIV and poor gynecologic and obstetric outcomes. Male circumcision reduces BV-associated bacteria on the penis and decreases BV in female partners, but the link between penile microbiota and female partner BV is not well understood. We tested the hypothesis that having a female partner with BV increases BV-associated bacteria in uncircumcised men. We characterized penile microbiota composition and density (i.e., the quantity of bacteria per swab) by broad-coverage 16S rRNA gene-based sequencing and quantitative PCR (qPCR) in 165 uncircumcised men from Rakai, Uganda. Associations between penile community state types (CSTs) and female partner’s Nugent score were assessed. We found seven distinct penile CSTs of increasing density (CST1 to 7). CST1 to 3 and CST4 to 7 were the two major CST groups. CST4 to 7 had higher prevalence and abundance of BV-associated bacteria, such as Mobiluncus and Dialister, than CST1 to 3. Men with CST4 to 7 were significantly more likely to have a female partner with a high Nugent score (P = 0.03). Men with two or more extramarital partners were significantly more likely to have CST4 to 7 than men with only marital partners (CST4 to 7 prevalence ratio, 1.84; 95% confidence interval [CI], 1.16 to 2.92). Female partner Nugent BV is significantly associated with penile microbiota. Our data support the exchange of BV-associated bacteria through intercourse, which may explain BV recurrence and persistence. PMID:26081632

  9. Small dense LDL particles - a predictor of coronary artery disease evaluated by invasive and CT-based techniques: a case-control study

    Directory of Open Access Journals (Sweden)

    Andreasen Annette

    2011-01-01

    Full Text Available Abstract Background Coronary angiography is the current standard method to evaluate coronary atherosclerosis in patients with suspected angina pectoris, but non-invasive CT scanning of the coronaries are increasingly used for the same purpose. Low-density lipoprotein (LDL cholesterol and other lipid and lipoprotein variables are major risk factors for coronary artery disease. Small dense LDL particles may be of particular importance, but clinical studies evaluating their predictive value for coronary atherosclerosis are few. Methods We performed a study of 194 consecutive patients with chest pain, a priori considered of low to intermediate risk for significant coronary stenosis (>50% lumen obstruction who were referred for elective coronary angiography. Plasma lipids and lipoproteins were measured including the subtype pattern of LDL particles, and all patients were examined by coronary CT scanning before coronary angiography. Results The proportion of small dense LDL was a strong univariate predictor of significant coronary artery stenosis evaluated by both methods. After adjustment for age, gender, smoking, and waist circumference only results obtained by traditional coronary angiography remained statistically significant. Conclusion Small dense LDL particles may add to risk stratification of patients with suspected angina pectoris.

  10. Clopidogrel, independent of vascular P2Y12 receptor, improves the arterial function in small mesenteric arteries from Ang II-hypertensive rats.

    Science.gov (United States)

    Giachini, Fernanda Rc; Osmond, David A; Zhang, Shali; Carneiro, Fernando S; Lima, Victor V; Inscho, Edward W; Webb, R Clinton; Tostes, Rita C

    2009-10-01

    The P2Y12 receptor antagonist clopidogrel blocks platelet aggregation, improves systemic endothelial nitric oxide bioavailability, and has anti-inflammatory effects. Since P2Y12 receptors have been identified in the vasculature, we hypothesized that clopidogrel ameliorates angiotensin II (Ang II) -induced vascular functional changes by blockade of P2Y12 receptors in the vasculature. Male Sprague Dawley rats were infused with Ang II (60 ng.min-1) or vehicle for 14 days. The animals were treated with clopidogrel (10mg*kg-1*day-1) or vehicle. Vascular reactivity was evaluated in second-order mesenteric arteries. Clopidogrel treatment did not change systolic blood pressure [(mmHg) control-vehicle, 117+/-7.1 vs. control- Clopidogrel, 125+/-4.2; AngII-vehicle, 197+/-10.7 vs. AngII-Clopidogrel, 198+/-5.2], but it normalized increased phenylephrine-induced vascular contractions [(%KCl) vehicle-treated, 182.2+/-18 vs. Clopidogrel, 133+/-14%), as well as impaired vasodilation to acetylcholine [(%) vehicle-treated, 71.7+/-2.2 vs. Clopidogrel, 85.3+/-2.8) in Ang II-treated animals. Vascular expression of P2Y12 receptor was determined by western blot. Pharmacological characterization of vascular P2Y12 was performed with the P2Y12 agonist 2-MeS-ADP. Although 2-MeSADP induced endothelium-dependent relaxation [(Emax %) = 71%+/-12), as well as contractile vascular responses (Emax %= 83+/-12) these actions are not mediated by P2Y12 receptor activation. 2-MeS-ADP produced similar vascular responses in control and Ang II rats. These results indicate potential effects of Clopidogrel, such as improvement of hypertension-related vascular functional changes that are not associated with direct actions of clopidogrel in the vasculature, supporting the concept that activated platelets contribute to endothelial dysfunction, possibly via impaired NO bioavailability. PMID:19811450

  11. Combined technetium radioisotope penile plethysmography and xenon washout: A technique for evaluating corpora cavernosal inflow and outflow during early tumescence

    International Nuclear Information System (INIS)

    Combined technetium radioisotope penile plethysmography and xenon washout is a new technique that measures both corporal arterial inflow and venous sinusoidal outflow during early tumescence in patients with erectile dysfunction. Fourteen patients were studied using 99mTc-RBCs to measure inflow and 133Xe or 127Xe in saline to measure outflow. Tumescence was induced by injecting papaverine intracorporally. Peak corporal rates corrected for inflow (r = 0.88) and uncorrected for outflow (r = 0.91) and change in volume over 2 min centered around peak inflow (r = 0.96) all correlated with angiography. Outflow measurements did not correlate with intracorporal resistance. Thus, outflow rates alone could not be used to predict venous sinusoidal competence. Normal inflow rate is greater than 20 ml/min; probable normal 12-20; indeterminate inflow 7-12; and abnormal inflow less than 7 ml/min. Technetium-99m radioisotope penile plethysmography and xenon washout can be performed together and both provide a method for simultaneously evaluating the relationship between corporal inflow and outflow rates in patients with erectile dysfunction

  12. Arteria Circunfleja Iliaca Superficial: Importancia Anátomo Quirúrgica / Superficial Circumflex Iliac Artery: Anatomical Surgical Importance

    Scientific Electronic Library Online (English)

    Mariano, del Sol; Bélgica, Vásquez.

    2013-06-01

    Full Text Available La arteria circunfleja ilíaca superficial es un pequeño vaso que se origina, generalmente, en la arteria femoral a nivel del triángulo femoral, dirigiéndose paralela al ligamento inguinal hacia la espina ilíaca anterosuperior. Actualmente es utilizada frecuentemente en colgajos libres llevados a cab [...] eza, cuello, miembros e incluso en reconstrucciones peneanas. Disecamos 68 regiones inguinales de cadáveres formolizados en la disciplinas de anatomía topográfica de las Universidades de La Frontera, Chile y Federal de Sao Paulo, Brasil. La arteria cincunfleja ilíaca superficial tuvo un diámetro externo de 1,42 mm en promedio y la distancia desde su origen al ligamento inguinal fue de 15,1 mm. La arteria se originó directamente de la arteria femoral en 47 casos (69,1%); de un tronco común con la arteria epigástrica superficial en 14 (20,5%) y de la arteria circunfleja femoral lateral en tres casos (4,41%) y en otros cuatro orígenes (5,9%). Aunque tiene un pequeño diámetro, la arteria circunfleja ilíaca superficial es importante tanto para el anatomista como para los cirujanos vasculares y plásticos, siendo fundamental para el éxito en la obtención de un buen colgajo. Abstract in english The superficial circumflex iliac artery is a small vessel that originates, usually in the femoral artery at the femoral triangle, heading parallel to the inguinal ligament to the anterior superior iliac spine. Currently it is frequently used in free flaps for head, neck, limbs and even in penile rec [...] onstruction. We dissected 68 inguinal regions in corpses in formolized topographic anatomy courses of the Universidad de La Frontera, Chile and Federal University of São Paulo, Brazil. The superficial circumflex iliac artery had a diameter of 1.42 mm on average, and the distance from its origin to the inguinal ligament was 15.1 mm. The artery originated directly from the femoral artery in 47 cases (69.1%), from a common trunk with the superficial epigastric artery in 14 (20.5%) and the lateral femoral circumflex artery in three cases (4.41 %) and four other sources (5.9%). Although it has a small diameter, superficial circumflex iliac artery is important for the anatomist as well as vascular and plastic surgeons, and essential for success in obtaining a good flap.

  13. US and MRI Findings of Penile Metastasis from Rectal Adenocarcinoma: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Ha Yeun [Kangwon National University Hospital, Chuncheon (Korea, Republic of)

    2012-03-15

    Metastatic tumors of the penis originating from the gastrointestinal tract are rare clinical conditions. We experienced a case of penile metastasis in a 59-year-old man who underwent an abdomino-peritoneal resection for a moderately-differentiated adenocarcinoma of the rectum 4 years earlier. We report penile ultrasonography and magnetic resonance imaging findings on this uncommon metastatic penile tumor from a rectal adenocarcinoma and briefly review radiologic findings and relevant literature

  14. Alpha-adrenoceptor function in isolated penile circumflex veins from potent and impotent men

    DEFF Research Database (Denmark)

    Kirkeby, H J; Forman, Axel

    1989-01-01

    Alpha-adrenoceptor functions were investigated in isolated human penile circumflex veins from six potent and four impotent men. Contractions elicited by noradrenaline and phenylephrine were inhibited by prazosin, yohimbine, phentolamine and papaverine. No differences were found between vessels from potent and impotent men. The results suggest that alpha-adrenoceptors in penile circumflex veins are of both alpha 1- and alpha 2-type, and that no changes in alpha-adrenoceptor function occur in impotence associated with an increased penile venous outflow.

  15. Long-term follow-up of penile curvature correction utilizing autologous albugineal crural graft

    Directory of Open Access Journals (Sweden)

    Carlos Teodósio Da Ros

    2012-04-01

    Full Text Available PURPOSE: Peyronie's disease is an acquired connective tissue disorder of the penile tunica albuginea with fibrosis and inflammation. The disease produces palpable plaques, penile curvature and pain during erections. Usually it results in impairment of the quality of life. Our objective is to review the long-term results of the albugineal grafting harvested from the penile crura for the treatment of severe penile curvature. MATERIALS AND METHODS: Thirty-three patients with Peyronie's disease were submitted to a grafting with tunica albuginea from the penile crura for the correction of penile curvature. The results were evaluated after 6 months of the procedure. Variables studied were overall satisfaction with the procedure, correction of the penile curvature, erectile capacity, penile shortening and the presence of surgical complications. RESULTS: Mean follow-up after surgery was 41 months. Complete correction of the curvature was achieved in 30 patients (90%. The mean preoperative curvature was 91.8 degrees and median plaque length was 2 cm (ranged from 1 to 5 cm. Three patients (9% experienced recurrence of the penile curvature and required a new procedure. In 30 men (90% the procedure fulfilled their expectations and in 31 patients (93.9% their opinions were that sexual partners were satisfied with the penile correction. Penile shortening or augmentation was referred in 6 (18.1% and 1 (3% patient, respectively. CONCLUSION: Our series demonstrated that grafting the albugineal defect after incision of the tunica albuginea with tunica from the crus for the correction of penile curvature is safe and results in satisfactory straight erections duringa long-term follow-up.

  16. Long-term follow-up of penile curvature correction utilizing autologous albugineal crural graft

    Scientific Electronic Library Online (English)

    Carlos Teodósio, Da Ros; Túlio Meyer, Graziottin; Eduardo, Ribeiro; Márcio Augusto, Averbeck.

    2012-04-01

    Full Text Available PURPOSE: Peyronie's disease is an acquired connective tissue disorder of the penile tunica albuginea with fibrosis and inflammation. The disease produces palpable plaques, penile curvature and pain during erections. Usually it results in impairment of the quality of life. Our objective is to review [...] the long-term results of the albugineal grafting harvested from the penile crura for the treatment of severe penile curvature. MATERIALS AND METHODS: Thirty-three patients with Peyronie's disease were submitted to a grafting with tunica albuginea from the penile crura for the correction of penile curvature. The results were evaluated after 6 months of the procedure. Variables studied were overall satisfaction with the procedure, correction of the penile curvature, erectile capacity, penile shortening and the presence of surgical complications. RESULTS: Mean follow-up after surgery was 41 months. Complete correction of the curvature was achieved in 30 patients (90%). The mean preoperative curvature was 91.8 degrees and median plaque length was 2 cm (ranged from 1 to 5 cm). Three patients (9%) experienced recurrence of the penile curvature and required a new procedure. In 30 men (90%) the procedure fulfilled their expectations and in 31 patients (93.9%) their opinions were that sexual partners were satisfied with the penile correction. Penile shortening or augmentation was referred in 6 (18.1%) and 1 (3%) patient, respectively. CONCLUSION: Our series demonstrated that grafting the albugineal defect after incision of the tunica albuginea with tunica from the crus for the correction of penile curvature is safe and results in satisfactory straight erections duringa long-term follow-up.

  17. Penile Low-Intensity Shock Wave Therapy: A Promising Novel Modality for Erectile Dysfunction

    OpenAIRE

    Abu-Ghanem, Yasmin; Kitrey, Noam D; Gruenwald, Ilan; Appel, Boaz; Vardi, Yoram

    2014-01-01

    Penile extracorporeal low-intensity shock wave therapy (LIST) to the penis has recently emerged as a novel and promising modality in the treatment of erectile dysfunction (ED). LIST has angiogenic properties and stimulates neovascularization. If applied to the corpora cavernosa, LIST can improve penile blood flow and endothelial function. In a series of clinical trials, including randomized double-blind sham-controlled studies, LIST has been shown to have a substantial effect on penile hemody...

  18. Venous Ligation: A Novel Strategy for Glans Enhancement in Penile Prosthesis Implantation

    OpenAIRE

    Geng-Long Hsu; James W. Hill; Cheng-Hsing Hsieh; Shih-Ping Liu; Chih-Yuan Hsu

    2014-01-01

    Although penile implantation remains a final solution for patients with refractory impotence, undesirable postoperative effects, including penile size reduction and cold sensation of the glans penis, remain problematic. We report results of a surgical method designed to avoid these problems. From 2003 to 2013, 35 consecutive patients received a malleable penile implant. Of these, 15 men (the enhancing group) were also treated with venous ligation of the retrocoronal venous plexus, deep dorsal...

  19. Tadalafil rehabilitation therapy preserves penile size after bilateral nerve sparing radical retropubic prostatectomy

    Directory of Open Access Journals (Sweden)

    Ozgu Aydogdu

    2011-06-01

    Full Text Available OBJECTIVE: To evaluate the change in penile size r bilateral nerve sparing retropubic radical prostatectomy (BNSRRP and possible effect of Tadalafil. MATERIALS AND METHODS: A total of 65 patients underwent BNSRRP and they were evaluated prospectively for a whole year of follow-up . The patients were randomized to control without rehabilitation (Group 1 or Tadalafil rehabilitation group (Group 2. The patients were evaluated at months 3, 6 and 12 postoperatively for erectile function, penile measurements (flaccid penile length, penile length at maximum erection, penile circumference at flaccid status, and penile circumference at maximum erection, penile abnormalities and general health status. Statistical analysis was performed by Chi-Square test and significance was defined as p value < 0.05. RESULTS: In Group 1 there was significant decrease in penile measurements at month 3 compared to preoperative measurements. There was decrease in all parameters at month 6 compared to month 3 but only the decrease in penile length at maximum erection was significant. There were no significant differences between postoperative months 6 and 12 for all measurements. In Group 2 there was a tendency to decrease in all measurements at month 3 compared to baseline. There was no significant difference for penile measurements between postoperative 3rd and 6th months and between 6th month and the first year. CONCLUSION: Although further large sampled trials are needed to describe the possible positive effect of tadalafil or other PDE5-I's on penile size after BNSRRP, tadalafil rehabilitation is effective in preserving penile size especially in the early postoperative period after BNSRRP.

  20. Arterial hypertension due to fructose ingestion: model based on intermittent osmotic fluid trapping in the small bowel

    OpenAIRE

    Kurbel Sven

    2010-01-01

    Abstract Based on recently reported data that fructose ingestion is linked to arterial hypertension, a model of regulatory loops involving the colon role in maintenance of fluid and sodium homeostasis is proposed. In normal digestion of hyperosmolar fluids, also in cases of postprandial hypotension and in patients having the "dumping" syndrome after gastric surgery, any hyperosmolar intestinal content is diluted by water taken from circulation and being trapped in the bowel until reabsorption...

  1. Reconstruction of Long Anterior Urethral Strictures by Dorsally Quilted Penile Skin Flap

    OpenAIRE

    Abuzeid, Abdel Moneim M.; Abdel Kader, M. S.

    2012-01-01

    Objective. To present the results of reconstruction of long (>5?cm), penile, bulbar, and bulbopenile urethral strictures by penile skin flap as dorsal onlay in one-stage procedure. Patients and Methods. Between January, 1998 and December, 2004, 18 patients (aged from 28-65 years) presented with long urethral strictures, 5.6–13.2?cm (penile in 6, bulbar in 2 and combined in 10 cases), those were repaired utilizing long penile skin flaps placed as dorsal onlay flap in one stage (Orandi fl...

  2. Carotid Artery Disease

    Science.gov (United States)

    ... involves the placement of a small flexible tube (catheter) into an artery from the groin. The catheter is then directed to the neck to reach ... of atherosclerosis (build-up of plaque in the peripheral, coronary or carotid arteries) • Age (men have a ...

  3. Penile fracture following husband abuse: a case report.

    Science.gov (United States)

    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. PMID:19477737

  4. Penile strangulation and necrosis due to condom catheter.

    Science.gov (United States)

    Özkan, Heval S; ?rkoren, Saime; Sivrio?lu, Nazan

    2015-06-01

    Condom catheters are often used in the management of male urinary incontinence, and are considered to be safe. As condom catheters are placed on the male genitalia, sometimes adequate care is not taken after placement owing to poor medical care of debilitated patients and feelings of embarrassment and shame. Similarly, sometimes the correct size of penile sheath is not used. Strangulation of penis due to condom catheter is a rare condition; only few such cases have been reported in the literature. Proper application and routine care of condom catheters are important in preventing this devastating complication especially in a neurologically debilitated population. We present a case of penile necrosis due to condom catheter. We will also discuss proper catheter care and treatment of possible complications. PMID:23758994

  5. Self-contained inflatable penile prosthesis: magnetic resonance appearance

    International Nuclear Information System (INIS)

    The appearance of an inflatable penile prosthesis, visualized on a short tau inversion recovery sequence, is reported, in a patient who had magnetic resonance imaging for pelvic pain subsequent to radical cystoprostatectomy for bladder carcinoma. With suppression of adjacent fat signal, the prosthesis is well delineated from adjacent structures. The fluid-containing cylinders of the prosthesis are of very bright signal intensity, with the relief valve assembly of low signal intensity. 5 refs., 2 figs

  6. Patient perspectives on quality of life after penile cancer

    DEFF Research Database (Denmark)

    Mortensen, Gitte Lee; Jakobsen, Jakob Kristian

    2013-01-01

    Penile cancer (PC) is a rare, but ominous disease. In 50-60% of squamous cell carcinomas of the penis, human papilloma virus infection, particularly with types 16 and 18, is part of the pathogenesis. Depending on cancer invasiveness, PC is treated with local resection of the glans and partial or total penectomy. This quality of life (QoL) study aimed at obtaining in-depth knowledge about patients' experiences with PC.

  7. Metachronous penile metastasis from rectal cancer after total pelvic exenteration

    OpenAIRE

    Satoru Inoue; Masahiro Warabi; Hiroki Matsunaga; Keiichi Nasu; Dai Shida; Yuta Kimura

    2012-01-01

    Despite its abundant vascularization and extensive circulatory communication with neighboring organs, metastases to the penis are a rare event. A 57-year-old male, who had undergone total pelvic exenteration for rectal cancer sixteen months earlier, demonstrated an abnormal uptake within his penis by positron emission tomography/computed tomography. A single elastic nodule of the middle penis shaft was noted deep within Bucks fascia. No other obvious recurrent site was noted except the penile...

  8. Penile Augmentation with Resultant Foreign Material Granuloma and Sequalae

    OpenAIRE

    Inn, Fam Xeng; Imran, Farrah-Hani; Ali, Mohd Faizal; IH, Rizuana; Z, Zulkifli

    2012-01-01

    Throughout history, a proportion of men appear to correlate penis size and dimensions directly with physical fitness and sexual prowess. Foreign materials, such as paraffin oil, paraffin balm, mineral oils, and silicone, have been used to promise an improvement in penile shaft contour and dimensions. These materials are injected directly into the penis; inducing granuloma formation to achieve increased penis length and girth. However, the result is a severely disfigured and swollen penis, whi...

  9. Penile Replantation, Science or Myth? A Systematic Review

    OpenAIRE

    Mohammad Reza Safarinejad; Ali Reza Babaei

    2007-01-01

    Introduction: Penile amputation is a rare urologic condition for which immediate surgical replantation is warranted. The surgical technique used for repair has been modified and refined. Our aim was to assess the effects of several interventions and management for amputated penis after replantation. Materials and Methods: We searched the MEDLINE (January 1966 to May 2007), EMBASE (January 1988 to January 2007), CINAHL (January 1982 to January 2007), PsycLIT (January 1984 to January 2007), ...

  10. CO2-enhanced sonographically guided radiofrequency ablation and transcatheter arterial chemoembolization for small hepatocellular carcinoma poorly defined on conventional sonography.

    Science.gov (United States)

    Ohmoto, Kenji; Yoshioka, Naoko; Tomiyama, Yasuyuki; Shibata, Norikuni; Kawase, Tomoya; Yoshida, Koji; Kuboki, Makoto; Yamamoto, Shinichiro

    2007-02-01

    We report a case of hepatocellular carcinoma located just below the right hemidiaphragm that was diagnosed as having hepatitis C virus-related cirrhosis 12 years ago. Although the lesion was not clear on conventional sonography, it was clearly defined on CO(2)-enhanced sonography, allowing safe and accurate radiofrequency ablation. By combining radiofrequency ablation with transcatheter arterial chemoembolization, extensive cauterization and complete tumor necrosis were obtained with only 1 session of treatment. The patient had no serious adverse effects and has shown no recurrence during 35 months of follow-up. PMID:17195192

  11. Evaluation and Treatment of Penile Thrombophlebitis (Mondor's Disease).

    Science.gov (United States)

    Manimala, Neil J; Parker, Justin

    2015-06-01

    Superficial penile thrombophlebitis or penile Mondor's disease (PMD) is an underreported condition that causes anxiety and embarrassment in affected men. Patients usually present with a smooth, cord-like induration on the dorsal penile shaft 1-7 days after prolonged or intensive sexual intercourse, but other presentations of disease and triggers for endothelial damage are possible. The condition is typically self-limited with expected spontaneous resolution within 4-8 weeks of initial presentation, and absolute diagnosis is usually not necessary with management including supportive care and pain control. However, when disease course is prolonged or there are concerning risk factors, it may be important to differentiate PMD from other conditions such as Peyronie's disease, hypercoagulability, blood stasis, genitourinary infection, and malignancy. History and physical are often sufficient to distinguish these conditions from PMD, but providers may employ ultrasound to assist with the diagnosis. If PMD does not spontaneously resolve, patients may be considered for thrombectomy, at which point histological analysis can confirm the diagnosis. PMID:25962547

  12. Penile Reconstruction: Evaluation of the Most Accepted Techniques

    Directory of Open Access Journals (Sweden)

    Alireza Babaei

    2010-05-01

    Full Text Available Purpose: Loss of the penis can have a devastating effect on the lives of sufferers with significant psychogenic implications. Penile reconstruction or phallus construction poses a difficult challenge and a demanding problem to the urologists and plastic surgeons. Different techniques have been used forconstruction of a total penis and reconstruction of severely injured penis. The objective of this review was to determine the efficacy, advantages and disadvantages of the most popular penile reconstruction (PR and phallus construction techniques.Materials and Methods: We searched without language restriction MEDLINE, Pre-MEDLINE EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL from January 1960 to January 2009. In addition, we searched the citation lists of relevant articles and book chapters. Studies evaluating the functional and cosmetic results of different techniques of total phallus construction (TPC and penile reconstruction (PR were identified. Two authors independently evaluated studies for selection, study quality, and extracted data. The primary outcome was creation of a sensate and cosmetically acceptable phallus. The secondary outcomes were competent neourethra that allows voiding in comfortable position, sexual intercourse, and the rate of complications. Results: One hundred and forty-six studies with a total of 1622 patients were included in this review.Conclusion: Data from the available studies are insufficient to recommendany technique for TPC or PR. In the absence of evidence to support any method, the review authors recommend the one-stage TPC or PR. Further studies are warranted, preferably multi-centered studies.

  13. Non-visualization of sentinel lymph nodes in penile carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kroon, Bin K.; Horenblas, Simon [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Urology, Amsterdam (Netherlands); Valdes Olmos, Renato [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Nuclear Medicine, Amsterdam (Netherlands); Nieweg, Omgo E. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Surgery, Amsterdam (Netherlands)

    2005-09-01

    The purpose of this study was to analyse the incidence and cause of non-visualization of sentinel lymph nodes on preoperative lymphoscintigrams for penile cancer and its implications for further management. Preoperative lymphoscintigraphy was performed after injection of {sup 99m}Tc-labelled nanocolloid in 123 clinically node-negative penile carcinoma patients. Anterior dynamic lymphoscintigraphy was performed during 20 min immediately after tracer injection. Subsequently, 5-min anterior and lateral static images were obtained 30 min and 2 h post injection. Lymphatic drainage to both groins was seen in 98 patients (79%), unilateral drainage in 23 patients (19%) and no drainage at all in two patients (2%). Thus, in 27 (11%) of 246 groins, no sentinel node was visualized. The amount of administered tracer dose was associated with non-visualization (p=0.01). Unilateral drainage was initially interpreted as a normal physiological phenomenon. After the occurrence of a tumour-positive node in a non-visualized groin, we explore non-visualized groins by blue dye mapping and intraoperative palpation. Sentinel nodes were retrieved in four out of eight such groins, of which one contained metastasis. In penile carcinoma patients, preoperative lymphoscintigraphy visualizes a sentinel node in 89% of groins. Visualization depends on the administered tracer dose. It is worthwhile to explore non-visualized groins. Sentinel nodes can be intraoperatively identified in more than half of these cases. (orig.)

  14. Optimizing Penile Length in Patients Undergoing Partial Penectomy for Penile Cancer: Novel Application of the Ventral Phalloplasty Oncoplastic Technique

    Scientific Electronic Library Online (English)

    Jared J., Wallen; Adam S., Baumgarten; Tim, Kim; Tariq S., Hakky; Rafael E., Carrion; Philippe E., Spiess.

    2014-10-01

    Full Text Available The ventral phalloplasty (VP) has been well described in modern day penile prosthesis surgery. The main objectives of this maneuver are to increase perceived length and patient satisfaction and to counteract the natural 1-2 cm average loss in length when performing implantation of an inflatable peni [...] le prosthesis. Similarly, this video represents a new adaptation for partial penectomy patients. One can only hope that the addition of the VP for partial penectomy patients with good erectile function will increase their quality of life. The patient in this video is a 56-year-old male who presented with a 4.0x3.5x1.0 cm, pathologic stage T2 squamous cell carcinoma of the glans penis. After partial penectomy with VP and inguinal lymph node dissection, pathological specimen revealed negative margins, 3/5 right superficial nodes and 1/5 left superficial nodes positive for malignancy. The patient has been recommended post-operative systemic chemotherapy (with external beam radiotherapy) based on the multiple node positivity and presence of extranodal extension. The patient’s pre-operative penile length was 9.5 cm, and after partial penectomy with VP, penile length is 7 cm.

  15. Recurrent furunculosis as a cause of isolated penile lymphedema: a case report

    Directory of Open Access Journals (Sweden)

    Sood Suneet

    2010-06-01

    Full Text Available Abstract Introduction Isolated lymphedema of the penis is extremely rare: combined involvement of the scrotum and penis is the norm. Furunculosis as a cause is not, to our knowledge, previously reported. We present a case of isolated penile lymphedema that responded to excision of lymphedematous tissue and reconstruction with flaps. Case presentation A 32-year-old Arab man presented with a three-year history of a gradually increasing, painless penile swelling. Our patient's main complaint was non-erectile sexual dysfunction. The swelling was preceded by at least three prior episodes of severe furunculosis at the penile root. He had no other contributory past medical or family history. On examination there was gross penile enlargement, maximally at the mid shaft, associated with thickened skin at the sites of prior furunculosis. The glans and scrotum were normal. Both testes were palpable. Serology for filariasis, and urinary tract ultrasound and computed tomography scan were normal. The clinical diagnosis was lymphedema following recurrent penile furunculosis. At operation the lymphedematous tissues were removed. Closure of the penile shaft was accomplished by bilateral advancement of flaps from both ends of the penis. He resumed normal sexual activity one month after surgery. At 12 months, he had a good cosmetic result, with no signs of recurrence. Conclusions Furunculosis at the penile root may result in lymphedema confined to the penile shaft, sparing the scrotum. Excision of abnormal tissue and cover with a skin flap gave excellent cosmetic results, and allowed satisfactory sexual activity.

  16. A comprehensive, prospective study of penile dimensions in Chinese men of multiple ethnicities.

    Science.gov (United States)

    Chen, X B; Li, R X; Yang, H N; Dai, J C

    2014-01-01

    This study aimed to establish a reference range of penile length and circumference of adult males in China, and to compare the penile dimensions of different ethnical backgrounds. To do this, penile length and circumference measurements were obtained from 5196 healthy males attending the Urology Counseling Clinic. The mean value of penile dimensions was a flaccid length of 6.5 ± 0.7 cm, a stretched length of 12.9 ± 1.2 cm and a flaccid circumference of 8.0 ± 0.8 cm. In the subgroup of 311 males, the mean erectile length was 12.9 ± 1.3 cm and the mean erectile circumference was 10.5 ± 0.9 cm, the mean flaccid and erectile glans lengths were 2.7 ± 0.3 and 3.4 ± 0.4 cm, respectively, and the mean flaccid and erectile glans diameters were 2.6 ± 0.2 and 3.4 ± 0.4 cm, respectively. We found that flaccid penile length and circumference varied among different ethnicities. This study established a reference range for penile dimensions, which will help when counseling patients worried about their penile size or seeking penis enlargement surgery. We also found that penile dimensions are different in different ethnicities, but further investigations are needed to validate this. PMID:24784891

  17. Surgery and radiation therapy for extramedullary plasmacytoma of the penile mucosa in a dog

    OpenAIRE

    Wypij, Jackie M.; Lorimier, Louis-philippe

    2012-01-01

    A 10-year-old neutered male Italian greyhound dog was presented because it had a penile plasmacytoma. Surgery followed by radiation therapy resulted in local control and survival for 1688 days. This is the first report of surgery and definitive radiation therapy for curative intent therapy of extramedullary penile plasmacytoma in a dog.

  18. Comparison of blood velocity measurements between ultrasound Doppler and accelerated phase-contrast MR angiography in small arteries with disturbed flow

    Energy Technology Data Exchange (ETDEWEB)

    Jiang Jingfeng; Johnson, Kevin; Wieben, Oliver; Zagzebski, James [Medical Physics Department, University of Wisconsin-Madison School of Medicine and Public Health, WI (United States); Strother, Charles; Consigny, Dan [Radiology Department, University of Wisconsin-Madison School of Medicine and Public Health, WI (United States); Baker, Sara, E-mail: jjiang2@wisc.edu [School of Ultrasound, University of Wisconsin-Madison School of Medicine and Public Health, WI (United States)

    2011-03-21

    Ultrasound Doppler (UD) velocity measurements are commonly used to quantify blood flow velocities in vivo. The aim of our work was to investigate the accuracy of in vivo spectral Doppler measurements of velocity waveforms. Waveforms were derived from spectral Doppler signals and corrected for intrinsic spectral broadening errors by applying a previously published algorithm. The method was tested in a canine aneurysm model by determining velocities in small arteries (3-4 mm diameter) near the aneurysm where there was moderately disturbed flow. Doppler results were compared to velocity measurements in the same arteries acquired with a rapid volumetric phase contrast MR angiography technique named phase contrast vastly undersampled isotropic projection reconstruction magnetic resonance angiography (PC-VIPR MRA). After correcting for intrinsic spectral broadening, there was a high degree of correlation between velocities obtained by the real-time UD and the accelerated PC-MRA technique. The peak systolic velocity yielded a linear correlation coefficient of r = 0.83, end diastolic velocity resulted in r = 0.81, and temporally averaged mean velocity resulted in r = 0.76. The overall velocity waveforms obtained by the two techniques were also highly correlated (r = 0.89 {+-} 0.06). There were, however, only weak correlations for the pulsatility index (PI: 0.25) and resistive index (RI: 0.14) derived from the two techniques. Results demonstrate that to avoid overestimations of peak systolic velocities, the results for UD must be carefully corrected to compensate for errors caused by intrinsic spectral broadening.

  19. Comparison of blood velocity measurements between ultrasound Doppler and accelerated phase-contrast MR angiography in small arteries with disturbed flow

    Science.gov (United States)

    Jiang, Jingfeng; Strother, Charles; Johnson, Kevin; Baker, Sara; Consigny, Dan; Wieben, Oliver; Zagzebski, James

    2011-03-01

    Ultrasound Doppler (UD) velocity measurements are commonly used to quantify blood flow velocities in vivo. The aim of our work was to investigate the accuracy of in vivo spectral Doppler measurements of velocity waveforms. Waveforms were derived from spectral Doppler signals and corrected for intrinsic spectral broadening errors by applying a previously published algorithm. The method was tested in a canine aneurysm model by determining velocities in small arteries (3-4 mm diameter) near the aneurysm where there was moderately disturbed flow. Doppler results were compared to velocity measurements in the same arteries acquired with a rapid volumetric phase contrast MR angiography technique named phase contrast vastly undersampled isotropic projection reconstruction magnetic resonance angiography (PC-VIPR MRA). After correcting for intrinsic spectral broadening, there was a high degree of correlation between velocities obtained by the real-time UD and the accelerated PC-MRA technique. The peak systolic velocity yielded a linear correlation coefficient of r = 0.83, end diastolic velocity resulted in r = 0.81, and temporally averaged mean velocity resulted in r = 0.76. The overall velocity waveforms obtained by the two techniques were also highly correlated (r = 0.89 ± 0.06). There were, however, only weak correlations for the pulsatility index (PI: 0.25) and resistive index (RI: 0.14) derived from the two techniques. Results demonstrate that to avoid overestimations of peak systolic velocities, the results for UD must be carefully corrected to compensate for errors caused by intrinsic spectral broadening.

  20. Necrosis de pene: Revisión de 18 casos en el Hospital de Especialidades Centro Médico nacional Siglo XXI / Penile necrosis: a review of 18 cases at the Hospital de Especialidades Centro Médico nacional Siglo XXI

    Scientific Electronic Library Online (English)

    Guillermo, Montoya Martínez; José Manuel, Otero García; Virgilio, López Samano; José, González Martínez; Eduardo, Serrano Brambila.

    2006-08-01

    Full Text Available Objetivo: Presentar la experiencia en el manejo de necrosis de pene en nuestro centro hospitalario. Métodos: Se realizó la revisión de expedientes clínicos con diagnóstico de necrosis de pene en el servicio de Urología del Hospital de Especialidades Centro Medico Nacional Siglo XXI de enero de 1995 [...] a marzo de 2005. Resultados: Se encontraron 18 casos con necrosis de pene con edades entre 28 a 78 años (edad media de 58.1 años). Los antecedentes personales patológicos con mayor incidencia fueron la diabetes mellitus en 10 casos e insuficiencia renal crónica terminal en 11 casos. Los motivos de consultas fueron presencia de escaras en pene en cinco casos, exudado purulento, inflamación de glande y prepucio en tres casos, priapismo isquémico en dos casos, síndrome de Fournier dos casos, uretrorrea un caso, necrosis de pene secundario a compresión extrínseca en un caso y absceso periuretral un caso. De los 18 casos a 13 se les realizó penectomía total o parcial, de los cuales 3 fallecieron. A 5 pacientes se les dio manejo conservador con antibióticos, uno de ellos falleció. El análisis de patología reportó trombosis arterial y venosa además de necrosis isquémica en 3 casos; trombosis arterial y venosa, necrosis isquémica y calcificación distrófica arterial y venosa en 10 casos. Conclusiones: Los cambios vasculares oclusivos son un factor condicionante en la mayoría de los pacientes con necrosis de pene esto además se hace más evidente en pacientes con insufiiencia renal crónica terminal, diabetes mellitus e hipertensión arterial sistémica. Las manifestaciones clínicas de la necrosis de pene son escaras, momificación, autoamputación y sobreinfección, es por eso que el diagnostico temprano y el tratamiento oportuno es determinante en la evolución de este padecimiento. Abstract in english Objectives: To report the experience in the management of penile necrosis at our hospital. Methods: We performed a review of the medical penile necrosis at the Department of the Urology of the Hospital de Especialidades Centro Médico nacional Siglo XXI from January 1995 to March 2005. Results: 18 ca [...] ses of penile necrosis were found, with ages from 28 to 78 years (mean age 58.1 yr.). Diabetes mellitus and end stage renal disease were the most frequent associated diseases, with 10 and 11 cases respectively. Reasons for consultation were penile scars in 5 cases, purulent exudation, inflammation of the glans penis and prepuce in 3 ,ischemic priapism in 2, Fournier`s syndrome in 2, urethral bleeding in one, penile necrosis secondary to extrinsic compression in one,and periurethral abscess in another. Thirteen out of the 18 cases underwent partial or complete penectomy, and three of them died. Five patients were managed conservatively with antibiotics, one of them died. The pathology report showed ischemic necrosis in 3 cases, arterial and venous thrombosis, ischemic necrosis and dystrophic arterial and venous calcifications in 10 cases. Conclusions: Occlusive vascular changes are a conditioning factor in most patients with penile necrosis. This is more evident in patients with end stage renal disease,diabetes mellitus and hypertension. Clinical features of penile necrosis include scars, mummification, self-amputation,and superinfection, so that an early diagnosis and proper treatment are decisive for the evolution of this disease.

  1. “Bird-Wing” abdominal phalloplasty: A novel surgical technique for penile reconstruction

    Science.gov (United States)

    Bajpai, Minu

    2013-01-01

    Aim: To describe a technique of phalloplasty that is devoid of donor site scarring and suitable for urethral inlay and penile prosthesis in subsequent stages in cases of aphallia. Materials and Methods: Four patients with various disorders of sex development with 46 XY and severe penile deficiency, including one with complete androgen insensitivity syndrome who was initially raised as female, have been operated using a “Bird Wing” lower abdominal skin crease incision. Results: The patients’ age ranged from 6 to 17 years with preoperative stretched penile lengths between 1 and 2.5 cm. Phallic sizes between 7.5 and 12.5 cm was achieved leaving the donor site unremarkable with lower abdominal skin crease linear scar and excellent postoperative recovery. Conclusions: This phalloplasty technique can be utilized as a definitive procedure in many situations of penile insufficiency. Subsequent stages of urethral repair and insertion of penile prosthesis can be easily added. PMID:23798805

  2. Stent farmacológico autoexpansível miniaturizado em coronárias de pequeno calibre: eficácia tardia / Miniaturized self-expanding drug-eluting stent in small coronary arteries: late effectiveness

    Scientific Electronic Library Online (English)

    Flavio Roberto Azevedo de, Oliveira; Luiz Alberto Piva e, Mattos; Alexandre, Abizaid; Andrea S., Abizaid; J. Ribamar, Costa; Ricardo, Costa; Rodolfo, Staico; Roberto, Botelho; J. Eduardo, Sousa; Amanda, Sousa.

    2013-11-01

    Full Text Available FUNDAMENTO: Na angioplastia coronária percutânea (ACP), os vasos de fino calibre representam um fator de risco para reestenose. O stent farmacológico (SF) autoexpansível Sparrow®, de perfil menor que os sistemas atuais, nunca foi testado nesse cenário. OBJETIVOS: Avaliar a eficácia tardia do SF Spar [...] row®, com relação à perda luminal tardia intrastent (PLT intrastent) aos oito meses. MÉTODOS: Estudo prospectivo, randomizado, em P com doença arterial coronária (DAC) sintomática ou com isquemia documentada, submetido à ACP em vasos de calibre Abstract in english BACKGROUND: Small vessels represent a risk factor for restenosis in percutaneous coronary angioplasty (PCA). The Sparrow® self-expanding drug-eluting stent, which has a lower profile than the current systems, has never been tested in this scenario. OBJECTIVES: To evaluate the late effectiveness of t [...] he Sparrow® drug-eluting stent, regarding in-stent late lumen loss (LLL). METHODS: Patients with ischemia, symptomatic or documented, were submitted to PCA in vessels with reference diameter

  3. Bronchial artery infusion of Gemcitabine and Cisplatin combined with systemic chemotherapy for advanced non-small cell lung cancer: its short-term efficacy

    International Nuclear Information System (INIS)

    Objective: To assess the short-term efficacy of bronchial artery infusion (BAI) of Gemcitabine (GEM) plus Cisplatin (DDP) combined with systemic chemotherapy of GEM for advanced non-small cell lung cancer (NSCLC). Methods: A total of 60 patients with pathologically proved primary NSCLC were randomly selected. BAI with GEM (1000 mg/m2) and DDP (DDP 50 mg/m2) was performed on the first day, and systemic chemotherapy of GEM (1000 mg/m2) was carried out on the eighth day. The clinical results were analyzed. Results: Of the 60 patients, CR, PR, SD and PD were obtained in 3, 35, 17 and 5, respectively, with an overall effective rate of 63%. Twenty-two patients had adenocarcinoma and the effective rate of them was 45%. Thirty-eight patients had squamous cell carcinoma and their effective rate was 74%. The difference in the effective rate between the above two pathologic types was significant (P<0.05). Central type lung cancer was seen in 37 cases, their effective rate was 73%. The peripheral type lung cancer was seen in the remaining 23 patients and the effective rate was 48%. The difference in the effective rate was statistically significant between the central type and the peripheral type (P<0.05). Conclusion: The combination of bronchial artery infusion with systemic chemotherapy by using GP plan is an effective, feasible approach in the treatment of advanced non-small cell lung cancer. The short-term efficacy of the treatment bears a close relationship to the anatomical location and pathological type of the cancer. (authors)

  4. Increase by lysophosphatidylcholines of smooth muscle Ca2+ sensitivity in alpha-toxin-permeabilized small mesenteric artery from the rat

    DEFF Research Database (Denmark)

    Jensen, P E; Ohanian, J

    1996-01-01

    1. Pharmacological characterization of different lysophosphatidylcholines was performed based on their effect on the Ca2+ sensitivity of contraction in alpha-toxin-permeabilized rat mesenteric arteries. Furthermore, the effect of noradrenaline on [3H]-myristate-labelled lysophosphatidylcholine levels was assessed, to investigate whether lysophosphatidylcholines could be second messengers. 2. Palmitoyl or myristoyl L-alpha-lysophosphatidylcholine increased the sensitivity to Ca2+, whereas lysophosphatidylcholines containing other fatty acids had less or no effect. 3. L-alpha-phosphatidylcholine, L-alpha-glycerophosphorylcholine, palmitic acid, myristic acid and choline, potential metabolites of lysophosphatidylcholines, did not affect contractions. 4. Noradrenaline (GTP was required) and GTP gamma S increased the sensitivity to Ca2+, and GDP-beta-S inhibited the effect of noradrenaline. Lysophosphatidylcholines, however, had no requirement for GTP and caused sensitization in the presence of GDP-beta-S. 5. Calphostin C, a relatively specific protein kinase C inhibitor, did not affect contraction induced by Ca2+, but abolished the sensitizing effect of lysophosphatidylcholine. 6. Noradrenaline caused no measurable changes in the levels of [3H]-myristate-labelled phosphatidylcholine and lysophosphatidylcholine at 30 s and 5 min stimulation. 7. These results suggest that lysophosphatidylcholines can increase Ca2+ sensitivity through a G-protein-independent, but a protein kinase C-dependent mechanism. However, the role for lysophosphatidylcholines as messengers causing Ca2+ sensitization during stimulation with noradrenaline remains uncertain because no increase in [3H]-myristate labelled lysophosphatidylcholine could be measured during noradrenaline stimulation.

