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Sample records for penile small arteries

  1. Role for Tyrosine Kinases in Contraction of Rat Penile Small Arteries

    DEFF Research Database (Denmark)

    Villalba, Nuria; Kun, Attila; Stankevicius, Edgaras; Simonsen, Ulf

    2010-01-01

    ABSTRACT Introduction. The devasting effect of cancer and treatment thereof contribute to sexual dysfunction. Recently, a series of tyrosine kinase inhibitors have been approved either as add-on or for targeted treatment of cancer. However, tyrosine kinases are not only important for cell growth and proliferation, but also in regulation of vascular tone. Aim. The present study investigated whether tyrosine kinases contribute to contractility in rat penile arteries, and addressed whether they are...

  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

    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.

  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 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. 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; Bajory, Zoltán; Simonsen, Ulf; Varro, András; Papp, Julius Gy; Pajor, Lászlo; Kun, Attila

    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-depe...

  5. 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; Bajory, Zoltán; Simonsen, Ulf; Varro, András; Papp, Julius Gy; Pajor, Lászlo; Kun, Attila

    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...

  6. MicroRNA Expression Profile in Penile Cancer Revealed by Next-Generation Small RNA Sequencing.

    Science.gov (United States)

    Zhang, Li; Wei, Pengfei; Shen, Xudong; Zhang, Yuanwei; Xu, Bo; Zhou, Jun; Fan, Song; Hao, Zongyao; Shi, Haoqiang; Zhang, Xiansheng; Kong, Rui; Xu, Lingfan; Gao, Jingjing; Zou, Duohong; Liang, Chaozhao

    2015-01-01

    Penile cancer (PeCa) is a relatively rare tumor entity but possesses higher morbidity and mortality rates especially in developing countries. To date, the concrete pathogenic signaling pathways and core machineries involved in tumorigenesis and progression of PeCa remain to be elucidated. Several studies suggested miRNAs, which modulate gene expression at posttranscriptional level, were frequently mis-regulated and aberrantly expressed in human cancers. However, the miRNA profile in human PeCa has not been reported before. In this present study, the miRNA profile was obtained from 10 fresh penile cancerous tissues and matched adjacent non-cancerous tissues via next-generation sequencing. As a result, a total of 751 and 806 annotated miRNAs were identified in normal and cancerous penile tissues, respectively. Among which, 56 miRNAs with significantly different expression levels between paired tissues were identified. Subsequently, several annotated miRNAs were selected randomly and validated using quantitative real-time PCR. Compared with the previous publications regarding to the altered miRNAs expression in various cancers and especially genitourinary (prostate, bladder, kidney, testis) cancers, the most majority of deregulated miRNAs showed the similar expression pattern in penile cancer. Moreover, the bioinformatics analyses suggested that the putative target genes of differentially expressed miRNAs between cancerous and matched normal penile tissues were tightly associated with cell junction, proliferation, growth as well as genomic instability and so on, by modulating Wnt, MAPK, p53, PI3K-Akt, Notch and TGF-β signaling pathways, which were all well-established to participate in cancer initiation and progression. Our work presents a global view of the differentially expressed miRNAs and potentially regulatory networks of their target genes for clarifying the pathogenic transformation of normal penis to PeCa, which research resource also provides new insights into future investigations aimed to explore the in-depth mechanisms of miRNAs and other small RNAs including piRNAs in penile carcinogenesis regulation and effective target-specific theragnosis. PMID:26158897

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

    Energy Technology Data Exchange (ETDEWEB)

    Kawanisi, Yasuo; Kimura, Kazunori; Lee, Kyong Soo; Koizumi, Takahiro; Nakatsuji, Hiroyoshi; Kojima, Keiji; Yamamoto, Akira; Numata, Akira [Takamatsu Red Cross Hospital (Japan)

    2001-11-01

    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 E{sub 1} 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 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)

  8. 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.)