  5. Penile Prosthesis: What Should We Do about Complications?

    Directory of Open Access Journals (Sweden)

    M. Battaglia

    2008-11-01

    Full Text Available Even in the era of phoshodiesterase type 5 inhibitors, penile implants are considered the definitive solution for the treatment of organic erectile disfunction. The advent of new surgical tools and new infection-resistant materials has significantly reduced the risk of intra and post-operative complications and the need for revision surgery. Various companies have also improved their mechanical systems in order to reduce the risk of failures, and their products are now so good they may last lifelong. In this article, we evaluate the intraoperative and postoperative complications recorded in our experience and in literature reports, and make some suggestions as to how to prevent or correct them.

  6. Alternatively spliced neuronal nitric oxide synthase mediates penile erection

    OpenAIRE

    Hurt, K. Joseph; Sezen, Sena F.; Champion, Hunter C.; Crone, Julie K.; Palese, Michael A.; Huang, Paul L.; Sawa, Akira; Luo, Xiaojiang; Musicki, Biljana; Snyder, Solomon H.; Burnett, Arthur L.

    2006-01-01

    A key role for nitric oxide (NO) in penile erection is well established, but the relative roles of the neuronal NO synthase (nNOS) versus endothelial forms of NOS are not clear. nNOS- and endothelial NOS-deficient mice maintain erectile function and reproductive capacity, questioning the importance of NO. Alternatively, residual NO produced by shorter transcripts in the nNOS?/? animals might suffice for normal physiologic function. We show that the ? splice variant of nNOS elicits normal...

  7. Spontaneous bilateral rod fracture of malleable penile prosthesis

    OpenAIRE

    Bozkurt, Ibrahim Halil; Yonguc, Tarik; Arslan, Burak; Kozacioglu, Zafer; Degirmenci, Tansu; Polat, Salih; Minareci, Suleyman

    2014-01-01

    Mechanical failure with a malleable penile prosthesis is very rare. To the best of our knowledge, this is the first case reporting on a bilateral AMS 650 rod mechanical failure. We present a 50-year-old man with organic erectile dysfunction who experienced bilateral AMS 650 rod fracture after 14 years. The rod fracture of the left side was confirmed via X-ray preoperatively. The surgical exploration revealed a fracture of both rods. After the removal of both rods, we implanted a new malleable...

  8. Xeroradiography and ultrasonography in the evaluation of a penile injury.

    Science.gov (United States)

    Oesterling, J E; Bromberg, W D; Albertsen, P C

    1986-04-01

    A 34-year-old white man presented with severe penile cellulitis following injection of epoxy glue into the shaft of the penis. Preoperative xeroradiography and ultrasonography localized the hardened masses of glue to the left corpus cavernosum and subcutaneous tissues. Under the guidance of intraoperative ultrasonography this foreign material was removed surgically. Postoperatively, the cellulitis resolved promptly and xeroradiography demonstrated no residual fragments. Although various modalities, including computerized tomography and roentgenography, are available to detect foreign bodies in soft tissues, xeroradiography and ultrasonography are ideally suited for use in the male external genitalia. PMID:3514963

  9. Therapeutic results of non-small cell lung cancer in stage III. Combined synchronous irradiation with bronchial artery infusion of CDDP

    International Nuclear Information System (INIS)

    The present series consisted of 55 patients with non-small cell lung cancer in stage III who underwent radiotherapy from 1986-1989. They were divided into two groups: 35 patients with combined concurrent bronchial artery infusion (BAI) of CDDP (50 mg) and unevenly fractionated radiotherapy (combined group) and 20 with evenly fractionated irradiation (radiation group). The combined therapy was expected to achieve higher local control of disease. The rationale for the combined regime was based on the effects of CDDP, which causes cytostasis following intra-arterial infusion, and increased radiosensitivity from unevenly fractionated irradiation just after BAI. The radiotherapy group was considered a control in this study. The results of the combined group were limited to no CR, PR in 33 patients and NC in two with a period of 30±13 days for 50% reduction of tumor, superior to the radiation group. There was no difference between the two groups in the rate of local recurrence (combined group: 63%). The combined group showed 28 months of MST in cause-specific survival, a significant difference. Survival rates were 71% at one year, 27% at three years, and 15% at five years, including three survivors without recurrence. Stage III a patients in the combined group showed a better outcome than stage III b patients in the same group, and stage III a patients in the radiation group. Although radiation pneumonitis as a fatal side effect was noted in one patient of the combined gro noted in one patient of the combined group, the combined therapy presented here seemed to improve the prognosis of locally advanced lung cancer if properly indicated. (author)

  10. Comparison of blood velocity measurements between ultrasound Doppler and accelerated phase-contrast MR angiography in small arteries with disturbed flow

    International Nuclear Information System (INIS)

    Ultrasound Doppler (UD) velocity measurements are commonly used to quantify blood flow velocities in vivo. The aim of our work was to investigate the accuracy of in vivo spectral Doppler measurements of velocity waveforms. Waveforms were derived from spectral Doppler signals and corrected for intrinsic spectral broadening errors by applying a previously published algorithm. The method was tested in a canine aneurysm model by determining velocities in small arteries (3-4 mm diameter) near the aneurysm where there was moderately disturbed flow. Doppler results were compared to velocity measurements in the same arteries acquired with a rapid volumetric phase contrast MR angiography technique named phase contrast vastly undersampled isotropic projection reconstruction magnetic resonance angiography (PC-VIPR MRA). After correcting for intrinsic spectral broadening, there was a high degree of correlation between velocities obtained by the real-time UD and the accelerated PC-MRA technique. The peak systolic velocity yielded a linear correlation coefficient of r = 0.83, end diastolic velocity resulted in r = 0.81, and temporally averaged mean velocity resulted in r = 0.76. The overall velocity waveforms obtained by the two techniques were also highly correlated (r = 0.89 ± 0.06). There were, however, only weak correlations for the pulsatility index (PI: 0.25) and resistive index (RI: 0.14) derived from the two techniques. Results demonstrate that to avoid overestimations of nstrate that to avoid overestimations of peak systolic velocities, the results for UD must be carefully corrected to compensate for errors caused by intrinsic spectral broadening.

  11. Functional effects, binding sites and immunolocalization of endothelin-1 in isolated penile tissues from man and rabbit

    DEFF Research Database (Denmark)

    Holmquist, F; Kirkeby, H J

    1992-01-01

    Functional effects of endothelin-1 (ET-1) were investigated in isolated preparations of human and rabbit corpus cavernosum (CC) and human penile circumflex veins (CV). In all preparations, ET-1 induced slowly developing, concentration-dependent contractions. The threshold concentration of ET-1 in CV was approximately 10 and 112 times lower than the threshold concentrations in human and rabbit CC, respectively. Furthermore, the contractions in CV reached a defined maximum at 10(-7) M ET-1 (-log EC50 = 9.12 +/- 0.17), whereas no maximum was obtained in CC preparations within the concentration range used (less than or equal to 3 x 10(-7) M). Pretreatment with the Ca++ channel blocker nimodipine partly reduced the ET-1-induced contractions in human and rabbit CC, but had no significant effect on CV preparations. In a Ca(++)-free medium containing the chelator ethyleneglycol-bis-(beta-aminoethylether)-N,N'-tetra-acetic acid, the contractions induced by ET-1 were reduced, but not abolished, in all preparations. Thecontractions induced by ET-1 are thus mediated mainly by influx of Ca++, although there seem to exist differences in the relative contribution of L-type Ca++ channels in CC and CV. Furthermore, additional mechanisms beside Ca++ influx are likely to be involved in both tissues. A high density of [125I]ET-1 binding sites was observed throughout the stroma and in the muscle layer of the deep penile artery in both human and rabbit CC. In the human CV, numerous binding sites were observed, but no clear difference between the various structures of the vessel wall could be detected.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Reconstruction of the penile skin loss due to 'radical' circumcision with a full thickness skin graft

    Directory of Open Access Journals (Sweden)

    Ignjatovi? Ivan

    2010-01-01

    Full Text Available Background. Excessive resection of penile skin is a rare but important complication of circumcision. Penis 'trapping' under the skin and consequent sexual dysfunction occur as a result. Case report. Excessive circumcision with complete resection of the penile skin is shown. Penis, trapped under the skin, was deliberated and skin defect was substituted with the full thickness skin graft. One year after the surgery penis has a good cosmetic appearance, adequate size and sexual function. Conclusion. Full thickness skin graft is a good option for augmentation of the penile skin loss in cases with intact hypodermal tissue and extensive skin loss, for the reconstruction in a single act.

  13. Nitric oxide-dependent penile erection in mice lacking neuronal nitric oxide synthase.

    OpenAIRE

    Burnett, A. L.; Nelson, R. J.; Calvin, D. C.; Liu, J. X.; Demas, G. E.; Klein, S. L.; Kriegsfeld, L. J.; Dawson, V. L.; Dawson, T. M.; Snyder, S. H.

    1996-01-01

    BACKGROUND: Nitric oxide (NO) has been implicated as a mediator of penile erection, because the neuronal isoform of NO synthase (NOS) is localized to the penile innervation and NOS inhibitors selectively block erections. NO can also be formed by two other NOS isoforms derived from distinct genes, inducible NOS (iNOS) and endothelial NOS (eNOS). To clarify the source of NO in penile function, we have examined mice with targeted deletion of the nNOS gene (nNOS- mice). MATERIALS AND METHODS: Mat...

  14. One-sheet spiraling full thickness skin graft for penile resurfacing after paraffinoma excision

    OpenAIRE

    Theddeus O.H. Prasetyono

    2011-01-01

    In the midst of on-going non-illicit practice of silicone or paraffin injection to enlarge penis, the author reported 3 cases of surgical treatment to resurface the body of the penis after excision of the destructed penile skin using full thickness skin graft. The skin excision was performed technically through penile body degloving procedure. Full thickness skin graft was then applied as a single sheet donor tissue to cover the denuded penile body spirally. The full thickness graft, which is...

  15. MRI of penile fracture: diagnosis and therapeutic follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Uder, Michael; Gohl, Dietrich; Takahashi, Masahide; Kramann, Bernhard; Schneider, Guenther [Universitaet des Saarlandes, Homburg/Saar (Germany). Radiologische Klinik; Derouet, Harry [Universitaet des Saarlandes, Homburg/Saar (Germany). Urologische Klinik; Defreyne, Luc [Department of Radiology and Medical Imaging, University Hospital of Gent (Belgium)

    2002-01-01

    A rupture of corpus cavernosum (CC) is a rare injury of the erect penis. The present study describes the role of MRI for diagnosis and follow-up of this injury. Four patients with clinically suspected acute penile fractures underwent MRI. Imaging findings were confirmed at surgery. In three patients, follow-up MRI was also available at 1, 6 and 16 weeks after surgical repair. In all patients pre-contrast T1-weighted images (T1WI) clearly disclosed ruptures of CC, which depicted as discontinuity of low signal intensity of the tunica albuginea (TA). Concomitant subcutaneous haematoma were well visualised both on T1-weighted (T1WI) and T2-weighted images, whereas haematoma in CC were optimally demonstrated on contrast-enhanced T1WI. On follow-up MRI all fractures presented similar healing process. Shortly after the repair, the tunical suture showed an increase in signal intensity on pre-contrast T1WI and was strongly enhanced with the administration of contrast material. Then the tear site gradually recovered low signal intensity on all spin-echo sequences by 4 months after surgery. These serial findings may suggest the formation of vascularised granulation tissue during cicatrisation. Magnetic resonance imaging is of great value for the diagnosis and follow-up in patients with penile fracture. (orig.)

  16. Disfunción eréctil de origen estructural peneano / Penile structural erectile dysfunction

    Scientific Electronic Library Online (English)

    Natalio, Cruz Navarro.

    2010-10-01

    Full Text Available La delicada armonía con la que los diferentes elementos del pene funcionan se puede ver alterada por diferentes patologías que dañan su estructura. Los fallos estructurales del pene condicionan un fracaso de este evento hemodinámico, y una disfunción eréctil que suele ser severa, resistente al trata [...] miento médico y generalmente irreversible. La pérdida de complianza en el tejido eréctil un drenaje anómalo de éste o las alteraciones severas en la geometría del pene son los mecanismos fisiopatológicos más frecuentes de estas disfunciones. Entre sus posibles causas figuran, entre otras, la enfermedad de La Peyronie, el priapismo, la diabetes, los traumatismos peneanos y la infiltración de los cuerpos cavernosos por algún proceso inflamatorio o neoplásico. Abstract in english The delicate harmony by which the various elements in the penis work may be altered by different pathologies that damage its structure. Structural anomalies in the penis cause a failure of the hemodynamic event and erectile dysfunction, which is usually severe, resistant to medical treatment and gen [...] erally non reversible. The most frequent physiopathologic mechanisms of these dysfunctions are loss of compliance in the erectile tissue, abnormal drainage, or severe alterations of penile geometry. Among possible etiologies are La Peyronie disease, priapism, diabetes, penile trauma, infiltration of corpora cavernosa by an inflammatory or neoplasic processes, and others.

  17. Penile necrosis due to calciphylaxis in a patient of end stage renal disease

    International Nuclear Information System (INIS)

    A case of a 72-year-old diabetic, hypertensive male with end stage renal disease as a result of the underlying condition of calciphylaxis, presenting with gangrene of the glans penis is reported. In calciphylaxis, calcification of small and medium-sized arteries occurs, which may result in ischemia and gangrene. A computed tomography scan of the lower abdomen, pelvis and the upper thigh was performed, which showed diffuse and extensive calcification of the walls of the small and medium-sized arteries, with almost complete obliteration of the lumen of the small arteries. A 3-dimensional reconstruction of the penis using volume rendering technique, demonstrated the ulceration of the glans penis in an exquisite manner. The appearance is so peculiar that no histological confirmation is needed. A review of relevant literature related to the etiopathogenesis, radiological findings, treatment and prognosis is also discussed. (author)

  18. Histomorphometry of penile smooth muscle fiber in severe erectile dysfunction / Histomorfometria das fibras musculares cavernosas na disfunção erétil grave

    Scientific Electronic Library Online (English)

    Joaquim de Almeida, Claro; José, Aboim; Enrico, Andrade; Gustavo, Alarcon; Valdemar, Ortiz; Francisco, Sampaio; Miguel, Srougi.

    Full Text Available CONTEXTO E OBJETIVO: A fibra muscular lisa apresenta fundamental importância no mecanismo de ereção e alterações em sua função ou em sua quantidade podem estar associadas à disfunção erétil. O objetivo do estudo é analisar a proporção de fibras musculares lisas em pacientes com disfunção erétil grav [...] e. TIPO DE ESTUDO E LOCAL: Estudo clínico, realizado no Grupo de Disfunção Erétil da Universidade Federal de São Paulo (Unifesp) e no Laboratório de Anatomia e Urologia da Universidade Estadual do Rio de Janeiro (UERJ). MÉTODOS: 20 pacientes com disfunção erétil grave de acordo com o Índice Internacional de Função Erétil e Teste de Ereção Fármaco-Induzida divididos em dois grupos de 10 pacientes, sendo um com fluxo arterial normal (44 a 78 anos, média @ 63 anos) e o outro com fluxo arterial alterado (38 a 67 anos, média @ 56,2 anos) ao duplex ultra-som. Os resultados são comparados com um grupo formado por 10 cadáveres de 18 a 25 anos (média @ 21,6 anos) presumidamente potentes. A quantificação das fibras musculares lisas foi realizada a partir de estudo imunoistoquímico com anticorpo anti-actina e análise computadorizada da imagem pelo sistema HSL (matiz, saturação e luminosidade). RESULTADOS: A proporção de fibras musculares lisas encontradas foi de 41,15% para o grupo controle. Os pacientes com disfunção erétil apresentaram 27,24% de fibras musculares lisas para o grupo com fluxo arterial normal e 25,74% para o grupo com fluxo arterial insuficiente. Com exceção de apenas um paciente (do grupo com fluxo arterial normal), 19 pacientes apresentavam ao menos uma doença crônica ou fator de risco para disfunção erétil, destacando-se diabetes mellitus, hipertensão arterial sistêmica e tabagismo, nesta ordem. CONCLUSÃO: Nos pacientes com disfunção erétil grave, o fluxo arterial isoladamente não apresenta interferência na proporção de fibras musculares lisas, pois os resultados foram semelhantes. Nestes pacientes com disfunção grave, a diminuição das fibras musculares lisas em relação ao grupo controle pode decorrer das doenças crônicas e de seu potencial aterosclerótico. Abstract in english CONTEXT AND OBJECTIVE: Smooth muscle fiber has fundamental importance in erection. Alterations in its function or quantity may be associated with erectile dysfunction. The study objective was to assess the proportion of penile smooth muscle fiber in patients with severe erectile dysfunction. DESIGN [...] AND SETTING: Clinical study, in the Sexual Dysfunction Group, Universidade Federal de São Paulo (Unifesp), and in the Anatomy Laboratory, Universidade Estadual do Rio de Janeiro (UERJ). METHODS: Twenty patients with severe erectile dysfunction were selected to form two groups of ten patients: one with normal arterial flow (age range: 44 to 78 years) and the other with altered arterial flow (age range: 38 to 67 years). These groups were compared with a group formed by ten cadavers aged 18 to 25 years that were presumed to have been potent. Quantification of the smooth muscle fibers was done by means of an immunohistochemical study. RESULTS: The proportion of smooth muscle fiber found was 41.15% for the control group. The patients with erectile dysfunction and normal arterial flow presented 27.24% and those with altered arterial flow presented 25.74%; 19 patients presented at least one chronic disease or risk factor for erectile dysfunction, with prominence for diabetes mellitus, systemic arterial hypertension and smoking. CONCLUSION: Among patients with severe erectile dysfunction, the arterial flow on its own does not present interference in the proportion of smooth muscle fiber. The diminution of the proportion of smooth muscle fiber may result from chronic diseases and vascular risk factors.

  19. Penile cancer brachytherapy HDR mould technique used at the Holycross Cancer Center

    OpenAIRE

    Piotr Paw?owski; Jaros?aw ?yczek; Robert Matys; Iwona Kubicka-Mendak; Iwona Stawiarska; Joanna Miedzinska; Pawe? Banatkiewicz; Aldona ?askawska-Wiatr; Justyna Wittych

    2011-01-01

    The aim of this pictorial essay is to present the mould based HDR brachytherapy technique used at the Holycross Cancer Center for penile cancer patients. We use images to describe this method step by step.

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

    Science.gov (United States)

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

    2012-01-01

    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. PMID:23093645

  1. Penis auto-amputation and chasm of the lower abdominal wall due to advanced penile carcinoma: a case report

    Science.gov (United States)

    2011-01-01

    Introduction Penile cancer is uncommon. When penile cancer is left untreated, at an advanced stage it can have tragic consequences for the patient. Case presentation Our case report does not concern a new manifestation of penile cancer, but an interesting presentation with clinical significance that emphasizes the need to diagnose and treat penile cancer early. It is an unusual case of a neglected penile cancer in a 57-year-old Greek man that led to auto-amputation of the penis and a large chasm in the lower abdominal wall. The clinical staging was T4N3M0 and our patient was treated with a bilateral cutaneous ureterostomy, chemotherapy and radiotherapy. Our patient died 18 months after his first admission in our clinic. Conclusions Emphasis must be placed on early diagnosis and treatment of penile cancer, so further development of the disease can be prevented. PMID:22152757

  2. Penis auto-amputation and chasm of the lower abdominal wall due to advanced penile carcinoma: a case report

    Directory of Open Access Journals (Sweden)

    Baltogiannis Dimitrios

    2011-12-01

    Full Text Available Abstract Introduction Penile cancer is uncommon. When penile cancer is left untreated, at an advanced stage it can have tragic consequences for the patient. Case presentation Our case report does not concern a new manifestation of penile cancer, but an interesting presentation with clinical significance that emphasizes the need to diagnose and treat penile cancer early. It is an unusual case of a neglected penile cancer in a 57-year-old Greek man that led to auto-amputation of the penis and a large chasm in the lower abdominal wall. The clinical staging was T4N3M0 and our patient was treated with a bilateral cutaneous ureterostomy, chemotherapy and radiotherapy. Our patient died 18 months after his first admission in our clinic. Conclusions Emphasis must be placed on early diagnosis and treatment of penile cancer, so further development of the disease can be prevented.

  3. Comparison of Small Intestinal Submucosa-Covered and Noncovered Nitinol Stents with PTFE Endografts in Injured Ovine Femoral Arteries: A Pilot Study

    International Nuclear Information System (INIS)

    The purpose of this study was to compare performance of small intestinal submucosa (SIS)-covered endografts (SCEs) to polytetra-fluoroethylene (PTFE)-covered endografts (PCEs) and to bare nitinol stents (BSs) in injured sheep femoral artery (FA). Bare Zilver 6 mm x 40 mm nitinol stents (n = 6), Zilver stents covered with SIS (n = 6), and Palmaz stents 6 mm x 37 mm covered with PTFE (n = 6) were implanted in the balloon-injured FAs of nine female sheep. Follow-up arteriograms were obtained before animal sacrifice at 1, 3 and 6 months, with three animals at each time point. The FAs with the implanted device were explanted for histologic studies and morphologic measurements. Stent implantation was technically successful in all sheep. All BS and SCEs were patent at each time point. Five BSs and five SCEs exhibited formation of progressive eccentric intimal hyperplasia (IH) that was more advanced in SCE at 6 months. Cross-sectional area narrowing averaged 60% for BSs and 67% for SCEs. One BS, one SCE and two patent PCEs exhibited mild-to-moderate formation of concentric IH. Four PCS occluded one at 1 month, two at 3 months and one at 6 months. Performance of the devices placed into sheep FAs depended on their relation to the curving peri-articular portion of the FA during extremity flexion. BSs and SCEs placed in this portion exhibited progressive growth of eccentric IH while PCEs placed in this portion occluded

  4. Imaging Findings of Sonography and Computed Tomography for a Penile Leiomyosarcoma: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Jin; Chung, Jae Joon; Yu, Jeong Sik; Kim, Joo Hee [Gangnam Severance Hospital, Seoul (Korea, Republic of)

    2009-12-15

    We report the ultrasonographic and computed tomography (CT) findings of a deep type of penile leiomyosarcoma that helped characterize a penile mass along with a review of the published literature. Leiomyosarcoma of the penis is a very rare disease characterized by a lobulated, expansile, soft tissue mass in CT images, with peripheral rim enhancement and internal homogeneous low density. The ultrasonographic findings revealed a lobulated and heterogeneously hypoechoic solid mass at the distal tip of the penis.

  5. Shah's Indian penile prosthesis placement after phallic reconstruction with radial forearm flap

    OpenAIRE

    Patwardhan, Sujata K.; Shah, Rupin; Kulkarni, Vijay; Varma, Radheshyam R.

    2008-01-01

    We report a successful implantation of Indian penile prosthesis after total phallic reconstruction. The differential stiffness of the Shah penile prosthesis is felt to have less potential for erosion, the most common complication of rigid prosthetic stiffening devices when used in a neo-phallus. This prosthesis is an alternative to the inflatable prosthesis in patients who choose a rigid prosthesis due to economical constraints.

  6. Neoadjuvant Concurrent Chemoradiation for Curative Treatment of Penile Squamous Cell Carcinoma

    OpenAIRE

    Arpit Chhabra; David Schwartz; Andrea Leaf; Nikolaos Karanikolas; Weiss, Jeffrey P.; David Schreiber

    2014-01-01

    Introduction. Penile cancer is a rare malignancy often treated with neoadjuvant chemotherapy followed by surgery. However, the utility of neoadjuvant chemoradiation, particularly when the tumor is resistant to chemotherapy alone, has not been established. In this study, we report a case of pT3cN3M0 penile squamous cell carcinoma with progression of nodal disease on chemotherapy, which was cured with use of neoadjuvant concurrent chemoradiation. Case Report. A 65-year-old male presented with a...

  7. Penile and scrotal strangulation caused by a steel ring: a case report

    OpenAIRE

    Efthimiou, Ioannis; Kazoulis, Savas; Christoulakis, Ioannis

    2008-01-01

    Application of constricting devices on the external male genitalia for increasing sexual performance is an unusual practice that can potentially lead to penile strangulation with severe consequences. In this case report we describe a case of a 48 year old male who presented in our hospital with a steel ring on his external genitalia which led to penile strangulation and a short review of the literature. The foreign body was successfully removed by an angle grinder which was not immediately av...

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

    Science.gov (United States)

    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. PMID:24931740

  9. Cyclic AMP-dependent phosphorylation of neuronal nitric oxide synthase mediates penile erection

    OpenAIRE

    Hurt, K. Joseph; Sezen, Sena F.; Lagoda, Gwen F.; Musicki, Biljana; Rameau, Gerald A.; Snyder, Solomon H.; Burnett, Arthur L.

    2012-01-01

    Nitric oxide (NO) generated by neuronal NO synthase (nNOS) initiates penile erection, but has not been thought to participate in the sustained erection required for normal sexual performance. We now show that cAMP-dependent phosphorylation of nNOS mediates erectile physiology, including sustained erection. nNOS is phosphorylated by cAMP-dependent protein kinase (PKA) at serine(S)1412. Electrical stimulation of the penile innervation increases S1412 phosphorylation that is blocked by PKA inhib...

  10. Penile neurilemmoma: Utility of fine-needle aspiration cytology in diagnosis of a rare entity

    OpenAIRE

    Malhotra, Kiran Preet; Shukla, Saumya; Gupta, Anurag; Awasthi, Namrata Punit; Husain, Nuzhat; Dhayal, Lshwar Ram

    2014-01-01

    Subcutaneous lesions in the penis are of rare occurrence and encompass benign as well as malignant tumors. These include lipomas, leiomyomas, neurilemmomas and their malignant counterparts. A surgical excision at this site carries the risk of postoperative penile curvature and erectile dysfunction. We report a rare case of penile neurilemmoma which presented as a subcutaneous nodule on the dorsal surface of the penis. A fine-needle aspiration was performed which aided in the preoperative diag...

  11. Mechanisms Predisposing Penile Fracture and Long-Term Outcomes on Erectile and Voiding Functions

    OpenAIRE

    Reis, Leonardo O.; Marcelo Cartapatti; Rafael Marmiroli; Xfa Nior, Eduardo Jeronimo Oliveira J.; Ricardo Destro Saade; Adriano Fregonesi

    2014-01-01

    Purpose. To determine the mechanisms predisposing penile fracture as well as the rate of long-term penile deformity and erectile and voiding functions. Methods. All fractures were repaired on an emergency basis via subcoronal incision and absorbable suture with simultaneous repair of eventual urethral lesion. Patients' status before fracture and voiding and erectile functions at long term were assessed by periodic follow-up and phone call. Detailed history included cause, symptoms, and single...

  12. Fístula uretrocavernosa por fractura penena / Urethrocavernous fistula due to penile fracture

    Scientific Electronic Library Online (English)

    B., Juaneda Castell; M., Montlleó González; X., Ponce de León Roca; L.l., Gausa Gascón; J., Caparrós Sariol; H., Villavicencio Mavrich.

    1043-10-01

    Full Text Available La fractura de pene con laceración de la uretra se presenta con dolor y hematoma, detumescencia, fallo en la erección y uretrorragia. Describimos el tercer caso publicado en la literatura de fistula uretrocavernosa por fractura peneana ocurrida durante el coito. [...] Abstract in english Penile fracture with urethral laceration usually presents with pain and haematoma, detumescence, erectile failure and blood loss through urethral meatus. We describe the third published case of urethrocavernous fistula following blunt penile trauma sustained durind sexual intercourse. [...

  13. Penile Reconstruction for a Case of Genital Lymphoedema Secondary to Proteus Syndrome

    OpenAIRE

    R Rees; Manners, J.; F. Ashouri

    2011-01-01

    To our knowledge penile lymphoedema secondary to Proteus syndrome has not previously been reported. Hence we report a case of a 16-year-old male who was referred with features of right hemi-hypertrophy and severe lymphoedema affecting his scrotum and penis. He had previously undergone scrotal reduction surgery at the age of 13, but had since developed worsening penile oedema. His main concern was that of cosmetic appearance prior to sexual debut, and he also complained of erectile dysf...

  14. Standard penile size for normal full term newborns in the Saudi population.

    OpenAIRE

    Abdullah S. Al-Herbish

    2002-01-01

    OBJECTIVES To establish norms for penile size for normal full term Saudi newborns. METHODS The length between the pubic ramus and the tip of the glans was measured in 379 normal full term Saudi newborns. An unmarked spatula was used where its edge was placed against the pubic ramus and the shaft of the penis was stretched to the point of increased resistance. The penile circumference was measured using a non- stretchable plastic tube placed around the midshaft of the uncircumcised pe...

  15. Focal Urethral Stricturing Following Intraurethral Mitomycin-C Gel and the Use of a Penile Clamp

    OpenAIRE

    Stanford, Richard F. J.; Thomas, Stephen A.

    2012-01-01

    We present a case of a 51-year-old gentleman, previously diagnosed with high-grade superficial transitional cell carcinoma of the bladder and treated with intravesical mitomycin C and BCG, who developed serial recurrences in the prostatic urethra. This was resected and treated further with intraurethral mitomycin-C gel. He subsequently developed an almost impassable distal penile urethral stricture, corresponding to the site of penile clamp application which we hypothesise is secondary to a c...

  16. Tadalafil rehabilitation therapy preserves penile size after bilateral nerve sparing radical retropubic prostatectomy

    OpenAIRE

    Ozgu Aydogdu; Mehmet Ilker Gokce; Berk Burgu; Sumer Baltaci; Onder Yaman

    2011-01-01

    OBJECTIVE: To evaluate the change in penile size r bilateral nerve sparing retropubic radical prostatectomy (BNSRRP) and possible effect of Tadalafil. MATERIALS AND METHODS: A total of 65 patients underwent BNSRRP and they were evaluated prospectively for a whole year of follow-up . The patients were randomized to control without rehabilitation (Group 1) or Tadalafil rehabilitation group (Group 2). The patients were evaluated at months 3, 6 and 12 postoperatively for erectile function, penile...

  17. Penile Gangrene with Abscess Formation after Modified Al-Ghorab Shunt for Idiopathic Ischemic Priapism

    OpenAIRE

    Ford-glanton, Beneranda S.; Parth Patel; Sameer Siddiqui

    2014-01-01

    Penile gangrene is a rare but unfortunate complication of surgical intervention and priapism shunts. The literature regarding penile gangrene following surgical correction of priapism is sparse, the majority of which dates back to thirty to forty years. Here, we present the case of a 60-year-old man who presented with priapism that required operative management with a modified Al-Ghorab shunt and eventually suffered from complete necrosis of the penis with abscess formation in both corpora ca...

  18. Penile Replantation, Science or Myth? A Systematic Review

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Safarinejad

    2007-02-01

    Full Text Available Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Introduction: Penile amputation is a rare urologic condition for which immediate surgical replantation is warranted. The surgical technique used for repair has been modified and refined. Our aim was to assess the effects of several interventions and management for amputated penis after replantation. Materials and Methods: We searched the MEDLINE (January 1966 to May 2007, EMBASE (January 1988 to January 2007, CINAHL (January 1982 to January 2007, PsycLIT (January 1984 to January 2007, ERIC (January 1984 to January 2007, and the bibliographic data of relevant articles; hand-searched conference proceedings; and contacted investigators to locate studies. All reported cases of penile replantation were studied. We assessed all titles, abstracts, and extracted data from the articles identified for inclusion. Outcome measures included cosmetic outcomes, acceptability, operative time, restoration of erectile function, sensibility of the glans, and long-term outcomes. Results: Eighty patients had undergone penile replantation. There was considerable variation in the interventions, patients, and outcome measures. The majority of the reported cases in this area continue to be of moderate quality, although more recent cases have been of higher quality in terms of both patients' demographics and surgical techniques. Data were not available in all of the cases for many of the outcomes expected to be reported. There were several important variations in the cases studied. Conclusion: The value of the various microsurgical techniques for replantation of the penis remains uncertain. Meticulous microsurgical techniques by experienced surgeons can reduce skin, urethra, and graft loss complications and produce a functional organ; nonetheless, such complications are still highly prevalent.

  19. Magnetic resonance imaging of penile metastases: a report on five cases

    Energy Technology Data Exchange (ETDEWEB)

    Lau, T.N. [Singapore General Hospital, (Singapore). Department of Diagnostic Radiology; Wakeley, C.J.; Goddard, P. [Bristol Royal Infirmary, Bristol, (United Kingdom). Department of Clinical Radiology

    1999-08-01

    Five cases of penile metastases are presented. Axial and sagittal T1-weighted and T2-weighted scans were performed in all patients. In some, coronal images were also obtained. The penile metastases were most often seen as discrete masses in the corpora cavernosa or corpus spongiosum. An atypical pattern of diffuse infiltration is also illustrated. Limitations of cavernosography, ultrasound (US) and computed tomography (CT) are discussed. The magnetic resonance (MR) features of penile metastases and possible role MR may have in the management of these patients are described. Metastatic deposits in the penis are uncommon. First described by Eberth in 1870 in a patient with a primary rectal carcinoma, there have since been over 300 cases reported in the literature. The imaging of penile metastases is, however, less clearly defined. Until now, cavernosography, ultrasound (US) and computed tomography (CT) have been used. These techniques have limitations. Only recently has magnetic resonance imaging (MRI) been employed. We describe five cases of penile metastases evaluated with MRI and discuss the role and features of penile metastases on MRI. Copyright (1999) Blackwell Science Pty Ltd 12 refs., 4 figs.

  20. Preservation of Cavernosal Erectile Function after Soft Penile Prosthesis Implant in Peyronie's Disease: Long-Term Followup

    OpenAIRE

    Igor Piacentini; Salvatore Blanco; Flavio Fortuna; Caterina Lania; Marco Grasso

    2008-01-01

    The aim of this retrospective study is to evaluate the long-term followup of soft penile SSDA prosthesis, without plaque surgery in the treatment of Peyronie's disease. This study included 12 men with Peyronie's disease who underwent placement of a penile prosthesis. All patients were followed for at least 6 years. Prosthesis straightened the penile shaft in all cases, restoring patient sexual satisfaction. No operative or postoperative complications occurred, and no reoperations were needed....

  1. Effects of small doses of ouabain on the arterial blood pressure of anesthetized hypertensive and normotensive rats

    Scientific Electronic Library Online (English)

    L.V., Rossoni; V.D., Pinto; D.V., Vassallo.

    2001-08-01

    Full Text Available Ouabain increases vascular resistance and may induce hypertension by inhibiting the Na+ pump. The effects of 0.18 and 18 µg/kg, and 1.8 mg/kg ouabain pretreatment on the phenylephrine (PHE; 0.1, 0.25 and 0.5 µg, in bolus)-evoked pressor responses were investigated using anesthetized normotensive (co [...] ntrol and uninephrectomized) and hypertensive (1K1C and DOCA-salt treated) rats. Treatment with 18 µg/kg ouabain increased systolic and diastolic blood pressure in all groups studied. However, the magnitude of this increase was larger for the hypertensive 1K1C and DOCA-salt rats than for normotensive animals, while the pressor effect of 0.18 µg/kg ouabain was greater only in DOCA-salt rats. A very large dose (1.8 mg/kg) produced toxic effects on the normotensive control but not on uninephrectomized or 1K1C rats. Rat tail vascular beds were perfused to analyze the effects of 10 nM ouabain on the pressor response to PHE. In all animals, 10 nM ouabain increased the PHE pressor response, but this increase was larger in hypertensive DOCA-salt rats than in normotensive and 1K1C rats. Results suggested that a) increases in diastolic blood pressure induced by 18 µg/kg ouabain were larger in hypertensive than normotensive rats; b) in DOCA-salt rats, smaller ouabain doses had a stronger effect than in other groups; c) hypertensive and uninephrectomized rats were less sensitive to toxic doses of ouabain, and d) after treatment with 10 nM ouabain isolated tail vascular beds from DOCA-salt rats were more sensitive to the pressor effect of PHE than those from normotensive and 1K1C hypertensive rats. These data suggest that very small doses of ouabain, which might produce nanomolar plasma concentrations, enhance pressor reactivity in DOCA-salt hypertensive rats, supporting the idea that endogenous ouabain may contribute to the increase and maintenance of vascular tone in hypertension.

  2. A case of linear porokeratosis with penile localization

    Directory of Open Access Journals (Sweden)

    Turna ?lknur

    2014-09-01

    Full Text Available Porokeratosis (PK, a disorder of epidermal keratinization with a unique clinical appearance, is characterized histopathologically by the presence of cornoid lamella. Many different clinical forms of PK have been described i.e., classical plaque-type PK of Mibelli, disseminated superficial actinic PK, linear PK, PK palmaris et plantaris disseminata, and punctate PK. Linear PK is a rare variant of PK presenting with slightly scaly atrophic papules following Blaschko’s lines. Additionally, PK confined to the genital area is also an uncommon condition. Both genital and linear PK are extremely rare and only one case of genital linear PK has been reported in the literature. Here, we report the case of a patient with penile linear PK who was treated with diclofenac sodium gel and imiquimod cream but did not recover.

  3. Current status of penile rehabilitation after radical prostatectomy.

    Science.gov (United States)

    Kim, Jae Heon; Lee, Seung Wook

    2015-02-01

    Although disease-free survival remains the primary goal of prostate cancer treatment, erectile dysfunction (ED) remains a common complication that affects the quality of life. Even though several preventive and therapeutic strategies are available for ED after radical prostatectomy (RP), no specific recommendations have been made on the optimal rehabilitation or treatment strategy. Several treatment options are available, including phosphodiesterase-5 inhibitors, vacuum erection devices, intracavernosal or intraurethral prostaglandin injections, and penile prostheses. Urologists must consider more effective ways to establish optimal treatments for ED after RP. ED is an important issue among patients with prostate cancer, and many patients hope for early ED recovery after surgery. This review highlights the currently available treatment options for ED after RP and discusses the limitations of each. PMID:25685296

  4. Penile Kaposi's Sarcoma in an HIV Negative Male Patient

    Directory of Open Access Journals (Sweden)

    Ekrem Akta?

    2008-12-01

    Full Text Available Classic Kaposi’ssarcoma (KS is usually present with asymptomatic brownish-red to purple or blue-coloured patches, plaques or nodular lesions most frequently located on the lower extremities, especially the ankles and soles. Penile Kaposi’s sarcoma is very rare and usually observed in AIDS patients. Herein we present an HIV-negative 66-year-old man who presented with a reddish, violaceous papule 0,3 cm in diameter on the glans penis and multipl violaceous papules on the palmar and dorsal side of the left hand, whose histopathological examination revealed KS. A diagnosis of Kaposi’s sarcoma was made after clinicopathological evaluation. The cure was obtained with interferon alfa-2b and radiotherapy. (Turkderm 2008; 42: 131-3

  5. Acute arterial occlusion - kidney

    Science.gov (United States)

    ... arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery ... often result in permanent kidney failure. Acute arterial occlusion of the renal artery can occur after injury ...

  6. Distribution of mesenteric cranial artery in the small intestine of Procyon cancrivorus (Cuvier, 1798 (Mammalia, Procyonidae = Comportamento da artéria mesentérica cranial no intestino delgado de mão-pelada Procyon cancrivorus (Cuvier, 1798 (Mammalia, Procyonidae

    Directory of Open Access Journals (Sweden)

    Vanessa Morais Lima

    2010-04-01

    Full Text Available The mesenteric artery is a high caliber vessel dependent on the abdominal artery, right below the emergence of the vessels destined for the liver and stomach. The present study aimed to describe the behavior of the arterial vessel in the small intestine of the crab-eating raccoon (Procyon cancrivorus. The animals were collected on highways (roadkill. Cannulation of the abdominal aorta, perfusion with warmed water (40ºC and stained latex injection (Neoprene 450, Dupont do Brasil and Sulvinil stain, Glassuret S.A were performed, followed by formaldehyde fixation (10%. The dissection and photographic documents (Sony Cyber-shot, 8.1 megapixels made it possible to systemize the arteries and define the vascular patterns of the viscera. It was verified that the mesenteric cranial artery supports the entire jejune and the mesenteric portion of the ileum. Next to the mesenteric border, it becomes an anastomosis forming vascular arches from where straight arteries leave, supplying the mesenteric portion and sometimes also the jejunal antimesentericportion. The artery that irrigates the ileum comes up as a branch of the cranial mesenteric artery. Anatomic knowledge of the vascular pattern of the crab-eating raccoon (Procyon cancrivorus is of fundamental importance for researches regarding the arterialdistribution of the intestine considering anatomic variances.A artéria mesentérica é um vaso de grande calibre dependente da artéria aorta abdominal, imediatamente abaixo da emergência dos vasos destinados ao fígado e estômago. O objetivo do presente estudo foi descrever o comportamento dos vasos arteriais do intestino delgado em mão-pelada (Procyon cancrivorus. Os animais são procedentes de coleta em rodovias (mortos por acidente. Realizou-se a canulação da aorta abdominal, perfusão com água aquecida (40ºC e injeção de látex corado (Neoprene 450, Dupont do Brasil e Sulvinil Corante, Glassuret S.A, seguido de fixação em formaldeído (10%. As dissecações edocumentação fotográfica (Câmera Sony Cyber-shot, 8.1 megapixels permitiram sistematizar as artérias e definir os padrões vasculares da víscera. Verificamos que a artéria mesentérica cranial supre todo o jejuno e a face mesentérica do íleo. Próximo à borda mesentérica, anastomosa-se formando as arcadas vasculares e desta partem as artérias retas, que suprem à face mesentérica e, às vezes, a face antimesentérica do jejuno. A artéria que irriga o íleo surge como último ramo da artéria mesentérica cranial. O conhecimento anatômico do padrão vascular de mão-pelada (Procyon cancrivorus é de fundamental importância em pesquisas que se referem à distribuição arterial do intestino, levando-se em consideração as variações anatômicas.