  9. Structure and function of small arteries

    DEFF Research Database (Denmark)

    Mulvany, M J; Aalkjær, Christian

    1990-01-01

    The small arteries (prearteriolar vessels with lumen diameter less than approximately 500 microns) contribute importantly to and participate actively in the regulation of the peripheral resistance. New techniques, building on the classic histological and hemodynamic techniques, have enabled detailed in vitro investigation of small arteries. At present, research in small arteries is in its infancy, and our understanding of the heterogeneity of small arteries within vascular beds, between vascular...

  10. Endothelin-1 contributes to endothelial dysfunction and enhanced vasoconstriction through augmented superoxide production in penile arteries from insulin-resistant obese rats: role of ETA and ETB receptors

    Science.gov (United States)

    Sánchez, A; Martínez, P; Muñoz, M; Benedito, S; García-Sacristán, A; Hernández, M; Prieto, D

    2014-01-01

    Background and Purpose We assessed whether endothelin-1 (ET-1) inhibits NO and contributes to endothelial dysfunction in penile arteries in a model of insulin resistance-associated erectile dysfunction (ED). Experimental Approach Vascular function was assessed in penile arteries, from obese (OZR) and lean (LZR) Zucker rats, mounted in microvascular myographs. Changes in basal and stimulated levels of superoxide (O2?) were detected by lucigenin-enhanced chemiluminescence and ET receptor expression was determined by immunohistochemistry. Key Results ET-1 stimulated acute O2? production that was blunted by tempol and the NADPH oxidase inhibitor, apocynin, but markedly enhanced in obese animals. ET-1 inhibited the vasorelaxant effects of ACh and of the NO donor S-nitroso-N-acetyl-DL-penicillamine in arteries from both LZR and OZR. Selective ETA (BQ123) or ETB receptor (BQ788) antagonists reduced both basal and ET-1-stimulated superoxide generation and reversed ET-1-induced inhibition of NO-mediated relaxations in OZR, while only BQ-123 antagonized ET-1 actions in LZR. ET-1-induced vasoconstriction was markedly enhanced by NO synthase blockade and reduced by endothelium removal and apocynin. In endothelium-denuded penile arteries, apocynin blunted augmented ET-1-induced contractions in OZR. Both ETA and ETB receptors were expressed in smooth muscle and the endothelial layer and up-regulated in arteries from OZR. Conclusions and Implications ET-1 stimulates ETA-mediated NADPH oxidase-dependent ROS generation, which inhibits endothelial NO bioavailability and contributes to ET-1-induced contraction in healthy penile arteries. Enhanced vascular expression of ETB receptors contributes to augmented ROS production, endothelial dysfunction and increased vasoconstriction in erectile tissue from insulin-resistant obese rats. Hence, antagonism of ETB receptors might improve the ED associated with insulin-resistant states. PMID:25091502

  11. MicroRNA Expression Profile in Penile Cancer Revealed by Next-Generation Small RNA Sequencing

    OpenAIRE

    Zhang, Li; Wei, Pengfei; Shen, Xudong; Zhang, Yuanwei; XU, BO; Zhou, Jun; Fan, Song; Hao, Zongyao; Shi, Haoqiang; Zhang, Xiansheng; Kong, Rui; Xu, Lingfan; Gao, JingJing; Zou, Duohong; Liang, Chaozhao

    2015-01-01

    Penile cancer (PeCa) is a relatively rare tumor entity but possesses higher morbidity and mortality rates especially in developing countries. To date, the concrete pathogenic signaling pathways and core machineries involved in tumorigenesis and progression of PeCa remain to be elucidated. Several studies suggested miRNAs, which modulate gene expression at posttranscriptional level, were frequently mis-regulated and aberrantly expressed in human cancers. However, the miRNA profile in human PeC...