  7. Penile prosthesis implantation in an academic institution in Latin America

    Scientific Electronic Library Online (English)

    Mario, Paranhos; Enrico, Andrade; Alberto A., Antunes; Ana L. N., Barbieri; Joaquim A., Claro; Miguel, Srougi.

    2010-10-01

    Full Text Available PURPOSE: We performed a retrospective study to analyze the effectiveness of implantable penile prostheses in the treatment of erectile dysfunction. MATERIALS AND METHODS: This study included 249 patients who received implants between 2001 and 2008. A total of 139 patients who underwent penile prosth [...] esis implantation were interviewed. RESULTS: Approximately half of patients had previously used oral drugs before implantation of the prosthesis. About 45% had diabetes, 25.9% had previously undergone radical prostatectomy (RP), and 64% had hypertension. Exchange was performed in 5.7% for fracture, inadequate size, or extrusion. A total of 24.5% of men had immediate postoperative pain, 7.9% had local infection, and 8.6% had other complications. Patients who had previously undergone RP were 3.2 times more likely to experience a postoperative complication than patients who had not (p = 0.061). Eighty-nine (64%) patients returned to having sex as they had before being diagnosed with ED. Ninety-two of the men (66.2%) had sexual intercourse one to two times per week. One hundred twenty patients (86.3%) rated their level of satisfaction as good, excellent or very good, which was similar to the percentage of partners. The mean follow-up was 40 months. CONCLUSION: Higher rates of postoperative infections and mechanical problems with the implant were found in this study as compared to other studies, which was probably associated with the relative lack of experience of the trainees who were performing the surgeries. Patients with a history of RP or diabetes mellitus prior to implantation were at higher risk of postoperative complications.

  8. High-dose-rate interstitial brachytherapy for the treatment of penile carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Petera, J.; Odrazka, K.; Zouhar, M.; Bedrosova, J.; Dolezel, M. [Dept. of Oncology and Radiotherapy, Charles Univ. Medical School and Teaching Hospital, Hradec Kralove (Czech Republic)

    2004-02-01

    Background: interstitial low-dose-rate (LDR) brachytherapy allows conservative treatment of T1-T2 penile carcinoma. High-dose-rate (HDR) is often considered to be dangerous for interstitial implants because of a higher risk of complications, but numerous reports suggest that results may be comparable to LDR. Nevertheless, there are no data in the literature available regarding HDR interstitial brachytherapy for carcinoma of the penis. Case report: a 64-year-old man with T1 NO MO epidermoid carcinoma of the glans is reported. Interstitial HDR brachytherapy was performed using the stainless hollow needle technique and a breast template for fixation and good geometry. The dose delivered was 18 x 3 Gy twice daily. Results: after 232 days from brachytherapy, the patient was without any evidence of the tumor, experienced no serious radiation-induced complications, and had a fully functional organ. Conclusion: HDR interstitial brachytherapy is feasible in selected case of penis carcinoma, when careful planning and small single fractions are used. (orig.)

  9. Countercurrent aortography via radial artery

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, Hyung Kuk; Lee, Young Chun; Lee, Seung Chul; Jeon, Seok Chol; Joo, Kyung Bin; Lee, Seung Ro; Kim, Soon Yong [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

    1987-06-15

    Countercurrent aortography via radial artery was performed for detection of aortic arch anomalies in 4 infants with congenital heart disease. Author's cases of aortic arch anomalies were 3 cases of PDA, 1 case of coarctation of aorta, and 1 case of occlusion of anastomosis site on subclavian artery B-T shunt. And aberrant origin of the right SCA, interrupted aortic arch, hypoplastic aorta, anomalous origin of the right pulmonary artery from the ascending aorta can be demonstrated by this method. Countercurrent aortography affords an safe and simple method for detection of aortic arch anomalies without retrograde arterial catheterization, especially in small infants or premature babies.

  10. Penile necrosis due to calciphylaxis in a patient of end stage renal disease.

    OpenAIRE

    Tanvir Rizvi; Al-Nakshabandi, Nizar A.

    2009-01-01

    ABSTRACT A case of a 72-year-old diabetic, hypertensive male with end stage renal disease as a result of the underlying condition of calciphylaxis, presenting with gangrene of the glans penis is reported. In calciphylaxis, calcification of small and medium-sized arteries occurs, which may result in ischemia and gangrene. A computed tomography scan of the lower abdomen, pelvis, and the upper thigh was performed, which showed diffuse and extensive calcification of the walls of the small and ...

  11. Prevalence of human papillomavirus and Epstein-Barr virus DNA in penile cancer cases from Brazil

    Scientific Electronic Library Online (English)

    Larissa Alves, Afonso; Natalia, Moyses; Gilda, Alves; Antônio Augusto, Ornellas; Mauro Romero Leal, Passos; Ledy do Horto dos Santos, Oliveira; Silvia Maria Baeta, Cavalcanti.

    2012-02-01

    Full Text Available Penile cancer is a potentially mutilating disease. Although its occurrence is relatively rare worldwide, penile cancer rates can be high in developing countries. A few studies have been conducted on the involvement of human papillomavirus (HPV) in penile carcinoma, which have found HPV present in 30 [...] -70% of penile malignant lesions, with a higher prevalence of HPV 16 and 18. It has been assumed that cofactors, such as Epstein-Barr virus (EBV) infections, may play a role in the progression of penile neoplasia. The aim of this study was to determine HPV and EBV prevalence in 135 penile malignant lesions from Brazilian men through the use of MY09/11 polymerase chain reaction (PCR), type-specific PCR and restriction fragment length polymorphism analysis. HPV prevalence among the men tested was 60.7%. Of the men who tested positive, 27 presented with HPV 16 (29.7%), five with HPV 18 (5.5%), 21 with HPV 45 (23.1%) and nine with HPV 6 (9.9%). Seven mixed infections were detected (9.2%), while 11 cases remained untyped (13.4%). Regarding EBV positivity, 46.7% of the samples contained EBV DNA with EBV-1 as the most prevalent type (74.6%). More than 23% of the men were co-infected with both HPV and EBV, while 35% presented exclusively with HPV DNA and 20% presented only with EBV DNA. Penile carcinoma aetiology has not been fully elucidated and the role of HPV and EBV infections individually or synergistically is still controversial. Hence, more studies are needed to determine their possible role in carcinogenesis.

  12. Prevalence of human papillomavirus and Epstein-Barr virus DNA in penile cancer cases from Brazil

    Directory of Open Access Journals (Sweden)

    Larissa Alves Afonso

    2012-02-01

    Full Text Available Penile cancer is a potentially mutilating disease. Although its occurrence is relatively rare worldwide, penile cancer rates can be high in developing countries. A few studies have been conducted on the involvement of human papillomavirus (HPV in penile carcinoma, which have found HPV present in 30-70% of penile malignant lesions, with a higher prevalence of HPV 16 and 18. It has been assumed that cofactors, such as Epstein-Barr virus (EBV infections, may play a role in the progression of penile neoplasia. The aim of this study was to determine HPV and EBV prevalence in 135 penile malignant lesions from Brazilian men through the use of MY09/11 polymerase chain reaction (PCR, type-specific PCR and restriction fragment length polymorphism analysis. HPV prevalence among the men tested was 60.7%. Of the men who tested positive, 27 presented with HPV 16 (29.7%, five with HPV 18 (5.5%, 21 with HPV 45 (23.1% and nine with HPV 6 (9.9%. Seven mixed infections were detected (9.2%, while 11 cases remained untyped (13.4%. Regarding EBV positivity, 46.7% of the samples contained EBV DNA with EBV-1 as the most prevalent type (74.6%. More than 23% of the men were co-infected with both HPV and EBV, while 35% presented exclusively with HPV DNA and 20% presented only with EBV DNA. Penile carcinoma aetiology has not been fully elucidated and the role of HPV and EBV infections individually or synergistically is still controversial. Hence, more studies are needed to determine their possible role in carcinogenesis.

  13. Penile Revascularization for Erectile Dysfunction: a Systematic Review and Meta-Analysis of Effectiveness and Complications

    Directory of Open Access Journals (Sweden)

    Ali Reza Babaei

    2009-02-01

    Full Text Available

    Introduction: Patients with arteriogenic erectile dysfunction (ED caused by traumatic localized arterial lesions can be treated successfully by penile revascularization (PR surgery. We aimed to determine the subjective and objective outcomes of PR surgery in patients with arteriogenic ED.

    Materials and Methods: We searched for relevant publications released up to May 2008 in the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and Biological Abstracts. The citation lists of review articles and included trials were also searched. Published studies on different operative techniques of PR for men with ED due to traumatic penile arterial lesions were selected by 2 reviewers. Data on participants’ characteristics, study quality, population, intervention, cure and adverse effects were collected and analyzed.

    Results: There were 25 studies that compared the selected operative techniques. Concerning subjective cure, the results in men younger than 30 years old were better than older ones (odds ratio, 3.7; 95% confidence interval, 2.2 to 6.4; P = .001. Venous leak (odds ratio, 1.8; 95% confidence interval, 1.2 to 2.6 and history of smoking (odds ratio, 3.4; 95% confidence interval, 2.2 to 5.6 influenced success rate. Inconsistent measurements of outcomes limited the findings, and none of the studies were randomized controlled trials.

    Conclusion: Traumatic patients with arteriogenic ED might benefit from PR. Patient selection is vital for a successful outcome. Variations in penile vascular anatomy are also likely to b

  14. Myriad presentations of penile fracture: report of three cases and review of literature.

    Science.gov (United States)

    Faridi, M S; Agarwal, Nitin; Saini, Pradeep; Kaur, Navneet; Gupta, Arun

    2015-01-01

    Penile fracture is an unusual though not a rare condition but underreported. It is defined classically as the disruption of the tunica albuginea with rupture of the corpus cavernosum. Penile fracture can be misdiagnosed with rupture of corpus spongiosum clinically. Therefore, we are presenting three cases due to its varied clinical presentation and management. In first patient, there was a tear in the corpus spongiosum and a partial tear in the ventral urethra. Both defects were repaired with interrupted sutures. In the second patient, there was a rupture of corpus cavernosum, which was primarily repaired. After 1-year of primary surgery, patient again came with similar complaints, and diagnosis of scar dehiscence was made. Patient was treated conservatively with satisfactory results on follow-up. Third patient came with a history of 1-week. Intra-operative findings revealed only hematoma without any defect in corpora cavernosum, corpus spongiosum, and urethra. Only evacuation of hematoma was done. Early surgical treatment of penile fracture is advantageous. In recurrent penile fracture, if no penile deformity or any reasonable clinical and radiological evidence, then conservative management is advocated. Even when presentation is delayed up to 1-week, operative management has shown good results. PMID:25949981

  15. Preservation of Cavernosal Erectile Function after Soft Penile Prosthesis Implant in Peyronie's Disease: Long-Term Followup

    Directory of Open Access Journals (Sweden)

    Igor Piacentini

    2008-12-01

    Full Text Available The aim of this retrospective study is to evaluate the long-term followup of soft penile SSDA prosthesis, without plaque surgery in the treatment of Peyronie's disease. This study included 12 men with Peyronie's disease who underwent placement of a penile prosthesis. All patients were followed for at least 6 years. Prosthesis straightened the penile shaft in all cases, restoring patient sexual satisfaction. No operative or postoperative complications occurred, and no reoperations were needed. All patients have undergone further examination with basal and dynamic eco color Doppler. The findings are encouraging as the penis preserves the ability to enhance the tumescence and penile girth. We can conclude that SSDA penile prosthesis is safe and effective in Peyronie's disease.

  16. Early Onset Inflammation in Pre-Insulin-Resistant Diet-Induced Obese Rats Does Not Affect the Vasoreactivity of Isolated Small Mesenteric Arteries

    DEFF Research Database (Denmark)

    Blædel, Martin; Raun, Kirsten

    2012-01-01

    Background: Obesity is an increasing burden affecting developed and emerging societies since it is associated with an increased risk of diabetes and consequent cardiovascular complications. Increasing evidence points towards a pivotal role of inflammation in the etiology of vascular dysfunction. Our study aimed to investigate signs of inflammation and their relation to vascular dysfunction in rats receiving a high fat diet. Methods: Diet-induced obese (DIO) rats were used as a model since these rats exhibit a human pre-diabetic pathology. Oral glucose and insulin tolerance tests were conducted on DIO rats and their controls prior to the development of insulin resistance. Furthermore, the plasma contents of selected cytokines [macrophage chemoattractant protein (MCP-1), interleukin-6 (IL-6), and interleukin-1 (IL-1)] and the concentration of adiponectin were measured. Using wire myography, we tested the vascular function of isolated small mesenteric arteries. Results: DIO animals had significantly (p <0.05) increased body weight (721.2 ± 6.3 g) compared to age- and sex-matched controls (643.4 ± 14.6 g), as well as a significant increase (p <0.01) in body fat percentage (29.7 ± 1.7% and 22.7 ± 0.97%, respectively). No significant difference in fasting plasma insulin levels could be detected between the two groups (chow-fed group 141.5 ± 15.1 pmol/l; high fat-fed group 125.9 ± 18.8 pmol/l). However, the levels of MCP-1 (89.7 ± 4.2 pg/ml vs. 60.8 ± 7.7 pg/ml) and IL-6 (61.6 ± 3.1 pg/ml vs. 41.6 ± 7.4 pg/ml) were significantly elevated in DIO animals (p <0.05) as compared to controls. Adiponectin levels were also significantly increased (p <0.01) in DIO rats (10.8 ± 0.7 ng/ml) versus controls (6.9 ± 0.5 ng/ml). No difference in vascular or endothelial function was evident as determined by responses to acetylcholine, sodium nitroprusside, endothelin-1, and calcitonin gene-related peptide. Conclusion: In DIO rats, which have not yet developed hyperinsulinaemia or glucose intolerance, the levels of inflammatory mediatorsMCP-1 and Il-6 are significantly increased without concomitant vascular dysfunction. The results show that inflammation and obesity are tightly associated, and that inflammation is manifested prior to significant insulin resistance and vascular dysfunction.

  17. Effect of blood flow on penile MR imaging at 1.5 T

    International Nuclear Information System (INIS)

    Variations in signal intensity of the corpora cavernosa were observed in patients undergoing routine pelvic magnetic resonance (MR) imaging. This study was designed to determine whether changes in penile blood flow could account for these variations. T1- and T2-weighted images of the penis were obtained in 14 healthy patients and five patients before and after erection was achieved. There was marked variation in signal intensity of the corpora cavernosa in healthy patients. All patients in the second group demonstrated an increase in signal intensity on posterection images. In conclusion: decreased corpus cavernosal signal intensity can be seen in healthy patients; increased penile blood flow results in increased signal intensity on T1- and T2-weighted images; and changes in penile blood flow most likely account for the variations in signal intensity observed during MR imaging of the penis

  18. Conservative management of penile trauma may be complicated by abscess formation

    Directory of Open Access Journals (Sweden)

    Athanasios Bantis

    2014-10-01

    Full Text Available Blunt penile trauma during sexual activity, although highly underreported due to the associated patient embarrassment, constitutes a real urological emergency requiring immediate attention and possibly early surgical intervention. We report a case of a 58-year old man who presented with penile pain following excessive masturbation. Although there were no clinical signs of penile deformity or hematoma, magnetic resonance imaging revealed the presence of a rupture in the tunica albuginea. The patient opted for non-surgical management and his recovery period was complicated by the formation of an abscess at the site of the albugineal tear thus prolonging his hospital stay. The abscess was surgically drained and the patient reports to have normal erections at 3-month follow up.

  19. Pro-VGF-derived peptides induce penile erection in male rats: possible involvement of oxytocin.

    Science.gov (United States)

    Succu, Salvatora; Cocco, Cristina; Mascia, Maria Stefania; Melis, Tiziana; Melis, Maria Rosaria; Possenti, Roberta; Levi, Andrea; Ferri, Gian Luca; Argiolas, Antonio

    2004-12-01

    The effect of five peptides derived from the C-terminal portion of rat pro-VGF (VGF(577-617), VGF(588-617), VGF(599-617), VGF(556-576) and VGF(588-597)) on penile erection was studied after injection into the hypothalamic paraventricular nucleus of male rats. VGF(577-617), VGF(588-617), VGF(599-617) and, to a lower extent, VGF(588-597) (0.1-2 microg) induced penile erection episodes in a dose-dependent manner when injected into the paraventricular nucleus, while VGF(556-576) was ineffective. VGF(588-617)-induced penile erection was reduced by nitro(omega)-L-arginine methylester (L-NAME; 20 microg), by morphine (5 microg) and by muscimol (1 microg), but not by dizocilpine [(+)MK-801; 1 microg], nor by cis-flupenthixol (10 microg) given into the paraventricular nucleus 10 min before the VGF peptide. d(CH2)5Tyr(Me)-Orn8-vasotocin (1 microg) effectively reduced VGF(588-617)-induced penile erection when given into the lateral ventricles but not when injected into the paraventricular nucleus. Immunocytochemistry with antibodies specific for the C-terminal nonapeptide sequence of pro-VGF (VGF(609-617)) revealed numerous neuronal fibres and terminals within the paraventricular nucleus, including its parvocellular components. Here, many immunostained neuronal terminals impinged on parvocellular oxytocinergic neurons. The present results show for the first time that certain pro-VGF C-terminus-derived peptides promote penile erection when injected into the paraventricular nucleus and suggest that, within this nucleus, these or closely related pro-VGF-derived peptides may be released to influence sexual function by activating paraventricular oxytocinergic neurons mediating penile erection. PMID:15579158

  20. Pro-VGF-derived peptides induce penile erection in male rats: Involvement of paraventricular nitric oxide.

    Science.gov (United States)

    Succu, Salvatora; Mascia, Maria Stefania; Melis, Tiziana; Sanna, Fabrizio; Melis, Maria Rosaria; Possenti, Roberta; Argiolas, Antonio

    2005-12-01

    The effect of four peptides derived from the C-terminal portion of rat pro-VGF(556-617) (VGF(556-576), VGF(588-617), VGF(599-617), and VGF(588-597)), on penile erection and nitric oxide production in the paraventricular nucleus of the hypothalamus was studied in male rats after injecting into this hypothalamic nucleus. VGF(588-617) (0.5, 1 and 2 microg), VGF(599-617) (0.5, 2 and 5 microg) and, to a lower extent, VGF(588-597) (2 and 5 microg) induced penile erection episodes when injected into the paraventricular nucleus and concomitantly increased paraventricular nitric oxide production, while VGF(556-576) (5 microg) was ineffective. VGF(588-617)-induced nitric oxide production was reduced by N(G)-nitro-l-arginine methylester (l-NAME) (20 microg), a nitric oxide synthase inhibitor, which also reduced penile erection when injected in the paraventricular nucleus 15 min before the VGF peptide. The oxytocin receptor antagonist d(CH(2))(5)Tyr(Me)-Orn(8)-vasotocin (1 microg) also effectively reduced VGF(588-617)-induced penile erection when given into the lateral ventricles, but not when injected into the paraventricular nucleus. In both experimental conditions, d(CH(2))(5)Tyr(Me)-Orn(8)-vasotocin was unable to influence nitric oxide production in the paraventricular nucleus. The present results confirm that C-terminal pro-VGF-derived peptides induce penile erection when injected into the paraventricular nucleus and show that this effect is mediated by an increased nitric oxide production in this hypothalamic nucleus. Apparently, this causes the activation of paraventricular oxytocinergic neurons projecting to extra-hypothalamic brain areas and mediating penile erection, as found with dopamine agonists, oxytocin, excitatory amino acids and hexarelin analogue peptides. PMID:16087201

  1. MR diagnosis of penile agenesis: is it just absence of a phallus?

    Energy Technology Data Exchange (ETDEWEB)

    Goenka, Ajit; Jain, Vaibhav; Sharma, Raju; Gupta, Arun K. [All India Institute of Medical Sciences, Department of Radiodiagnosis, New Delhi (India); Bajpai, Minu [All India Institute of Medical Sciences, Department of Paediatric Surgery, New Delhi (India)

    2008-10-15

    Penile agenesis is an extremely rare anomaly that results from absence of the genital tubercle or its failure to develop into a penis during embryonic life. Associated anomalies of the genitourinary and distal gastrointestinal tracts are frequently present. Imaging modalities, particularly MRI and cystography, play a crucial role in establishing the diagnosis and guiding further management. We report a child with penile agenesis with a urethroanal fistula and a blind-ending anterior urethra who had been reared as a male until presentation. (orig.)

  2. Activation of dopamine D4 receptors by ABT-724 induces penile erection in rats

    OpenAIRE

    Brioni, Jorge D.; Moreland, Robert B.; Cowart, Marlon; Hsieh, Gin C.; Stewart, Andrew O.; Hedlund, Petter; Donnelly-roberts, Diana L.; Nakane, Masaki; Lynch, James J.; Kolasa, Teodozyi; Polakowski, James S.; Osinski, Mark A.; Marsh, Kennan; Andersson, Karl-erik; Sullivan, James P.

    2004-01-01

    Apomorphine, a nonselective dopamine receptor agonist, facilitates penile erection and is effective in patients suffering from erectile dysfunction. The specific dopamine receptor subtype(s) responsible for its erectogenic effect is not known. Here we report that the dopamine D4 receptor plays a role in the regulation of penile function. ABT-724 is a selective dopamine D4 receptor agonist that activates human dopamine D4 receptors with an EC50 of 12.4 nM and 61% efficacy, with no effect on do...

  3. MR diagnosis of penile agenesis: is it just absence of a phallus?

    International Nuclear Information System (INIS)

    Penile agenesis is an extremely rare anomaly that results from absence of the genital tubercle or its failure to develop into a penis during embryonic life. Associated anomalies of the genitourinary and distal gastrointestinal tracts are frequently present. Imaging modalities, particularly MRI and cystography, play a crucial role in establishing the diagnosis and guiding further management. We report a child with penile agenesis with a urethroanal fistula and a blind-ending anterior urethra who had been reared as a male until presentation. (orig.)

  4. Penile Mondor's Syndrome after endovenous treatment of the great saphenous vein with 1470?nm diode laser.

    Science.gov (United States)

    Zerweck, Christof; Knittel, Matthias; Zeller, Thomas; Schwarz, Thomas

    2015-04-01

    We report a penile Mondor's disease after endovenous laser ablation with a 1470?nm diode laser of the great saphenous vein with additional foam sclerotherapy of distal tributaries. We administered body-weight adjusted full dose of low-molecular weight heparin (enoxaparin) in a therapeutic dosage for 10 days. In addition, anti-inflammatory therapy with diclofenac-sodium 75?mg twice a day for the following five days was initiated. One month later, the patient reported no further discomfort or pain and the thrombophlebitis of the superficial dorsal penile vein had sonographically disappeared completely. PMID:24335089

  5. A synthetic erectile optogenetic stimulator enabling blue-light-inducible penile erection.

    Science.gov (United States)

    Kim, Taeuk; Folcher, Marc; Baba, Marie Doaud-El; Fussenegger, Martin

    2015-05-11

    Precise spatiotemporal control of physiological processes by optogenetic devices inspired by synthetic biology may provide novel treatment opportunities for gene- and cell-based therapies. An erectile optogenetic stimulator (EROS), a synthetic designer guanylate cyclase producing a blue-light-inducible surge of the second messenger cyclic guanosine monophosphate (cGMP) in mammalian cells, enabled blue-light-dependent penile erection associated with occasional ejaculation after illumination of EROS-transfected corpus cavernosum in male rats. Photostimulated short-circuiting of complex psychological, neural, vascular, and endocrine factors to stimulate penile erection in the absence of sexual arousal may foster novel advances in the treatment of erectile dysfunction. PMID:25788334

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

    OpenAIRE

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

    2012-01-01

    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 suggest...

  7. Kaposi?s sarcoma: HIV-negative man with isolated penile localization

    Directory of Open Access Journals (Sweden)

    Soufiane Mellas

    2010-07-01

    Full Text Available Kaposi?s sarcoma is the malignant proliferation of the endothelial cell vessels. Its genesis is still unclear; however, it seems to be related to the herpes virus infection (HHV-8. This neoplasia usually affects the lower limbs and the affected persons are mostly from the Mediterranean region. The exclusive penile localization of the Kaposi?s sarcoma in a patient with a negative HIV serologia is exceptional. Our case is of a 73-year old patient with a negative HIV serology presenting an exclusive penile localization of the Kaposi?s sarcoma treated by radiotherapy.

  8. Arterial embolism

    Science.gov (United States)

    ... There may be signs of tissue death or gangrene. Tests to diagnose arterial embolism or reveal the ... or permanent kidney failure Tissue death ( necrosis ) and gangrene Transient ischemic attack (TIA)

  9. Contouring Variability of the Penile Bulb on CT Images: Quantitative Assessment Using a Generalized Concordance Index

    International Nuclear Information System (INIS)

    Purpose: Within a multicenter study (DUE-01) focused on the search of predictors of erectile dysfunction and urinary toxicity after radiotherapy for prostate cancer, a dummy run exercise on penile bulb (PB) contouring on computed tomography (CT) images was carried out. The aim of this study was to quantitatively assess interobserver contouring variability by the application of the generalized DICE index. Methods and Materials: Fifteen physicians from different Institutes drew the PB on CT images of 10 patients. The spread of DICE values was used to objectively select those observers who significantly disagreed with the others. The analyses were performed with a dedicated module in the VODCA software package. Results: DICE values were found to significantly change among observers and patients. The mean DICE value was 0.67, ranging between 0.43 and 0.80. The statistics of DICE coefficients identified 4 of 15 observers who systematically showed a value below the average (p value range, 0.013 — 0.059): Mean DICE values were 0.62 for the 4 “bad” observers compared to 0.69 of the 11 “good” observers. For all bad observers, the main cause of the disagreement was identified. Average DICE values were significantly worse from the average in 2 of 10 patients (0.60 vs. 0.70, p < 0.05) because of the limited visibility of the PB. Excluding the bad observers and the “bad” patients,” the mean DICE value increased from 0.67 to 0.70; interobserver variability, expresserver variability, expressed in terms of standard deviation of DICE spread, was also reduced. Conclusions: The obtained values of DICE around 0.7 shows an acceptable agreement, considered the small dimension of the PB. Additional strategies to improve this agreement are under consideration and include an additional tutorial of the so-called bad observers with a recontouring procedure, or the recontouring by a single observer of the PB for all patients included in the DUE-01 study.

  10. New technique "Right Anterior Small Thoracotomy (RAST operation)" for beating heart grafting of the right internal thoracic artery to the posterior descending artery to the posterior descending artery in a third redo CABG patient. A novel coronary technique / Nova técnica "Pequena toracotomia anterior direita (operação RAST)" para enxerto da artéria torácica interna direita para a artéria descendente posterior com o coração batendo em paciente de terceira RM. Uma técnica coronária nova

    Scientific Electronic Library Online (English)

    Maximo, Guida; Gustavo, Guida; Giuseppina, Pecora; Estefania De, Garate.

    2014-09-01

    Full Text Available A terceira reoperação de revascularização miocárdica é um desafio para a equipe cirúrgica. Normalmente, uma mamária patente é a única possibilidade de enxerto e a esternotomia torna-se um procedimento arriscado. A lesão de enxerto patente tem sido associada a uma alta taxa de mortalidade. Muitas abo [...] rdagens diferentes têm sido propostas. Descrevemos uma nova técnica de abordagem da artéria coronária direita através de uma pequena toracotomia anterior direita usando a mamária direita prolongada com enxerto de veia safena para a artéria descendente posterior com o coração batendo. A técnica é muito simples e viável, pois anatomicamente a artéria coronária direita e a mamária direita estão muito próximas e a mobilização do coração é mínima. Abstract in english Third REDO-CABG is a challenge for the surgical team. Usually a patent mammary is the only graft working and the sternotomy becomes a risky procedure. Injury to a patent graft has been associated to a high mortality rate. Many different approaches have been proposed. We describe a novel technique to [...] approach the right coronary artery through a right anterior small thoracotomy using the right mammary prolonged with saphenous vein for grafting the posterior descending artery on the beating heart. The technique is very simple and feasible because anatomically the right coronary artery and the right mammary are very close and the mobilization of the heart is minimal.

  11. Genetics of Pulmonary Arterial Hypertension

    OpenAIRE

    Austin, Eric D.; Loyd, James E.; Phillips, John A.

    2009-01-01

    Tremendous progress has been made in understanding the genetics of hereditable pulmonary arterial hypertension (HPAH) since its description in the 1950s. Germline mutations in the gene coding bone morphogenetic receptor type 2 (BMPR2) are detectable in the majority of cases of HPAH, and in a small proportion of cases of idiopathic pulmonary arterial hypertension (IPAH). HPAH is an autosomal dominant disease characterized by reduced penetrance, variable expressivity, female predominance, and g...

  12. Preferential Coronary Arterial Drug Delivery

    OpenAIRE

    Anderson, James H; Gianturco, Cesare; Wallace, Sidney; Dodd, Gerald D.

    1982-01-01

    A transcatheter technique for administering drugs preferentially to the canine left coronary circulation is described. The method involves pulsed, diastolic, small-volume (0.2 ml) injections through a specially designed aortic cusp catheter. In order to evaluate preferential delivery to the coronary circulation, papaverine was administered using this technique and compared to intravenous delivery. Left circumflex and carotid arterial blood flow, as well as systemic arterial pressure, were sim...

  13. Significance of CaV3.2 T-type Ca2+ channels for pressure- and flow-dependent vasomotor responses in rat and mouse mesenteric small arteries : (Oral Communication)

    DEFF Research Database (Denmark)

    Jensen, Lars JØrn; Björling, K.

    We investigated the potential significance of CaV3.2 channels in the myogenic response (MR) and flow-mediated vasodilatation (FMVD). CaV3.2 channels were immunolocalized to EC and VSMC in rat and mouse small mesenteric arteries. The myogenic tone at pressures of 40-120 mmHg was significantly larger in young CaV3.2-/- mice (8-15 weeks) vs. age-matched WT mice (P<0.05; N=3-4), whereas no difference was observed in older (6-8 months) WT vs. KO mice (N=4-5). In young WT mice, the CaV3.2 blocker NiCl2 (30 µM) significantly enhanced myogenic tone (P<0.05; N=4), whereas in old WT mice this effect was not seen (N=4). In young and old CaV3.2-/- mice no effects of NiCl2 were observed. The FMVD response in rat mesenteric arteries was not blocked by L-NAME, but was almost abolished by the SKCa/IKCa channel blockers apamin/TRAM-34 (50 nM/1 µM) (P<0.01; N=6). Interestingly the vessels constricted to flow in the presence of 100 µM NiCl2 (P<0.001; N=6), and this led us to investigate FMVD in CaV3.2-/- mice. The FMVD responsewas not significantly different in old WT (N=8) vs. CaV3.2-/- mice (N=8), whereas preliminary data suggested a reduced FMVD in young KO mice. Expression of Cagna1A/C/G and TRPC1/3/6 mRNA was similar in WT vs. CaV3.2-/- mice. CONCLUSION: FMVD responses appear to rely on an endothelium-dependent hyperpolarization in rat small mesenteric arteries. CaV3.2 channels are negative feedback modulators of myogenic tone in small mesenteric artery in young mice. The age-dependent decline in CaV3.2-mediated negative feedback modulation in old animals might be clinically relevant.

  14. Detection of human papillomavirus DNA in semen from patients with intrameatal penile warts.

    OpenAIRE

    Green, J.; Monteiro, E.; Gibson, P.

    1989-01-01

    Fifteen semen specimens from 10 men with intrameatal penile warts attending a genitourinary clinic were tested by Southern blot hybridisation for the presence of human papillomavirus (HPV) DNA. Five specimens were positive for HPV types 6/11. This observation may have implications for screening of semen used for artificial insemination by donor.

  15. Detection of penile metastasis from bladder cancer using F 18 FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dong Yun; Lee, Jong Jin [Univ. of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2012-12-15

    A 74 year old man who had experienced priapism for 2 months after radical cystectomy for bladder cancer visited our hospital, and underwent metastatic work up {sup 18}F fluorodeoxyglucose (FDG) positron emission tomography/computed tomography(PET/CT)showed diffuse hypermetabolic activity along the penis shaft, which was confirmed as a penile metastasis.

  16. One-sheet spiraling full thickness skin graft for penile resurfacing after paraffinoma excision

    Directory of Open Access Journals (Sweden)

    Theddeus O.H. Prasetyono

    2011-08-01

    Full Text Available In the midst of on-going non-illicit practice of silicone or paraffin injection to enlarge penis, the author reported 3 cases of surgical treatment to resurface the body of the penis after excision of the destructed penile skin using full thickness skin graft. The skin excision was performed technically through penile body degloving procedure. Full thickness skin graft was then applied as a single sheet donor tissue to cover the denuded penile body spirally. The full thickness graft, which is relatively easy to be performed, is no doubt much thinner than a skin flap, while it also bears a smaller degree of secondary contraction than split skin graft. The color of the skin is considerably matched as it comes from the groin, which is a nearby area of penis. The size and skin sensitization of the penis looks to be natural. The only disadvantage is the common possibility of either spiral or circular junctional scar in between graft edges and between the graft and the penile mucosa and skin to develop hypertrophic scar. However, this possible scar problem applies also to any other surgical scar with any donor tissue. Fortunately, the 3 cases posed no scar problem and normal appearance. All the patients have also regained their normal sexual function. (Med J Indones 2011; 20:222-5Keywords: full thickness skin graft, paraffinoma, siliconoma, sexual function

  17. Blunt Trauma to the Penis Post Penile Augmentation Surgery: Case Report

    Directory of Open Access Journals (Sweden)

    James J. Elist

    2014-11-01

    Full Text Available Introduction: Blunt trauma to the penis is a rare but potentially serious injury that can occur by various mechanisms (e.g., kicks, accidents, sexual activity, and falls. The most common clinical presentation is sudden pain, swelling, and discoloration. Depending on the type and severity of injury, management can include conservative treatment or surgery, with the ultimate goal being the prevention of delayed complications. Case presentation: A 30-year-old male presented with penile pain, swelling, and redness as a result of blunt trauma to his penis 1 week after penile enhancement surgery using a subcutaneous soft silicone implant. Once the patient’s blood pressure was stabilized, surgical management consisted of exploration with evacuation of a large hematoma and removal of the subcutaneous penile implant to avoid further perioperative and postoperative bleeding. Discussion: Postoperative bleeding is a risk factor associated with almost all types of surgical procedures, and its prevention is best achieved by identification and elimination of potential causes pre- and postoperatively. Hypertension is another risk factor for excessive postsurgical bleeding, particularly bleeding associated with prosthetic implant surgeries, and should be considered for any potential surgical patient. Conclusion: With penile prosthesis and implant surgery, hypertension is an especially serious risk factor. Early surgical management is warranted in cases involving a major hematoma and swelling. Even cases with minimal bleeding should be evaluated in a timely manner, with surgical treatment indicated, rather than watchful waiting, to prevent further damage to the penis.

  18. Long-term patient satisfaction after surgical correction of penile curvature via tunical plication

    Directory of Open Access Journals (Sweden)

    Alvaro Paez

    2007-08-01

    Full Text Available OBJECTIVE: To assess patient satisfaction and functional results at long term follow-up after surgical correction for Peyronie's disease (PD and congenital penile curvature (CPC with the technique of tunical plication. MATERIALS AND METHODS: One hundred and two men operated for PD (n = 76 or CPC (n = 26 in four different departments of urology in public hospitals agreed to answer a six-question telephone questionnaire about treatment satisfaction. Tunica albuginea plication procedures represented the standard surgical approach. Subjects under investigation were correction of the deformity, feeling of bumps under the skin, pain during erection, penile sensory changes, development of erectile dysfunction (ED and postoperative ability for complete vaginal intromission. Subjective response rates were compared using the chi square test on the basis of the etiology of the disease (CPC or PD. RESULTS: Significant differences (p < 0.05 between patients with CPC and PD were noticed in the prevalence of postoperative penile deformity, sensory changes, ED and ability to complete vaginal intromission, PD patients always showing a more pessimistic view. No significant differences (p = ns were detected in terms of unpleasant nodes under the penile skin or pain during erection. CONCLUSIONS: Long-term outcome after surgical correction for PD and CPC with the technique of tunical plication can be poor. Probably patient expectations are above the real performance of surgical techniques. Preoperative information should be more exhaustive.

  19. Progression of penile cutaneous horn to squamous cell carcinoma: A case report

    OpenAIRE

    ZHOU, YIHONG; Tang, Yuxin; TANG, JIN; XIA, BING; DAI, YINGBO

    2014-01-01

    The current report presents the case of a 43-year-old male suffering from a penile cutaneous horn. A surgical excision of the lesion was performed and histopathology demonstrated hyperkeratosis, dyskeratosis and epithelial hyperplasia. The cutaneous horn progressed to squamous cell carcinoma

  20. Venous ligation: a novel strategy for glans enhancement in penile prosthesis implantation.

    Science.gov (United States)

    Hsu, Geng-Long; Hill, James W; Hsieh, Cheng-Hsing; Liu, Shih-Ping; Hsu, Chih-Yuan

    2014-01-01

    Although penile implantation remains a final solution for patients with refractory impotence, undesirable postoperative effects, including penile size reduction and cold sensation of the glans penis, remain problematic. We report results of a surgical method designed to avoid these problems. From 2003 to 2013, 35 consecutive patients received a malleable penile implant. Of these, 15 men (the enhancing group) were also treated with venous ligation of the retrocoronal venous plexus, deep dorsal vein, and cavernosal veins. The remaining 20 men formed the control group, treated with only a penile implant. Follow-up ranged from 1.1 to 10.0 years, with an average of 6.7 ± 1.5 years. Although preoperative glanular dimension did not differ significantly between the two groups, significant respective difference at one day and one year postoperatively was found in the glanular circumference (128.8 ± 6.8 mm versus 115.3 ± 7.2 mm and 130.6 ± 7.2 mm versus 100.5 ± 7.3 mm; both Ppenis dimension in implant patients. PMID:25165719

  1. The 2011 WPATH Standards of Care and Penile Reconstruction in Female-to-Male Transsexual Individuals

    Science.gov (United States)

    Selvaggi, Gennaro; Dhejne, Cecilia; Landen, Mikael; Elander, Anna

    2012-01-01

    The World Professional Association for Transgender Health (WPATH) currently publishes the Standards of Care (SOC), to provide clinical guidelines for health care of transsexual, transgender and gender non-conforming persons in order to maximize health and well-being by revealing gender dysphoria. An updated version (7th version, 2011) of the WPATH SOC is currently available. Differences between the 6th and the 7th versions of the SOC are shown; the SOC relevant to penile reconstruction in female-to-male (FtM) persons are emphasized, and we analyze how the 2011 WPATH SOC is influencing the daily practice of physicians involved in performing a penile reconstruction procedure for these patients. Depending by an individual's goals and expectations, the most appropriate surgical technique should be performed: the clinic performing penile reconstruction should be able to offer the whole range of techniques, such as: metoidioplasty, pedicle and free flaps phalloplasty procedures. The goals that physicians and health care institutions should achieve in the next years, in order to improve the care of female-to-male persons, consist in: informing in details the individuals applying for penile reconstruction about all the implications; referring specific individuals to centers capable to deliver a particular surgical technique; implementing the surgery with the most updated refinements. PMID:22654902

  2. Pulmonary Arterial Hypertension (PAH)

    Science.gov (United States)

    ... the arteries of the lungs. Pulmonary arterial hypertension (PAH) is one form of pulmonary hypertension. Pulmonary arteries ... oxygen to be delivered throughout your body. In PAH, the pulmonary arteries constrict abnormally. This forces your ...

  3. Coronary Artery Bypass Grafting

    Science.gov (United States)

    ... from the NHLBI on Twitter. What Is Coronary Artery Bypass Grafting? Coronary artery bypass grafting (CABG) is ... bypass multiple coronary arteries during one surgery. Coronary Artery Bypass Grafting Figure A shows the location of ...

  4. Satisfaction and complications with the Titan® one-touch release penile implant

    DEFF Research Database (Denmark)

    Lindeborg, Lisa; Fode, Mikkel

    2014-01-01

    OBJECTIVE: The aim of this study was to assess complication rates and patient satisfaction with Coloplast Titan® one-touch release (OTR) inflatable penile implants inserted at one university hospital centre between November 2008 and April 2011. MATERIAL AND METHODS: Overall, 33 patients with organic erectile dysfunction underwent penile implant surgery during the study period. The Titan OTR inflatable penile implants were inserted using a penoscrotal approach. Patient and partner satisfaction was assessed with the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire. RESULTS: One implant was removed because of infection, and three patients underwent revision surgery due to problems with autoinflation, deflation, and a displaced reservoir, respectively. In all cases the problems were solved and the implants were salvaged. Further complications included one patient with haematoma and sustained scrotal pain, one patient with meatal stenosis, and four patients with infections not related to the implant. In total, 30 EDITS questionnaires were administered and 26 (87%) were completed. Twenty-two patients (85%) reported being satisfied with the implant and two (8%) were dissatisfied. Twenty-four patients (92%) would recommend a penile implant to someone with a similar medical condition. Eighteen patients (72%) believed that their partner was satisfied with the implant. Nineteen patients (76%) felt that the process of achieving an erection with the implant was natural. CONCLUSION: Although it is important to inform patients about potential problems such as infection, pain and mechanical failure, the results show that inflatable penile implants are a good treatment choice for erectile dysfunction when conservative measures have failed.

  5. Slightly modified technique of the original essed plication procedure for congenital penile deviation

    Directory of Open Access Journals (Sweden)

    Van Der Horst C

    2003-01-01

    Full Text Available PURPOSE: The Schroeder-Essed plication procedure is a standard technique for the correction of penile curvature. In a retrospective analysis we compared functional results and quality of life (LQ of the original technique with inverted sutures as described by Schroeder-Essed and our slight modification consisting of horizontal incisions into the tunica albuginea. MATERIALS AND METHODS: Twenty-six patients with congenital penis deviation were treated for penile deviation by the original Schroeder-Essed plication with inverted sutures (11 patients and by the described modification (15 patients. In case of modified technique, horizontal and parallel incisions 4 mm to 6 mm apart and about 8 mm - 10 mm long were made through the tunica albuginea. The outer edges of the incisions were then approximated with permanent inverted sutures (Gore-Tex® 3-0. Mean age was 21.6 years in the first group and 23.2 years in the second group. Average follow-up was 28 months and 13 months, respectively. The preoperative penile deviation angle was > 25º in all patients without difference between the 2 groups. RESULTS: All patients in both groups reported an improvement in their quality of life and full ability to engage in sexual intercourse. Nine patients (88% in the first group and 14 patients (93% in the second group were satisfied with the cosmetic result. In contrast, 10 patients (91% of the first and 13 patients (87% of the second group complained of penile shorting. Recurrence of deviation was only noticed in 2 males in the first group (18%. CONCLUSIONS: Our results indicate that this simple modification of the Schroeder-Essed plication offers good functional and cosmetic results. Most patients were satisfied with the penile angle correction results.

  6. A Preliminary Report on Combined Penoscrotal and Perineal Approach for Placement of Penile Prosthesis with Corporal Fibrosis

    Directory of Open Access Journals (Sweden)

    Sherif R. Aboseif

    2008-11-01

    Full Text Available Purpose. This paper aims at describing the combined penoscrotal and perineal approach for placement of penile prosthesis in cases of severe corporal fibrosis and scarring. Materials and methods. Three patients with extensive corporal fibrosis underwent penile prosthesis placement via combined penoscrotal and perineal approach from 1997 to 2006. Follow-up ranged from 15 to 129 months. Results. All patients underwent successful implantation of semirigid penile prosthesis. There were no short- or long-term complications. Conclusions. Results on combined penoscrotal and perineal approach to penile prosthetic surgery in this preliminary series of patients suggest that it is a safe technique and increases the chance of successful outcome in the surgical management of severe corporal fibrosis.

  7. Delayed Perilesional Ischemic Stroke after Gamma-knife Radiosurgery for Unruptured Deep Arteriovenous Malformation: Two Case Reports of Radiation-induced Small Artery Injury as Possible Cause

    Science.gov (United States)

    Kang, Dong-Hun; Park, Jaechan; Hwang, Jeong-Hyun; Park, Seong-Hyun; Son, Won-Soo

    2015-01-01

    Radiation-induced vasculopathy is a rare occurrence, however, it is one of the most serious complications that can occur after gamma-knife radiosurgery (GKRS). The authors present two cases of incidentally found deep cerebral arteriovenous malformation (AVM), which were treated by GKRS, where subsequently there occurred delayed-onset cerebral infarction (11 and 17 months after GKRS) at an area adjacent to the AVM. In both cases, perforators of the M1 segment of the middle cerebral artery were included in the radiation field and delayed injury to these is suggested to be the mechanism of the ischemic event. PMID:25874184

  8. Squamous cell carcinoma of the penis and scrotum in a patient with chronic scrotal and penile lymphedema

    Directory of Open Access Journals (Sweden)

    Abhyankar Suhas

    2010-01-01

    Full Text Available Squamous cell carcinoma arising from tissue affected by chronic lymphedema is rare, though it is recognized that a variety of malignant tumors can arise in chronic congenital or acquired lymphedema. We describe, a case of scrotal and penile squamous cell carcinoma arising in a patient with a history of chronic scrotal and penile lymphedema of filarial origin. We here discuss the management and possible etiology of this unusual case.

  9. Reconstructive Surgery for Severe Penile Inadequacy: Phalloplasty with a Free Radial Forearm Flap or a Pedicled Anterolateral Thigh Flap

    OpenAIRE

    Hoebeke, P.; Laecke, E.; Ceulemans, P.; Monstrey, S.; Lumen, N.

    2008-01-01

    Objectives. Severe penile inadequacy in adolescents is rare. Phallic reconstruction to treat this devastating condition is a major challenge to the reconstructive surgeon. Phallic reconstruction using the free radial forearm flap (RFF) or the pedicled anterolateral thigh flap (ALTF) has been routinely used in female-to-male transsexuals. Recently we started to use these techniques in the treatment of severe penile inadequacy. Methods. Eleven males (age ...

  10. A2B adenosine receptor contributes to penile erection via PI3K/AKT signaling cascade-mediated eNOS activation

    OpenAIRE

    Wen, Jiaming; Grenz, Almut; Zhang, Yujin; Dai, Yingbo; Kellems, Rodney E.; Blackburn, Michael R.; Eltzschig, Holger K.; Xia, Yang

    2011-01-01

    Normal penile erection is under the control of multiple factors and signaling pathways. Although adenosine signaling is implicated in normal and abnormal penile erection, the exact role and the underlying mechanism for adenosine signaling in penile physiology remain elusive. Here we report that shear stress leads to increased adenosine release from endothelial cells. Subsequently, we determined that ecto-5?-nucleotidase (CD73) is a key enzyme required for the production of elevated adenosin...

  11. Can the Anesthesiologist Use the Radial Artery for Monitoring After Transradial Artery Catheterization?

    Science.gov (United States)

    Awad, Hamdy; Quevedo, Eduardo; Abas, Motaz; Brown, Michelle; Satiani, Bhagwan; Capers, Quinn; Starr, Jean E

    2015-06-15

    The use of transradial coronary angiography and intervention is growing because of its advantages over the femoral approach. However, the small size of the radial artery can contribute to complications. We present a case of an in situ access complication of transradial coronary artery catheterization. It is important for the anesthesiologist to know about the short-term and long-term consequences of this intervention, which could lead to narrowing of the artery even beyond the site of puncture. Understanding these changes could help anesthesiologists make better decisions about using the radial artery for monitoring after transradial coronary artery catheterization procedures. PMID:26050247

  12. Accessory splenic artery from left gastroepiploic artery

    Directory of Open Access Journals (Sweden)

    Padmalatha K

    2010-08-01

    Full Text Available Splenic artery is the largest branch of celiac axis and its course is among the most tortuous in the body. We describe a rare variation of accessory splenic artery originating from the left gastroepiploic artery. Knowledge of variations of splenic artery is essential to successfully accomplish surgical, oncologic or any interventional procedures.

  13. Outcomes of follow-up CT for small (5-10-mm) arterially enhancing nodules in the liver and risk factors for developing hepatocellular carcinoma in a surveillance population

    International Nuclear Information System (INIS)

    To evaluate the outcomes of small (5-10 mm), arterially enhancing nodules (SAENs) shown exclusively at the hepatic arterial phase of CT in a hepatocellular carcinoma (HCC) surveillance population and to determine risk factors for developing HCC. The study population included 112 patients (male:female = 100:12; aged 36-92 years) with 175 SAENs who were at risk of HCC. We evaluated serial changes during follow-up (1.4-41.8 months, mean 35.7 months) and analysed the initial CT findings of SAENs and the accompanying lesions to elucidate the risk factors for HCC development. Of 175 SAENs, 101(57.7%) disappeared and 34(19.4%) persisted. Forty SAENs (22.9%) became HCC in 33 patients (29.5%). Presence of HCC treatment history (p = 0.005, risk ratio = 7.429), a larger size of SAEN (p = 0.003, risk ratio = 1.630), presence of coexistent HCC (p = 0.021, risk ratio = 3.777) and absence of coexistent typical arterioportal shunts (p = 0.003, risk ratio = 4.459) turned out to be independently significant risk factors for future development of HCC. SAENs were frequently seen in an HCC surveillance population and have a 22.9% probability of becoming HCC on a per-lesion basis. Risk increased particularly when the lesion was associated with a previous or concurrent HCC, a large size or found without a coexistent typical arterioportal shunt. (orig.)

  14. Outcomes of follow-up CT for small (5-10-mm) arterially enhancing nodules in the liver and risk factors for developing hepatocellular carcinoma in a surveillance population

    Energy Technology Data Exchange (ETDEWEB)

    Park, Min Jung; Kim, Young-sun; Lee, Won Jae; Lim, Hyo K.; Rhim, Hyunchul [Sungkyunkwan University School of Medicine, Department of Radiology, Center for Imaging Science, Samsung Medical Center, Seoul (Korea, Republic of); Lee, Jongmee [Korea University Guro Hospital, Department of Radiology, Seoul (Korea, Republic of)

    2010-10-15

    To evaluate the outcomes of small (5-10 mm), arterially enhancing nodules (SAENs) shown exclusively at the hepatic arterial phase of CT in a hepatocellular carcinoma (HCC) surveillance population and to determine risk factors for developing HCC. The study population included 112 patients (male:female = 100:12; aged 36-92 years) with 175 SAENs who were at risk of HCC. We evaluated serial changes during follow-up (1.4-41.8 months, mean 35.7 months) and analysed the initial CT findings of SAENs and the accompanying lesions to elucidate the risk factors for HCC development. Of 175 SAENs, 101(57.7%) disappeared and 34(19.4%) persisted. Forty SAENs (22.9%) became HCC in 33 patients (29.5%). Presence of HCC treatment history (p = 0.005, risk ratio = 7.429), a larger size of SAEN (p = 0.003, risk ratio = 1.630), presence of coexistent HCC (p = 0.021, risk ratio = 3.777) and absence of coexistent typical arterioportal shunts (p = 0.003, risk ratio = 4.459) turned out to be independently significant risk factors for future development of HCC. SAENs were frequently seen in an HCC surveillance population and have a 22.9% probability of becoming HCC on a per-lesion basis. Risk increased particularly when the lesion was associated with a previous or concurrent HCC, a large size or found without a coexistent typical arterioportal shunt. (orig.)

  15. Hydroxyethyl starch increases patency and reduces thrombus formation following arteriotomy/intimectomy in small arteries: An experimental study in the rabbit

    International Nuclear Information System (INIS)

    Twenty-four arteries of rabbit ears, divided into two groups of 12 vessels each, were prepared and 32P-labelled platelets were infused. Arteriotomy/intimectomy was performed after 1 hr and in vivo platelet accumulation recorded for 2 hr. Group A comprised untreated control animals and group B was treated with 1 g hydroxyethyl starch (HES), MW 450,000 in 17 ml saline/kg b.w. (Plasma-steril). Vessel bleeding-times were normal, patency was improved, and intraluminal thrombotic material was reduced after HES treatment. Initial in vivo platelet accumulation was rapid and reached similar levels in both groups. However, the platelet accumulation curves decreased more frequently following HES than in the control group. HES does not prevent platelet accumulation at trauma sites, but reduces the sizes of the thrombi formed and may enhance disaggregation/fibrinolysis

  16. Development of a modified artificial insemination technique combining penile vibration stimulation and the swim-up method in the common marmoset.

    Science.gov (United States)

    Takabayashi, Shuji; Suzuki, Yuiko; Katoh, Hideki

    2015-05-01

    The common marmoset, Callithrix jacchus, is used as a New World monkey species in biomedical studies because of its small body size and good reproduction in captivity. A modified artificial insemination technique was developed in this species to encourage breeding of lines carrying interesting genes and traits. Fresh semen was collected by penile vibratory stimulation. Medium containing highly motile sperm was inseminated into the uterus using a catheter. Seven females were inseminated using freshly prepared sperm from different males every day for 3 days including the expected ovulation day. As a result, four females conceived, and three females delivered six offspring in total (two singletons and one quadruplet). The paternity of the newborns was determined using microsatellite markers to accurately pinpoint the timing of insemination and ovulation. It is expected that our artificial insemination protocol can be effectively used to establish marmoset lines and genetically manage marmoset colonies. PMID:25732321

  17. Primary penile adenocarcinoma with concurrent hypercalcaemia of malignancy in a dog.

    Science.gov (United States)

    Furtado, A R R; Parrinello, L; Merlo, M; Di Bella, A

    2015-04-01

    A 13-year-old male neutered Siberian husky crossbreed dog was presented with a 3-week history of haematuria and penile swelling. Clinical examination and computed tomography demonstrated a soft-tissue mass located at the base of the penis without signs of other primary tumours or metastasis. Clinicopathological findings revealed paraneoplastic hypercalcaemia. Fine-needle aspiration cytology of the mass suggested an epithelial tumour with several criteria of malignancy present. Following surgical excision of the mass, the hypercalcaemia resolved. Histopathology and immunohistochemistry revealed features consistent with an adenocarcinoma. Despite thorough examination, no perineal or anal sac tumour was found. To the authors' knowledge, this is the first reported case of a penile adenocarcinoma with hypercalcaemia of malignancy. PMID:25370307

  18. Penile xenon (133Xe) washout: a rapid method of screening for vasculogenic impotence

    International Nuclear Information System (INIS)

    The radioactive inert gas xenon (133Xe) is a well-established isotopic indicator used to assess vascular status in many organ systems. Xenon-133 was used to evaluate male impotence. Xenon-133 was injected subcutaneously at the level of the coronal sulcus in the detumescent state. Using the gamma camera, sequential images were obtained and computer-generated curves calculated. The clearance time for 50 per cent washout of the injected 133Xe (T1/2) was then calculated for each patient, as well as a control group. Preliminary findings indicate a correlation with such established techniques of evaluating erectile impotence as history, physical examination, penile pulse Doppler tracings, and brachial-penile blood pressure index. The xenon-133 washout study was a rapid, minimally invasive, reproducible, and cost-effective method of screening those impotent patients for vasculogenic etiology of their erectile impotence. We recommend the addition of this method to the surgeon engaged in the care of impotent males

  19. Penile myiasis as a differential diagnosis for genital ulcer: a case report

    Directory of Open Access Journals (Sweden)

    Mauro R.L. Passos

    2008-04-01

    Full Text Available The genital localized myiasis is a rare zooparasitic dermatosis. This case reported to a penile myiasis by Dermatobia hominis larvae in a 62 year-old man, who is a retired military official from São Gonçalo city, Rio de Janeiro state, Brazil. This patient was guided to the sexually transmitted diseases (STD clinic from Universidade Federal Fluminense (UFF by professionals from a urology outpatient clinic of a public hospital from Rio de Janeiro state. The exam showed a 2 cm diameter nodular lesion with a hyperemic area in the glands penis that had arisen 20 days before the exam. It evolved in a favorable way after larvae removal, through previous local anesthesia and slight pressure in lesion's base with the extraction of the larvae. Penile myiasis is not a very frequent situation, although it must be considered as an option in differential diagnosis of genital infectious diseases, even among people of low economical level, as in the case presented.

  20. Penile myiasis as a differential diagnosis for genital ulcer: a case report

    Scientific Electronic Library Online (English)

    Mauro R.L., Passos; Dennis C., Ferreira; Wilma N.C., Arze; José Carlos S., Silva; Felipe D.L., Passos; José Alexandre R., Curvelo.

    2008-04-01

    Full Text Available The genital localized myiasis is a rare zooparasitic dermatosis. This case reported to a penile myiasis by Dermatobia hominis larvae in a 62 year-old man, who is a retired military official from São Gonçalo city, Rio de Janeiro state, Brazil. This patient was guided to the sexually transmitted disea [...] ses (STD) clinic from Universidade Federal Fluminense (UFF) by professionals from a urology outpatient clinic of a public hospital from Rio de Janeiro state. The exam showed a 2 cm diameter nodular lesion with a hyperemic area in the glands penis that had arisen 20 days before the exam. It evolved in a favorable way after larvae removal, through previous local anesthesia and slight pressure in lesion's base with the extraction of the larvae. Penile myiasis is not a very frequent situation, although it must be considered as an option in differential diagnosis of genital infectious diseases, even among people of low economical level, as in the case presented.

  1. Long-term patient satisfaction after surgical correction of penile curvature via tunical plication

    Scientific Electronic Library Online (English)

    Alvaro, Paez; Juan, Mejias; Jorge, Vallejo; Ignacio, Romero; Miguel de, Castro; Fernando, Gimeno.

    2007-08-01

    Full Text Available OBJECTIVE: To assess patient satisfaction and functional results at long term follow-up after surgical correction for Peyronie's disease (PD) and congenital penile curvature (CPC) with the technique of tunical plication. MATERIALS AND METHODS: One hundred and two men operated for PD (n = 76) or CPC [...] (n = 26) in four different departments of urology in public hospitals agreed to answer a six-question telephone questionnaire about treatment satisfaction. Tunica albuginea plication procedures represented the standard surgical approach. Subjects under investigation were correction of the deformity, feeling of bumps under the skin, pain during erection, penile sensory changes, development of erectile dysfunction (ED) and postoperative ability for complete vaginal intromission. Subjective response rates were compared using the chi square test on the basis of the etiology of the disease (CPC or PD). RESULTS: Significant differences (p

  2. Comparison of Efficacy of Sertralin on Patients with Premature Ejaculation By Penile Biothesiometry

    Directory of Open Access Journals (Sweden)

    Emrah Okulu

    2013-07-01

    Full Text Available Aim: We examine the efficacy of the low dose, high dose and on demand use of sertraline on patients with primary premature ejaculation.The value of penile biothesiometry on interpretation of responses from these treatments is also evaluated. Material and Method: A total of 70 men, 23 to 55 years old(mean age 36.4,with premature ejaculation were randomized into two treatment groups,each consisting of 35 patients,receiving placebo,sertraline, in a fashion.Because 10 patients dropped out for some reason,the study was completed with 32 patients in placebo,28 patients in sertraline groups. The study was divided into five periods in order, i.e. before treatment(BT, low dose(LD, high dose(HD, on demand(OD and after treatment(AT.Patients did not use any of these drugs during BT and AT periods. Drug visits, intravaginal ejaculation latencies and sexual satisfaction score of the previous period were recorded,penile biothesiometric analysis was performed as well. Results: The percentage of patients with a SES score ‘moderate’ or ‘good’ for placebo group on LD period, was 25%;for sertraline group was 46.4%, but on HD and OD periods it was about %40 for placebo group and 71.4% for sertraline group.According to latancies and penile biothesiometric data,both sertraline group was superior to placebo in all LD, HD and OD periods(pOD>LD.Drug caused non-serious side effects in 10 of 60 patients(16.6%. Discussion: Sertraline is effective in primary premature ejaculation.On demand use of both drugs following a two week high dose use,is an effective treatment for primary premature ejaculation with less side effects. Penile biothesiometry can be used to evaluate the efficacy of pharmacotherapy in primary premature ejaculation in place of intravaginal latency measurements and satisfaction scores.

  3. The 2011 WPATH Standards of Care and Penile Reconstruction in Female-to-Male Transsexual Individuals

    OpenAIRE

    Gennaro Selvaggi; Cecilia Dhejne; Mikael Landen; Anna Elander

    2012-01-01

    The World Professional Association for Transgender Health (WPATH) currently publishes the Standards of Care (SOC), to provide clinical guidelines for health care of transsexual, transgender and gender non-conforming persons in order to maximize health and well-being by revealing gender dysphoria. An updated version (7th version, 2011) of the WPATH SOC is currently available. Differences between the 6th and the 7th versions of the SOC are shown; the SOC relevant to penile reconstruction in fem...

  4. Nitric oxide as a mediator of cocaine-induced penile erection in the rat.

    OpenAIRE

    Chan, J. Y.; Huang, C. L.; Chan, S. H.

    1996-01-01

    1. The effect of local application of cocaine to the corpus cavernosum on intracavernous pressure (ICP), an experimental index for penile erection, was examined in Sprague-Dawley rats anaesthetized with chloral hydrate. The potential involvement of dopamine, noradrenaline or nitric oxide as the chemical mediator in this process, and the pharmacological action of cocaine as a local anaesthetic in the induced increase in ICP, were also investigated. 2. Intracavernous (i.c.) administration of co...

  5. Long-term patient satisfaction after surgical correction of penile curvature via tunical plication

    OpenAIRE

    Alvaro Paez; Juan Mejias; Jorge Vallejo; Ignacio Romero; Miguel Castro; Fernando Gimeno

    2007-01-01

    OBJECTIVE: To assess patient satisfaction and functional results at long term follow-up after surgical correction for Peyronie's disease (PD) and congenital penile curvature (CPC) with the technique of tunical plication. MATERIALS AND METHODS: One hundred and two men operated for PD (n = 76) or CPC (n = 26) in four different departments of urology in public hospitals agreed to answer a six-question telephone questionnaire about treatment satisfaction. Tunica albuginea plication procedures rep...

  6. Prenatal exposure to phthalates is associated with decreased anogenital distance and penile size in male newborns

    OpenAIRE

    Bustamante-Montes, L P; Hernández-Valero, M. A.; Flores-Pimentel, D; García-Fábila, M; Amaya-Chávez, A; Barr, D B; Borja-Aburto, V H

    2013-01-01

    Reproductive effects from phthalate exposure have been documented mostly in animal studies. This study explored the association between prenatal exposure to phthalate metabolites, anogenital distance and penile measurements in male newborns in Toluca, State of Mexico. A total of 174 pregnant women provided urine samples for phthalate analysis during their last prenatal visit, and the 73 who gave birth to male infants were included in the study. The 73 male newborns were weighed and measured u...

  7. Penile Tumescence Assessment Used for a Diagnosis of Paraphilia: A Pedophilia Case Report

    Directory of Open Access Journals (Sweden)

    Ker-Li Hsueh

    2003-02-01

    Full Text Available We report on the use of penile tumescence assessment to diagnose a paraphiliac clientwho was in denial about his problem. An 18-year-old male was accused of sexually assaultinga 4-year-old girl using physical restraint and vaginal penetration with a finger. During apsychiatric evaluation requested by the court, a comprehensive psychosexual assessmentrevealed that the subject was in denial about clarification of the paraphiliac experience.Penile tumescence under distinct visual stimulus was evaluated with electrobioimpedencevolumetric assessment using child and adult female pictures in separate time frames. Bothtypes of stimuli evoked arousal responses. However, child female stimuli demonstratedstronger responses than did adult female ones. Deviant sexual interest in children as well asa diagnosis of pedophilia was implied. Paraphiliac clients tend to be in denial toward psychosexualassessment which limits the interpretation of its results. Penile tumescence assessmentmay be more reliable than psychosexual assessment alone for detecting and diagnosingparaphilia. Further study is warranted in order to aid in more accurate diagnoses of paraphilia.

  8. Neoadjuvant concurrent chemoradiation for curative treatment of penile squamous cell carcinoma.

    Science.gov (United States)

    Chhabra, Arpit; Schwartz, David; Leaf, Andrea; Karanikolas, Nikolaos; Weiss, Jeffrey P; Schreiber, David

    2014-01-01

    Introduction. Penile cancer is a rare malignancy often treated with neoadjuvant chemotherapy followed by surgery. However, the utility of neoadjuvant chemoradiation, particularly when the tumor is resistant to chemotherapy alone, has not been established. In this study, we report a case of pT3cN3M0 penile squamous cell carcinoma with progression of nodal disease on chemotherapy, which was cured with use of neoadjuvant concurrent chemoradiation. Case Report. A 65-year-old male presented with a fixed left inguinal lymph node with associated firmness of the penile glans. Biopsies of both sites revealed evidence of squamous cell carcinoma. The patient underwent partial penectomy for the primary lesion and began neoadjuvant chemotherapy to reduce the size of the unresectable left inguinal node. However, he displayed disease progression in the left inguinal node. As such, we attempted concurrent chemoradiation therapy with regression of his nodal disease. The patient was able to undergo left inguinal node dissection and has no evidence of disease 18 months since his initial surgery. Conclusion. The use of neoadjuvant chemoradiation for bulky cN2-3 disease seems appropriate in the setting of progressive disease. Further studies are necessary to assess the utility of concurrent chemoradiation both in the neoadjuvant and salvage setting. PMID:25400960

  9. Assessment of conduit artery vasomotion using photoplethysmography

    Science.gov (United States)

    Kanders, Karlis; Grabovskis, Andris; Marcinkevics, Zbignevs; Aivars, Juris Imants

    2013-11-01

    Vasomotion is a spontaneous oscillation of vascular tone. The phenomenon has been observed in small arterioles and capillaries as well as in the large conduit arteries. The layer of smooth muscle cells that surrounds a blood vessel can spontaneously and periodically change its tension and thereby the arterial wall stiffness also changes. As the understanding of the phenomenon is still rather obscure, researchers would benefit from a low-cost and reliable investigation technique such as photoplethysmography (PPG). PPG is an optical blood pulsation measurement technique that can offer substantial information about the arterial stiffness. The aims of this pilot study were to evaluate the usefulness of the PPG technique in the research of vasomotion and to investigate vasomotion in the relatively large conduit arteries. Continuous 15 minute long measurements of posterior tibial artery wall stiffness were taken. Artery diameter, electrocardiogram, blood pressure and respiration were also simultaneously registered. Fast Fourier Transform power spectra were calculated to identify unique stiffness oscillations that did not correspond to fluctuations in the systemic parameters and thus would indicate vasomotion. We concluded that photoplethysmography is a convenient method for the research of the vasomotion in large arteries. Local stiffness parameter b/a is more accurate to use and easier to measure than the pulse wave velocity which describes stiffness of a segment of an artery. Conduit arteries might exhibit a low amplitude high frequency vasomotion ( 9 to 27 cycles per minute). Low frequency vasomotion is problematic to distinguish from the passive oscillations imposed by the arterial pressure.

  10. Hipertensão arterial e sua correlação com alguns fatores de risco em cidade brasileira de pequeno porte Hipertensión arterial y su correlación con algunos factores de riesgo en ciudad brasileña de pequeño tamaño Arterial hypertension and its correlation with some risk factors in a small brazilian town

    OpenAIRE

    Flávia Miquetichuc Nogueira Nascente; Paulo César Brandão Veiga Jardim; Maria do Rosário Gondim Peixoto; Estelamaris Tronco Monego; Humberto Graner Moreira; Priscila Valverde de Oliveira Vitorino; Weimar Kunz Sebba Barroso Souza; Luiz Nazário Scala

    2010-01-01

    FUNDAMENTO: A hipertensão arterial (HA) é um problema de saúde que atinge um grande número de hipertensos não diagnosticados ou não tratados adequadamente e que possui um alto índice de abandono ao tratamento. OBJETIVO: Estimar a prevalência da HA e sua correlação com alguns fatores de risco cardiovasculares na população adulta de Firminópolis-GO. MÉTODOS: Estudo descritivo, observacional e transversal com base populacional, amostra aleatória simples (> 18 anos): questionários...

  11. A preliminary study of the sensory distribution of the penile dorsal and ventral nerves: implications for effective penile block for circumcision.

    LENUS (Irish Health Repository)

    Long, Ronan M

    2012-01-31

    OBJECTIVE: To determine the sensory innervation of the penis, as regional anaesthesia is often used either for postoperative analgesia or as the sole anaesthetic technique for circumcision. Since first described in 1978 the dorsal penile nerve block has become the standard technique, but some blocks are ineffective; a better understanding of the sensory innervation of the penis might improve the efficacy of the dorsal penile block technique. PATIENTS AND METHODS: In 13 men undergoing circumcision with local anaesthetic, cutaneous sensation was tested before and after infiltration of the dorsal aspect of the penis, and then again after infiltration of the ventral aspect. The area of anaesthesia was mapped using pin-prick sensation. RESULTS: Ten of the 13 patients showed a similar pattern of sensory distribution. After the dorsal block, the dorsal aspect of the shaft of the penis and glans penis became insensate. The ventral aspect of the shaft remained sensate up to and including the frenulum. After successful ventral infiltration all sensate areas became insensate and circumcision proceeded. In one case the frenulum and distal ventral foreskin was anaesthetized after the dorsal block and ventral infiltration was not required. No patient experienced pain during circumcision. CONCLUSION: For consistently successful regional anaesthesia of the foreskin in circumcision, a dorsal block must be used. This should be combined with ventral infiltration at the site of incision. This method will avoid inconsistencies and allow pain-free circumcision using local anaesthesia in most men.

  12. Patent arterial duct

    OpenAIRE

    Martin Robin P; Elmasry Ola A; Forsey Jonathan T

    2009-01-01

    Abstract Patent arterial duct (PAD) is a congenital heart abnormality defined as persistent patency in term infants older than three months. Isolated PAD is found in around 1 in 2000 full term infants. A higher prevalence is found in preterm infants, especially those with low birth weight. The female to male ratio is 2:1. Most patients are asymptomatic when the duct is small. With a moderate-to-large duct, a characteristic continuous heart murmur (loudest in the left upper chest or infraclavi...

  13. Carotid Artery Screening

    Science.gov (United States)

    Carotid Artery Screening What is carotid artery screening? Who should consider heart screening – and why? How are the procedures ... more information about heart screening? What is carotid artery screening? Screening examinations are tests performed to find ...

  14. Comparing the pre-operative and post-operative data of penile prosthetic implants with and without antibiotics

    Directory of Open Access Journals (Sweden)

    Yi?it Ak?n

    2012-03-01

    Full Text Available Objective: The aim of this study is to evaluate surgical results and postoperative results of men diagnosed with organic erectile dysfunction (ED who underwent penile prosthesis (antibiotic-coated vs. non-coated implantation in the last 13 years. Additionally, we compared the frequency of complications between the two groups.Materials and methods: In the last 13 years, 202 men diagnosed with organic erectile dysfunction (ED had previously undergone penile prosthesis implantation. Patient data were evaluated retrospectively. Of the 202 patients, 175 were included to the study. The mean age of patients was 57.5 (34-83 years. Preoperatively, a physical examination, medical and sexual history, International Index of Erectile Function (IIEF questionnaire, Combined Injection and Stimulation (CIS test and, if necessary, Nocturnal Penile Tumescence (NPT / Penile Doppler ultrasonography (US were performed in all cases. Results: All patients were diagnosed with organic ED. We determined that 43 (21% patients had diabetes mellitus, 53 (26% had a history of radical pelvic surgery, 38 (19% had cardiovascular pathology and 19 (9% had other reasons for ED. Approximately 98% of patients and their partners were satisfied with the surgical results of the penile prosthesis operation. Conclusion: The infection rate results in the present study were not statistically significant, and the number of patients in our study was not sufficient to make reliable conclusions. Studies with a larger sample sizes are needed.

  15. Evaluation of the response chemotherapy for penile metastasis of bladder cancer using 18F-fluorodeoxyglucose-PET/CT

    Science.gov (United States)

    Öztürk, Hakan

    2015-01-01

    Background Metachronous penile metastasis of bladder cancer occurs very rarely. The clinical management of the disease involves complex problems, and the disease is associated with a poor prognosis. The common mode of spread to the penis is by the retrograde venous route. Patients and methods A 68-year-old patient who was diagnosed with invasive bladder cancer underwent 18F-fluorodeoxyglucose (FDG)-positron-emission tomography/computed tomography (PET/CT) for staging purposes. An 18 mm intracavernosal metastatic lesion was detected in the penis with a SUVmax of 12.9. Results After the administration of gemcitabine + cisplatin-based chemotherapy, remission was observed in the metastatic penile lesion according to EORTC criteria (12 mm, SUVmax: 9), and second line chemotherapy program was planned. Conclusion Penile metastasis from bladder cancer is an indicator of poor prognosis. The patients with penile metastasis poorly respond to therapy, despite the use of effective systemic chemotherapy. The researchers of the current study achieved a partial response to chemotherapy in the current case of penile metastasis. The disease-specific life expectancy is less than one year in these patients. Radical ablative surgery does not contribute to survival; however, it offers an alternative method in symptomatic patients. PMID:25912005

  16. Índice de pene brazo en el diagnóstico de la disfunción sexual eréctil / Penile brachial index in the diagnosis of sexual erectile dysfunction

    Scientific Electronic Library Online (English)

    Celso, Suárez Lescay.

    1361-13-01

    Full Text Available Se efectuó un estudio descriptivo y prospectivo de 58 pacientes a los cuales se les indicó la realización del índice de presiones de pene brazo para el diagnóstico de disfunción sexual eréctil en el Hospital Provincial Docente "Dr. Joaquín Castillo Duany" de Santiago de Cuba, en el periodo de un año [...] (2010-2011), con vistas a identificar los parámetros hemodinámicos y otras condiciones asociadas para evaluar la participación vascular en la enfermedad. El mayor número de hombres con resultados positivos tenía más de 50 años y los índices inferiores a las cifras normales se presentaron en 46,5 % de ellos. La edad, el tabaquismo y la hipertensión arterial proporcionaron los valores más bajos de ese indicador en la casuística. Abstract in english A descriptive and prospective study was conducted in 58 patients in whom the penile brachial pressure index was measured for the diagnosis of sexual erectile dysfunction in "Dr. Joaquín Castillo Duany" Provincial Teaching Hospital of Santiago de Cuba during a year (2010-2011) in order to identify th [...] e hemodynamic parameters and other associated conditions and evaluate vascular involvement in the disease. The greater number of men with positive results were over 50 years and the indexes below normal range were observed in 46,5 % of them. Age, smoking habit and hypertension provided the lowest values of this indicator in our cases.

  17. Índice de pene brazo en el diagnóstico de la disfunción sexual eréctil Penile brachial index in the diagnosis of sexual erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Celso Suárez Lescay

    2011-10-01

    Full Text Available Se efectuó un estudio descriptivo y prospectivo de 58 pacientes a los cuales se les indicó la realización del índice de presiones de pene brazo para el diagnóstico de disfunción sexual eréctil en el Hospital Provincial Docente "Dr. Joaquín Castillo Duany" de Santiago de Cuba, en el periodo de un año (2010-2011, con vistas a identificar los parámetros hemodinámicos y otras condiciones asociadas para evaluar la participación vascular en la enfermedad. El mayor número de hombres con resultados positivos tenía más de 50 años y los índices inferiores a las cifras normales se presentaron en 46,5 % de ellos. La edad, el tabaquismo y la hipertensión arterial proporcionaron los valores más bajos de ese indicador en la casuística.A descriptive and prospective study was conducted in 58 patients in whom the penile brachial pressure index was measured for the diagnosis of sexual erectile dysfunction in "Dr. Joaquín Castillo Duany" Provincial Teaching Hospital of Santiago de Cuba during a year (2010-2011 in order to identify the hemodynamic parameters and other associated conditions and evaluate vascular involvement in the disease. The greater number of men with positive results were over 50 years and the indexes below normal range were observed in 46,5 % of them. Age, smoking habit and hypertension provided the lowest values of this indicator in our cases.

  18. Force, membrane potential, and [Ca2+]i during activation of rat mesenteric small arteries with norepinephrine, potassium, aluminum fluoride, and phorbol ester. Effects of changes in pHi

    DEFF Research Database (Denmark)

    Jensen, P E; Hughes, A

    1993-01-01

    In activated rat mesenteric small arteries, the effect of pHi on force, membrane potential, and free cytosolic calcium ([Ca2+]i) was assessed. Arteries were mounted in a myograph for isometric force development, and [Ca2+]i, pHi, or membrane potential was measured simultaneously with force. During activation with norepinephrine, potassium, aluminum fluoride (AlF-4), and phorbol 12-myristate 13-acetate (PMA, a phorbol ester), the vessels depolarized and [Ca2+]i increased, although the ratio of force to [Ca2+]i was less during potassium activation than with the other types of activation. Changes in pHi, with a constant pHo, were induced with NH4Cl or by changing PCO2. In resting vessels, the effects of the changes in pHi on tension, membrane potential, and [Ca2+]i were negligible. In vessels activated with norepinephrine or AlF-4, alkalinization caused an acute decrease of tone, which could be explained by a decrease in [Ca2+]i consequent to repolarization of the membrane. In vessels activated with potassium orPMA, the effects of alkalinization were smaller. This is consistent with acute alkalinization, affecting steps proximal in the excitation-contraction coupling distal to activation of G proteins. Acidification caused a transient increase in tone and [Ca2+]i, irrespective of the mode of stimulation, without affecting the membrane potential. Ryanodine did not abolish the transient increase in tone and [Ca2+]i. Thus, acute intracellular acidification may induce tone by release of an intracellular ryanodine-insensitive calcium pool or by affecting transmembranal calcium flux although in a membrane potential-independent way.

  19. Resolution of peripheral artery catheter-induced ischemic injury in infants -Two case reports-

    OpenAIRE

    Park, Sung Yong; Kim, Dae Hee; Kim, Jin Soo; Kim, Kye Sook; Hong, You Sun; Hong, Yong Woo

    2010-01-01

    The occurrence of catheter-induced vasospasm of small caliber arteries is a well known complication of arterial catheterization in neonates. However, there is rare publication about these complications in infants. We report infants with peripheral ischemia caused by arterial catheterization of the femoral artery.

  20. An unexpected course after simultaneous urethral repair and reimplantation of penile prosthesis in a patient with a urethral stricture.

    Science.gov (United States)

    Shin, Yu Seob; Ko, Oh Seok; Zhang, Li Tao; Zhao, Chen; Park, Jong Kwan

    2014-12-01

    We experienced the growth of urethral hair along the urethral stricture six years after simultaneous urethral repair and reimplantation of penile prosthesis (RPP) in a patient with a urethral stricture. We detected hair in the urethra with a stricture on the bulbous urethra. Further, we performed hair removal by using a pair of cystoscopic forceps and internal urethrotomy. Then, we performed RPP, and the patient voided well; the prosthesis worked very well and without any complications. One-stage urethroplasty with a pedicle island of the penile skin and RPP in a simultaneous stage may be an option for treating the long-segment urethral stricture in the penile prosthesis patient. However, we should pay attention to the urethral hair growth that can occur after urethral repair performed using a skin graft. PMID:25606569

  1. Selective arterial thrombolysis with urokinase

    International Nuclear Information System (INIS)

    Seven patients with thrombotic occlusions of the peripheral arteries or grafts were treated with urokinase by direct intraarterial selective infusion. During the infusion, simultaneous heparin infusion was used to reduce the frequency of thrombus formation on the infusion catheter or recurrent thrombosis. In 4 patients in whom a complete thrombolysis occurred, urokinase was infused by a high-dose transthrombus bolus technique followed by continuous infusion. There other patients, in whom thrombolysis was partially accomplished and then surgical thrombectomy was performed, were treated only by continuous urokinase infusion. Small hematomas developed at the infusion catheter entry site in 2 patients, but transfusion or operation was not required. Other significant complications were not found. Our results suggest that selective arterial infusion of urokinase with a transthrombus bolus technique can accomplish a complete arterial thrombolysis without any significant complications

  2. Outcomes following unilateral uterine artery embolisation.

    Science.gov (United States)

    McLucas, B; Reed, R A; Goodwin, S; Rappaport, A; Adler, L; Perrella, R; Dalrymple, J

    2002-02-01

    Uterine artery embolisation has been described as successful only when both arteries are embolised. However, results in patients with one congenitally absent or previously ligated artery are unknown. Women suffering from symptomatic uterine myomata were treated at a university teaching hospital, a community hospital and an outpatient surgery centre. Retrospective review of patient response to embolisation was assessed by chart review and questionnaire. Uterine and dominant fibroid size response was assessed by comparing pre- and post-embolisation ultrasound examinations. This study analysed three patient groups within the general population: those who underwent unilateral embolisation because of technical failure, those who ultimately underwent bilateral embolisation after initial technical failure and those who underwent unilateral embolisation because of an absent uterine artery. 12 patients underwent unilateral embolisation, 4 of whom underwent this procedure because of an absent uterine artery. Three of these four patients had a congenitally absent uterine artery arising from the internal iliac artery and all three experienced successful outcomes. The fourth patient had a previously ligated internal iliac artery and her symptoms worsened after the procedure. Eight patients had unilateral embolisation due to technical failure. Five of these patients underwent a subsequent procedure during which the contralateral uterine artery was embolised. Four of these five patients had successful outcomes and one was lost to follow-up. Another of the eight patients suffered an arterial injury leading to technical failure, and was lost to follow-up. Of the two remaining patients with unilateral technical failure, only one had a successful outcome. This study concluded that patients who undergo unilateral embolisation for technical reasons should be offered a second embolisation procedure shortly after the initial procedure. Patients with a congenitally absent uterine artery may respond with similar success to those who underwent bilateral embolisation. In contrast, the patient with a previously ligated internal iliac artery failed. The numbers in this study are too small for statistical analysis and subsequent studies should be performed to confirm these findings. PMID:11893635

  3. Numerical validation of pulse wave propagation: effects of arterial length

    International Nuclear Information System (INIS)

    In this paper, the effects of arterial length on pulse wave propagation are presented to validate our fluid–structure interaction model. Three models, called the original, lengthened and shortened artery models, were obtained by changing arterial length. The results show that there is an obvious time delay between the velocity waveforms at two different locations in the original artery model, the same as the lengthened artery model. Furthermore, the velocity amplitude increases greatly in the two models. However the time delay cannot be seen clearly and the increase of the velocity amplitude is very small in the shortened artery model. There is a highest increase in the velocity amplitude of the lengthened artery model. The results indicate that arterial length plays an important role and give our model effective.

  4. New Surgical Technique for Treatment of Obstructive Penile Urethrolithiasis without Interference with Breeding Capability: Clinical Study on 25 Calves

    OpenAIRE

    Aiman Mahmoud Seddek* and Hossam Ahmad Bakr1

    2013-01-01

    A clinical study performed on 25 calves suffered from urine retention with intact bladder as a result of lodgment of urinary stone at the penile sigmoid flexure. Paracentesis of the bladder were applied to the cases with over distended bladder. All animals were subjected to dorsal penile urethrotomy for removal of the stone and temporary retrograde catheterization of the bladder using suitable diameter Rayle’s tube. The tube was removed 8-10 days post-surgery, and the calves were observed f...

  5. Three-dimensional mapping and comparative analysis of the distal human corpus cavernosum and the inflatable penile prosthesis

    OpenAIRE

    Hakky, Tariq S.; Ferguson, Daniel; Spiess, Philippe E.; Bradley, Paul; Lue, Tom F.; Carrion, Rafael E.

    2013-01-01

    The intricate anatomy of the corpus cavernosum in both the flaccid and tumescent state has not been fully elucidated. We report our experience using a three-dimensional (3D) scanner to reconstruct cadaveric casts and compare them with 3D images of two prototypes of penile prosthesis. Two different models of the Titan Coloplast inflatable penile prosthesis were analyzed using a 3D scanner. The first was the standard model and the second was a newer model with a rounder silicone tip. Two cadave...

  6. Off-Pump Coronary Artery Bypass: A Beating Heart Procedure

    Medline Plus

    Full Text Available ... veins or the arteries with minimally invasive, with small incisions, I remember 10, 15 years ago, when ... who has a very diffuse disease and very small vessels, et cetera, maybe the traditional surgery would ...