  12. Structure and function of small arteries

    DEFF Research Database (Denmark)

    Mulvany, M J; Aalkjær, Christian

    1990-01-01

    The small arteries (prearteriolar vessels with lumen diameter less than approximately 500 microns) contribute importantly to and participate actively in the regulation of the peripheral resistance. New techniques, building on the classic histological and hemodynamic techniques, have enabled detailed in vitro investigation of small arteries. At present, research in small arteries is in its infancy, and our understanding of the heterogeneity of small arteries within vascular beds, between vascular beds, and between species is extremely limited. This review attempts to describe the current status of the field. New techniques, based primarily on a wire myograph (where the vessels are mounted as ring preparations) and a pressure myograph (where vessels are cannulated and pressure-lumen relations are determined), have allowed in vitro investigations of small arteries. The more physiological arrangement of the pressure myograph allows, for example, investigation of the vasoconstrictor response to raised intravascular pressure (the Bayliss response), whereas the less-sophisticated wire myograph is similar to use and may be more useful in certain situations where particular mechanisms are being investigated. Both techniques allow simultaneous measurements of vessel tone and a variety of parameters (e.g., membrane potential and intracellular ion activities) and thus allow precise determination of the relation between small artery structure and function. The vessels appear to remain fully viable with regard to the contractility of their smooth muscle cells as well as to the function of their perivascular nerves and their endothelium. The evidence suggests that the monovalent transport mechanisms in the plasma membrane, in particular potassium channels, play an important role in the determination of the membrane potential in small arteries, although the relation is more complex than indicated by the Goldman equation. Confirmation of these findings requires, however, simultaneous determinations of ion transport and vascular tone under conditions where vessels are subjected to mechanical loading. The membrane potential, through its effect on potential-dependent calcium channels, plays an important role in the determination of vascular tone. With regard to calcium homeostasis, current knowledge is hampered by the lack of direct measurements of the relation between cytoplasmic calcium and vascular tone. The evidence, however, suggests that besides potential-dependent calcium channels, receptor-operated calcium channels are present in the plasma membrane, although this still requires confirmation. The role of the sarcoplasmic reticulum is not clarified.(ABSTRACT TRUNCATED AT 400 WORDS)

  13. Penile reconstruction.

    Science.gov (United States)

    Garaffa, Giulio; Sansalone, Salvatore; Ralph, David J

    2013-01-01

    During the most recent years, a variety of new techniques of penile reconstruction have been described in the literature. This paper focuses on the most recent advances in male genital reconstruction after trauma, excision of benign and malignant disease, in gender reassignment surgery and aphallia with emphasis on surgical technique, cosmetic and functional outcome. PMID:22426595

  14. Penile reconstruction

    OpenAIRE

    Garaffa, Giulio; Sansalone, Salvatore; David J. Ralph

    2012-01-01

    During the most recent years, a variety of new techniques of penile reconstruction have been described in the literature. This paper focuses on the most recent advances in male genital reconstruction after trauma, excision of benign and malignant disease, in gender reassignment surgery and aphallia with emphasis on surgical technique, cosmetic and functional outcome.

  15. Sonographic features of penile-gland lithiasis

    OpenAIRE

    Solivetti, F. M.; Drusco, A.; Pizzi, G.; F. Elia; A. Andreoli

    2008-01-01

    A 52-year-old man presented with a small, red, tender swelling near the penile frenulum at the lower edge of the base of the glans. Lower urinary tract symptoms were absent. Ultrasonography revealed a stone lodged in the distalmost portion of the glands of Littre. Combined with a good knowledge of penile anatomy, use of this simple imaging tool allows reliable diagnosis of even the rarest cases of penile pathology.

  16. Sonographic features of penile-gland lithiasis.

    Science.gov (United States)

    Solivetti, F M; Drusco, A; Pizzi, G; Elia, F; Andreoli, A

    2008-06-01

    A 52-year-old man presented with a small, red, tender swelling near the penile frenulum at the lower edge of the base of the glans. Lower urinary tract symptoms were absent. Ultrasonography revealed a stone lodged in the distalmost portion of the glands of Littre. Combined with a good knowledge of penile anatomy, use of this simple imaging tool allows reliable diagnosis of even the rarest cases of penile pathology. PMID:23396221

  17. Acupuncture assisted local anesthesia for penile surgeries

    Science.gov (United States)

    Zaid, Uwais X.; Hsieh, Cheng-Hsing; Huang, Sheng-Jean

    2013-01-01

    Although the mechanism of acupuncture for analgesia is not fully elucidated, a combination of acupuncture and several methods of topical blocks for local anesthesia has been effective to patients with indications for penile surgeries on ambulatory basis. We sought to review this unique clinical application since 1998. To summarize practice-based medical literature contingent this unique application and, in contrast, the commonly agreed either general or spinal anesthesia concerning those surgeries on this most sensitive organ—the delicate penis. From July 1998 to July 2013, total of 1,481 males underwent penile surgeries with specific topical nerve blockage in addition to acupuncture in which the acupoints of Hegu (LI4), Shou San Li (LI10), Quchi (LI11), and either Waiguan (TE5) or Neiguan (PC6) were routinely used. Careful anesthetic block of the paired dorsal nerve in the penile hilum associated with a peripenile infiltration was categorized to method I which is sufficient to anesthetize the penile structures for varied penile surgeries including 993 men of penile venous stripping surgeries, 336 cases of penile corporoplasty, 8 males of urethroplasty, 7 patients of vaso-vasostomy, 6 men of penile arterial reconstruction and 3 surgeries of penectomy. Whereas the bilateral cavernous nerve block and crural blockage were indispensably added up for anesthetizing the sinusoids of the corpora cavernosa (CC) for penile implant of varied model. It was allocated to method II and had been applied in 125 males. A further topical injection of the medial low abdominal region made it possible for implanting a three-piece model in three males. Thus recent discoveries and better understanding of the penile anatomy had been meaningful in the development and improvement of specific nerve blockade techniques for penile surgeries in particularly adding up with acupuncture techniques, while minimizing anesthetic adverse effects and resulting in a rapid return to daily activity with minimal complications.

  18. Development of Small Diameter Nanofiber Tissue Engineered Arterial Grafts

    OpenAIRE

    Kurobe, Hirotsugu; Maxfield, Mark W; 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 (

  19. Penile Cancer

    Science.gov (United States)

    Clark, Peter E.; Spiess, Philippe E.; Agarwal, Neeraj; Biagioli, Matthew C.; Eisenberger, Mario A.; Greenberg, Richard E.; Herr, Harry W.; Inman, Brant A.; Kuban, Deborah A.; Kuzel, Timothy M.; Lele, Subodh M.; Michalski, Jeff; Pagliaro, Lance; Pal, Sumanta K.; Patterson, Anthony; Plimack, Elizabeth R.; Pohar, Kamal S.; Porter, Michael P.; Richie, Jerome P.; Sexton, Wade J.; Shipley, William U.; Small, Eric J.; Trump, Donald L.; Wile, Geoffrey; Wilson, Timothy G.; Dwyer, Mary; Ho, Maria

    2014-01-01

    Squamous cell carcinoma of the penis represents approximately 0.5% of all cancers among men in the United States and other developed countries. Although rare, it is associated with significant disfigurement, and only half of the patients survive beyond 5 years. Proper evaluation of both the primary lesion and lymph nodes is critical, because nodal involvement is the most important factor of survival. The NCCN Clinical Practice Guidelines in Oncology for Penile Cancer provide recommendations on the diagnosis and management of this devastating disease based on evidence and expert consensus. PMID:23667209

  20. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... our gloves. It’s really – it’s a high-scroll [sp?] incision, Dr. Goldstein, so we avoid any cuts ... who only do penile implants, like Dr. Greiner [sp?] and myself, is quite small. 00:16:37 ...

  1. Videodermatoscopy of pearly penile papules. Case reports

    Directory of Open Access Journals (Sweden)

    Hristo Petrov Dobrev

    2015-01-01

    Full Text Available Pearly penile papules are harmless dermatological condition characterized by small dome-shaped to filiform skin-colored papules located in one to several rows along the sulcus or corona of the glans penis. We describe six male patients with pearly penile papules whose diagnosis was assisted by means of videodermatoscopy. All lesions showed a characteristic whitish pink cobblestone appearance arranged in one or several rows. Each papule contained central dotted or commalike vessels and was surrounded by crescent-shaped whitish structures. Videodermatoscopy may assist the diagnosis of pearly penile papules and successfully differentiate them from genital warts and molluscum contagiosum.

  2. Can Penile Cancer Be Prevented?

    Science.gov (United States)

    ... Next Topic Can penile cancer be found early? Can penile cancer be prevented? The large variations in ... the world strongly suggest that many penile cancers can be prevented. The best way to reduce the ...