  7. Titanium-bone-anchored penile epithesis: preoperative planning and immediate postoperative results.

    Science.gov (United States)

    Selvaggi, Gennaro; Branemark, Rickard; Elander, Anna; Liden, Mattias; Stalfors, Joacim

    2015-02-01

    The principle of osseointegration is accepted and used in reconstructive surgery. This study presents the first series of five patients where titanium implants have been implanted into the pubic bones of female-to-male (FTM) transsexual patients, in order to attach a "bone-anchored" penile epithesis. Following patient selection based on patients' wishes, pubic bones of 10 FTM transsexuals were analysed by CT-scan and a virtual planning was made. A surgical plan was also developed. To date, five FTM transsexuals have undergone the two-stage surgery. During stage-1, two titanium implants ("fixtures") are implanted onto the pubic bone. Four weeks postop, a new CT scan is performed to analyze osseointegration and the final implant position. During stage-2, the soft tissue of the pubic area is reduced; abutments are inserted and passed through the skin. A few weeks after stage 2 surgery, a penile epithesis is connected to the skin-penetrating titanium implants. Two out of 10 patients who received preoperative CT scan presented with smaller pubic bones, not able to accommodate the fixtures as chosen originally. Preoperative virtual planning is crucial for the selection of the appropriate implants size. The stage-1 and stage-2 surgery occurred uneventfully in all five patients. One patient presented with a wound infection 1 week after stage-2 surgery. Postoperative CT scan demonstrates implant osseointegration in all cases. This experimental clinical study demonstrates that titanium osseointegration is feasible onto the pubic bone. This new approach for penile reconstruction constitutes another alternative for both transsexual patients and cases following genital development disorders, post-trauma and surgery. PMID:24931337

  8. Necrosis of the Ventral Penile Skin Flap: A Complication of Hypospadias Surgery in Children

    Science.gov (United States)

    Bakal, Ünal; Abe?, Musa; Sarac, Mehmet

    2015-01-01

    Objectives. To review cases of hypospadias that were repaired with TIPU method and consequently resulted in the necrosis of ventral penile skin flaps. Methods. Eighty-three patients with hypospadias underwent TIPU procedure by two surgeons. Neourethra in all patients was covered with dartos flap prepared from the preputium or penile shaft. In cases where ventral skin could not be covered primarily, closure was ensured by using preputial Ombredanne or Byars' flaps to repair ventral defects. Results. The median age of patients was 4 years. Twenty-five (30.12%) patients that underwent hypospadias repair had urethral opening at the coronal level, 33 (39.75%) at the distal penis, 10 (12.04%) at the midpenis, and 15 (18.07%) at the proximal penis. The ventral skin defect could not be primarily covered in 10 patients with penile shaft hypospadias. Consequently, Byars' method was used in 8 of these patients to cover the defect and the Ombredanne method was used in the remaining 2. Ventral skin flap necrosis developed in 5 patients (4 Byars and 1 Ombredanne). It was medically treated in 4 patients. Urethral fistula developed in the other patient whose necrosis was deeper. The mean hospital stay was 7 days for patients without necrosis, and 14 for those with necrosis. Conclusion. We are of the opinion that dartos flaps used in the TIPU method in order to cover neourethra and decrease the incidence of fistula development lead to necrosis in the Ombredanne or Byars' flaps by causing low blood supply to the preputium and thus extend hospital stay. PMID:25922604

  9. The role of radiation therapy after incomplete resection of penile cancer

    Energy Technology Data Exchange (ETDEWEB)

    Langsenlehner, T.; Mayer, R.; Prettenhofer, U.; Kapp, K.S. [Dept. of Therapeutic Radiology and Oncology, Medical Univ. of Graz (Austria); Quehenberger, F. [Inst. for Medical Informatics, Statistics and Documentation, Medical Univ. of Graz (Austria); Langsenlehner, U. [Div. of Oncology, Dept. of Internal Medicine, Medical Univ. of Graz (Austria); Pummer, K. [Dept. of Urology, Medical Univ. of Graz (Austria)

    2008-07-15

    Purpose: to retrospectively assess the outcome in patients treated with adjuvant radiotherapy for penile cancer. Patients and methods: between 1987 and 2006, 24 patients (median age, 62.7 years; range, 35.5-90.4 years) with squamous cell carcinoma of the penis (T1, n = 10; T2, n = 11; T3, n = 3) received megavoltage external radiotherapy (n = 22) or {sup 192}Ir high-dose-rate brachytherapy (n = 2) following total penectomy (n = 7), partial penectomy (n = 10), or local excision (n = 7); lymphadenectomy was performed in eight patients. In 14 patients, radiotherapy was delivered after incomplete tumor resection, and in 20 patients the planning target volume included the regional lymph nodes. Median total dose of external radiotherapy was 56 Gy/1.8-2 Gy (range, 50-60 Gy). Brachytherapy was given with a total dose of 45 Gy/3 Gy. Results: during a median follow-up of 58.4 months, penile or perineal recurrence was found in four patients giving a 5-year local control rate of 74.8%. Regional failure occurred in two patients. 5-year metastases-free survival and progression-free survival rates were 86.7% and 64.5%, respectively. Four patients died due to tumor progression. The actuarial 5-year cause-specific and overall survival rates were 84.3 and 56.6%, respectively. Conclusion: radiation therapy is a successful method of treatment for penile cancer in terms of local control and organ preservation after microscopically incomplete surgery. Radiotherapy of the regional lymph nodes might also be effective in preventing regional recurrence and can be considered in case of high-risk features and following excision of extensive lymph node involvement. (orig.)

  10. The value of magnetic resonance imaging in the diagnosis of penile fracture

    Scientific Electronic Library Online (English)

    Ibrahim, Guler; Kemal, Ödev; Havva, Kalkan; Cihan, Simsek; Suat, Keskin; Mehmet, Kilinç.

    2015-04-01

    Full Text Available 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 i [...] ntercourse, 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

  11. Uretrostomia peniana e perineal em felinos domésticos Penile and perineal urethrostomy in domestic cats

    Directory of Open Access Journals (Sweden)

    Erika Cosendey Toledo de Mello Peixoto

    1997-12-01

    Full Text Available O conteúdo do presente trabalho é o resultado de diferentes técnicas de uretrostomia em felinos domésticos. Foram utilizados vinte quatro gatos sem raça definida, machos, distribuídos em quatro grupos de seis animais cada e submetidos a orquiectomia e aos seguintes procedimentos cirúrgicos: uretrostomia peniana cranial (grupo I, uretrostomia peniana caudal (grupoII, uretrostomia peniana craniocaudal (grupo III e uretrostomia perineal associada à penectomia cranial (grupo IV. Os resultados foram avaliados através de exame clínico geral, realizado do primeiro dia ao nonagésimo dia após intervenção cirúrgica. O aspecto macroscópico da ferida cirúrgica, grau de contração e aspecto estético foram inspecionados diariamente até a retirada dos pontos externos. Foram realizados exame de urina tipo l e urocultura, apenas nos animais que apresentaram melhores resultados: aqueles submetidos à uretrostomia peniana craniocaudal e à uretrostomia perineal associada à penectomia cranial. Esses exames foram realizados 24h antes do procedimento cirúrgico (T0, 15 (Tl e 30 (T2 do período pós-operatório. Os animais do primeiro grupo apresentaram fechamento completo da uretra peniana, os do segundo grupo apresentaram intensa retração cicatricial pós-operatória que promoveu exposição peniana permanente. Os animais do grupo III, também desenvolveram exposição peniana permanente, porém em menor grau. Os resultados apresentados por todos os indivíduos do grupo IV foramos melhores, sendo a técnica recomendada para desobstrução uretral em gatos.The content of lhe present paper is lhe result of different technics for urethrostomy in domestic cats. Twenty four mongrel males cats were used. They were distributed in four groups of six animais each and the following protocol were used: cranial penile urethrostomy (group 1, caudal penile urethrostomy (group II, association of the previous techniques (group III and association of cranial penectomy and perineal urethrostomy (group IV. Previously orchiectomy was performed in all animals. The results were evaluated through a daily clinical examination considering the macroscopic aspect of the wound, the contraction and the aesthetic view. Urianalysis and culture of urine were performed at the animais of groups III and IV, which are the groups with the best surgical results. In the first group it was observed the complete closure of the penile uretra around the 15th pos-operative day. All animals from group II, presented penile exposition due to tissue retraction after surgery. The best results were obtained with animals of the group IV, wich presented acceptable aesthetical results and maintence of urethral patency. This tecnique is indicated for relief urethral obstruction in cats.

  12. Fratura de pênis com trauma uretra / Penile fracture with urethral trauma

    Scientific Electronic Library Online (English)

    Arlindo Monteiro de, Carvalho Junior; Fábio Martinez de, Melo; Gabriella Alves de Lima, Félix; Juliana Fernandes, Sarmento; Maria Luisa Dutra, Capriglione.

    2013-08-01

    Full Text Available [...] Abstract in english We reported a case of a twenty-nine-year-old male who presented a penile fracture associated with urethral injury caused by a sexual intercourse. An ideal anamnesis and a special physical examination were determinant to correct diagnostics. Ultrasonography and uretrocistography must be performed for [...] confirmation. The treatment is based on the presence of associated urethral injury. The surgical repair of cavernous body and urethra can produce good results, with a favorable prognosis and minimal rate of complications.

  13. Outcomes of and Satisfaction with the Inflatable Penile Prosthesis in the Elderly Male

    OpenAIRE

    Villarreal, Humberto G.; LeRoy Jones

    2012-01-01

    Objective. To determine the outcomes of and satisfaction with the multi-component inflatable penile prosthesis (IPP) in the elderly male (age >71). Methods. Using a chart review and telephone survey, we retrospectively assessed patients who underwent IPP or combined IPP/artificial urinary sphincter (AUS) from 2004–2006. Results. We identified 56 patients that underwent IPP (48) or IPP/AUS (8). The age range was 71–86 (mean 74.3) at the time of surgery, with a follow-up range of 0.5–2.4 ...

  14. Blunt trauma to the carotid arteries.

    Science.gov (United States)

    Martin, R F; Eldrup-Jorgensen, J; Clark, D E; Bredenberg, C E

    1991-12-01

    Blunt carotid artery trauma is an uncommon but potentially dangerous clinical entity. We report eight patients from a 10-year interval who sustained blunt injuries to the carotid arteries. Six of eight patients suffered a hyperextension injury or had a cervical spine fracture or both. Arteriography revealed four arterial dissections and four thrombotic occlusions. Two asymptomatic common carotid artery occlusions and one dissection with transient ischemic attacks had successful arterial reconstructions. Five patients were treated nonoperatively: three internal carotid artery dissections with minor or no neurologic deficit; one asymptomatic thrombosis; and one internal carotid artery thrombosis with a major fixed neurologic deficit that did not improve. No patient died, and seven of eight made a complete neurologic recovery or remained asymptomatic. The diagnosis of blunt carotid artery injuries should be suspected in patients with neck hyperextension injuries or with cervical spine fractures as well as in patients with neurologic deficits not explained by intracranial trauma. Duplex scanning may be a useful noninvasive study. Surgery is indicated for selected patients with accessible lesions who have minor or no neurologic deficits. Asymptomatic patients with small intimal flaps or dissections may be successfully treated nonoperatively. PMID:1960809

  15. Hipertensão arterial e sua correlação com alguns fatores de risco em cidade brasileira de pequeno porte / Arterial hypertension and its correlation with some risk factors in a small brazilian town / Hipertensión arterial y su correlación con algunos factores de riesgo en ciudad brasileña de pequeño tamaño

    Scientific Electronic Library Online (English)

    Flávia Miquetichuc Nogueira, Nascente; Paulo César Brandão Veiga, Jardim; Maria do Rosário Gondim, Peixoto; Estelamaris Tronco, Monego; Humberto Graner, Moreira; Priscila Valverde de Oliveira, Vitorino; Weimar Kunz Sebba Barroso de, Souza; Luiz Nazário, Scala.

    2010-10-01

    Full Text Available FUNDAMENTO: A hipertensão arterial (HA) é um problema de saúde que atinge um grande número de hipertensos não diagnosticados ou não tratados adequadamente e que possui um alto índice de abandono ao tratamento. OBJETIVO: Estimar a prevalência da HA e sua correlação com alguns fatores de risco cardiov [...] asculares na população adulta de Firminópolis-GO. MÉTODOS: Estudo descritivo, observacional e transversal com base populacional, amostra aleatória simples (> 18 anos): questionários padronizados com medidas de pressão arterial (critério de HA > 140 x 90 mmHg), peso, altura, índice de massa corporal (IMC) e circunferência da cintura (CC). Dados armazenados (Microsoft Acess) e analisados pelo Epi-info. RESULTADOS: Investigados 1.168 indivíduos, com predomínio de mulheres. Sexo feminino - 63,2% com média de idade entre 43,2 ± 14,9 anos. Prevalência de sobrepeso em 33,7% e obesidade em 16,0% dos indivíduos. Prevalência de CC alterada em 51,8% e de tabagismo em 23,2%. Sedentarismo no trabalho e no lazer presente em 67,6% e em 64,8% dos indivíduos, respectivamente, com proporção maior entre as mulheres. Etilismo em 33,3% da amostra. A prevalência de HA foi de 32,7%, em maior número entre os homens (35,8%) do que entre as mulheres (30,9%). Encontrada correlação positiva da HA com IMC, CC e faixa etária. Correlação negativa de HA e escolaridade, com 18,2% de hipertensos com nove anos ou mais de estudo. CONCLUSÃO: Encontrada alta prevalência de HA, excesso de peso e CC. O sexo feminino representou fator de proteção para o risco de HA. Encontradas correlação positiva da HA com IMC, CC, e faixa etária e correlação negativa com escolaridade. Abstract in spanish FUNDAMENTO: La hipertensión arterial (HA) es un problema de salud que alcanza a un gran número de hipertensos no diagnosticados o no tratados adecuadamente y que posee un alto índice de abandono del tratamiento. OBJETIVO: Estimar la prevalencia de la HA y su correlación con algunos factores de riesg [...] os cardiovasculares en la población adulta de Firminópolis-GO. MÉTODOS: Estudio descriptivo, observacional y transversal con base poblacional, muestra aleatoria simple (>18 años): cuestionarios estandarizados con medidas de presión arterial (criterio de HA > 140 x 90 mmHg), peso, altura, índice de masa corporal (IMC) y circunferencia de la cintura (CC). Datos almacenados (Microsoft Acess) y analizados por el Epi-info. RESULTADOS: Investigados 1.168 individuos, con predominio de mujeres. Sexo femenino (63,2%) con media de edad entre 43,2 ± 14,9 años. Prevalencia de sobrepeso en 33,7% y obesidad en 16,0% de los individuos. Prevalencia de CC alterada en 51,8%y de tabaquismo en 23,2%. Sedentarismo en el trabajo y en el ocio presente en 67,6% y en 64,8% de los individuos, respectivamente, con proporción mayor entre las mujeres. Etilismo en 33,3% de la muestra. La prevalencia de HA fue de 32,7%, en mayor número entre los hombres (35,8%) que entre las mujeres (30,9%). Encontrada correlación positiva de la HA con IMC, CC y franja etárea. Correlación negativa de HA y escolaridad, con 18,2% de hipertensos con nueve años o más de estudio. CONCLUSIÓN: Encontrada alta prevalencia de HA, exceso de peso y CC. El sexo femenino representó factor de protección para el riesgo de HA. Encontradas correlación positiva de la HA con IMC, CC, y franja etárea y correlación negativa con escolaridad. Abstract in english BACKGROUND: Arterial hypertension (AH) is a health problem that affects a large number of undiagnosed or inadequately treated hypertensive individuals and presents a high rate of treatment nonadherence. OBJECTIVE: To estimate the prevalence of AH and its correlation with some cardiovascular risk fac [...] tors among the adult population of the town of Firminopolis, state of Goiás, Brazil. METHODS: Descriptive, observational and cross-sectional population-based study of a simple random sample (age > 18 years): standardized questionnaires with blood pressure (BP) measurements (AH criterion: BP > 1

  16. Hipertensão arterial e sua correlação com alguns fatores de risco em cidade brasileira de pequeno porte Hipertensión arterial y su correlación con algunos factores de riesgo en ciudad brasileña de pequeño tamaño Arterial hypertension and its correlation with some risk factors in a small brazilian town

    Directory of Open Access Journals (Sweden)

    Flávia Miquetichuc Nogueira Nascente

    2010-10-01

    Full Text Available FUNDAMENTO: A hipertensão arterial (HA é um problema de saúde que atinge um grande número de hipertensos não diagnosticados ou não tratados adequadamente e que possui um alto índice de abandono ao tratamento. OBJETIVO: Estimar a prevalência da HA e sua correlação com alguns fatores de risco cardiovasculares na população adulta de Firminópolis-GO. MÉTODOS: Estudo descritivo, observacional e transversal com base populacional, amostra aleatória simples (> 18 anos: questionários padronizados com medidas de pressão arterial (critério de HA > 140 x 90 mmHg, peso, altura, índice de massa corporal (IMC e circunferência da cintura (CC. Dados armazenados (Microsoft Acess e analisados pelo Epi-info. RESULTADOS: Investigados 1.168 indivíduos, com predomínio de mulheres. Sexo feminino - 63,2% com média de idade entre 43,2 ± 14,9 anos. Prevalência de sobrepeso em 33,7% e obesidade em 16,0% dos indivíduos. Prevalência de CC alterada em 51,8% e de tabagismo em 23,2%. Sedentarismo no trabalho e no lazer presente em 67,6% e em 64,8% dos indivíduos, respectivamente, com proporção maior entre as mulheres. Etilismo em 33,3% da amostra. A prevalência de HA foi de 32,7%, em maior número entre os homens (35,8% do que entre as mulheres (30,9%. Encontrada correlação positiva da HA com IMC, CC e faixa etária. Correlação negativa de HA e escolaridade, com 18,2% de hipertensos com nove anos ou mais de estudo. CONCLUSÃO: Encontrada alta prevalência de HA, excesso de peso e CC. O sexo feminino representou fator de proteção para o risco de HA. Encontradas correlação positiva da HA com IMC, CC, e faixa etária e correlação negativa com escolaridade.FUNDAMENTO: La hipertensión arterial (HA es un problema de salud que alcanza a un gran número de hipertensos no diagnosticados o no tratados adecuadamente y que posee un alto índice de abandono del tratamiento. OBJETIVO: Estimar la prevalencia de la HA y su correlación con algunos factores de riesgos cardiovasculares en la población adulta de Firminópolis-GO. MÉTODOS: Estudio descriptivo, observacional y transversal con base poblacional, muestra aleatoria simple (>18 años: cuestionarios estandarizados con medidas de presión arterial (criterio de HA > 140 x 90 mmHg, peso, altura, índice de masa corporal (IMC y circunferencia de la cintura (CC. Datos almacenados (Microsoft Acess y analizados por el Epi-info. RESULTADOS: Investigados 1.168 individuos, con predominio de mujeres. Sexo femenino (63,2% con media de edad entre 43,2 ± 14,9 años. Prevalencia de sobrepeso en 33,7% y obesidad en 16,0% de los individuos. Prevalencia de CC alterada en 51,8%y de tabaquismo en 23,2%. Sedentarismo en el trabajo y en el ocio presente en 67,6% y en 64,8% de los individuos, respectivamente, con proporción mayor entre las mujeres. Etilismo en 33,3% de la muestra. La prevalencia de HA fue de 32,7%, en mayor número entre los hombres (35,8% que entre las mujeres (30,9%. Encontrada correlación positiva de la HA con IMC, CC y franja etárea. Correlación negativa de HA y escolaridad, con 18,2% de hipertensos con nueve años o más de estudio. CONCLUSIÓN: Encontrada alta prevalencia de HA, exceso de peso y CC. El sexo femenino representó factor de protección para el riesgo de HA. Encontradas correlación positiva de la HA con IMC, CC, y franja etárea y correlación negativa con escolaridad.BACKGROUND: Arterial hypertension (AH is a health problem that affects a large number of undiagnosed or inadequately treated hypertensive individuals and presents a high rate of treatment nonadherence. OBJECTIVE: To estimate the prevalence of AH and its correlation with some cardiovascular risk factors among the adult population of the town of Firminopolis, state of Goiás, Brazil. METHODS: Descriptive, observational and cross-sectional population-based study of a simple random sample (age > 18 years: standardized questionnaires with blood pressure (BP measurements (AH criterion: BP > 140 x 90 mmHg, weight, height, Body Mass Index (BMI and waist circumference (WC. Dat

  17. Arterial Microcalcifications in the Breast Mimicking Malignancy

    OpenAIRE

    Janzen, Katrin; Janzen, Jan

    2012-01-01

    Microcalcifications in the breast are highly suggestive of malignancy; they can occur in many pathological conditions. A 36-years-old nondiabetic woman came to the gynaecologist with a suspect palpable mass in the upper outer quadrant of the right breast. Histopathological examination confirmed a calcification of a small artery (diameter: 0.45?mm). Arterial calcifications can mimic a malignant lesion in the breast.

  18. Polyarteritis nodosa with renal artery stenosis.

    Science.gov (United States)

    Adhisivam, B; Vasanthi, T; Nammalwar, B R; Vijayakumar, M

    2004-01-01

    Renal angiographic signs in Polyarteritis Nodosa (PAN) vary from aneursyms of medium and small vessels, perfusion defects and delayed emptying of renal arteries. These vascular changes are usually responsible for the hypertension. In this case study stenosis of a main renal artery, an unusual finding in classical PAN, is believed to be the cause of hypertension. Hence renal angiography is essential to define the renal vascular changes and confirm the cause of hypertension. PMID:14767092

  19. Microsurgical Penile Replantation after Self-inflicted Amputation in a Schizophrenic Patient: 5-year Follow-up

    Science.gov (United States)

    Shah, Manish; Kim, Fernando

    2015-01-01

    Summary: In this article, we report on the long-term follow-up of a microvascular penile replantation resulting from self-inflicted amputation in a schizophrenic patient. An interdisciplinary approach with the involvement of urology, plastic surgery, endocrinology, and psychiatry is imperative for optimal treatment of these catastrophic injuries. PMID:25878930

  20. Comparison between Tubularised Incised Plate Urethroplasty and Onlay Island Flap Repair in Mid and Proximal Penile Hypospadias

    International Nuclear Information System (INIS)

    Objectives: To evaluate the surgical outcome of tubularised incised plate urethroplasty and onlay island flap repair for mid and proximal penile hypospadias. Methods: The prospective study was conducted at the Bahawal Victoria Hospital, Bahawalpur from June 2011 to May 2013. A total of 60 patients with mid and proximal penile hypospadias in the age range of 02 to 06 years were included. Patients with hypospadias other than mid and proximal penile, with chordee and history of previous hypospadias repair were excluded. Patients were divided into two equal groups. Urethroplasty was done for group I and flap repair for group II. The follow-up period was 12-24 months. SPSS 16 was used for statistical analysis. Results: The mean duration of surgery was 62+-8.72 minutes for group I and 90+-11.25 minutes for group II (p<0.0001). In group I, only 03 (10.0%) patients had complications, while in group II, 09 (30.0%) patients developed complications (p=0.02). Cosmetic results were also excellent in group I compared to group II. Conclusion: Tubularised incised plate urethroplasty was better and superior than onlay island flap repair in terms of less operative time, complication rate and satisfactory cosmetic results for mid and proximal penile hypospadias. (author)

  1. Strategies for penile prosthesis placement in Peyronie's disease and corporal fibrosis.

    Science.gov (United States)

    Yafi, Faysal A; Sangkum, Premsant; McCaslin, Ian Ross; Hellstrom, Wayne J G

    2015-04-01

    Peyronie's disease (PD) is a wound healing disorder of the tunica albuginea of the penis. PD is generally categorized into two phases: the early acute inflammatory and late chronic fibrotic. Surgical reconstruction is only recommended during the latter established phase. There are a variety of options when erections are functional. However, when erectile dysfunction is present, the gold standard treatment is the placement of an inflatable penile prosthesis with or without additional straightening procedures. General recommendations include that after implanting and inflating the cylinders, if a clinically significant curvature is present, manual modeling is performed. If a residual curve >30° remains after modeling, then various techniques, including plaque releasing incision, is the next step. Grafting can be considered if tunical defects are >2.0 cm. Causes of corporal fibrosis include complications from an infected implant such as explantation, priapism, penile trauma, and prolonged use of an intracavernosal injection agent. Implant placement in the setting of corporal fibrosis can be technically challenging. Available strategies include incision or excision of the scar, corporotomies with or without grafting, the use of cavernotomes, or other specialized dilators, implant downsizing, and transcorporeal resection. PMID:25712763

  2. Celulitis de pene tras sexo oral / Penile cellulitis after oral sex

    Scientific Electronic Library Online (English)

    Francisco, Serrano de la Cruz Torrijos; Francisco Javier, Ramada Benlloch; Joaquín Ulises, Juan Escudero; Milagros, Fabuel Deltoro; Emilio, López Alcina; Pedro, Navalón Verdejo; Macarena, Ramos de Campos; Emilio, Marqués Vidal.

    2008-10-01

    Full Text Available Objetivo: En la actualidad la prevalencia de relaciones sexuales en las que se incluye sexo oral es elevada, esto conlleva una serie de peculiaridades en las infecciones, balanopostitis y celulitis, que pueden producirse en relación con estas prácticas. Métodos: Aportamos 2 nuevos casos de celulitis [...] penea0 na tratados en el Servicio de Urología de nuestro hospital. Discusión: Revisamos las indicaciones de profilaxis, tratamiento médico y quirúrgico referidas en la literatura y practicadas en nuestros pacientes. Conclusiones: La anamnesis ante balanopostitis y celulitis peneanas, debe incluir referencias explícitas a la práctica de sexo oral. La precocidad en el tratamiento, tanto médico como quirúrgico, influye favorablemente en la evolución de las lesiones. Abstract in english Objective: Nowadays, there is the high prevalence of sexual intercourse including oral sex, which implies some peculiarities in the infections, balanitis and cellulitis they may produce. Methods: We report two new cases of penile cellulitis treated in the urology department in our hospital. Discussi [...] on: We review the indications of prophylaxis, and the medical and surgical treatment both referred in the literature and carried out in our patients. Conclusions: When dealing with balanitis and penile cellulitis, the history should include explicit references to the practice of oral sex. Early medical or surgical treatment has a favourable influence on the evolution of the lesions.

  3. Tubularized Penile-Flap Urethroplasty Using a Fasciocutaneous Random Pedicled Flap for Recurrent Anterior Urethral Stricture

    Directory of Open Access Journals (Sweden)

    Yong Jig Lee

    2012-05-01

    Full Text Available This report describes the use of a tubularized random flap for the curative treatment ofrecurrent anterior urethral stricture. Under the condition of pendulous lithotomy andsuprapubic cystostomy, the urethral stricture was removed via a midline ventral penileincision followed by elevation of the flap and insertion of an 18-Fr catheter. Subcutaneousburied interrupted sutures were used to reapproximate the waterproof tubularizedneourethra and to coapt with the neourethra and each stump of the urethra, first proximallyand then distally. The defect of the penile shaft was covered by advancement of thesurrounding scrotal flap. The indwelling catheter was maintained for 21 days. A 9 monthpostoperative cystoscopy showed no flap necrosis, no mechanical stricture, and no hairgrowth on the lumen of the neourethra. The patient showed no voiding discomfort 6 monthsafter the operation. The advantages of this procedure are the lack of need for microsurgery,shortening of admission, the use of only spinal anesthesia (no general anesthesia, and arelatively short operative time. The tubularized unilateral penile fasciocutaneous flap shouldbe considered an option for initial flap urethroplasty as a curative technique.

  4. Comparison of the effects of prostanoids on human penile circumflex veins and corpus cavernosum tissue

    DEFF Research Database (Denmark)

    Kirkeby, H J; Andersson, K E

    1993-01-01

    The mechanical effects of the prostaglandins PGE1, PGE2, PGF2 alpha and PGI2 were investigated in human isolated penile circumflex veins (CV) and corpus cavernosum (CC) tissue. PGE1 did not affect resting tension, while the compound produced relaxation of both CC and CV preparations after precontraction with noradrenaline (NA) 3 x 10(-6)M. PGE2 produced contraction in CC and CV preparations. After precontraction with NA, however, relaxation was induced in both tissues. PGF2 alpha induced contraction in CC and CV preparations, while no relaxant responses were seen in preparations precontracted with NA. PGI2 produced no mechanical effects in unstimulated CV preparations, whereas dose-related contraction was induced in CC tissue strips. After precontraction with NA, PGI2 showed no effect in 2 of 6 CC preparations, while relaxation was seen in 4. In CV preparations precontracted with NA, PGI2 produced relaxation. Local synthesis of prostanoids may influence resting tension and modulate NA-induced responses not only in human penile CC but also in CV smooth muscle.

  5. Extended long term functional outcome of inflatable penile prosthesis in a single institution.

    LENUS (Irish Health Repository)

    Thomas, A Z

    2011-02-01

    We sought to evaluate the extended long term functional outcome of the AMS700 three piece inflatable prosthesis in men with erectile dysfunction in a single urological department and assess our revision rates. Patients that underwent first-time insertion or revision of an AMS700 3 piece inflatable penile prosthesis between 1984-2007 were included. Data was obtained from medical records and long term follow up of patients was conducted by telephone interview. The medical records of 38 patients were available for review. Of these 38 men, 56 prostheses were inserted. The mean follow up was 8.4 years (101 months). The revision rate at 50 months postoperatively was 7\\/38 (18%). The overall revision rate was 18\\/38 (47%). The mean time to revision in these 18 patients was 72 months (12-156 months) after initial insertion of AMS700 penile prosthesis. This study highlights that with longer follow u revision rates markedly increase after 72 months.

  6. Penile Fracture in A Patient With Spinal Cord Injury: A Case Report

    Directory of Open Access Journals (Sweden)

    Ümüt GÜZELKÜÇÜK

    2013-09-01

    Full Text Available Herein, we present a case of penile fracture (PF in a patient with spinal cord injury (SCI. A 36-year-old male patient with T12 paraplegia ASIA-B fell during transfer from wheelchair to the bed. He had no complaint during the night. He observed swelling of the penis when he was doing clean intermittent catheterization in the morning. On physical examination, edema and ecchymosis were observed on the penis. Penil ultrasound revealed haematoma in the corpus cavernosum. The diagnosis of PF was established. Because the patient did not accept surgery, conservative treatment was performed. An indwelling catheter and Coban bandage were applied for 10 days. One month later, the appearance of the penis was normal. Patients with SCI might develop PF accidentally. Loss of sensation in SCI might cause delayed diagnosis of PF and increased complication risk. PF and its complications might further deteriorate the sexual or voiding problems that SCI patients already have. Turk J Phys Med Rehab 2013;59:268-70.

  7. Human papillomavirus and penile cancers in Rio de Janeiro, Brazil: HPV typing and clinical features

    Scientific Electronic Library Online (English)

    Marcos A., Scheiner; Mercia M., Campos; Antonio A., Ornellas; Eduardo W., Chin; Maria H., Ornellas; Maria J., Andrada-Serpa.

    2008-08-01

    Full Text Available OBJECTIVE: To determine the prevalence of human papillomavirus (HPV) DNA in penile cancers in Rio de Janeiro, Brazil. MATERIALS AND METHODS: We studied, prospectively, 80 consecutive cases of patients with penile cancers who underwent surgical treatment at three different Hospitals in Rio de Janeiro [...] between March 1995 and June 2000. Of these patients, 72 were diagnosed with invasive squamous cell carcinoma and 8 patients with verrucous carcinoma. The following parameters were observed: presence or absence of HPV DNA viral type, histological subtypes, clinical stage and overall survival. RESULTS: HPV DNA was detected in 75% of patients with invasive carcinomas and in 50% of patients with verrucous carcinomas. High risk HPVs were detected in 15 of 54 (27.8%) patients with HPV positive invasive tumors and in 1 of 4 (25%) patients with HPV positive verrucous tumors. HPV 16 was the most frequent type observed. No correlation was observed between HPV status and histological subtype (p = 0.51) as well as HPV status and stage stratification (p = 0.88). HPV status was also not significantly associated with the presence of regional metastases (p = 0.89). The overall survival was related to the presence of lymph node metastases (p

  8. Fractura de pene: Estudio de 10 años / Penile fracture: Study of 10 years

    Scientific Electronic Library Online (English)

    Ariel, Núñez Roca; Tomás Lázaro, Rodríguez Collar; José Antonio, García Monzón; Santiago, Carrillo González; Gilberto, Martínez Ramos.

    2010-12-01

    Full Text Available INTRODUCCIÓN: La fractura de pene ocurre la mayoría de las veces durante el coito, cuando el órgano, al estar erecto, se flexiona bruscamente. OBJETIVOS: Describir aspectos de la presentación y características de esta entidad, así como su diagnóstico y tratamiento. MÉTODOS: Se realizó un estudio des [...] criptivo, a partir de las historias clínicas de 25 pacientes ingresados en el servicio de urología del Hospital Militar Central "Dr. Carlos J. Finlay", de enero de 1997 a diciembre de 2006, con el diagnóstico de fractura de pene. Las variables descritas fueron: edad, síntomas y signos, agentes causales, medios diagnósticos utilizados, tratamiento aplicado y complicaciones presentadas. RESULTADOS: Predominó el grupo de edades de 26 a 44 años con el 56 %. El síntoma principal fue el hematoma del pene en el 100 % de los casos y la causa más frecuente fue el traumatismo durante el coito en el 68_%. En el 24 % de los pacientes fue necesario el auxilio de la ecografía peneana, simple o Doppler, para confirmar el diagnóstico; se aplicó el tratamiento quirúrgico en el 72 % de los pacientes. Las complicaciones se presentaron en los casos no operados y consistieron en fibrosis de los cuerpos cavernosos y la disfunción sexual eréctil. CONCLUSIONES: La fractura de pene ocurre fundamentalmente durante el coito. La sintomatología clínica tiene gran valor para el diagnóstico. En caso de dudas, la ecografía simple o Doppler resulta muy útil. El tratamiento quirúrgico es el indicado para evitar secuelas en estos pacientes. Abstract in english INTRODUCTION: The penile fracture is very frequent during the coitus when the organ is in erection undergoes a sudden flexion. OBJECTIVES: To describe the features of presentation and its entity characteristics, as well as its diagnostic and treatment. METHODS: A descriptive study was conducted from [...] the medical records of 25 patients admitted in the Urology Service of the "Dr. Carlos J. Finlay" Military Hospital from January, 1997 to December, 2006 diagnosed with penile fracture. The variables described were: age, symptoms and signs, causal agents, diagnostic means used, applied treatment and present complications. RESULTS: There was predominance of ages from 26 to 44 years with the 565. The major symptom was a penile hematoma in the 100 % of cases and the more frequent cause was the trauma during coitus in the 68 %. In the 24% of patients it was necessary the penile single echography or Doppler to verify the diagnosis; surgical treatment was applied in the 72 % of patients. The complications were present in the non-operated on cases including fibrosis of cavernous bodies and an erectile sexual dysfunction. CONCLUSIONS: The penile fracture occurs mainly during the coitus. The clinical symptomatology is very important for diagnosis. If there are doubts the single echography or Doppler is very useful. The surgical treatment is the more appropriate to avoid sequelae in these patients.

  9. Fractura de pene: Estudio de 10 años Penile fracture: Study of 10 years

    Directory of Open Access Journals (Sweden)

    Ariel Núñez Roca

    2010-12-01

    Full Text Available INTRODUCCIÓN: La fractura de pene ocurre la mayoría de las veces durante el coito, cuando el órgano, al estar erecto, se flexiona bruscamente. OBJETIVOS: Describir aspectos de la presentación y características de esta entidad, así como su diagnóstico y tratamiento. MÉTODOS: Se realizó un estudio descriptivo, a partir de las historias clínicas de 25 pacientes ingresados en el servicio de urología del Hospital Militar Central "Dr. Carlos J. Finlay", de enero de 1997 a diciembre de 2006, con el diagnóstico de fractura de pene. Las variables descritas fueron: edad, síntomas y signos, agentes causales, medios diagnósticos utilizados, tratamiento aplicado y complicaciones presentadas. RESULTADOS: Predominó el grupo de edades de 26 a 44 años con el 56 %. El síntoma principal fue el hematoma del pene en el 100 % de los casos y la causa más frecuente fue el traumatismo durante el coito en el 68_%. En el 24 % de los pacientes fue necesario el auxilio de la ecografía peneana, simple o Doppler, para confirmar el diagnóstico; se aplicó el tratamiento quirúrgico en el 72 % de los pacientes. Las complicaciones se presentaron en los casos no operados y consistieron en fibrosis de los cuerpos cavernosos y la disfunción sexual eréctil. CONCLUSIONES: La fractura de pene ocurre fundamentalmente durante el coito. La sintomatología clínica tiene gran valor para el diagnóstico. En caso de dudas, la ecografía simple o Doppler resulta muy útil. El tratamiento quirúrgico es el indicado para evitar secuelas en estos pacientes.INTRODUCTION: The penile fracture is very frequent during the coitus when the organ is in erection undergoes a sudden flexion. OBJECTIVES: To describe the features of presentation and its entity characteristics, as well as its diagnostic and treatment. METHODS: A descriptive study was conducted from the medical records of 25 patients admitted in the Urology Service of the "Dr. Carlos J. Finlay" Military Hospital from January, 1997 to December, 2006 diagnosed with penile fracture. The variables described were: age, symptoms and signs, causal agents, diagnostic means used, applied treatment and present complications. RESULTS: There was predominance of ages from 26 to 44 years with the 565. The major symptom was a penile hematoma in the 100 % of cases and the more frequent cause was the trauma during coitus in the 68 %. In the 24% of patients it was necessary the penile single echography or Doppler to verify the diagnosis; surgical treatment was applied in the 72 % of patients. The complications were present in the non-operated on cases including fibrosis of cavernous bodies and an erectile sexual dysfunction. CONCLUSIONS: The penile fracture occurs mainly during the coitus. The clinical symptomatology is very important for diagnosis. If there are doubts the single echography or Doppler is very useful. The surgical treatment is the more appropriate to avoid sequelae in these patients.

  10. Spiral CT angiography (SCTA) study of celiac artery and superior mesenteric artery

    International Nuclear Information System (INIS)

    Objective: To study the visualization capability and scanning technique of SCTA in celiac artery, superior mesenteric artery (SMA) and other branches. Methods: Thirty patients, with normal abdominal SCTA results, were given small injection test dose after plain scan. The abdominal aorta parallel to the body of pancreas was chosen as target vessel, the peak-time plus 2 seconds as the best delay scan time. Iodine contrast medium 90?110 ml was injected into antecubital vein at the speed of 3.5 ml/s, then scan from cranial to caudal was performed. Pitch 1.0 and slice thickness 3.2 mm were selected as the scan parameters. Maximum intensity projection (MaxIP) was employed in all patients and shaded surface display (SSD) in 23 cases. Results: The display rate using MaxIP and SSD of celiac artery, splenic artery, common hepatic artery, proper hepatic artery and SMA were all 100%, the gastroduodenal artery 100% and 91%, the left gastric artery 83% and 87%, respectively. Conclusions: SCTA as a minimally invasive examination is a valuable method to detect and diagnose disease or variations of celiac artery, its branches and SMA. Spiral scanning technique and image processing have a decisive effect on the image quality

  11. Anomalous origin of right coronary artery from pulmonary artery

    OpenAIRE

    Gupta, Rajat; Marwah, Ashutosh; Shrivastva, Savitri

    2012-01-01

    Anomalous origin of coronary artery from the pulmonary artery is a rare anomaly that most frequently involves the left coronary artery and very rarely the right coronary artery. These lesions can be missed on echocardiography unless carefully looked for. We describe a case of isolated anomalous origin of right coronary artery from pulmonary artery diagnosed on echocardiography and confirmed by computed tomography (CT) angiography.

  12. Penile primary melanoma: analysis of 6 patients treated at Brazilian national cancer institute in the last eight years

    Scientific Electronic Library Online (English)

    Gustavo Ruschi, Bechara; Aline Barros de Santos, Schwindt; Antonio Augusto, Ornellas; Diogo Eugenio Abreu da, Silva; Felipe Monnerat, Lott; Franz Santos de, Campos.

    2013-12-01

    Full Text Available Purpose To describe our experience in treating penile melanoma in 06 patients followed at our institution. Materials and Methods Between 2004 and 2012 six consecutive patients with penile melanoma were treated at our Institution. Stage of the disease was classified according to the 2002 AJCC patho [...] logic system. Melanoma in situ (TIS) was diagnosed in one patient. One patient was staged as T1b, two patients as T2b and two patients as T4b. The clinical and pathological findings were evaluated. Immunohistochemical tests were performed for Melan-A, HNB-45, S-100 and C-KIT. All histological specimens were examined by the same pathologist (ABSS). The patients with Cis, stages T1b and one patient T2b underwent only local excision. One patient T2b underwent local excision and sentinel lymph node dissection. Two patients with melanoma stage T4b underwent partial penile amputation. One of these last patients had palpable inguinal lymph nodes at diagnosis and underwent bilateral inguinal lymphadenectomy and received systemic chemotherapy (dacarbazine, 30 cycles). Results Mean follow-up was 36.3 months. One patient, with stage T2b, died after 12 months due to disease recurrence with bilateral inguinal involvement. The patient who underwent chemotherapy progressed with lung metastases and died after 14 months of follow up. The disease-free survival at five years was 33.3%. Conclusion: Penile melanoma is a disease with poor prognosis in most cases. Local excision or partial penile amputation may have effective control for stages T1 and T2 lesions. Patients who have clinically proven metastases died despite surgical and adjuvant chemotherapy.

  13. Patent arterial duct

    Directory of Open Access Journals (Sweden)

    Martin Robin P

    2009-07-01

    Full Text Available Abstract Patent arterial duct (PAD is a congenital heart abnormality defined as persistent patency in term infants older than three months. Isolated PAD is found in around 1 in 2000 full term infants. A higher prevalence is found in preterm infants, especially those with low birth weight. The female to male ratio is 2:1. Most patients are asymptomatic when the duct is small. With a moderate-to-large duct, a characteristic continuous heart murmur (loudest in the left upper chest or infraclavicular area is typical. The precordium may be hyperactive and peripheral pulses are bounding with a wide pulse pressure. Tachycardia, exertional dyspnoea, laboured breathing, fatigue or poor growth are common. Large shunts may lead to failure to thrive, recurrent infection of the upper respiratory tract and congestive heart failure. In the majority of cases of PAD there is no identifiable cause. Persistence of the duct is associated with chromosomal aberrations, asphyxia at birth, birth at high altitude and congenital rubella. Occasional cases are associated with specific genetic defects (trisomy 21 and 18, and the Rubinstein-Taybi and CHARGE syndromes. Familial occurrence of PAD is uncommon and the usual mechanism of inheritance is considered to be polygenic with a recurrence risk of 3%. Rare families with isolated PAD have been described in which the mode of inheritance appears to be dominant or recessive. Familial incidence of PAD has also been linked to Char syndrome, familial thoracic aortic aneurysm/dissection associated with patent arterial duct, and familial patent arterial duct and bicuspid aortic valve associated with hand abnormalities. Diagnosis is based on clinical examination and confirmed with transthoracic echocardiography. Assessment of ductal blood flow can be made using colour flow mapping and pulsed wave Doppler. Antenatal diagnosis is not possible, as PAD is a normal structure during antenatal life. Conditions with signs and symptoms of pulmonary overcirculation secondary to a left-to-right shunt must be excluded. Coronary, systemic and pulmonary arteriovenous fistula, peripheral pulmonary stenosis and ventricular septal defect with aortic regurgitation and collateral vessels must be differentiated from PAD on echocardiogram. In preterm infants with symptomatic heart failure secondary to PAD, treatment may be achieved by surgical ligation or with medical therapy blocking prostaglandin synthesis (indomethacin or ibuprofen. Transcatheter closure of the duct is usually indicated in older children. PAD in preterm and low birth weight infants is associated with significant co-morbidity and mortality due to haemodynamic instability. Asymptomatic patients with a small duct have a normal vital prognosis but have a lifetime risk of endocarditis. Patients with moderate-to-large ducts with significant haemodynamic alterations may develop irreversible changes to pulmonary vascularity and pulmonary hypertension.