  3. Evolution of penile prosthetic devices

    OpenAIRE

    Le, Brian; 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 pro...

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

    DEFF Research Database (Denmark)

    Tang, J; Sheykhzade, Majid; Clausen, B F; Boonen, H C M

    2014-01-01

    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...

  5. Review of penile fracture

    International Nuclear Information System (INIS)

    A detailed current review was performed of penile fracture. A literature search and analysis were compiled of studies made in the last 15 years about the proper management of penile fracture. These have allowed for a practical guide to the diagnosis and early treatment by the urologist

  6. 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

  7. Penil kalcifylaksi

    DEFF Research Database (Denmark)

    Kjaerskov, Mette Wanscher; Comstedt, Lisbeth Rosholm; Bygum, Anette; Yderstraede, Knud Bonnet

    2009-01-01

    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......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...

  8. 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

  9. '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.)

  10. 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.

  11. Small artery structure during antihypertensive therapy is an independent predictor of cardiovascular events in essential hypertension

    DEFF Research Database (Denmark)

    Buus, Niels H; Mathiassen, Ole N; Fenger-Grøn, Morten; Præstholm, Michael N; Sihm, Inger; Thybo, Niels K; Schroeder, Anne P; Thygesen, Kristian; Aalkjær, Christian; Lederballe, Ole; Mulvany, Michael J; Christensen, Kent L

    2013-01-01

    Structural changes of small resistance arteries occur early in the disease process of essential hypertension and predict cardiovascular events in previously untreated patients. We investigated whether on-treatment small artery structure also identifies patients at elevated risk despite...

  12. Penile rehabilitation after pelvic cancer surgery.

    Science.gov (United States)

    Aoun, Fouad; Peltier, Alexandre; van Velthoven, Roland

    2015-01-01

    Erectile dysfunction is the most common complication after pelvic radical surgery. Rehabilitation programs are increasingly being used in clinical practice but there is no high level of evidence supporting its efficacy. The principle of early penile rehabilitation stems from animal studies showing early histological and molecular changes associated with penile corporal hypoxia after cavernous nerve injury. The concept of early penile rehabilitation was developed in late nineties with a subsequent number of clinical studies supporting early pharmacologic penile rehabilitation. These studies included all available phosphodiesterase type 5 inhibitors, intracavernosal injection and intraurethral use of prostaglandin E1 and to lesser extent vacuum erectile devices. However, these studies are of small number, difficult to interpret, and often with no control group. Furthermore, no studies have proven an in vivo derangement of endothelial or smooth muscle cell metabolism secondary to a prolonged flaccid state. The purpose of the present report is a synthetic overview of the literature in order to analyze the concept and the rationale of rehabilitation program of erectile dysfunction following radical pelvic surgery and the evidence of such programs in clinical practice. Emphasis will be placed on penile rehabilitation programs after radical cystoprostatectomy, radical prostatectomy, and rectal cancer treatment. Future perspectives are also analyzed. PMID:25785286

  13. A microfluidic platform for probing small artery structure and function†‡

    OpenAIRE

    Gunther, Axel; Yasotharan, Sanjesh; Vagaon, Andrei; Lochovsky, Conrad; Pinto, Sascha; Yang, Jingli; Lau, Calvin; Voigtlaender-Bolz, Julia; Bolz, Steffen-Sebastian

    2010-01-01

    Although pathologic changes to the structure and function of small blood vessels are hallmarks of various cardiovascular diseases, limitations of conventional investigation methods (i.e. pressure myography) have prohibited a comprehensive understanding of the underlying mechanisms. We developed a microfluidic device to facilitate assessment of resistance artery structure and function under physiological conditions (37 °C, 45 mmHg transmural pressure). The platform allows for on-chip fixation,...

  14. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... next hour you’ll see a live panel discussion of penile implant surgery. For men with severe ... 01:03:32 ANNOUNCER: This has been a discussion of penile implant surgery live from Coral Gables ...