  14. Carotid artery surgery

    Science.gov (United States)

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... During carotid endarterectomy: You receive general anesthesia . You are asleep and pain-free. Some hospitals use local anesthesia instead. Only ...

  15. Peripheral Artery Disease

    Science.gov (United States)

    ... In P.A.D., the arteries that carry oxygenated blood throughout the body become narrowed or even ... artery. Catheter-directed Thrombolysis : In this minimally invasive treatment, an interventional radiologist uses a catheter to reach ...

  16. Radial Artery Catheterization

    Science.gov (United States)

    ... by Shah, P. B. Related Content Load related Internet Resources information Social ... of Radial Artery Catheterization The Radial Artery Catheterization Procedure Risks of Radial Catheterization Deciding Between the Radial and ...

  17. Coronary Artery Disease

    Science.gov (United States)

    Coronary artery disease (CAD) is the most common type of heart disease. It is the leading cause of death ... both men and women. CAD happens when the arteries that supply blood to heart muscle become hardened ...

  18. Coronary Artery Bypass

    Science.gov (United States)

    ... procedures performed each year in the United States. Arteries can become clogged over time by the buildup ... bypass" around a section of clogged or diseased artery. The surgery involves using a section of blood ...

  19. Digital ischemia: angiographic differentiation of embolism from primary arterial disease

    International Nuclear Information System (INIS)

    Embolic disease is often overlooked as a cause of digital ischemia. Unilateral symptoms, in particular, should suggest the possibility of emboli arising from the subclavian or more distal upper extremity vessels. Emboli may originate in the subclavian artery as the result of atherosclerosis at its origin or arterial injury secondary to thoracic outlet compression. Arteriography can be useful in the identification of upper extremity emboli and their source, and should include studies of the aortic, arch, proximal subclavian artery, and digital arteries. Retrograde subclavian injections may be required to adequately demonstrate the origin of the subclavian artery. Magnification technique is often essential in differentiating small digital artery emboli from primary arterial diseases, such as Buerger disease or scleroderma

  20. Methodological evaluation for catheterization of hepatic artery in rat

    International Nuclear Information System (INIS)

    Objective: To search for a modified route for catheterization of hepatic artery via gastroduodenal artery approach. Methods: The drug or cell suspension was infused into hepatic artery in rat via gastroduodenal artery route by opening operation. Results: Fifty two rats were enrolled with 47 alive and recovered from operation quickly, but 4 of them died and the other one was failure due to having too small artery to be catheterized. The mortality might possibly be vascular injury, liver damage, accident in anesthesia or infection after operation and skillful manipulation is necessary for prevention. Conclusion: The way of hepatic artery infusion in rat via gastroduodenal artery route is simple, easy to be mastered, and it is suitable to study the effect of drug or cell suspension on liver. (authors)

  1. Laser irradiation of penile blood as treatment of sexual dysfunctions

    Science.gov (United States)

    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.

  2. Acute Arterial Emergencies

    OpenAIRE

    Dagnone, L. E.; Brown, P. M.

    1983-01-01

    The response of the primary care physician in the initial assessment and management of acute arterial injuries will often be the deciding factor in survival of life, limb or organ system. Most arterial emergencies occur as a result of trauma, disruption of vessel wall and/or occlusion of flow. The common clinical syndromes of acute arterial emergencies are injuries to and beyond the aorta, acute aortic dissection, ruptured aortic aneurysm, and thromboembolic occlusive arterial disease. The ro...

  3. Trombose em artérias pulmonares pequenas e médias em granulomatose de Wegener: um estudo com microscopia confocal por varredura a laser / Thrombosis in small and medium-sized pulmonary arteries in Wegener's granulomatosis: a confocal laser scanning microscopy study

    Scientific Electronic Library Online (English)

    Alfredo Nicodemos Cruz, Santana; Alexandre Muxfeldt, Ab' Saber; Walcy Rosolio, Teodoro; Vera Luiza, Capelozzi; Carmen Silvia Valente, Barbas.

    2010-12-01

    Full Text Available OBJETIVO: A granulomatose de Wegener (GW) pode causar dano nas células endoteliais e fenômenos tromboembólicos. Entretanto, poucos estudos analisaram a microcirculação pulmonar - artérias pulmonares de pequeno/médio calibre (APPMC) - em pacientes com GW. O objetivo deste estudo foi quantificar tromb [...] os de fibrina em amostras de APPMC de pacientes com GW. MÉTODOS: Analisamos 24 APPMC de seis pacientes com GW e 16 APPMC de quatro pacientes controles sem WG. Utilizamos CD34 para a marcação do endotélio em todas as amostras e microscopia confocal a laser para detectar trombos de fibrina intravasculares. Calculamos a área total do vaso, a área livre do lúmen e a área trombótica. RESULTADOS: A média da área total do vaso foi similar no grupo GW e no grupo controle (32.604 µm² vs. 32.970 µm², p = 0,8793). Trombos foram identificados em 22 das 24 APPMC (91,67%) no grupo GW, e em nenhuma do grupo controle (p Abstract in english OBJECTIVE: Wegener's granulomatosis (WG) can cause endothelial cell damage and thromboembolic events. Nevertheless, there have been few studies on the pulmonary microcirculation-small and medium-sized pulmonary arteries (SMSPA)-in patients with WG. The objective of this study was to quantify fibrin [...] thrombi in the SMSPA of patients with WG. METHODS: We analyzed 24 SMSPA samples collected from six patients with WG and 16 SMSPA samples collected from four patients without WG. In all samples, we used the endothelial cell marker CD34 and confocal laser scanning microscopy in order to detect intravascular fibrin thrombi. We calculated the total vessel area, the free lumen area, and the thrombotic area. RESULTS: The mean total vessel area was similar in the WG and control groups (32,604 µm² vs. 32,970 µm², p = 0.8793). Thrombi were present in 22 (91.67%) of the 24 WG group samples and in none of the control group samples (p

  4. Penile vibratory stimulation in the recovery of urinary continence and erectile function after nerve-sparing radical prostatectomy : a randomized, controlled trial

    DEFF Research Database (Denmark)

    Fode, Mikkel; Borre, Michael

    2013-01-01

    To examine the effect of penile vibratory stimulation (PVS) in the preservation and restoration of erectile function and urinary continence in conjunction with nerve-sparing radical prostatectomy (RP).

  5. Stroboscopic nuclear magnetic resonance microscopy of arterial blood flow.

    OpenAIRE

    Behling, R. W.; Tubbs, H. K.; Cockman, M. D.; Jelinski, L. W.

    1990-01-01

    NMR microscopy was used to obtain transverse flow profiles of arterial blood flow in the rat carotid artery at 33 microns resolution. The images were gated to the EKG and correspond to identified regions of diastole. The profiles show that flow is laminar during this part of the heart cycle. These results provide the first direct view of blood flow profiles in arteries of submillimeter diameter and suggest that animals as small as juvenile rodents will serve as valuable models for hemodynamic...

  6. Postoperative pulmonary edema secondary to rapid fluid injection into the corporal bodies during surgical correction of penile curvature: a rare consequence of artificial erection

    OpenAIRE

    Grober, Ethan D.; Shin, Eyun-jung

    2010-01-01

    Some experts contend that occlusion of the proximal corpora cavernosal bodies of the penis with a tourniquet or manual compression during induction of an artificial erection distorts the penile anatomy and potentially masks proximal curvatures. The current report highlights a rare, but potentially morbid, case of postoperative pulmonary edema as a consequence of rapid fluid injection into the corporal bodies during surgical correction of penile curvature, in a 48-year-old male with a high-ris...

  7. Impact of penile rehabilitation with low-dose vardenafil on recovery of erectile function in Japanese men following nerve-sparing radical prostatectomy

    Directory of Open Access Journals (Sweden)

    Yuzo Nakano

    2014-12-01

    Full Text Available Erectile dysfunction (ED is a major complication after radical prostatectomy (RP; however, debate continues regarding the efficacy of penile rehabilitation in the recovery of the postoperative erectile function (EF. This study included a total of 103 consecutive sexually active Japanese men with localized prostate cancer undergoing nerve-sparing RP, and analyzed the postoperative EF, focusing on the significance of penile rehabilitation. In this series, 24 and 79 patients underwent bilateral and unilateral nerve-sparing RPs, respectively, and 10 or 20 mg of vardenafil was administered to 35 patients at least once weekly, who agreed to undergo penile rehabilitation. Twelve months after RP, 48 (46.6% of the 103 patients were judged to have recovered EF sufficient for sexual intercourse without any assistance. The proportion of patients who recovered EF in those undergoing penile rehabilitation (60.0% was significantly greater than that in those without penile rehabilitation (38.2%. Of several parameters examined, the preoperative International Index of Erectile Function-5 (IIEF-5 score and nerve-sparing procedure were significantly associated with the postoperative EF recovery rates in patients with and without management by penile rehabilitation, respectively. Furthermore, univariate analysis identified the preoperative IIEF-5 score, nerve-sparing procedure and penile rehabilitation as significant predictors of EF recovery, among which the preoperative IIEF-5 score and nerve-sparing procedure appeared to be independently associated with EF recovery. Considering these findings, despite the lack of independent significance, penile rehabilitation with low-dose vardenafil could exert a beneficial effect on EF recovery in Japanese men following nerve-sparing RP.

  8. Impact of penile rehabilitation with low-dose vardenafil on recovery of erectile function in Japanese men following nerve-sparing radical prostatectomy

    OpenAIRE

    Nakano, Yuzo; Miyake, Hideaki; Chiba, Koji; Fujisawa, Masato

    2014-01-01

    Erectile dysfunction (ED) is a major complication after radical prostatectomy (RP); however, debate continues regarding the efficacy of penile rehabilitation in the recovery of the postoperative erectile function (EF). This study included a total of 103 consecutive sexually active Japanese men with localized prostate cancer undergoing nerve-sparing RP, and analyzed the postoperative EF, focusing on the significance of penile rehabilitation. In this series, 24 and 79 patients underwent bilater...

  9. Penile density and globally used chemicals in Canadian and Greenland polar bears.

    Science.gov (United States)

    Sonne, Christian; Dyck, Markus; Rigét, Frank F; Beck Jensen, Jens-Erik; Hyldstrup, Lars; Letcher, Robert J; Gustavson, Kim; Gilbert, M Thomas P; Dietz, Rune

    2015-02-01

    Industrially produced chemicals have been a major environmental concern across our entire Globe since the onset of rapid industrial development around the early 1900. Many of the substances being used are known to be endocrine disrupting chemicals (EDCs) and are also known to be long-range dispersed and to biomagnify to very high concentrations in the tissues of Arctic apex predators such as polar bears (Ursus maritimus). A major concern relating to EDCs is their effects on vital organ-tissues such as bone and it is possible that EDCs represent a more serious challenge to the species' survival than the more conventionally proposed prey reductions linked to climate change. We therefore analyzed penile bone mineral density (BMD) as a key phenotype for reproductive success in 279 polar bear samples born 1990-2000 representing eight polar bear subpopulations. Since EDC concentrations were not available from the same specimens, we compared BMD with published literature information on EDC concentrations. Latitudinal and longitudinal BMD and EDC gradients were clearly observed, with Western Hudson bears having the highest BMD and lowest EDCs, and North East Greenland polar bears carrying the lowest BMD and highest EDCs. A BMD vs. polychlorinated biphenyls (PCB) regression analysis showed that BMD decreased as a function of the eight subpopulations' PCB concentrations and this relationship was close to being significant (p=0.10, R(2)=0.39). Risk quotient (RQ) estimation demonstrated that PCBs could be in a range that may lead to disruption of normal reproduction and development. It is therefore likely that EDCs directly affect development and bone density in polar bears. Canadian bears had in general the best health and the North East Greenland subpopulation being at the highest risk of having negative health effects. While reductions in BMD is in general unhealthy, reductions in penile BMD could lead to increased risk of species extinction because of mating and subsequent fertilization failure as a result of weak penile bones and risk of fractures. Based on this, future studies should assess how polar bear subpopulations respond upon EDC exposure since information and understanding about their circumpolar reproductive health is vital for future conservation. PMID:25601730

  10. Microflora of the penile skin-lined neovagina of transsexual women

    Directory of Open Access Journals (Sweden)

    Claeys Geert

    2009-05-01

    Full Text Available Abstract Background The microflora of the penile skin-lined neovagina in male-to-female transsexuals is a recently created microbial niche which thus far has been characterized only to a very limited extent. Yet the knowledge of this microflora can be considered as essential to the follow-up of transsexual women. The primary objective of this study was to map the neo-vaginal microflora in a group of 50 transsexual women for whom a neovagina was constructed by means of the inverted penile skin flap technique. Secondary objectives were to describe possible correlations of this microflora with multiple patients' characteristics, such as sexual orientation, the incidence of vaginal irritation and malodorous vaginal discharge. Results Based on Gram stain the majority of smears revealed a mixed microflora that had some similarity with bacterial vaginosis (BV microflora and that contained various amounts of cocci, polymorphous Gram-negative and Gram-positive rods, often with fusiform and comma-shaped rods, and sometimes even with spirochetes. Candida cells were not seen in any of the smears. On average 8.6 species were cultured per woman. The species most often found were: Staphylococcus epidermidis, Streptococcus anginosus group spp., Enterococcus faecalis, Corynebacterium sp., Mobiluncus curtisii and Bacteroides ureolyticus. Lactobacilli were found in only one of 30 women There was no correlation between dilatation habits, having coitus, rinsing habits and malodorous vaginal discharge on the one hand and the presence of a particular species on the other. There was however a highly significant correlation between the presence of E. faecalis on the one hand and sexual orientation and coitus on the other (p = 0.003 and p = 0.027 respectively. Respectively 82%, 58% and 30% of the samples showed an amplicon after amplification with M. curtisii, Atopobium vaginae and Gardnerella vaginalis primer sets. Conclusion Our study is the first to describe the microflora of the penile skin-lined neovagina of transsexual women. It reveals a mixed microflora of aerobe and anaerobe species usually found either on the skin, in the intestinal microflora or in a BV microflora.

  11. Human penile ossification: case report / Ossificação no pênis humano: relato de caso

    Scientific Electronic Library Online (English)

    Homero Oliveira de, Arruda; Hudson de, Lima; Valdemar, Ortiz.

    2007-03-01

    Full Text Available CONTEXTO: Ossificação do pênis humano é uma condição rara e apenas 34 casos histologicamente evidentes foram relatados. Várias condições foram relacionadas com o problema e o mais freqüente foi a Doença de Peyronie. Em todas, as ossificações parecem ser resultado de um processo de metaplasia com for [...] mação óssea. RELATO DO CASO: Um homem de 59 anos branco apresentou-se com história de leve dor no pênis durante as ereções há um ano. Ele também referia a presença de uma placa dura na base do pênis, que começou a crescer após um trauma na relação sexual. O exame do pênis revelou tratar-se de uma massa fixa, firme, no terço proximal do pênis de aproximadamente 3.0 x 3.0 x 2.0 cm, sem extensão para a superfície. Não havia impotência ou outra alteração clínica relevante. A radiografia do pênis identificou extensa área calcificada no corpo esponjoso e região do septo, em correspondência à massa palpada. A importância deste relato é a extensão da ossificação de acordo com a radiologia e confirmação histológica. Abstract in english CONTEXT: Ossification in the human penis is such a rare condition that only 34 histologically evident cases have previously been reported. Among several conditions that have been correlated with this problem the most frequent is Peyronie disease. In all these conditions, human penile ossification ap [...] pears to be a metaplastic bone formation process. CASE REPORT: A 59-year-old white man presented with a one-year history of slight pain upon erection and during intercourse. He also complained of hard plaque near the base of the penis. One year earlier, he had sustained blunt trauma during intercourse. Examination of the penis revealed a fixed firm mass extending over the proximal third of the penile shaft, measuring 3.0 x 3.0 x 2.0 cm and involving the corporal sponge, without surface extension. There was no impotence or other relevant clinical finding. Radiography on the penis revealed irregular calcification in the same position as the palpable mass and in the septum of the proximal inner third of the penis. The importance of this report lies in the extent of the human penile ossification, as demonstrated by the radiological and histological confirmation.

  12. Incidence and cost of anal, penile, vaginal and vulvar cancer in Denmark

    Directory of Open Access Journals (Sweden)

    Olsen Jens

    2012-12-01

    Full Text Available Abstract Background Besides being a causative agent for genital warts and cervical cancer, human papillomavirus (HPV contributes to 40-85% of cases of anal, penile, vaginal and vulvar cancer and precancerous lesions. HPV types 16 & 18 in particular contribute to 74-93% of these cases. Overall the number of new cases of these four cancers may be relatively high implying notable health care cost to society. The aim of this study was to estimate the incidence and the health care sector costs of anal, penile, vaginal and vulvar cancer. Methods New anogenital cancer patients were identified from the Danish National Cancer Register using ICD-10 diagnosis codes. Resource use in the health care sector was estimated for the year prior to diagnosis, and for the first, second and third years after diagnosis. Hospital resource use was defined in terms of registered hospital contacts, using DRG (Diagnosis Related Groups and DAGS (Danish Outpatient Groups System charges as cost estimates for inpatient and outpatient contacts, respectively. Health care consumption by cancer patients diagnosed in 2004–2007 was compared with that by an age- and sex-matched cohort without cancer. Hospital costs attributable to four anogenital cancers were estimated using regression analysis. Results The annual incidence of anal cancer in Denmark is 1.9 per 100,000 persons. The corresponding incidence rates for penile, vaginal and vulvar cancer are 1.7, 0.9 and 3.6 per 100,000 males/females, respectively. The total number of new cases of these four cancers in Denmark is about 270 per year. In comparison, the total number of new cases cervical cancer is around 390 per year. The total cost of anogenital cancer to the hospital sector was estimated to be 7.6 million Euros per year. Costs associated with anal and vulvar cancer constituted the majority of the costs. Conclusions Anogenital cancer incurs considerable costs to the Danish hospital sector. It is expected that the current HPV vaccination program will markedly reduce this burden.

  13. Incidence and cost of anal, penile, vaginal and vulvar cancer in Denmark

    DEFF Research Database (Denmark)

    Olsen, J.; Jorgensen, T. R.

    2012-01-01

    Background: Besides being a causative agent for genital warts and cervical cancer, human papillomavirus (HPV) contributes to 40-85% of cases of anal, penile, vaginal and vulvar cancer and precancerous lesions. HPV types 16 & 18 in particular contribute to 74-93% of these cases. Overall the number of new cases of these four cancers may be relatively high implying notable health care cost to society. The aim of this study was to estimate the incidence and the health care sector costs of anal, penile, vaginal and vulvar cancer. Methods: New anogenital cancer patients were identified from the Danish National Cancer Register using ICD-10 diagnosis codes. Resource use in the health care sector was estimated for the year prior to diagnosis, and for the first, second and third years after diagnosis. Hospital resource use was defined in terms of registered hospital contacts, using DRG (Diagnosis Related Groups) and DAGS (Danish Outpatient Groups System) charges as cost estimates for inpatient and outpatient contacts, respectively. Health care consumption by cancer patients diagnosed in 2004-2007 was compared with that by an age-and sex-matched cohort without cancer. Hospital costs attributable to four anogenital cancers were estimated using regression analysis. Results: The annual incidence of anal cancer in Denmark is 1.9 per 100,000 persons. The corresponding incidence rates for penile, vaginal and vulvar cancer are 1.7, 0.9 and 3.6 per 100,000 males/females, respectively. The total number of new cases of these four cancers in Denmark is about 270 per year. In comparison, the total number of new cases cervical cancer is around 390 per year. The total cost of anogenital cancer to the hospital sector was estimated to be 7.6 million Euros per year. Costs associated with anal and vulvar cancer constituted the majority of the costs. Conclusions: Anogenital cancer incurs considerable costs to the Danish hospital sector. It is expected that the current HPV vaccination program will markedly reduce this burden.

  14. Penile density and globally used chemicals in Canadian and Greenland polar bears

    DEFF Research Database (Denmark)

    Sonne, Christian; Dyck, Markus

    2015-01-01

    Industrially produced chemicals have been a major environmental concern across our entire Globe since the onset of rapid industrial development around the early 1900. Many of the substances being used are known to be endocrine disrupting chemicals (EDCs) and are also known to be long-range dispersed and to biomagnify to very high concentrations in the tissues of Arctic apex predators such as polar bears (Ursus maritimus). A major concern relating to EDCs is their effects on vital organ-tissues such as bone and it is possible that EDCs represent a more serious challenge to the species' survival than the more conventionally proposed prey reductions linked to climate change. We therefore analyzed penile bone mineral density (BMD) as a key phenotype for reproductive success in 279 polar bear samples born 1990-2000 representing eight polar bear subpopulations. Since EDC concentrations were not available from the same specimens, we compared BMD with published literature information on EDC concentrations. Latitudinal and longitudinal BMD and EDC gradients were clearly observed, with Western Hudson bears having the highest BMD and lowest EDCs, and North East Greenland polar bears carrying the lowest BMD and highest EDCs. A BMD vs. polychlorinated biphenyls (PCB) regression analysis showed that BMD decreased as a function of the eight subpopulations' PCB concentrations and this relationship was close to being significant (p=0.10, R-2=0.39). Risk quotient (RQ) estimation demonstrated that PCBs could be in a range that may lead to disruption of normal reproduction and development. It is therefore likely that EDCs directly affect development and bone density in polar bears. Canadian bears had in general the best health and the North East Greenland subpopulation being at the highest risk of having negative health effects. While reductions in BMD is in general unhealthy, reductions in penile BMD could lead to increased risk of species extinction because of mating and subsequent fertilization failure as a result of weak penile bones and risk of fractures. Based on this, future studies should assess how polar bear subpopulations respond upon EDC exposure since information and understanding about their circumpolar reproductive health is vital for future conservation. (C) 2014 Elsevier Inc. All rights reserved.

  15. Calcifilaxis de pene: nuestra experiencia en 5 años y revisión de la literatura científica / Penile calciphylaxis: 5-year experience and literature review

    Scientific Electronic Library Online (English)

    Alejandro, García Morúa; Jesús Domingo, Gutiérrez García; José Gustavo, Arrambide Gutiérrez; Lauro Salvador, Gómez Guerra.

    1019-10-01

    Full Text Available Introducción: La necrosis de pene es una entidad infrecuente, que puede ocurrir como diseminación de infecciones, desórdenes circulatorios, o incluso en pacientes con prótesis peneana. Se han descrito pocos casos en pacientes sometidos a diálisis, que suelen asociarse a diabetes mellitus, embolismos [...] de colesterol y calcifilaxis. Casos clínicos: Exponemos los casos clínicos de 3 pacientes con esta entidad, manejados en nuestro hospital durante los últimos 5 años. Conclusiones: La calcifilaxis es una rara pero frecuentemente fatal condición en pacientes con fallo renal crónica, aproximadamente en el 1% de estos pacientes; se caracteriza por calcificación de arteriolas subcutáneas e infarto del tejido celular subcutáneo y la piel adyacente. Se asocia a una elevada morbimortalidad; el diagnóstico habitualmente es clínico. En lo referente al manejo, existe controversia, sobre todo en relación con la conducta quirúrgica que se debe seguir, que va desde falectomía hasta cuidados locales de la lesión, desbridación y antibioticoterapia. Abstract in english Introduction: Necrosis of the penis is a rare conditon that may occur as a result of infectious dissemination, circulatory disorders, or even in patients with penile prostheses. It has been reported in a few patients on dialysis, usually associated with diabetes mellitus, cholesterol embolism, and c [...] alciphylaxis. Case reports: Three patients with this condition seen at our hospital in the last 5 years are reported. Conclusions: Calciphylaxis is a rare but often fatal condition occurring in approximately 1% of patients with chronic renal failure. It is characterized by calcification of subcutaneous arteries and infarction of the subcutaneous cellular tissue and overlying skin. It is associated to a high morbidity and mortality, and diagnosis is usually based on clinical signs and symptoms. Management is controversial, particularly with regard to surgery, which may range from penectomy to local care of lesion, debridement, or antibiotic therapy.

  16. Jet pump assisted artery

    Science.gov (United States)

    1975-01-01

    A procedure for priming an arterial heat pump is reported; the procedure also has a means for maintaining the pump in a primed state. This concept utilizes a capillary driven jet pump to create the necessary suction to fill the artery. Basically, the jet pump consists of a venturi or nozzle-diffuser type constriction in the vapor passage. The throat of this venturi is connected to the artery. Thus vapor, gas, liquid, or a combination of the above is pumped continuously out of the artery. As a result, the artery is always filled with liquid and an adequate supply of working fluid is provided to the evaporator of the heat pipe.

  17. Outflow boundary conditions for blood flow in arterial trees.

    Science.gov (United States)

    Du, Tao; Hu, Dan; Cai, David

    2015-01-01

    In the modeling of the pulse wave in the systemic arterial tree, it is necessary to truncate small arterial crowns representing the networks of small arteries and arterioles. Appropriate boundary conditions at the truncation points are required to represent wave reflection effects of the truncated arterial crowns. In this work, we provide a systematic method to extract parameters of the three-element Windkessel model from the impedance of a truncated arterial tree or from experimental measurements of the blood pressure and flow rate at the inlet of the truncated arterial crown. In addition, we propose an improved three-element Windkessel model with a complex capacitance to accurately capture the fundamental-frequency time lag of the reflection wave with respect to the incident wave. Through our numerical simulations of blood flow in a single artery and in a large arterial tree, together with the analysis of the modeling error of the pulse wave in large arteries, we show that both a small truncation radius and the complex capacitance in the improved Windkessel model play an important role in reducing the modeling error, defined as the difference in dynamics induced by the structured tree model and the Windkessel models. PMID:26000782

  18. Ischemic stroke: carotid and vertebral artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Vilela, P.; Goulao, A. [Hospital Garcia de Orta, Servico de Neurorradiologia, Almada (Portugal)

    2005-03-01

    Ischemic strokes may have distinct aetiologies, including several different intrinsic arterial pathological disorders. The diagnosis and understanding of these arterial diseases is critical for the correct management of stroke as different treatment approaches are undertaken according to the aetiology. Atherosclerosis is by far the most common arterial disease among adults, and other pathological processes include arterial dissection, small vessel disease, inflammatory and non-inflammatory vasculopathy and vasomotor disorders. In children, there are several vasculopathies responsible for vaso-occlusive disease such as sickle-cell anemia, acute regressive angiopathy and Moya-Moya disease, neurofibromatosis, dissections, vasculitis associated with intracranial and systemic infections. An overview of the major carotid and vertebral pathological diseases responsible for ischemic stroke in adults and children, highlighting the accuracy of the different imaging modalities for its diagnosis and the imaging appearance of these diseases, is given. (orig.)

  19. Assessment of problematic sexual interests with the penile plethysmograph: an overview of assessment laboratories.

    Science.gov (United States)

    Murphy, Lisa; Ranger, Rebekah; Stewart, Hannah; Dwyer, Gregg; Fedoroff, J Paul

    2015-05-01

    Phallometric testing, or penile plethysmography (PPG), is an objective measure of sexual arousal for males. While extensive research on the reliability and validity of PPG has promoted its reputation as the "gold standard" of objective measurement of sexual arousal, there is a lack of standardization of stimulus sets and interpretation of results between sites. This article describes the laboratory protocol employed for PPG at the Royal Ottawa Mental Health Centre's Sexual Behaviours Clinic (SBC) in Ottawa, Ontario, as well as those used by the Sexual Behaviors Clinic and Lab (SBCL) in the Community and Public Safety Psychiatry Division (CPSPD) of the Department of Psychiatry and Behavioral Sciences at Medical University of South Carolina (MUSC) in Charleston, South Carolina. The need for standardization in both testing protocol and stimuli use across sites are highlighted. PMID:25773223

  20. Early history of inflatable penile prosthesis surgery: a view from someone who was there

    Directory of Open Access Journals (Sweden)

    David F Mobley

    2015-04-01

    Full Text Available The publication of the use of an inflatable penile prosthesis (IPP in 1973 by Dr. FB Scott. changed the world of treatment options for erectile dysfunction (ED. Much has been written since then about techniques, improvements, management of difficult cases, complications and their management, and mechanical and device changes over time. Few reports, if any, are available in the medical literature regarding the early development, surgical techniques, and controversies surrounding its introduction to the world's urological community. This article is, for the most part, the observations of one who was "there" in the early and mid-1970's and was a witness to the history of this remarkable marvel of creativity, engineering, design, and to the personalities involved.

  1. Y-STR analysis of digital and/or penile penetration cases with no detected spermatozoa.

    Science.gov (United States)

    McDonald, Andrew; Jones, Emma; Lewis, Jennie; O'Rourke, Paula

    2015-03-01

    This forensic casework trial involved Yfiler(®) testing samples from 47 digital and/or penile penetration cases where the medical examination had occurred within 48h of the alleged incident and no spermatozoa had been detected following Sperm Elution(©). 30% of these cases yielded at least one Y-STR profile comprising three or more alleles per profile and 21% yielded at least one Y-STR profile of ten or more alleles per profile. This trial further investigated the persistence of male DNA in different case types, the location of samples submitted for testing and whether samples from different locations benefit from being combined prior to testing. The data supports the use of Y-STR profiling to provide scientific evidence to investigate whether the alleged sexual activity had occurred as well as to obtain probative evidence in spermatozoa negative penetration cases. PMID:25458926

  2. Prótesis de pene: Resultados de calidad y morbilidad / Penile prosthesis: Quality outcomes and morbidity

    Scientific Electronic Library Online (English)

    Vicente, Chiva Robles; Luis, Llanes González; Carlos, Pascual Mateo; Gino, Espinales Castro; Ignacio, Romero Cajigal; Antonio, Berenguer Sánchez.

    2005-11-01

    Full Text Available OBJETIVO: Conocer la satisfacción y complicaciones presentadas en una serie de pacientes con disfunción eréctil sometidos a la implantación de una prótesis peneana. MÉTODOS: Estudio retrospectivo de los pacientes intervenidos quirúrgicamente por D.E. mediante la colocación de una prótesis de pene en [...] el periodo comprendido entre 1993 y 2003. Se recogieron datos como la edad del paciente en el momento de la intervención, el tratamiento previo y los diferentes antecedentes patológicos. Se revisaron los distintos modelos de prótesis, el tipo de incisión empleada y las distintas complicaciones que surgieron. Por último se elaboró un cuestionario para determinar el nivel de satisfacción del paciente. RESULTADOS: En el periodo comprendido entre los años 1993 y 2003 se implantaron 24 prótesis. La edad media de los pacientes fue 56,6 +/- 7,56 (36- 63) años mediana de 59,5. La incisión peno-escrotal se empleó en 13 (54,16%) pacientes, suprapúbica en 6 (25%) y subcoronal en 1 (4,16%). En cuanto a los modelos empleados, en 9 (37,5%) se utilizó la prótesis semirrígida AMS 600, y en 10 (41,66%) el modelo AMS 650, también semirrígida. Unicamente en una ocasión se empleó una prótesis hidráulica de dos componentes AMS Ambicor. Se presentaron complicaciones en 6 (25%) pacientes, de las cuales el 12,5% fueron menores como cavernositis, dolor o hematoma. En 3 (12,5%) ocasiones fue necesaria la retirada de la misma. Respondieron a la encuesta telefónica 13 (54,16%) pacientes, de los cuales un 85 % emplea la prótesis. Un 54% presentan una satisfacción propia y en la pareja adecuada (buena o mucha), un 23 % regular y el resto, otro 23 % mala o muy mala. CONCLUSIÓN: A pesar de la elevada tasa de complicaciones postoperatorias, la prótesis de pene es aceptada adecuadamente, incluso en los modelos maleables, por los enfermos con disfunción eréctil. La satisfacción por parte del paciente es alta, siendo mayor en la pareja. La mayor parte de los enfermos desearía volver a ser intervenido en el caso de encontrarse en una situación similar anterior al implante. Abstract in english OBJECTIVES: To study patient satisfaction and complications appeared in a series of patients with erectile dysfunction undergoing implant of penile prosthesis. METHODS: Retrospective study of all patients undergoing surgical treatment for erectile dysfunction by penile prosthesis implant between 199 [...] 3 and 2003. Collected data included patient age at the time of surgery, previous treatment, and significant medical history. We reviewed the models of prosthesis employed, incisions, and complications appeared. Finally, a questionnaire was elaborated to establish the level of patient satisfaction. RESULTS: 24 prostheses were implanted between 1993 and 2003. Mean patient age was 56.6 ± 7.56 years (36-63), median 59.5 yr. Penile-scrotal incision was employed in 13 (54.16%) patients, suprapubic incision in 6 (25%) and subcoronal incision in 1 (4.16%). Type of prosthesis: semirrigid AMS 600 9 (37.5%), semirrigid AMS 650 10 (41.66%); the two component hydraulic prosthesis AMS Ambicor was used only in one case. Six (25%) patients presented complications. 16.66% were minor, cavernositis, pain, hematoma or prosthesis extrusion. Prosthesis extraction was necessary in 2 (8.33%) cases. 13 (54.16%) patients responded to the telephone survey. 85% of them use their prosthesis. 54% percent refer adequate self-satisfaction and partner satisfaction (well satisfied/much satisfaction).23% not too bad, and the remainder 23% bad or very bad. CONCLUSIONS: Despite the highest rate of postoperative complications, penile prosthesis is adequately accepted by patients with erectile dysfunction, even malleable models. Patient satisfaction is high, being higher in partners. Most patients would desire to undergo surgery again if they were in the same situation.

  3. Epidemiological study of penile cancer in Pernambuco: experience of two reference centers

    Scientific Electronic Library Online (English)

    Thiago Costa do, Couto; Rodrigo Medeiros Barbosa, Arruda; Moisés Costa do, Couto; Felipe Dubourcq, Barros.

    2014-12-01

    Full Text Available Objectives To investigate and analyze the epidemiological profile of penile cancer in the state of Pernambuco and compare this information with other studies related to the issue. Material and Methods We conducted a retrospective, observational and descri [...] ptive study of all patients with penile cancer in two reference centers in Pernambuco - Brazil, from 2007 to 2012. The variables studied were: age, region from the state, socio-economic situation, previous postectomy, smoking, time from the beginning of injury to diagnosis, staging of the primary lesion, tumor differentiation, treatment performed and death due to cancer. Results The total number of patients was 88. The highest prevalence was seen in those aged between 66 and 75 years. About the socio-economic situation, 67% worked informally and 64.8% received up to two minimum wages. Of all patients, 57% were married and 50% illiterate. The Metropolitan Region of Recife was the one with the highest number of cases, 41%. Tobacco smoking was reported in 48.9% of cases and prior postectomy in 3.4%. Most often it was observed an average period of six months from the onset of symptoms to diagnosis. And when the lesion was diagnosed, it usually had 2 to 5 cm (64.7%), stage T2 in 50% and well differentiated in 79.6%. Partial penectomy was performed in 76.1% and total in 17%. Death was observed in 27.3%. Conclusion The clinical profile and epidemiological characteristics found in this study are similar to other national and international studies related to the issue, i.e., typical of underdeveloped or developing countries.

  4. Transposition of Anterior Choroidal Artery and Posterior Communicating Artery Origin

    OpenAIRE

    Choi, Chan Young; Lee, Chae Heuck

    2012-01-01

    The anterior choroidal artery has several kinds of variations. Among them, the transposition of anterior choroidal artery and posterior communicating artery origins has been extremely rare. We report a case with cerebral aneurysm arising from posterior communicating artery which origin was distal to the anterior choroidal artery and review the relevant literature.

  5. CO2 laser ablation of external genital lesions with a SwiftLase flashscanner: treatment of extramammary Paget's disease of the vulva, penile condylomata, and other lesions

    Science.gov (United States)

    Sacknoff, Eric J.; Schweitzer, Jay; Slatkine, Michael; Mead, Douglass S.

    1995-05-01

    The ability to vaporize extremely thin layers of epithelial tissue without any char and with minimal thermal necrosis is extremely advantageous in the treatment of superficial lesions of the external genitalia. We present a novel CO2 laser `SwiftLase' flashscan technology capable of providing char free ablation of 3 mm diameter lesions with only 150 micron residual thermal necrosis depth at power level as low as 10 watts. These power levels are achievable with a small transportable CO2 laser. The SwiftLaser is a miniature opto- mechanical scanner which homogeneously covers a 3 mm diameter surface with a 0.1 mm spot size focused beam within 0.1 seconds. The instantaneous beam's dwelling time is 1 millisecond. The instantaneous power density level at the focal point is higher than the threshold for char free ablation, thus providing a large char free ablation crater. Since depth of each ablated layer is 0.1 mm, the depth of treatment can be precisely controlled. The SwiftLaser technology has extensively and successfully been used in the last two years for the treatment of HPV in female lower tracts (Vulvectomy). The same technique may be performed with extramammary Paget's disease of the vulva, penile condylomata, and other epithelial disorders of the external genitalia without damage to surrounding healthy tissue. Technique and clinical results will be discussed.

  6. Projections from bed nuclei of the stria terminalis, magnocellular nucleus: implications for cerebral hemisphere regulation of micturition, defecation, and penile erection.

    Science.gov (United States)

    Dong, Hong-Wei; Swanson, Larry W

    2006-01-01

    The basic structural organization of axonal projections from the small but distinct magnocellular and ventral nuclei (of the bed nuclei of the stria terminalis) was analyzed with the Phaseolus vulgaris leucoagglutinin anterograde tract tracing method in adult male rats. The former's overall projection pattern is complex, with over 80 distinct terminal fields ipsilateral to injection sites. Innervated regions in the cerebral hemisphere and brainstem fall into nine general functional categories: cerebral nuclei, behavior control column, orofacial motor-related, humorosensory/thirst-related, brainstem autonomic control network, neuroendocrine, hypothalamic visceromotor pattern-generator network, thalamocortical feedback loops, and behavioral state control. The most novel findings indicate that the magnocellular nucleus projects to virtually all known major parts of the brain network that controls pelvic functions, including micturition, defecation, and penile erection, as well as to brain networks controlling nutrient and body water homeostasis. This and other evidence suggests that the magnocellular nucleus is part of a corticostriatopallidal differentiation modulating and coordinating pelvic functions with the maintenance of nutrient and body water homeostasis. Projections of the ventral nucleus are a subset of those generated by the magnocellular nucleus, with the obvious difference that the ventral nucleus does not project detectably to Barrington's nucleus, the subfornical organ, the median preoptic and parastrial nuclei, the neuroendocrine system, and midbrain orofacial motor-related regions. PMID:16304682

  7. A large unilateral renal artery aneurysm in a young child

    International Nuclear Information System (INIS)

    The case of a 13-month-old boy with fibromuscular dysplasia (FMD) presenting with a large saccular aneurysm of the left renal artery and renovascular hypertension is reported. Renal and intrarenal arteries showed numerous small aneurysms alternating with stenoses. All arterial lesions were localized to the left kidney. After left nephrectomy, the patient's blood pressure normalized. Histopathologic examination of the arteries disclosed changes typical of medial fibroplasias, the most frequently described form of FMD in children. This diagnosis is rewarding as it represents a surgically curable cause of severe hypertension. (orig.)

  8. Application of hyperbaric oxygen therapy in the rehabilitation of patients after surgical correction of the penile urethral strictures

    Directory of Open Access Journals (Sweden)

    Kotenko ?.V.

    2013-12-01

    Full Text Available The aim of the article is to examine the impact and justify the use of hyperbaric oxygenation in the complex rehabilitation of patients after surgery for penile urethral strictures. Material and Methods. A group of 37 patients were examined who underwent various reconstructive operations on the urethra, 16 of which in the postoperative period in addition to conventional therapy conducted hyperbaric oxygenation. Results. It is shown that the use of hyperbaric oxygenation in the early postoperative period in patients undergoing replacement plastic of urethra can reduce the incidence of postoperative complications, and reduced the time of urethral drainage. Conclusion. An integrated approach with the use of hyperbaric oxygen therapy in the rehabilitation of patients undergoing extended replacement plastic of penile urethral strictures, reduces the amount of potential effect-dependent postoperative complications, which generally leads to shorter hospital stay after surgical treatment.

  9. Comparison of Postoperative Analgesic Efficacy of Penile Block, Caudal Block and Intravenous Paracetamol for Circumcision: A prospective Randomized Study

    Scientific Electronic Library Online (English)

    Ahmet Hakan, Haliloglu; Mehmet Ilker, Gokce; Semih, Tangal; Mehmet Salih, Boga; Hakan, Tapar; Ebru, Aladag.

    2013-07-01

    Full Text Available Purpose To evaluate the postoperative analgesic efficacy of penile block, caudal block and intravenous paracetamol administration following circumcision. Materials and Methods In this prospective randomized study a total of 159 patients underwent circumcision under general anesthesia at urology c [...] linic of Ufuk University Faculty of Medicine and Sorgun State Hospital between May 2012 and September 2012. The patients were randomized to three groups to receive penile block (Group 1), caudal block (Group 2) and intravenous paracetamol administration (group 3). Pain measurement of the patients was done via CHEOPS scoring system at 30,60,120 and 180 minutes postoperatively and compared. Statistical tests were performed with a conventional statistics program and statistical significance was set at a p value of

  10. Laparoscopic management of superior mesentric artery syndrome: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Makam Ramesh

    2008-01-01

    Full Text Available Superior mesentric artery syndrome is a rare cause of high small bowel obstruction, caused by compression of the transverse part of the duodenum in between the superior mesentric artery and aorta. Patients present with chronic abdominal pain, vomiting and weight loss. We report a case of superior mesenteric artery syndrome, managed laparoscopically with laparoscopic duodenojejunostomy.

  11. About Peripheral Artery Disease (PAD)

    Science.gov (United States)

    About Peripheral Artery Disease (PAD) Updated:Sep 15,2014 Peripheral artery disease (PAD) is a narrowing of the peripheral arteries to ... was last reviewed on 8/05/2014. Peripheral Artery Disease • Home • About Peripheral Artery Disease (PAD) • Why ...

  12. Penile ulceration caused by a foreign body reaction in a crew member on board a cruise ship.

    Science.gov (United States)

    Garcia-Castaneda, Jenny; Harb-De la Rosa, Alfredo

    2015-01-01

    A crew member had a foreign body implanted subcutaneously on his dorsum penis stealthily 6 years earlier by a fellow crew member without any medical training. He presented to the ship's medical centre after a week of pain, erythema and oedema over the foreign body, which was eventually removed by the patient, leaving behind a penile ulceration. He was treated conservatively initially with intravenous and then with oral antibiotics until complete secondary wound closure was achieved. PMID:25792164

  13. Predictive factors for erectile dysfunction in men with prostate cancer after brachytherapy: Is dose to the penile bulb important?

    International Nuclear Information System (INIS)

    Purpose: To determine predictive factors for postimplant erectile dysfunction (ED) in a cohort of patients, according to prospectively collected data; specifically, to assess the impact of penile bulb volume and D50 and D95 (dose covering 50% and 95% of the penile bulb volume, respectively) on ED. Methods and Materials: Three hundred forty-two patients were identified who were potent before implant and who had at least 2 years' follow-up. Patient, tumor, treatment, and dosimetric data were collected on all patients. Postimplant ED was defined according to both physician-documented and patient-documented outcome data. Binary logistic regression analysis was used to create multivariable models of predictors for ED at 1, 2, and 3 years after implant. Results: Physician-documented rates of ED were 57%, 48%, and 38% at 1, 2, and 3 years after implant, respectively. Patient-documented rates of ED were 70% and 66% at 1 and 2 years, respectively. Multivariable analyses revealed age and degree of preimplant erectile function to be consistently significant predictors of ED. Use of hormones was significant at the 1-year physician-documented ED endpoint but not thereafter, in keeping with the time course of testosterone recovery. Penile bulb volume, D50, and D95 were not found to be predictive for ED at any time point, in contrast to previous studies. In addition, planning ultrasound target volume, number of needles, and institutional case sequence number were significant predicte sequence number were significant predictors of ED at various time points, consistent with a traumatic etiology of ED. Conclusions: We found no evidence to support penile bulb dosimetry as an independent predictive factor for ED after implant, using physician-documented or patient-documented outcomes

  14. Effects of Korean ginseng berry extract (GB0710) on penile erection: evidence from in vitro and in vivo studies

    OpenAIRE

    Cho, Ks; Park, Cw; Kim, Ck; Jeon, Hy; Kim, Wg; Lee, Sj; Kim, Ym; Lee, Jy; Choi, Yd

    2013-01-01

    Several reports have promoted the root-derived Korean red ginseng (KRG; Panax ginseng) as alternative treatment for erectile dysfunction (ED), and ginsenosides are known to be the principal active ingredients of ginseng. Recent studies showed that ginseng berries produce more ginsenosides than KRG; thus, we investigated the ability of the Korean ginseng berry extract GB0710 to relax the penile corpus cavernosum smooth muscle (CCSM) in this study. As a comparative control, the results were com...

  15. Immunohistochemical expression of ARID1A in penile squamous cell carcinomas: a tissue microarray study of 112 cases.

    Science.gov (United States)

    Faraj, Sheila F; Chaux, Alcides; Gonzalez-Roibon, Nilda; Munari, Enrico; Cubilla, Antonio L; Shih, Ie-Ming; Netto, George J

    2015-05-01

    ARID1A, a member of the chromatin remodeling genes family, has been suggested as a novel tumor suppressor gene in gynecologic malignancies. However, its role in penile cancer has yet to be determined. This study assesses the immunohistochemical expression of ARID1A in penile squamous cell carcinoma (SCC) and its association with pathologic features, human papillomavirus (HPV) status, and previously reported mammalian target of rapamycin pathway markers in the same cohort. Four tissue microarrays were constructed from 112 cases of formalin-fixed, paraffin-embedded penile SCC from Paraguay. Each tumor was sampled 3 to 12 times. ARID1A expression was evaluated by immunohistochemistry using a polyclonal rabbit anti-ARID1A (BAF250A) antibody. An H score was calculated in each spot as the sum of expression intensity (0-3+) by extent (0%-100%). Median H score per case was used for statistical analysis. ARID1A expression was observed in all cases, ranging from 3% to 100% of tumor cells (median, 95%). In 96 cases (86%), ARID1A expression was observed in 90% or more tumor cells. HPV DNA was detected in 20 (38%) of 52 analyzed samples. There was a significant trend of association between ARID1A and histologic grade. ARID1A expression was not associated with histologic subtype (P = .61) or HPV status (P = .18). ARID1A expression decreased with decreasing levels of PTEN expression (P = .01). ARID1A was expressed in penile SCC, in most cases at high levels. A significant trend of association was found between histologic grade and ARID1A expression, with lower ARID1A expression, lower histologic grades, and decreased PTEN expression. PMID:25776029

  16. Inhaled treprostinil for the treatment of pulmonary arterial hypertension.

    Science.gov (United States)

    Poms, Abby; Kingman, Martha

    2011-12-01

    Pulmonary arterial hypertension is a progressive disease characterized by vascular proliferation and vasoconstriction of the small pulmonary arteries that eventually leads to right-sided heart failure and death. Patients often initially have symptoms such as shortness of breath, fatigue, and edema; later in the disease, presyncope and syncope are common. Patients with progressive pulmonary arterial hypertension despite oral therapy and/or with severe disease typically require treatment with a prostanoid. Inhaled treprostinil (Tyvaso) is a prostacyclin analog indicated for the treatment of pulmonary arterial hypertension to increase walk distance in patients with symptoms classified as New York Heart Association functional class III. Inhaled treprostinil was approved by the Food and Drug Administration in July 2009. This article provides a brief overview of the pathophysiology of pulmonary arterial hypertension and reviews the mechanism of action, key clinical data, and the practical management of inhaled treprostinil in patients with pulmonary arterial hypertension. PMID:22135338

  17. Hepatic Artery Infusion Chemotherapy

    OpenAIRE

    Tuchmann, A.; Schu?ller, J.; Kroiss, A.; Dinstl, K.

    1990-01-01

    Hepatic artery chemotherapy was given to 36 patients, using totally implantable devices consisting of a port and external pump. Twenty-seven patients had inoperable liver metastases of colorectal origin. The infusion system was inserted by laparotomy into the hepatic artery via the gastroduodenal artery. There was no operative mortality. Thirteen infusion systems could not be used for chemotherapy due to dislodgement, early death and lack of follow-up. FUdR was infused every two w...

  18. Celiac Artery Compression Syndrome

    OpenAIRE

    Mohammed Muqeetadnan; Syed Amer; Ambreen Rahman; Salman Nusrat; Syed Hassan

    2013-01-01

    Celiac artery compression syndrome is a rare disorder characterized by episodic abdominal pain and weight loss. It is the result of external compression of celiac artery by the median arcuate ligament. We present a case of celiac artery compression syndrome in a 57-year-old male with severe postprandial abdominal pain and 30-pound weight loss. The patient eventually responded well to surgical division of the median arcuate ligament by laparoscopy.

  19. Popliteal artery entrapment syndrome.

    LENUS (Irish Health Repository)

    O'Leary, D P

    2010-01-01

    Popliteal artery entrapment syndrome is a rare abnormality of the anatomical relationship between the popliteal artery and adjacent muscles or fibrous bands in the popliteal fossa. The following is a case report of a 19 year old female, in whom popliteal artery entrapment syndrome was diagnosed, and successfully treated surgically. A review of literature is also presented and provides details on how PAES is classified, diagnosed both clinically and radiologically, and treated surgically.

  20. More than just a cut: a qualitative study of penile practices and their relationship to masculinity, sexuality and contagion and their implications for HIV prevention in Papua New Guinea

    Directory of Open Access Journals (Sweden)

    Kelly Angela

    2012-07-01

    Full Text Available Abstract Background Male circumcision (MC has been shown to reduce vaginal transmission of HIV to men. While community acceptability is important in a countries preparedness to introduce MC, it is equally important to map contemporary MC and other penile cutting practices, and the socio-cultural dimensions underpinning these practices. Methods A total of 482 men and women (n?=?276 and n?=?210, respectively participated in 82 semi-structured and 45 focus group discussions from four different provinces of Papua New Guinea (PNG, each representing one of the four socially and geographically diverse regions of the country. Results Of the men interviewed 131 self-reported that they had undergone a penile alteration with some reporting multiple types. Practices were diverse and could be grouped into five broad categories: traditional (customary penile cutting; contemporary penile cutting; medical circumcision; penile inserts; and penile bloodletting practices in which sharp objects are used to incise the glans and or inserted and withdrawn from the male urethra or in order to induce bleeding. Socio-cultural traditions, enhanced sexual pleasure and improved genital hygiene were key motivators for all forms of penile practices. Conclusions The findings from this study highlight the complex and diverse nature of penile practices in PNG and their association with notions of masculinity, sexuality and contagion. Contemporary penile practices are critical to a community’s acceptance of MC and of a country’s ability to successfully implement MC in the context of a rich and dynamic culture of penile practices. If a MC program were to be successfully rolled out in PNG to prevent HIV it would need to work within and build upon these diverse cultural meanings and motivators for penile practices already commonly performed in PNG by men.

  1. Reconstructive Surgery for Severe Penile Inadequacy: Phalloplasty with a Free Radial Forearm Flap or a Pedicled Anterolateral Thigh Flap

    Science.gov (United States)

    Lumen, N.; Monstrey, S.; Ceulemans, P.; van Laecke, E.; Hoebeke, P.

    2008-01-01

    Objectives. Severe penile inadequacy in adolescents is rare. Phallic reconstruction to treat this devastating condition is a major challenge to the reconstructive surgeon. Phallic reconstruction using the free radial forearm flap (RFF) or the pedicled anterolateral thigh flap (ALTF) has been routinely used in female-to-male transsexuals. Recently we started to use these techniques in the treatment of severe penile inadequacy. Methods. Eleven males (age 15 to 42 years) were treated with a phallic reconstruction. The RFF is our method of choice; the ALTF is an alternative when a free flap is contraindicated or less desired by the patient. The RFF was used in 7 patients, the ALTF in 4 patients. Mean followup was 25 months (range: 4–49 months). Aesthetic and functional results were evaluated. Results. There were no complications related to the flap. Aesthetic results were judged as “good” in 9 patients and “moderate” in 2 patients. Sensitivity in the RFF was superior compared to the ALTF. Four patients developed urinary complications (stricture and/or fistula). Six patients underwent erectile implant surgery. In 2 patients the erectile implant had to be removed due to infection or erosion. Conclusion. In case of severe penile inadequacy due to whatever condition, a phalloplasty is the preferred treatment nowadays. The free radial forearm flap is still the method of choice. The anterolateral thigh flap can be a good alternative, especially when free flaps are contraindicated, but sensitivity is markedly inferior in these flaps. PMID:19009034

  2. Two giant stones located in the penile and prostatic urethra: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Deniz Bolat

    2012-12-01

    Full Text Available Urethral stones account for less than 2% of all urinary stone diseases in developed countries. Most urethral stones are associated with abnormalities that predispose individuals to urinary stasis and infections, such as strictures, lower urinary tract surgery, congenital or acquired diverticula, chronic urinary infections, foreign bodies, and schistosomiasis. The aim of this case report was to present a fifty-nine-year-old man with two giant penile and prostatic ureteral stones who received a different treatment approach. After the impacted urethral stone was seen in the anterior urethra in ureteroscopy, urethrotomy was performed with a 3 cm vertical incision in the penile urethra. Pneumatic lithotripsy was performed extracorporeally via incision. The stone in the penile urethra was disintegrated and extracted using forceps. The prostatic stone was pushed back into the bladder and disintegrated by the same urethral incision with a lithotripter through a cystourethroscope. For large, impacted urethral stones, external urethrotomy combined with externally pneumatic lithotripsy may prevent long urethral incisions. Therefore, this technique may reduce the risk of postoperative stricture.

  3. New Surgical Technique for Treatment of Obstructive Penile Urethrolithiasis without Interference with Breeding Capability: Clinical Study on 25 Calves

    Directory of Open Access Journals (Sweden)

    Aiman Mahmoud Seddek* and Hossam Ahmad Bakr1

    2013-07-01

    Full Text Available A clinical study performed on 25 calves suffered from urine retention with intact bladder as a result of lodgment of urinary stone at the penile sigmoid flexure. Paracentesis of the bladder were applied to the cases with over distended bladder. All animals were subjected to dorsal penile urethrotomy for removal of the stone and temporary retrograde catheterization of the bladder using suitable diameter Rayle’s tube. The tube was removed 8-10 days post-surgery, and the calves were observed for six months post-surgery. Twenty one calves cured without surgical complications and kept their penile erection and breeding capability. Four calves showed post-surgical complications, two of them suffered from abscess formation at the sigmoid flexure, the third calf had adhesion at sigmoid flexure and the fourth had ruptured urethra. The technique is a rapid simple technique of many advantages over urethrostomy and it has the same cost. The technique can be considered an alternative technique for treatment of urine retention with intact bladder without affecting breeding capability.

  4. Human papillomavirus infection and immunohistochemical p16(INK4a) expression as predictors of outcome in penile squamous cell carcinomas.

    Science.gov (United States)

    Bezerra, Stephania M; Chaux, Alcides; Ball, Mark W; Faraj, Sheila F; Munari, Enrico; Gonzalez-Roibon, Nilda; Sharma, Rajni; Bivalacqua, Trinity J; Burnett, Arthur L; Netto, George J

    2015-04-01

    Approximately 50% of penile squamous cell carcinomas (SCC) are associated with high-risk human papillomavirus (HR-HPV) infection. We evaluated the correlation of p16(INK4a) expression and HR-HPV with clinicopathological features and outcome in a cohort of patients with penile SCC. Two tissue microarrays were constructed from 53 invasive penile SCC at our hospital. p16(INK4a) expression was assessed by immunohistochemistry (CINtec Kit). High-risk human papillomavirus status was assessed by in situ hybridization (INFORM HPV III family 16 probe B cocktail). High-risk human papillomavirus was detected in 8 cases (15%), and p16(INK4a) overexpression was found in 23 cases (44%). Both markers showed a significant association with histologic subtype (P = .017 and P = .01, respectively) and lymphovascular invasion (P = .015 and P = .015, respectively). Regarding outcome analyses, neither HPV infection nor p16(INK4a) overexpression significantly predicted overall survival or cancer-specific survival using Cox proportional hazards regression model. High-risk human papillomavirus positivity and p16(INK4a) overexpression were significantly associated with histologic subtype and presence of lymphovascular invasion. Human papillomavirus status was not predictive of outcome in our cohort. PMID:25661481

  5. Postnatal penile growth concurrent with mini-puberty predicts later sex-typed play behavior: Evidence for neurobehavioral effects of the postnatal androgen surge in typically developing boys.

    Science.gov (United States)

    Pasterski, Vickie; Acerini, Carlo L; Dunger, David B; Ong, Ken K; Hughes, Ieuan A; Thankamony, Ajay; Hines, Melissa

    2015-03-01

    The masculinizing effects of prenatal androgens on human neurobehavioral development are well established. Also, the early postnatal surge of androgens in male infants, or mini-puberty, has been well documented and is known to influence physiological development, including penile growth. However, neurobehavioral effects of androgen exposure during mini-puberty are largely unknown. The main aim of the current study was to evaluate possible neurobehavioral consequences of mini-puberty by relating penile growth in the early postnatal period to subsequent behavior. Using multiple linear regression, we demonstrated that penile growth between birth and three months postnatal, concurrent with mini-puberty, significantly predicted increased masculine/decreased feminine behavior assessed using the Pre-school Activities Inventory (PSAI) in 81 healthy boys at 3 to 4years of age. When we controlled for other potential influences on masculine/feminine behavior and/or penile growth, including variance in androgen exposure prenatally and body growth postnally, the predictive value of penile growth in the early postnatal period persisted. More specifically, prenatal androgen exposure, reflected in the measurement of anogenital distance (AGD), and early postnatal androgen exposure, reflected in penile growth from birth to 3months, were significant predictors of increased masculine/decreased feminine behavior, with each accounting for unique variance. Our findings suggest that independent associations of PSAI with AGD at birth and with penile growth during mini-puberty reflect prenatal and early postnatal androgen exposures respectively. Thus, we provide a novel and readily available approach for assessing effects of early androgen exposures, as well as novel evidence that early postnatal aes human neurobehavioral development. PMID:25597916

  6. A Combined Variation of the Arteries and The Nerve in a Leg

    OpenAIRE

    Kurtog?lu, Zeliha

    1999-01-01

    During the dissection of an amputed leg, we discovered a combined variation involving the branching of the popliteal artery and tibial nerve. The popliteal artery showed a trifurcation pattern, and one of its branches, the posterior tibial artery, was hypoplastic. In addition, a small branch arising from the tibial nerve in the upper part of the leg distally crossed the peroneal artery and contributed to the medial plantar nerve. In this article, such a case of embryonic origin is discuss...

  7. Coronary artery anomalies in adults: imaging at dual source CT coronary angiography

    International Nuclear Information System (INIS)

    Congenital abnormalities of the coronary arteries have an incidence of 1%, and most of these are benign. However, a small number are associated with myocardial ischaemia and sudden death. Various imaging modalities are available for coronary artery assessment. Recently, multi-detector CT has emerged as an accurate diagnostic tool for defining coronary artery anomalies. The purpose of this pictorial essay is to review the dual source CT appearance of congenital anomalies of the coronary arteries in adults.

  8. Transcatheter arterial embolization of splenic artery aneurysms with NBCA and steel coils

    International Nuclear Information System (INIS)

    Objective: To discuss the feasibility and safety of transcatheter arterial embolization with NBCA and steel coils for the treatment of splenic artery aneurysms (SAAs). Methods: Transcatheter arterial embolization with NBCA and steel coils was carried out in three patients with splenic aneurysms. The lesions were located at trunk of splenic artery (n=2) or at branch (n=1). After catheterization of the target artery, steel coils were implanted at the distal site of the aneurysm to obstruct the efferent artery, which was followed by the injection of NBCA-lipiodol mixture to occlude the proximal site of the aneurysm and the aneurysm as well. All the patients were followed up for 4 to 20 months and enhanced CT scanning was conducted to check the lesions. Results: The procedure was successful in all cases. No severe complications occurred. Follow-up enhanced CT scanning showed that the NBCA cast was clear and stable, the occlusion was complete and no sings of SAAs reopen could be found. Splenic infarction of small area was seen in 1 case. Conclusion: Treatment of splenic aneurysms transcatheter arterial embolization with NBCA and steel coils is a safe and effective technique. (authors)

  9. Evolución clínica en los pacientes con implante de prótesis peneana / Clinical evolution in patients with penile prosthesis implant

    Scientific Electronic Library Online (English)

    José, Carreño Rodríguez; Janet, Martínez Abreu; Alberto, Toledo Viera.

    2009-08-01

    Full Text Available Objetivos: 1) Evaluar la satisfacción y evolución clínica de los pacientes con prótesis peneana, como tratamiento de la disfunción eréctil biogénica severa. 2) Identificar las complicaciones más frecuentes asociadas a la intervención quirúrgica. 3) Comparar el comportamiento de la satisfacción sexua [...] l de los pacientes con implante de prótesis peneana y su pareja, antes y después de aplicado el tratamiento. Método: Se realizó un estudio descriptivo longitudinal con metodología cuantitativa y cualitativa donde se evaluaron a 25 hombres a los cuales se les había insertado prótesis peneana en el Hospital Faustino Pérez de Matanzas. Resultados: Las complicaciones que se presentaron en nuestra casuística fueron la perforación de la albugínea, el dolor post operatorio, el pene fino y la expulsión de uno o dos cilindros, esta última en un paciente que presentó sepsis peri protésica. Conclusiones: El implante de prótesis peneana constituyó una opción de tratamiento efectiva que logró un 88% de satisfacción sexual en los pacientes implantados. Los pacientes tratados con la implantación de prótesis peneana y sus parejas refirieron incremento en el erotismo, la actividad sexual satisfactoria, mejoría en la auto estima, la comunicación de pareja, el rendimiento laboral, las relaciones personales y sociales y el fortalecimiento del vínculo de la pareja. Abstract in english Objectives: 1). To evaluate the satisfaction and clinical outcome in patients with penile prosthesis implant as a treatment to Severe Biogenic Erectile Dysfunction. 2). To identify the most frequent complications associated with the surgical intervention. 3). To compare the behaviour of sexual satis [...] faction in partners and patients with penile prosthesis implant before and after the application of the treatment. Methods: A descriptive, (longitudinal) study with quantitative and qualitative methodology was done, where 25 men with penile prosthesis implants, performed at Faustino Perez Hospital, were evaluated. Results: The complications presented in the procedures were perforation of the tunica albuginea, postoperatory pain, thin penis and the expulsion of one or two cylinders, this latter case in a patient who presented periprosthetic sepsis. Conclusions: The penile prosthetic implant constitutes an option of effective treatment which achieves an 88 % of sexual satisfaction in patients. Both partners and patients treated with penile prosthetic implantation referred increase in erotism, satisfactory sexual activity, improvement of self-esteem, quality of communication with their partner, better labour results, interpersonal and social relationships and strengthening of couple's bonds.

  10. Numerical simulation of arterial dissection during balloon angioplasty of atherosclerotic coronary arteries.

    Science.gov (United States)

    Badel, Pierre; Avril, Stéphane; Sutton, Michael A; Lessner, Susan M

    2014-03-01

    Balloon angioplasty is a standard clinical treatment for symptomatic coronary artery disease. In this procedure, controlled damage is applied intraluminally to the wall of a stenotic artery. Dissection of the coronary artery is a commonly observed clinical complication of angioplasty; however, not all dissections can be detected angioscopically. This work focuses on studying the dissection mechanisms triggered during the early stages of angioplasty in an atherosclerotic coronary artery, addressing the problem by means of a parametric study based on a simplified finite element model and cohesive interface modeling. Our results emphasize the presence of several damage mechanisms, at different locations, that are triggered near the very beginning of the process and evolve competitively, depending on both geometry and material properties of the atherosclerotic vessel. Small-scale damage was evidenced, which would not be detectable by angiography or intravascular ultrasound, but could potentially be sufficient to stimulate smooth muscle cell activation, promoting late-onset complications such as restenosis. PMID:24480707

  11. Avaliação das medidas do comprimento peniano de crianças e adolescentes Penile anthropometry in Brazilian child and adolescent

    Directory of Open Access Journals (Sweden)

    Pedro N. Gabrich

    2007-10-01

    Full Text Available OBJETIVO: Classicamente, o pênis tem duas funções: permitir a fertilização interna e direcionar o jato miccional. Entretanto, alterações objetivas do tamanho peniano podem levar ao diagnóstico de doenças. Além disso, é motivo comum de consulta médica a busca por parâmetros de normalidade do tamanho do pênis. Contudo, a antropometria do pênis da criança e do adolescente brasileiros ainda não foi devidamente estudada. O objetivo do estudo é realizar a antropometria do pênis de crianças e adolescentes brasileiros, estabelecendo referências para aplicação clínica. MÉTODOS: Foi realizado um estudo transversal, envolvendo 2.010 pacientes com idades variando entre 0 e 18 anos. Foram obtidas cinco medidas penianas: diâmetro da haste peniana; comprimento aparente e real do pênis flácido; comprimento aparente e real (CRTmax do pênis flácido sob tração máxima. O desenvolvimento puberal foi caracterizado pelos critérios de Tanner. RESULTADOS: De todas as medidas penianas, o CRTmax foi a única que não apresentou variação significativa interpesquisador em todas as faixas etárias analisadas (p = 0,255. Os resultados foram distribuídos em tabelas com a média do CRTmax e os valores do que se considera micropênis (média - 2,5 desvio padrão de acordo com as diferentes faixas etárias e com os diferentes graus de maturação sexual de Tanner. Foi desenvolvido um gráfico com a distribuição dos valores do CRTmax distribuído por percentis 10, 25, 50, 75 e 90 por faixa etária. CONCLUSÕES: De todas as medidas antropométricas penianas, o CRTmax é a única clinicamente útil. Recomendamos nossos resultados como referência de antropometria peniana para crianças e adolescentes brasileiros.OBJECTIVE: Classically, the penis has two functions: to make internal fertilization possible and to direct the urine stream. However, objective abnormalities in penis size can lead to diseases being diagnosed. Furthermore, many medical consultations are the result of patients seeking parameters for normal penis size. Additionally, the penile anthropometry of Brazilian children and adolescents has not yet been properly studied. The objective of this study is to carry out penile anthropometry of Brazilian children and adolescents, establishing references for clinical use. METHODS: A cross-sectional study was carried out of 2,010 patients with ages varying from 0 to 18 years. Five penile measurements were taken: diameter of penile shaft; apparent and real length of flaccid penis; apparent and real (RSLmax length of flaccid penis fully stretched. Pubertal development was defined according to Tanner's criteria. RESULTS: Only RSLmax, out of all of the penile measurements, did not exhibit significant interobserver variation at all ages analyzed (p = 0.255. Results were tabulated with mean RSLmax and the values that define micropenis (mean - 2.5 standard deviations by age and by Tanner sexual maturity stages. A graph was plotted of the distribution of RSLmax results by the 10th, 25th, 50th, 75th and 90th percentiles and by age. CONCLUSIONS: Out of all of the penile anthropometric measurements, only RSLmax is clinically useful. We recommend our results as a reference standard for penile anthropometry of Brazilian children and adolescents.

  12. Avaliação das medidas do comprimento peniano de crianças e adolescentes / Penile anthropometry in Brazilian child and adolescent

    Scientific Electronic Library Online (English)

    Pedro N., Gabrich; Juliana S. P., Vasconcelos; Ronaldo, Damião; Eloísio A. da, Silva.

    2007-10-01

    Full Text Available OBJETIVO: Classicamente, o pênis tem duas funções: permitir a fertilização interna e direcionar o jato miccional. Entretanto, alterações objetivas do tamanho peniano podem levar ao diagnóstico de doenças. Além disso, é motivo comum de consulta médica a busca por parâmetros de normalidade do tamanho [...] do pênis. Contudo, a antropometria do pênis da criança e do adolescente brasileiros ainda não foi devidamente estudada. O objetivo do estudo é realizar a antropometria do pênis de crianças e adolescentes brasileiros, estabelecendo referências para aplicação clínica. MÉTODOS: Foi realizado um estudo transversal, envolvendo 2.010 pacientes com idades variando entre 0 e 18 anos. Foram obtidas cinco medidas penianas: diâmetro da haste peniana; comprimento aparente e real do pênis flácido; comprimento aparente e real (CRTmax) do pênis flácido sob tração máxima. O desenvolvimento puberal foi caracterizado pelos critérios de Tanner. RESULTADOS: De todas as medidas penianas, o CRTmax foi a única que não apresentou variação significativa interpesquisador em todas as faixas etárias analisadas (p = 0,255). Os resultados foram distribuídos em tabelas com a média do CRTmax e os valores do que se considera micropênis (média - 2,5 desvio padrão) de acordo com as diferentes faixas etárias e com os diferentes graus de maturação sexual de Tanner. Foi desenvolvido um gráfico com a distribuição dos valores do CRTmax distribuído por percentis 10, 25, 50, 75 e 90 por faixa etária. CONCLUSÕES: De todas as medidas antropométricas penianas, o CRTmax é a única clinicamente útil. Recomendamos nossos resultados como referência de antropometria peniana para crianças e adolescentes brasileiros. Abstract in english OBJECTIVE: Classically, the penis has two functions: to make internal fertilization possible and to direct the urine stream. However, objective abnormalities in penis size can lead to diseases being diagnosed. Furthermore, many medical consultations are the result of patients seeking parameters for [...] normal penis size. Additionally, the penile anthropometry of Brazilian children and adolescents has not yet been properly studied. The objective of this study is to carry out penile anthropometry of Brazilian children and adolescents, establishing references for clinical use. METHODS: A cross-sectional study was carried out of 2,010 patients with ages varying from 0 to 18 years. Five penile measurements were taken: diameter of penile shaft; apparent and real length of flaccid penis; apparent and real (RSLmax) length of flaccid penis fully stretched. Pubertal development was defined according to Tanner's criteria. RESULTS: Only RSLmax, out of all of the penile measurements, did not exhibit significant interobserver variation at all ages analyzed (p = 0.255). Results were tabulated with mean RSLmax and the values that define micropenis (mean - 2.5 standard deviations) by age and by Tanner sexual maturity stages. A graph was plotted of the distribution of RSLmax results by the 10th, 25th, 50th, 75th and 90th percentiles and by age. CONCLUSIONS: Out of all of the penile anthropometric measurements, only RSLmax is clinically useful. We recommend our results as a reference standard for penile anthropometry of Brazilian children and adolescents.

  13. Pulmonary Arterial Hypertension

    Science.gov (United States)

    ... Arterial Hypertension? With PAH, the arteries become too narrow to handle the amount of blood that must be pumped through the lungs. This causes several things to happen: a backup of blood in the veins returning blood to the heart; an increase in ...

  14. Application of Human Amniotic Membrane in Canine Penile Tunica Albuginea Defect: First Step toward an Innovating New Method for Treatment of Peyronie?s Disease

    Scientific Electronic Library Online (English)

    M., Salehipour; K., Izadpanah; A., Safaei; M., Kamranpoor; Farsiani, M.R..

    2014-06-01

    Full Text Available Purposes To evaluate the efficacy of human amniotic membrane (AM) grafting in the canine penile tunica albuginea defect; we developed an animal model as the first step toward an innovating new method for the treatment of Peyronie’s disease, penile cancers, and congenital deformities of the penis. [...] Material and Methods From August to September 2011, ten healthy male dogs were selected. A rhomboid incision about 3x2cm over the tunica albuginea and its overlying squamous epithelium was made and then excised. The amniotic membrane was folded twice on itself and grafted on the defect. After 8 weeks, artificial erection was made for 5 dogs and for the other 5 dogs after 12 weeks. After artificial erection, partial penectomy was done and histopathological evaluation was performed on the grafts. Results Artificial erection performed successfully in all of the dogs. No infection or any other complication was seen. Histopathological examination showed complete re-epithelialization with squamous epithelium and collagen fiber deposition. Also, no dysplasia was seen. Conclusions The amniotic membrane can be used as a suitable substitution for tunica albuginea. It is safe, inexpensive, biodegradable, and available and may be used for the treatment of Peyronie’s disease, penile cancers, congenital penile deformities, and penile reconstructive surgery.

  15. Cirugía correctora de la incurvación peneana / Corrective surgery of penile curvature

    Scientific Electronic Library Online (English)

    J.A., Portillo Martín; M.A., Correas Gómez; M.A., Rado Velásquez; J.L., Gutiérrez Baños; B., Martín García; R., Hernández Rodríguez; J.I. del, Valle Schaan; A., Roca Edreira; A., Hernández Castrillo; F., Ruiz Izquierdo.

    2003-02-01

    Full Text Available OBJETIVOS: Evaluar las técnicas de corporoplastia aplicadas a 59 pacientes afectos de incurvación peneana, tanto congénita como adquirida. PACIENTES Y MÉTODO: Desde abril de 1991 hasta diciembre del 2001 se aplicaron 39 técnicas de Nesbit, 12 de Ruiz-Castañé y 8 de Essed-Schröeder en 44 pacientes co [...] n incurvación congénita y 15 con enfermedad de Peyronie (edad media de 25 años). En cinco casos se utilizó material reabsorbible y en el resto irreabsorbible, aplicando puntos invertidos para enterrar los nudos. RESULTADOS: Con un seguimiento medio de 12 meses se ha obtenido la corrección de la incurvación en el 86% de los casos. Cuatro de los cinco casos en que se utilizó material reabsorbible requirieron segunda intervención por reincurvación. Un caso de acortamiento de pene, otro de hipoestesia glandar, un edema prolongado prepucial y cinco casos de palparse los puntos fueron las complicaciones más reseñables. No se observaron diferencias en cuanto a resultados y complicaciones según la técnica empleada. CONCLUSIONES: Con las tres técnicas empleadas se ha obtenido un buen resultado cosmético y funcional, que coincide con las series publicadas en la literatura. Preferimos la sutura irreabsorbible para evitar el alto índice de reincurvaciones con el material absorbible. Abstract in english OBJECTIVE: To evaluate the corporoplasty techniques performed on 59 patients to correct congenital penile curvature and Peyronie´s disease. PATIENTS AND METHOD: From april 1991 to december 2001, 39 Nesbit technique, 12 Ruiz-Castañé method and 8 Essed-Schröeder procedure were performed on forty-four [...] congenital curvatures and fiftean Peyronie´s diseases. The mean age was 24 years old. Trying to hide the knots, in all patients except five a nonabsorvable inverting sutures were placed. RESULTS: The mean follow-up was 12 months. Postoperatively, 53 patients (86%) had satisfactory cosmetic and functional results. Four patients of five with absorvable sutures had residual curvature which needed another successful surgical correction. One patient complained of penile shortening, one of glans hypoaesthesia, one of foreskin oedema and five of palpable plication sutures. No differences were found depending on the applied surgical technique. CONCLUSIONS: The results reported are in accordance with the literature showing a higher recurrence rate with the absorvable sutures. The outcome is very similar with the three described techniques.

  16. The 133Xe clearance technique in the assessment of hypogastric arteries insufficiency

    International Nuclear Information System (INIS)

    The clearance of the radioactive inert gas 133Xenon injected intramuscularly in the gluteal region was studied in healthy subjects and in patients with aortoiliac disease, in order to measure the muscular blood flow (MBF) in the vascular bed of the hypogastric arteries. At rest MBF averaged 6.0 +- 2.1 SD ml/100 g per min in healthy subjects and 5.1 +- 2.7 ml/100 g per min in patients with arterial disease. After exercise-induced hyperemia, maximal MBF in healthy subjects averaged 121.6 +- 60.9 ml/100 g per min, a value markedly higher than the corresponding 6.0 +- 3.6 ml/100 g per min observed in vascular disease patients. The 133Xe values corresponded well, in patients with occlusive vascular disease, with the results obtained in the same subjects by measurement of the penile blood pressure using a Doppler shift ultrasound detector. The 133Xe clearance is a simple and reliable procedure, which could be particularly useful for an assessment of the conditions of hypogastric arteries prior to abdominal surgery. (orig.)

  17. Glandectomy with preservation of corpora cavernosa in the treatment of penile carcinoma

    Directory of Open Access Journals (Sweden)

    Fonseca Aluizio G. da

    2003-01-01

    Full Text Available INTRODUCTION: The objective of this work is to describe a conservative surgical technique as an alternative to classic penile amputations, aiming the local control of the disease, in addition to trying to preserve the patient's sexual function. SURGICAL TECHNIQUE: After a circular incision of the skin around the penis, the subfascial plane is developed until the base of the organ. The dorsal neurovascular bundle and the urethra are isolated in their distal extremities. The neurovascular bundle is sectioned distally. A retrocoronal dissection plane is developed between the glans and the corpora cavernosa. When this stage is complete, the glans is fixed only to the urethra, which is distally sectioned as well. The neurovascular bundle is fixed to the dorsal albuginea. Following the spatulation of the urethra, a neomeatus is created using the overlay skin of the penis. Between January 2001 and July 2002, we employed this technique in 6 patients who had epidermoid carcinoma of the penis, which were limited to the glans, superficial, well or moderately differentiated and measuring up to 3 cm. COMMENTS: Several conservative surgical methods for treatment of carcinoma of the penis aim the organ's preservation, in an attempt of improving the quality of life of patients, however the indexes of local recurrence and failure in disease control are significant. The described technique showed to be safe and effective for disease control, in addition to preserving sexual function in all patients who were treated, representing, thus, a quite appealing conservative surgical alternative in selected cases.

  18. Expanded criteria for Video Endoscopic Inguinal Lymphadenectomy (VEIL) in penile cancer: palpable lymph nodes

    Scientific Electronic Library Online (English)

    Alexandre Stievano, Carlos; Pedro, Romanelli; Ricardo, Nishimoto; Luis M., Montoya; Cesar Augusto Braz, Juliano; Renato Meirelles M. da, Costa Jr; Antonio C. L., Pompeo; Marcos, Tobias-Machado.

    2013-12-01

    Full Text Available Introduction Open inguinal lymphadenectomy is the gold standard for the treatment of inguinal metastasis in patients with penile cancer (PC). Recently the Video Endoscopic Inguinal Lymphadenectomy (VEIL) was proposed as an option to reduce the morbidity of the procedure in patients without palpable [...] inguinal lymph nodes (PILN), however the oncological equivalency in patients with PILN remains poorly studied. The aims of this video are the demonstration of VEIL in patients with PILN and present the preliminary experience comparing patients with and without PILN. Materials and Methods The video illustrates the procedure performed in two cases that were previously underwent partial penectomy for PC with PILN. Data from the series of 15 patients (22 limbs operated) with PILN underwent VEIL were compared with our series of VEIL in 25 clinically N0 patients (35 limbs operated). Results The comparison between the groups with and without PILN found, respectively, these outcomes: age 52,45 × 53,2 years, operative time 126,8 × 95,5 minutes, hospital stay 5. × 3.1 days, drainage time 6.7 × 5.7 days, 9 resected lymph nodes on average in both groups, global complications 32% × 26%, cellulitis 4.5% × 0%, lymphocele 23% in both groups, skin necrosis 0% × 3%, myocutaneous necrosis 4.5% × 0%, pN+ 33% × 32%, cancer specific mortality 7% × 5% and mean follow-up 17.3 × 35.3 months. None of the variables presented p

  19. Preclinical Evidence for the Benefits of Penile Rehabilitation Therapy following Nerve-Sparing Radical Prostatectomy

    Directory of Open Access Journals (Sweden)

    H. Van Poppel

    2008-06-01

    Full Text Available Erectile dysfunction following radical prostatectomy remains a frequent problem despite the development of nerve-sparing techniques. This erectile dysfunction is believed to be neurogenic, enhanced by hypoxia-induced structural changes which result in additional veno-occlusive dysfunction. Recently, daily use of intracavernous vasoactive substances and oral use of PDE5-inhibitors have been clinically studied for treatment of postprostatectomy erectile dysfunction. Since these studies showed benefits of “penile rehabilitation therapy,” these effects have been studied in a preclinical setting. We reviewed experimental literature on erectile tissue preserving and neuroregenerative treatment strategies, and found that preservation of the erectile tissue by the use of intracavernous nitric oxide donors or vasoactive substances, oral PDE5-inhibitors, and hyperbaric oxygen therapy improved erectile function by antifibrotic effects and preservation of smooth muscle. Furthermore, neuroregenerative strategies using neuroimmunophilin ligands, neurotrophins, growth factors, and stem cell therapy show improved erectile function by preservation of NOS-containing nerve fibers.

  20. Urethral advancement technique for repair of distal penile hypospadias: A revisit

    Directory of Open Access Journals (Sweden)

    Awad Mohamed

    2006-01-01

    Full Text Available Background: Numerous ingenious methods have been described to repair hypospadias with variable results. The anterior urethral advancement technique reported by Chang[1] to repair distal hypospadias has shown encouraging results. We have reevaluated this technique with some modifications to improve its results. Materials and Methods: This study was done on 72 patients, 19 cases with glanular hypospadias, 20 cases with coronal hypospadias, 22 cases of subcoronal hypospadias,and 11 cases with anterior penile hypospadias in the period between September 1999 and October 2003. The patients? age ranged from two years to twenty five years (median age 5.6 years. All the patients were operated using Chang?s technique with our modifications. Results: There were no major complications in any of our patients, no postoperative fistulae or urethral stricture. Three patients had meatal stenosis and preputial edema occurred in 83.3% in non-circumcised patients. Conclusion: Modifications of the anterior advancement technique has produced excellent Results. It is easy to do and learn and also offers good cosmetic and functional results.

  1. Pólipo fibroepitelial del pene: Presentación de un caso / Penile fibroepithelial polyp: Case report

    Scientific Electronic Library Online (English)

    Tomás Lázaro, Rodríguez Collar; Basily, Valdés Estévez; Laura, López Marín; Roxana, Soranyer Horroutinel Scull.

    2010-05-01

    Full Text Available Objetivo: Presentar un nuevo caso de pólipo fibroepitelial del pene y su tratamiento. Métodos: Se presenta el caso de un paciente de 39 años de edad, que asistió a la consulta por notarse un crecimiento de aspecto verrugoso, en el frenillo del pene que le estaba estenosando el meato uretral dificult [...] ándole la micción. Resultados: Se le realizó la exéresis total de la lesión junto con la circuncisión. El estudio histopatológico informó pólipo fibroepitelial. Tras un año de operado el paciente está asintomático y libre de recurrencias. Conclusión: Se confirma la importancia de tener en consideración, este tipo de lesión en el diagnóstico diferencial de los tumores del pene, pues su aspecto macroscópico semeja una neoformación cancerosa en dicho órgano. Abstract in english Objetive: To report a new case of penile fibro-epithelial polyp and its treatment. Methods: A 39 year-old patient who came to the outpatient clinic due to a warted growth he had noticed on the frenulum of prepuce of his penis which was narrowing the urethral meatus and impairing his voiding. Results [...] : Total exeresis of the lesion and circumcision were performed. The histopathologic study revealed a fibroepithelial polyp. The patient is asymptomatic and without any recurrence. Conclusions: The importance of considering this type of lesion in the differential diagnosis of penis tumors is confirmed because its macroscopic aspect seems like a cancerogenic new formation on this organ.

  2. Study of the response of the penile corporal tissue and cavernosus muscles to micturition

    Directory of Open Access Journals (Sweden)

    El Sibai Olfat

    2008-03-01

    Full Text Available Abstract Background The reaction of the corpora cavernosa (CC, the corpus spongiosum (CS, the bulbocavernosus (BCM and ischiocavernosus (ICM muscles to passage of urine through the urethra during micturition is not known. We investigated the hypothesis that the passage of urine through the urethra stimulates the corporal tissue and cavernosus muscles. Methods In 30 healthy men (mean age 42.8 ± 11.7 years, the electromyographic activity (EMG of the CC, CS, BCM, and ICM were recorded before and during micturition, and on interruption of and straining during micturition. These tests were repeated after individual anesthetization of urethra, corporal tissue, and cavernosus muscles. Results During micturition, the slow wave variables (frequency, amplitude, conduction velocity of the CC and CS decreased while the motor unit action potentials of the BCM and ICM increased; these EMG changes were mild and returned to the basal values on interruption or termination of micturition. Micturition after individual anesthetization of urethra, corporal tissue and cavernosal muscles did not effect significant EMG changes in these structures, while saline administration produced changes similar to those occurring before saline administration. Conclusion The decrease of sinusoidal and increase of cavernosus muscles' EMG activity during micturition apparently denotes sinusoidal relaxation and cavernosus muscles contraction. Sinusoidal muscle relaxation and cavernosus muscles contraction upon micturition are suggested to be mediated through a 'urethro-corporocavernosal reflex'. These sinusoidal and cavernosus muscle changes appear to produce a mild degree of penile tumescence and stretch which might assist in urinary flow during micturition.