  15. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... or Cialis. The inflatable penile prosthesis consists of two cylinders, a reservoir, and pump, which are placed ... early 1970s. Today we are thrilled to have two contemporary experts in penile implant surgery for the ...

  16. 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.

  17. 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.

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

    OpenAIRE

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

    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...

  19. Relaxant effects of hexosamines on isolated small human placental arteries.

    Science.gov (United States)

    Uldbjerg, N; Allen, J; Maigaard, S; Forman, A

    1987-01-01

    Wharton's jelly contains large amounts of hyaluronic acid, and glucosamine is an important constituent of this macromolecule. In order to evaluate the placental vascular effects of this aminosugar, small chorionic and stem villous arteries were dissected from placental specimens obtained at normal term vaginal deliveries (n = 15). Ring preparations were mounted in organ baths, and isometric wall tensions were measured. Glucosamine and its epimer galactosamine (5 X 10(-4) to 10(-2) M) produced marked relaxation of contractions induced by PGF2 alpha (10(-5) M) in both chorionic and stem villous arteries. The effect was unchanged after pretreatment with atropin, propranolol and indomethacin. The relaxant effect of the neutral sugar mannose was less pronounced compared with that of the hexosamines. Total tissue concentrations of placental hexosamines have been reported within the range needed to produce placental vascular relaxation in the present study. However, the major part of these compounds is integrated in macromolecules, and the tissue level of free hexosamine is probably far below the total concentrations. Accordingly, the effects of hexosamines demonstrated in the present study might not be of physiological importance in the regulation of fetal placental medial smooth muscle tension. PMID:3684970

  20. 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 management. (author)

  1. 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.

  2. 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.

  3. 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 ...

  4. Minimally Invasive Penile Implant Surgery

    Science.gov (United States)

    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 ...

  5. Decellularized ovine arteries as small-diameter vascular grafts

    International Nuclear Information System (INIS)

    Atherosclerosis and its complications still represent the leading cause of death in the developed countries. While autologous blood vessels may be regarded as the best solution for peripheral and coronary bypass, they are unavailable in most patients. Even though tissue engineering techniques are often applied to the development of small-diameter vascular grafts, limiting factors of this approach are represented by the lack of essential extracellular matrix proteins and/or poor biomechanical properties of the scaffolds used. Along these lines, the aim of this study was to develop a decellularization protocol for ovine carotids to be used as suitable small-diameter vascular grafts. Samples were treated either with sodium dodecyl sulphate (SDS) or with Trypsin and Triton X-100; a final nuclease digestion was performed for both protocols. Morphological analyses demonstrate complete removal of nuclei and cellular components in treated vessels, also confirmed by significant reduction in wall thickness and DNA content. Essential extracellular matrix proteins such as collagen, elastin, and fibronectin are well preserved after decellularization. From a mechanical point of view, Trypsin and Triton X-100 treated arteries show elastic modules and compliance comparable to native carotids, whereas the use of SDS makes samples stiffer, with a significant decrease in the compliance mean value and an increase in longitudinal and circumferential Young’s modules. It is demonstrated that the treatment where Trypsin and Triton X-100 are combined guarantees complete decellularization of carotids, with no significant alteration of biomechanical and structural properties, thus preserving a suitable environment for adhesion, proliferation, and migration of cells. (paper)

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

    Energy Technology Data Exchange (ETDEWEB)

    Schwartz, A.N.; Graham, M.M.; Ferency, G.F.; Miura, R.S.

    1989-04-01

    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.

  7. Evaluation of carotid artery elasticity changes in patients with cerebral small vessel disease

    OpenAIRE

    Huang, Xiaochun; Kang, Xiaoyan; Xue, Jiping; Kang, Chunsong; Lv, Hong; Li, Zhaojun

    2015-01-01

    Background: The purpose of this study is to evaluate the intima-media thickness (IMT) and arterial elasticity of the common carotid artery (CCA) in patients with cerebral small vessel disease (SVD) by applying radiofrequency (RF) ultrasound technology. Methods: Fifty SVD subjects (SVD group) and fifty-three matched controls (Control group) were enrolled in the study. Structural and functional changes in the common carotid arterial wall were investigated by quality intima-media thickness (QIMT...

  8. 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 carefully. Super-selective catheterization with gelfoam particles is the method of choice to avoid potential ischemic complications. (authors)

  9. A review of penile metastasis

    Directory of Open Access Journals (Sweden)

    Luigi Mearini

    2012-06-01

    Full Text Available Penile cancer as primary disease is relatively rare in developed countries. The penis is a rare site of metastases in spite of its rich vascularization. Approximately 500 cases have been reported in the literature; almost 70% of primary lesions are of pelvic origin (from genitourinary or recto-sigmoid primary tumors. We describe a case of penile metastasis from lung cancer. The rarity of the event prompted us to also explore related reviews and discuss the incidence, physiopathology, diagnosis and therapy of penile secondary cancer.

  10. Ultrasound Diagnosis of Penile Fracture.

    Science.gov (United States)

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

    2015-10-01

    Arare but possibly underreported urological emergency is penile fracture which results from tear in the tunica albuginea of the penis. The proposed etiology is forceful manipulation of an erect penis or secondary to blunt trauma. We would like to report a case of young patient presenting with large penile shaft hematoma and deformity. The patient did not provide obvious history of trauma or sexual intercourse. The ultrasound of penis was performed which suggested the diagnosis of penile fracture and ultrasound findings were correlated with peroperative findings. PMID:26522196

  11. Pressure Myography to Study the Function and Structure of isolated small arteries

    DEFF Research Database (Denmark)

    SchjØrring, Olav; Carlsson, Rune

    2015-01-01

    Small arteries play an important role in regulation of peripheral resistance and organ perfusion. Here we describe a series of the methods allowing measurements in pressurized segments of small arteries from the systemic and coronary circulation of mice as well as other species. The pressure myography techniques described include measurements of wall structure, wall stress, strain, and of myogenic tone. The pressurized perfused small arteries also allow evaluation of responses to increases in pressure, flow, and drugs, where the main readout is changes in vascular diameter.

  12. 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.

  13. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... give you today is based on a recent abstract where I reviewed my last 300 penile prostheses. ... ve already been talking about that. In this abstract what I wanted to look at is I ...

  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 ... 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 ...

  16. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... to make sure that we have a happy customer after everything is done. 00:20:26 IRWIN ... minimally invasive penile implant. Any of the objective data that I’m going to give you today ...

  17. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... techniques potentially reduce the infec—the opportunity for infection, the most feared penile prosthetic complication. On my ... slide, and that is the slide on the infection prevention. And as you know, one of the ...

  18. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... Coral Gables Hospital in beautiful Coral Gables, Florida. My name is Irwin Goldstein. I am Director, San ... infection, the most feared penile prosthetic complication. On my immediate left is Dr. Francois Eid, clinical associate ...

  19. Drugs Approved for Penile Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for penile cancer. The list includes generic names and brand names. The drug names link to NCI’s Cancer Drug Information summaries.

  20. 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. ...

  1. 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 ...

  2. Penile rehabilitation after radical prostatectomy

    DEFF Research Database (Denmark)

    Fode, Mikkel; Ohl, Dana A; Ralph, David; Sønksen, Jens

    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 s...

  3. Different involvement of extracellular matrix components in small and large arteries during chronic NO synthase inhibition.

    Science.gov (United States)

    Bouvet, Céline; Gilbert, Liz-Ann; Girardot, Daphné; deBlois, Denis; Moreau, Pierre