  3. Vertebrobasilar Artery Occlusion

    Directory of Open Access Journals (Sweden)

    Schoen, Jessica

    2011-05-01

    Full Text Available The presentation of vertebrobasilar artery occlusion varies with the cause of occlusion and location of ischemia. This often results in delay in diagnosis. Areas of the brain supplied by the posterior circulation are difficult to visualize and usually require angiography or magnetic resonance imaging. Intravenous thrombolysis and local-intra arterial thrombolysis are the most common treatment approaches used. Recanalization of the occluded vessel significantly improves morbidity and mortality. Here we present a review of the literature and a case of a patient with altered mental status caused by vertebrobasilar artery occlusion. [West J Emerg Med. 2011;12(2:233-239.

  4. Coronary artery aneurysms

    International Nuclear Information System (INIS)

    Seven saccular coronary artery aneurysms have been demonstrated in the course of 1452 selective coronary artery angiograms. In six patients they were arterio-sclerotic; in one patient the aneurysm must have been congenital or of mycotic-embolic origin. The differential diagnosis between true aneurysms and other causes of vascular dilatation is discussed. Coronary artery aneurysms have a poor prognosis because of the possibility of rupture with resultant cardiac tamponade, or the development of thrombo-embolic myocardial infarction. These aneurysms can only be diagnosed by means of coronary angiography and require appropriate treatment. (orig.)

  5. Plicatura de la albúginea como tratamiento de la incurvación de pene causada por la enfermedad de Peyronie / Penile tunica albuginea plication for the treatment of penile curvature secondary Peyronie's disease

    Scientific Electronic Library Online (English)

    Guillermo, Cruceyra Betriu; José Manuel, Duarte Ojeda; Víctor, Martínez Silva; Enrique, Álvarez González; Carlos, Capitán Manjón; José David, Piedra Lara; Óscar, Leiva Galvis.

    2005-06-01

    Full Text Available OBJETIVO: Evaluar nuestros resultados en el tratamiento de la incurvación peneana causada por la enfermedad de Peyronie mediante la plicatura albugínea descrita por Essed. MÉTODOS:Revisión retrospectiva de los 83 pacientes tratados quirúrgicamente de incurvación peneana adquirida en nuestro centro m [...] ediante la técnica de plicatura entre enero de 1998 y junio de 2003, analizando las siguientes variables: edad, motivo de consulta, antecedentes personales, exploración física, datos ecográficos, tipo de incurvación, erección pre y postcirugía, complicaciones y resultados de la técnica quirúrgica. RESULTADOS: El seguimiento medio fue de 36 meses. El motivo de consulta principal fue la desviación peneana en erección (96,3%). El tipo de incurvación más frecuente fue dorsal (55,4%) y lateral izquierda (48,1%). La erección previa a la cirugía era suficiente para mantener una relación sexual en el 74,7% de los pacientes. La exploración física reveló la existencia de placa en el 79,5% de los casos. En cuanto a los resultados de la cirugía, el 93% refieren una corrección completa de la incurvación o una desviación residual menor de 10º. El 65,1% manifestaron encontrarse satisfechos o muy satisfechos con la operación, mientras que el 64% eran capaces de llevar a cabo una relación sexual. CONCLUSIONES: La plicatura de Essed es un procedimiento sencillo y mínimamente invasivo para corregir la desviación adquirida de pene. En nuestra experiencia, aunque los resultados funcionales parecen ser buenos, el grado de satisfacción entre los pacientes tras la cirugía no es tan alto como cabría esperar. Abstract in english OBJETIVE: To evaluate, in a retrospective analysis, our long term results of patients undergoing the Essed plication procedure for the correction of penile curvature due to Peyronie´s disease. METHODS: Between January 1998 and June 2003, 83 patients with acquired penile deviation were treated with t [...] he Essed technique in our hospital. We analyse the following data: age, main complaint, type of deviation, erection before and after the surgery, physical exploration, ecographic data, complications and results. RESULTS: Mean follow-up was 36 months. Main complaint was penile curvature in 96.3% of patients. The most frequent types of deviation were dorsal (55.4%) and left lateral (48.1%). Erection before surgery was sufficient for sexual intercourse in 74.7%. Physical exploration revealed a plaque in 79.5% of the patients. 93% of the cases reported complete penile curvature correction or residual deviation

  6. Twist Buckling Behavior of Arteries

    OpenAIRE

    Garcia, Justin R.; Lamm, Shawn D.; Han, Hai-chao

    2012-01-01

    Arteries are often subjected to torsion due to body movement and surgical procedures. While it is essential that arteries remain stable and patent under twisting loads, the stability of arteries under torsion is poorly understood. The goal of this work was to experimentally investigate the buckling behavior of arteries under torsion and to determine the critical buckling torque, the critical buckling twist angle, and the buckling shape. Porcine common carotid arteries were slowly twisted in v...

  7. Global metabolic optimality in the structure of the coronary arteries

    CERN Document Server

    Keelan, Jonathan; Hague, James P

    2014-01-01

    The structure of the large coronary arteries is both heritable and reasonably consistent between individuals, but the extent to which this results from evolutionary pressure towards an energy-efficient, globally-optimal, structure is unknown. We present an algorithm for the determination of an energetically globally optimal arterial tree in arbitrary tissue geometries. We demonstrate through application of the algorithm that it is possible to generate in-silico vasculatures that closely match porcine anatomical data on all length scales. We therefore conclude that evolutionary pressure has resulted in a near globally optimal structure of the larger coronary arteries. We also examine the effect of changing length scales, predicting that the structures of the coronary arteries can change from a meandering form for small animals to very straight vessels for large animals. The method presented here is not limited to hearts, and represents a major advance in modeling the arterial vasculature, that could have impor...

  8. Buckling instability in arteries.

    Science.gov (United States)

    Vandiver, Rebecca M

    2015-04-21

    Arteries can become tortuous in response to abnormal growth stimuli, genetic defects and aging. It is suggested that a buckling instability is a mechanism that might lead to artery tortuosity. Here, the buckling instability in arteries is studied by examining asymmetric modes of bifurcation of two-layer cylindrical structures that are residually stressed. These structures are loaded by an axial force, internal pressure and have nonlinear, anisotropic, hyperelastic responses to stresses. Strain-softening and reduced opening angle are shown to lower the critical internal pressure leading to buckling. In addition, the ratio of the media thickness to the adventitia thickness is shown to have a dramatic impact on arterial instability. PMID:25661070

  9. Buerger's disease associated with visceral artery occlusions: computed tomography angiography findings of a case

    International Nuclear Information System (INIS)

    Full text: Introduction: Thromboangiitis obliterans or Buerger's Disease (BD) is characterized by occlusive segmental and often multiple inflammatory lesions of medium and small-sized arteries and superficial veins.This disease rarely effects the visceral arteries. Objectives and tasks: In this report, we present the computed tomography angiography (CTA) findings of a BD case associated with inferior mesenteric and splenic artery occlusions. Materials and methods: A 35-year-old man with BD is referred to our department for aorta and bilateral lower extremity arterial CTA examination. Results: On CTA, abdominal aorta and bilateral iliac arteries were normal. The distal 2/3 of the anterior tibial artery was thin and there were multisegmented stenoses at proximal 1/3 part. Right posterior tibial artery was occluded. In addition to the stenoses of the extremity arteries, splenic artery was occluded and the spleen was feeding by collateral vessels. The proximal part of the inferior mesenteric artery was occluded, as well and the distal segment was filling retrogradely via collaterals. Conclusion: BD rarely effects the visceral arteries. CTA which is used commonly in daily radiology practice, is a reliable imaging modality for the detection of the visceral artery occlusions in addition to the pathologies of the extremity arteries in BD patients

  10. Reconstructive Surgery for Severe Penile Inadequacy: Phalloplasty with a Free Radial Forearm Flap or a Pedicled Anterolateral Thigh Flap

    Directory of Open Access Journals (Sweden)

    P. Hoebeke

    2008-11-01

    Full Text Available Objectives. Severe penile inadequacy in adolescents is rare. Phallic reconstruction to treat this devastating condition is a major challenge to the reconstructive surgeon. Phallic reconstruction using the free radial forearm flap (RFF or the pedicled anterolateral thigh flap (ALTF has been routinely used in female-to-male transsexuals. Recently we started to use these techniques in the treatment of severe penile inadequacy. Methods. Eleven males (age 15 to 42 years were treated with a phallic reconstruction. The RFF is our method of choice; the ALTF is an alternative when a free flap is contraindicated or less desired by the patient. The RFF was used in 7 patients, the ALTF in 4 patients. Mean followup was 25 months (range: 4–49 months. Aesthetic and functional results were evaluated. Results. There were no complications related to the flap. Aesthetic results were judged as “good” in 9 patients and “moderate” in 2 patients. Sensitivity in the RFF was superior compared to the ALTF. Four patients developed urinary complications (stricture and/or fistula. Six patients underwent erectile implant surgery. In 2 patients the erectile implant had to be removed due to infection or erosion. Conclusion. In case of severe penile inadequacy due to whatever condition, a phalloplasty is the preferred treatment nowadays. The free radial forearm flap is still the method of choice. The anterolateral thigh flap can be a good alternative, especially when free flaps are contraindicated, but sensitivity is markedly inferior in these flaps.

  11. Vertebrobasilar Artery Occlusion

    OpenAIRE

    Schoen, Jessica; Boysen, Megan; Warren, Chase; Chakravarthy, Bharath; Lotfipour, Shahram MD, MPH

    2011-01-01

    The presentation of vertebrobasilar artery occlusion varies with the cause of occlusion and location of ischemia. This often results in delay in diagnosis. Areas of the brain supplied by the posterior circulation are difficult to visualize and usually require angiography or magnetic resonance imaging. Intravenous thrombolysis and local-intra arterial thrombolysis are the most common treatment approaches used. Recanalization of the occluded vessel significantly improves morbidity and mortality...

  12. Hipertensão arterial e sua associação com índices antropométricos em adultos de uma cidade de pequeno porte do interior do Brasil / Hypertension and its association to anthropometric indexes in adults from a small city ln Brazil

    Scientific Electronic Library Online (English)

    Flávia Miquetichuc Nogueira, Nascente; Paulo César Brandão Veiga, Jardim; Maria do Rosário Gondim, Peixoto; Estelamaris Tronco, Monego; Weimar Kunz Sebba, Barroso; Humberto Graner, Moreira; Priscila Valverde de Oliveira, Vitorino; Luiz Nazário, Scala.

    Full Text Available OBJETIVO: Estimar a prevalência da Hipertensão Arterial (HA) em adultos e sua associação com o Índice de Massa Corporal (IMC) e Circunferência da Cintura (CC). MÉTODOS: Estudo descritivo, observacional e transversal, de base populacional, com amostra aleatória simples (>18 anos). Investigados 1.168 [...] indivíduos. Questionários padronizados. Realizadas medidas de pressão arterial (critério de HA > 140x90mmHg), peso, altura e CC. Dados armazenados (programa Microsoft Access) e analisados por meio do programa Epi-info, versão 3.3.2. RESULTADOS: Predomínio do sexo feminino (63,2%), idade média 43,2 ± 14,9 anos. Prevalência de HA de 32,7%, com tendência a ser maior entre homens (35,8%) que entre mulheres (30,9%) (p=0,084). Associação positiva (p Abstract in english OBJECTIVE: Estimate the prevalence of Arterial Hypertension (AH) and its association with Body Mass Index (BMI) and Abdominal Circumference (AC) in the adult population from the city of Firminópolis, in the state of Goiás, Brazil. METHODS: Descriptive, observational, cross sectional population-based [...] study substantiated by a home survey of a simple random sample (>18 years old). The study evaluated 1168 individuals. Standardized questionnaires. Measurements performed were Blood Pressure (BP) (hypertension: BP > 140x90mmHg), weight,, height and AC. Microsoft Office Access and Epi-info, 3.3.2 version were used for data storage and analysis, respectively. RESULTS: There was a predominance of females (63.2%), mean age was 43.2 ±14.9 years old. Prevalence of hypertension was 32.7%, with tendency to be higher among the male population (35.8%) when compared to the female (30.9%) (p=0.084). Association between AH and BMI was positive (p

  13. Visualization of HIV-1 Interactions with Penile and Foreskin Epithelia: Clues for Female-to-Male HIV Transmission

    Science.gov (United States)

    Dinh, Minh H.; Anderson, Meegan R.; McRaven, Michael D.; Cianci, Gianguido C.; McCoombe, Scott G.; Kelley, Z. L.; Gioia, Casey J.; Fought, Angela J.; Rademaker, Alfred W.; Veazey, Ronald S.; Hope, Thomas J.

    2015-01-01

    To gain insight into female-to-male HIV sexual transmission and how male circumcision protects against this mode of transmission, we visualized HIV-1 interactions with foreskin and penile tissues in ex vivo tissue culture and in vivo rhesus macaque models utilizing epifluorescent microscopy. 12 foreskin and 14 cadaveric penile specimens were cultured with R5-tropic photoactivatable (PA)-GFP HIV-1 for 4 or 24 hours. Tissue cryosections were immunofluorescently imaged for epithelial and immune cell markers. Images were analyzed for total virions, proportion of penetrators, depth of virion penetration, as well as immune cell counts and depths in the tissue. We visualized individual PA virions breaching penile epithelial surfaces in the explant and macaque model. Using kernel density estimated probabilities of localizing a virion or immune cell at certain tissue depths revealed that interactions between virions and cells were more likely to occur in the inner foreskin or glans penis (from local or cadaveric donors, respectively). Using statistical models to account for repeated measures and zero-inflated datasets, we found no difference in total virions visualized at 4 hours between inner and outer foreskins from local donors. At 24 hours, there were more virions in inner as compared to outer foreskin (0.0495 +/? 0.0154 and 0.0171 +/? 0.0038 virions/image, p = 0.001). In the cadaveric specimens, we observed more virions in inner foreskin (0.0507 +/? 0.0079 virions/image) than glans tissue (0.0167 +/? 0.0033 virions/image, p<0.001), but a greater proportion was seen penetrating uncircumcised glans tissue (0.0458 +/? 0.0188 vs. 0.0151 +/? 0.0100 virions/image, p = 0.099) and to significantly greater mean depths (29.162 +/? 3.908 vs. 12.466 +/? 2.985 ?m). Our in vivo macaque model confirmed that virions can breach penile squamous epithelia in a living model. In summary, these results suggest that the inner foreskin and glans epithelia may be important sites for HIV transmission in uncircumcised men. PMID:25748093

  14. A case of penile melanoma illustrating the low sensitivity of frozen sections in the assessment of sentinel lymph nodes.

    Science.gov (United States)

    Andonian, Sero; Meterissian, Sarkis H; Watters, A Kevin; Loutfi, Antoine

    2003-08-01

    A 75 year-old uncircumcised man presented with a 1.1mm thick malignant melanoma on the ventral aspect of the glans penis. He underwent isosulfan blue and technetium 99m guided sentinel lymph node (SLN) biopsy and distal penectomy with 2 cm margins. This is the third reported case of penile melanoma using both markers for SLN mapping. While frozen sections and H& E stains were negative, S-100 and HMB-45 immunohistochemistry revealed micrometastasis in one of the sentinel nodes. This case illustrates that any discussion with the patient about management and prognosis should await immunohistochemistry results. PMID:14503941

  15. Unusual origin of the left vertebral artery

    OpenAIRE

    Imre N; Yalcin B; Ozan H

    2010-01-01

    The vertebral artery is important to posterior cerebral circulation. Several researchers have reported anomalous origins of the vertebral artery such as from the aortic arch, between the left common carotid artery and left subclavian artery or after left subclavian artery, from the thyrocervical trunk, from the brachiocephalic trunk, from the common carotid artery, from the external carotid artery, from a common carotid trunk formed by left subclavian artery and left vertebral artery. We enco...

  16. [Malignant infarct of the middle cerebral artery in a patient with bacterial meningitis].

    Science.gov (United States)

    López, Mirta G; Mellado, Patricio T; Huete, Isidro L

    2004-10-01

    The mortality of acute bacterial meningitis (BM) has remained stable in the last decades in spite of the use of new antibiotics, probably due to vascular complications. We report a 68-year-old woman with BM who had a malignant infarction of left middle cerebral artery territory 72 hours after admission to the hospital. The patient experienced a bad evolution and died four days after admission. The arterial involvement in patients with BM is explained by vasospasm of large arteries and vasculitis of small arteries. The medical treatment of a malignant middle cerebral artery infarct has a high mortality. PMID:15631210

  17. Coronary Artery and Pulmonary Artery Fistula Originated from Significant Stenosis in the Left Anterior Descending Artery

    OpenAIRE

    Alper Sami Kunt

    2013-01-01

    Coronary artery fistula (CAF) is defined as a rare anomalous connection between a coronary artery and a major vessel or a cardiac chamber. We report a case of a left anterior descending coronary (LAD) stenosis and coronary artery fistula between the LAD coronary artery and the pulmonary artery (PA). CAF is often diagnosed by coronary angiogram. We describe our diagnostic approach and review the literature on the epidemiology, the pathophysiology, the diagnostic modalities, and the treatment o...

  18. Evaluating peripheral arterial volume distensibility by photoacoustic microscopy

    Science.gov (United States)

    Wang, Cheng; Xu, Guan; Wei, Xinbin; Cheng, Qian; Wang, Xueding

    2015-03-01

    Stiffness of arteries, especially small arteries, is an important marker for many diseases and a good parameter to evaluate the risks of cardiovascular problems. In this research, we proposed a new method for measurement of local arterial distensibility by using photoacoustic microscopy (PAM) technology. Taking advantages from its excellent sensitivity and high spatial resolution, PAM can evaluate the morphology and volume change of a small artery accurately without involving any contrast agent. When working in the linear elastic range of a vessel, measuring the initial and the distended diameters of the vessel before and after pressure change facilitates quantitative assessment of vessel distensibility. The preliminary experiment on well-controlled gel phantoms demonstrates the feasibility of this technology.

  19. Extracorporeal transient distal penile corporoglanular shunt in early ischemic priapism treatment

    Scientific Electronic Library Online (English)

    Onder, Canguven; Raidh A., Talib.

    2014-10-01

    Full Text Available Purpose Ischemic priapism, which is a compartment syndrome, needs urgent treatment in order to nourish corpora cavernosa. As the first step, the aspiration of blood and/or the irrigation of the cavernosal bodies are performed to prevent fibrotic activity and secure erectile capability. While perfor [...] ming aspiration and irrigation, there are some risks of the procedure in which most refrained one is cardiovascular side effects of adrenergic agonists. We aimed to evaluate extracorporeal transient distal penile corporoglanular shunt technique in place of aspiration/ irrigation techniques for early ischemic priapism treatment. Materials and Methods In this transient shunt technique, a sterile closed system blood collection set (BD Vacutainer, Cat. No.: 367282; NJ, USA), which has two 21G needles, was used. The length of the needle and tubing was 19 mm. (0.75 inch) and 178 mm. (7 inches), respectively. This blood collection set was designed to be used not only for blood collection but can also be used for short term infusions (maximum 2 hours). Results Ten patients out of fifteen with early ischemic priapism were successfully treated with this transient shunt technique. The permanent detumescence achieved in the first 10 minutes in nine out of fifteen patients. No additional procedure needed after the disappearance of rigidity in successfully treated patients. The permanent detumescence achieved in the first 10 minutes in nine out of fifteen patients. Conclusions We demonstrated that this extracorporeal transient shunt technique gets some advantages over aspiration and irrigation in early ischemic priapism treatment. Our results indicate that the presented technique to be offered for the patients with an ischemic priapism episode of no more than 7 hours.

  20. Influence of dihydroergotoxine, bromocriptine, and ergotamine on penile erection in Wistar rats.

    Science.gov (United States)

    Radosavljevic, Milovan; Pajovic, Bogdan; Radunovic, Miodrag; Radojevic, Nemanja; Bjelogrlic, Bojana

    2012-01-01

    The pilot study presented was conducted to determine as to whether ergot alkaloids (alpha-adrenergic blockers) have a potential effect on penile erectile function. The influence of dihydroergotoxine, bromocriptine, and ergotamine was studied on the erection ability in intact, two-grade outbred male Wistar albino rats that were out of their estrous phase. The experimental animals were injected intrapenially with the substances under examination: dihydroergotoxine mesylate (0.1 mg/0.1 mL, 0.3 mg/0.1 mL, and 1 mg/0.1 mL), bromocriptine mesylate (0.3 mg/0.1 mL, 1 mg/0.1 mL, and 3 mg/0.1 mL), and ergotamine tartrate (0.1 mg/0.1 mL, 0.3 mg/0.1 mL, and 1mg/0.1 mL). Every dose was tested on a pattern of 30 rats. These mentioned substances were injected in the amount of 1 mm to the left of the proximal part of the superficial dorsal vein of the penis, in the region of the penis root. After injection, the animals were then observed within the next 90 minutes. In the trial, the following was observed: the number of rats with an erection achieved, the period of time from intrapenial application to the appearance of the first erection, and the duration of the erection. Ultimately, the research results confirm the efficiency of dihydroergotoxine and bromocriptine as erectogenic agents, as well as ergotamine as a detumescent compared with saline solutions. PMID:22441761

  1. Intra-muscular arteries are also affected in Takayasu's arteritis.

    Science.gov (United States)

    Wang, Zhi-Wei; Li, Song-Hua; Yu, Yong-Wei; Dai, Sheng-Ming

    2013-10-01

    Takayasu's arteritis (TA) is a chronic vasculitis, primarily affecting large vessels, such as the aorta and its main branches. Several reports suggest that the vascular inflammatory process is not always confined to large vessels. Here, a new case of vasculitis in intra-muscular arteries associated with TA is reported. This case provides further support for the idea that TA also involves small arterial vessels. PMID:23011087

  2. Central administration of oxytocin differentially increases yawning, penile erections and scratching in high- (HY) and low-yawning (LY) sublines of Sprague-Dawley rats.

    Science.gov (United States)

    Eguibar, Jose R; Cortes, Carmen; Isidro, O; Ugarte, A

    2015-07-01

    Central administration of oxytocin has been shown to induce yawning, penile erection, grooming and scratching. Yawning and penile erections are due to activation of oxytocinergic neurons in the paraventricular nucleus of the hypothalamus. We selectively bred two sublines from Sprague-Dawley rats, one with a high-yawning frequency (HY) of 20yawns/h, and one with a low-yawning (LY) frequency of 2yawns/h. The aim of the current study was to analyze the behavioral effects of centrally-administered oxytocin [15ng-10?g; intracerebroventricularly (i.c.v.)] on yawning, penile erections, grooming and scratching in adult male rats from both sublines. Oxytocin produced a dose-dependent increase in yawning and penile erection frequencies and this effect was significantly higher in the HY, compared to the LY, subline. However, the number of oxytocin-induced scratching bouts was significantly higher in the LY, compared to the HY group. In conclusion, these sublines represent a suitable model for detailed analysis of behavior induced by oxytocin and other neuropeptides in animals with different spontaneous expression of behavioral traits. PMID:25931266

  3. Metástasis peneana como primera manifestación de un carcinoma esofágico / Penile metastasis like first sign of esophagus carcinoma

    Scientific Electronic Library Online (English)

    Miguel A., López-Aramburu; Amparo, Viguri Díaz; José, Rosa Arias; Pablo, Peña Pérez.

    2009-03-01

    Full Text Available Presentamos un nuevo caso de enfermedad metastásica en pene. El tumor primitivo se originó en el esófago, lo que es una rareza clínica. Pero lo que hace excepcional a nuestro caso clínico es que fue la metástasis peneana el primer síntoma de la enfermedad, ya que hasta entonces el tumor primitivo pe [...] rmanencia silente. Como en la mayoría de casos similares el pronóstico fue pésimo y el paciente falleció a los pocos meses del inicio clínico de la enfermedad metastásica peneana. Abstract in english We present a new case of penile metastatic disease. The original tumour has been situated in the esophagus, which is a rare clinical situation. But what becomes exceptional in our clinical case is that the penile metastasis was the first disease symptom, since until this moment the original tumour h [...] as been silent. Like the majority of these cases the prognosis was gloomy and the patient died in few months after the clinical beginning of the disease.

  4. Hipertensión arterial: Aspectos fisiopatológicos

    Directory of Open Access Journals (Sweden)

    Alfredo Vázquez Vigoa

    1996-12-01

    Full Text Available Se revisaron los aspectos fisiopatológicos que intervienen en la génesis de la enfermedad hipertensiva para actualizar los conocimientos en relación con los mecanismos que generan la hipertensión arterial. Se hizo hincapié en el aumento de la resistencia periférica, los trastornos de excreción del sodio y las alteraciones del transporte de sodio a través de la membrana. Comentamos además las nuevas teorías sobre recientes sustancias vasoactivas capaces de incrementar el tono vascular, como la endotelina, y relacionamos los sistemas locales o autocrinos de renina/angiotensina/aldosterona con la hipertensión arterial. Se concluye que sobre el sustrato o fondo poligénico de la hipertensión se superponen alteraciones humorales capaces de perpetuar la elevación de la presión arterial.The physiopathological aspects involved in the genesis of the hypertensive disease were revised in order to up-date the understanding regarding the mechanisms which generate high blood pressure. Emphasis was made in the increased peripheral resistance, the disorders of sodium excretion and on alterations regarding the sodium transport through the membrane. In addition, new theories about certain vasoactive substances recently found, capable of increasing the vascular tone such as endotelin, are also pointed out. Local or self endocrine systems of renin/angiotensin/aldosterone were found to be related to arterial hypertension. The authors concluded that certain humoral alterations capable of perpetuating the elevated arterial pressure are superimposed over the polygenic sustrate of hypertension.

  5. Brachial Artery Access for Percutaneous Renal Artery Interventions

    International Nuclear Information System (INIS)

    Purpose: To evaluate the suitability of transbrachial access for endovascular renal artery interventions. Methods: During 37 consecutive endovascular renal artery interventions, the transbrachial approach was used on nine patients (mean age 63 years; range 41-76 years) for 11 renal artery procedures on native kidneys and one percutaneous transluminal angioplasty (PTA) on a transplanted kidney. The reason for using transbrachial access was a steep aorta-renal angle in five, and severe aorta-iliac atherosclerosis in the remaining patients. In addition to the intervention catheter in the left brachial artery, an additional nonselective catheter for controlling the procedure was inserted transfemorally (six patients) or via the contralateral brachial artery. Results: Eleven interventions (six PTAs, five stents) were successfully completed. The one failure resulted from impenetrable subclavian artery stenosis. The only major complication was a brachial artery pseudoaneurysm requiring surgical treatment. Conclusion: Transbrachial access is an effective and relatively safe technique for renal artery interventions when transfemoral access is not possible

  6. Catheterization of cerebral arteries under real-time MR imaging guidance: an experimental study in pigs

    International Nuclear Information System (INIS)

    Objective: To investigate the feasibility of catheterization of cerebral arteries under the real-time MR imaging guidance in experimental pigs. Methods: Ten small-sized female pigs were selected for this study. Via the femoral access, percutaneous catheterization with a 3 F active MR-tracking microcatheter was performed under real-time MRI guidance and the microcatheter was separately placed into bilateral ascending pharyngeal arteries. After the procedure, all the pigs were sacrificed and sent for pathologic examination. Gross pathologic examination of aortic arches, brachio-cephalic arteries, carotid arteries and ascending pharyngeal arteries was performed to search for the perforation and dissection. Results: MR angiography revealed that in pigs the bilateral ascending pharyngeal arteries formed an arteriolar network at the cranial base, supplying blood flow to the brain. Catheterization of ascending pharyngeal arteries from the femoral artery access was successfully performed in all 10 pigs with the help of real-time MR imaging-guidance. A single procedure took about 4-12 minutes. Macroscopically, no evidence of vascular injury of aortic arches, brachio-cephalic arteries, carotid arteries and ascending pharyngeal arteries was found. Conclusion: Under real-time MRI guidance the catheterization of cerebral arteries can be correctly and quickly accomplished in experimental pigs. (authors)

  7. Cambios morfométricos peneanos tras prostatectomía radical: revisión de la evidencia / Penile morphometric changes after radical prostatectomy: Evidence-based

    Scientific Electronic Library Online (English)

    J.I., Martínez-Salamanca; C., Martínez-Ballesteros; L., Portillo; I., Moncada; J., Carballido.

    2010-08-01

    Full Text Available Introducción: La prostatectomía radical en cualquiera de sus abordajes representa el tratamiento de elección del cáncer localizado de la próstata y especialmente en pacientes jóvenes sexualmente activos con deseo de mantener su vida sexual. Además de la bien conocida y definida disfunción eréctil po [...] stoperatoria, el período de silencio eréctil causa en muchos pacientes (9-71%) cambios estructurales, a veces irreversibles, en la estructura peneana. Estos cambios tisulares derivan en una pérdida de longitud y grosor del pene, que preocupa a los pacientes. Objetivo: Revisar de manera sistemática los datos publicados en la literatura médica hasta el momento en relación con los cambios peneanos tras prostatectomía radical. Material y métodos: Realizamos una búsqueda sistemática en PubMed, EMBASE, Cochrane, SCOPUS y Science Citation Index durante el período de enero de 1990 a septiembre de 2009 para los términos «prostatectomy», «organ size», «fibrosis», «sexual activity», «erectile dysfunction», «penile size», «radical prostatectomy», «prostatic neoplasms», «body weights» y «penis measures». Se seleccionaron 7 series de pacientes para su análisis. Resultados: Se exponen los diferentes métodos de medición peneana y sus potenciales sesgos y diferencias. Asimismo, repasamos las principales teorías fisiopatogénicas para explicar este fenómeno. Finalmente, se detallan los resultados de diferentes series de pacientes comunicadas. Conclusiones: Parece un hecho demostrado que el pene sufre cambios importantes en su longitud y grosor tras prostatectomía radical. Diferentes autores han comunicado los datos de sus series así como las diferentes opciones de tratamiento (inhibidores de la 5-PDE, dispositivos de vacío [DV], extensores del pene, etc.). Las estrategias encaminadas a preservar y a proteger el tejido cavernoso y la túnica albugínea tras el procedimiento así como las que aumenten la oxigenación y permitan recuperar la erección en el menor tiempo posible impactarán positivamente en la calidad de nuestros pacientes. Abstract in english Introduction: Radical prostatectomy in all its approaches is the treatment of choice for localized prostate cancer and especially in young, sexually active patients with a desire to keep their sex life. In addition to the well-known and defined postoperative erectile dysfunction, erectile silent per [...] iod causes, in many patients (9-1%), structural changes, in the penile structure, sometimes irreversible. These tissue changes, resulting in a loss of length and girth, that concern patients. Objective: To systematically review to date published data in the literature regarding penile changes after radical prostatectomy. Material and methods: We performed a systematic search in: PubMed, EMBASE, Cochrane, SCOPUS, Science Citation Index period January 1990 to September 2009 for the terms "prostatectomy", "organ size", "fibrosis", "sexual activity", "erectile dysfunction", "penile size", "radical prostatectomy", "prostatic neoplasms", "body weights" and "penis measures". Seven series of patients were selected for analysis. Results: We described the different measurement methods and their potential biases and differences. Also, we reviewed main physiopathogenic theories to explain this phenomenon. Finally, we detail the results of different series of patients reported. Conclusions: It seems to be a proven fact that the penis undergoes major changes in its length and girth after radical prostatectomy. Several authors have communicated the data of their series and the different treatment options (5PDE inhibitors, vacuum devices, penile extenders, etc.). Strategies addressed to preserve and protect cavernous tissue and tunica albuginea after the procedure, as well as to increase oxygenation and allow erection to be recovered in the shortest posible time positive will impact on the quality of life of our patients.

  8. Hipertensión e hipotensión arterial

    Directory of Open Access Journals (Sweden)

    Carlos J. Mucha

    2007-07-01

    Full Text Available Si bien la hipertensión arterial (HTA, permanece como una de las causas más comunes de morbi-mortalidad en Medicina Humana, en la práctica Veterinaria todavía nos encontramos en las primeras etapas de diagnóstico y comprensión de la misma, debido a que la determinación de la presión arterial (PA no forma aun parte de la practica diaria y además no existen registros de parámetros normales en pequeños animales, de acuerdo a raza, sexo y edad lo que nos ayudaría a la mejor identificación del problema. De aquí el peligro de colocar el rotulo de hipertenso a un paciente, con solo la determinación de la PA, teniendo en cuenta además que la mayoría de los casos de HTA en Veterinaria, son secundarios a enfermedadessistémicas. Con respecto a la hipotensión arterial, los valores están más claros y su determinación es de fundamental importancia sobre todo en emergencias, pacientes en estado crítico y anestesia.

  9. Priapismo arterial de alto flujo secundario a fístula arterio-cavernosa bilateral post-traumática: Embolización supraselectiva con coágulo autólogo / High-flow arterial priapism for postraumatic bilateral arterial-cavernous fistula: Highly selective embolization using autologous blood clot

    Scientific Electronic Library Online (English)

    E., Fernández Rosado; A., Blanco Díez; A., Barbagelata López; L., Álvarez Castelo; A., Lancina Martín; J.I., Cao González; S., Novas Castro; M., Ruibal Moldes; V., Chantada Abal; M., González Martín.

    2004-02-01

    Full Text Available El priapismo arterial de alto flujo es una patología poco frecuente caracterizada por una erección parcial persistente no dolorosa. Por lo general, se asocia a un traumatismo perineal o peneano (área genitoperineal) que ha ocasionado una fístula arterio-cavernosa, raramente bilateral. Tan sólo se ha [...] n publicado once casos en los que dicha fístula es bilateral. Los tratamientos empleados han sido diversos, sin una pauta común para su resolución. Presentamos el caso de un varón de 27 años con priapismo de alto flujo arterial secundario a traumatismo perineal con fístula arterio-cavernosa bilateral. Se empleó coágulo autólogo para la embolización de las fístulas con el fin de minimizar el riesgo de lesión de la función eréctil en un paciente joven. No se registraron complicaciones. La función eréctil es normal 8 meses después del tratamiento sin evidencia de fístula en ecografía de control. Consideramos que la arteriografía supraselectiva junto a la embolización con sustancias reabsorbibles proporcionan los mejores resultados, menores riesgos y complicaciones en este tipo de patología. Abstract in english High flow arterial priapism is rare and characterized to a prolonged non-painful partial erection. Arteriocavernous fistula, rarely bilateral, is associated with penile or perineal trauma (genitoperineal area). Review of the literature, in only eleven cases this fistula is bilateral. Diferents treat [...] ments with non common norm has been used. We report a case of a 27 years old male who presented high folw priapism secondary to bilateral postraumatic arterio-cavernous fistula. Autologous blood clot was used for fistulas embolization to minimize the risk of impotence in this young patient. No complications was registered. Eight months later the patient had normal erectile function and no fistula was detected on ultrasonography doppler. We consider arteriography with highly selective embolization using reabsorbable agents obtains the best results, the least risks and complications in this process.

  10. Hepatic arterial collaterals in Ivalon embolization of hepatic artery

    International Nuclear Information System (INIS)

    Hepatic arterial collaterals after embolization of hepatic artery using Ivalon particles were evaluated with roentgenologic and pathologic procedures. The perivascular collaterals we observed that develop after peripheral occulsion of hepatic arteries with Ivalon probably represent perivascular arterioles or capillary networks that become enlarged. (author)

  11. Left Anterior Descending Artery-Pulmonary Artery Fistula

    Directory of Open Access Journals (Sweden)

    Turan Ege

    2011-12-01

    Full Text Available Despite the fact that coronary arteriovenous fistulas constitute approximately half (48% of coronary artery anomalies, they are rarely seen anomalies. In this report,we aim to present a coronary arteriovenous fistula case detected during a coronary angiography between left anterior descending artery and pulmonary artery.

  12. There Is No Correlation Between Erectile Dysfunction and Dose to Penile Bulb and Neurovascular Bundles Following Real-Time Low-Dose-Rate Prostate Brachytherapy

    International Nuclear Information System (INIS)

    Purpose: We evaluated the relationship between the onset of erectile dysfunction and dose to the penile bulb and neurovascular bundles (NVBs) after real-time ultrasound-guided prostate brachytherapy. Methods and Materials: One hundred forty-seven patients who underwent prostate brachytherapy met the following eligibility criteria: (1) treatment with 125I brachytherapy to a prescribed dose of 160 Gy with or without hormones without supplemental external beam radiation therapy, (2) identification as potent before the time of implantation based on a score of 2 or higher on the physician-assigned Mount Sinai Erectile Function Score and a score of 16 or higher on the abbreviated International Index of Erectile Function patient assessment, and (3) minimum follow-up of 12 months. Median follow-up was 25.7 months (range, 12-47 months). Results: The 3-year actuarial rate of impotence was 23% (34 of 147 patients). An additional 43% of potent patients (49 of 113 patients) were using a potency aid at last follow-up. The penile bulb volume receiving 100% of the prescription dose (V100) ranged from 0-0.05 cc (median, 0 cc), with a dose to the hottest 5% (D5) range of 12.5-97.9 Gy (median, 40.8 Gy). There was no correlation between penile bulb D5 or V100 and postimplantation impotency on actuarial analysis. For the combined right and left NVB structures, V100 range was 0.3-5.1 cc (median, 1.8 cc), and V150 cc (median, 1.8 cc), and V150 range was 0-1.5 cc (median, 0.31 cc). There was no association between NVB V100 or V150 and postimplantation impotency on actuarial analysis. Conclusion: Penile bulb doses are low after real-time ultrasound-guided prostate brachytherapy. We found no correlation between dose to either the penile bulb or NVBs and the development of postimplantation impotency.

  13. Living with Carotid Artery Disease

    Science.gov (United States)

    ... Living With Clinical Trials Links Related Topics Atherosclerosis Carotid Endarterectomy Carotid Ultrasound Stents Stroke Send a link to ... page from the NHLBI on Twitter. Living With Carotid Artery Disease If you have carotid artery disease, you can ...

  14. Peripheral Artery Disease and Diabetes

    Science.gov (United States)

    ... High Blood Pressure Tools & Resources Stroke More Peripheral Artery Disease & Diabetes Updated:Oct 7,2014 People with diabetes are at higher risk of developing peripheral artery disease (PAD) . And individuals with PAD are four ...

  15. All about Peripheral Arterial Disease

    Science.gov (United States)

    All About Peripheral Arterial Disease American Diabetes Association? ? 1–800–DIABETES (342–2383)? ? www.diabetes.org ©2009 ... Diabetes Association, Inc. 2/14 Toolkit No. 25: All About Peripheral Arterial Disease continued have PAD. The ...

  16. Pharmacological modulation of arterial stiffness.

    LENUS (Irish Health Repository)

    Boutouyrie, Pierre

    2011-09-10

    Arterial stiffness has emerged as an important marker of cardiovascular risk in various populations and reflects the cumulative effect of cardiovascular risk factors on large arteries, which in turn is modulated by genetic background. Arterial stiffness is determined by the composition of the arterial wall and the arrangement of these components, and can be studied in humans non-invasively. Age and distending pressure are two major factors influencing large artery stiffness. Change in arterial stiffness with drugs is an important endpoint in clinical trials, although evidence for arterial stiffness as a therapeutic target still needs to be confirmed. Drugs that independently affect arterial stiffness include antihypertensive drugs, mostly blockers of the renin-angiotensin-aldosterone system, hormone replacement therapy and some antidiabetic drugs such as glitazones. While the quest continues for \\'de-stiffening drugs\\

  17. Development of functional in vivo imaging of cerebral lenticulostriate artery using novel synchrotron radiation angiography

    Science.gov (United States)

    Lin, Xiaojie; Miao, Peng; Mu, Zhihao; Jiang, Zhen; Lu, Yifan; Guan, Yongjing; Chen, Xiaoyan; Xiao, Tiqiao; Wang, Yongting; Yang, Guo-Yuan

    2015-02-01

    The lenticulostriate artery plays a vital role in the onset and development of cerebral ischemia. However, current imaging techniques cannot assess the in vivo functioning of small arteries such as the lenticulostriate artery in the brain of rats. Here, we report a novel method to achieve a high resolution multi-functional imaging of the cerebrovascular system using synchrotron radiation angiography, which is based on spatio-temporal analysis of contrast density in the arterial cross section. This method provides a unique tool for studying the sub-cortical vascular elasticity after cerebral ischemia in rats. Using this technique, we demonstrated that the vascular elasticity of the lenticulostriate artery decreased from day 1 to day 7 after transient middle cerebral artery occlusion in rats and recovered from day 7 to day 28 compared to the controls (p artery in the ischemic brain.

  18. CAROTID ARTERY DISEASE

    Directory of Open Access Journals (Sweden)

    H. Van Damme

    2009-05-01

    Full Text Available Carotid artery disease (CAD become a commonly seen disease in general medical practice, due to the general population aging. Stroke, one of the most frequent complications of CAD and represents the third cause of death in Western countries. The leading cause of stroke in CAD is atheroembolism rather than flow-reduction. This paper reviewed imaging techniques, medical treatment and esepecially carotid endarterectomy (from point of view of indications, surgical technique and results and carotid artery stenting for the correct management of CAD.

  19. Arterial disease after radiotherapy

    International Nuclear Information System (INIS)

    Disease of the large arterial vessels is a relatively unknown complication of radiotherapy. However, it should be considered in the same manner as the other complications of irradiation when a tumour recurrence is suspected. The experimental studies of Kirkpatrick and Konings, demonstrating the synergy between irradiation and hypercholesterolemia in the precocity and gravity of vascular complications are recalled. The different localisations reported in the litterature are discussed: coronary, pulmonary, thoracic aorta, supra aortic, renal, digestive and ilio-femoral arteries. Finally, the difficulty of diagnosis of post-radiotherapy without clinical, radiological or anatomopathological confirmation, is underlined

  20. Radiative transport in large arteries

    OpenAIRE

    Ruh, Dominic; Subramanian, Sivaraman; Theodor, Michael; Zappe, Hans; Seifert, Andreas

    2013-01-01

    A refined model for the photon energy distribution in a living artery is established by solving the radiative transfer equation in a cylindrical geometry, using the Monte Carlo method. Combining this model with the most recent experimental values for the optical properties of flowing blood and the biomechanics of a blood-filled artery subject to a pulsatile pressure, we find that the optical intensity transmitted through large arteries decreases linearly with increasing arterial distension. T...