    2005-03-01

    In essential hypertension, conduit arteries present hypertrophic remodeling (increased cross-sectional area), whereas small arteries undergo eutrophic remodeling. The involvement of matrix metalloproteinases (MMPs) and de-adhesion proteins, such as tenascin-C and thrombospondin, has been relatively well characterized in large artery remodeling, but their contribution is not known in small artery remodeling. Rats received N(omega)-nitro-L-arginine methyl ester (L-NAME; 50 mg/kg per day) in their drinking water on days 1, 3, 7, 14, and 28. Arterial MMP-2 activity was measured by ELISA, whereas levels of tenascin-C and thrombospondin were assessed by Western blotting. To determine the involvement of MMPs, additional L-NAME rats received the nonselective MMP inhibitor doxycycline (30 mg/kg per day) on days 7, 14, and 28. Already, at day 1, pressure was elevated. Media/lumen ratio of mesenteric arteries and the aorta increased gradually to reach significance at 28 days. However, the cross-sectional area increased only in the aorta, confirming the heterogeneous remodeling process. In small arteries, MMP-2 activity increased after 7 and 14 days of treatment and returned to baseline at 28 days, whereas the elevation was more progressive but sustained in the aorta. The level of thrombospondin paralleled that of MMP-2 in small arteries, whereas tenascin-C levels declined rapidly and stayed below control values. Doxycycline blunted large artery remodeling but had no influence on the development of eutrophic remodeling despite elevation of MMP-2 activity in the process. Thus, in contrast to large artery hypertrophic remodeling, in which the contributions of cellular de-adhesion and matrix breakdown is manifest, the contribution of MMPs in eutrophic remodeling appears less crucial. PMID:15655118

  4. 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.)

  5. 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.)

  6. Penile injuries: A 10-year experience

    OpenAIRE

    Krishna Reddy, S.V.; Shaik, Ahammad Basha; Sreenivas, K

    2014-01-01

    We report our 10-year experience with penile injuries. We retrospectively reviewed the records of 156 cases of male external genitalia injuries between May 2002 and December 2012. Of these, only 26 patients presented without urethral injuries and were included in this study. Patients were divided into 4 groups: Group 1 (n = 12) with patients with penile fractures injuries; Group 2 (n = 5) with patients with penile amputation injuries; Group 3 (n = 2) with patients with penile penetrating inju...

  7. LARGE AND SMALL ARTERIAL ELASTICITY IN HEALTHY ACTIVE AND SEDENTARY PREMENOPAUSAL WOMEN

    Directory of Open Access Journals (Sweden)

    Anette S. Fjeldstad

    2007-06-01

    Full Text Available The purpose of this study was to compare large and small arterial elasticity in apparently healthy sedentary and recreationally active adult women, and to examine if age affects large and small arterial elasticity. This cross-sectional study consisted of 43 premenopausal women without overt cardiovascular disease (age = 43.4 ± 4.7 yrs; mean ± SD. The subjects were grouped into a sedentary group or a leisurely active group (30 min, 3d wk of low intensity in addition to the following age groups: 35-40 years, n = 13; 41-45 years, n = 14; 46-54 years, n = 16. Subjects rested supine while pulse contour analysis was measured from the radial artery using an HDI/Pulsewave CR-2000 instrument (Hypertension Diagnostic, Inc. to examine arterial elasticity in the large and small arteries. Activity level and menopausal status was based on self-report. There were no differences in large (14.5 ± 1.0 ml/mmHg x 10; 14.9 ± 0.9 ml/mmHg x 10; mean ± SD and small (5.5 ± 0.5 ml/mmHg x 100; 6.4 ± 0.4 ml/mmHg x 100 arterial elasticity between the sedentary group and the recreationally active group, respectively. Large (12.8 ± 0.9 ml/mmHg x 10 arterial elasticity was lower in the oldest group (p = 0.008 compared to the youngest group (17.6 ± 5.9 ml/mmHg x 10. After adjusting for body mass index, large arterial elasticity (p = 0.022 remained lower in the oldest group. There was a trend for small arterial elasticity to be lower in the older group compared to the young group (p = 0.063. There was no difference in large and small arterial elasticity between healthy sedentary and recreationally active premenopausal women. This suggests that more strenuous physical activity may be necessary to gain beneficial effects on the vasculature. Large arterial elasticity is decreasing with advancing age independent of body mass index

  8. Coronary angiography through ipsilateral ulnar approach in a patient with small-diameter radial artery

    Directory of Open Access Journals (Sweden)

    Staji? Zoran

    2013-01-01

    Full Text Available Introduction. Coronary procedures cannot be completed in 5-15% of cases through initially used radial artery approach due to frequent radial artery anomalies and vasospasm. In these cases, the ulnar artery approach could be the safe and effective alternative wrist approach. Case report. A 60-year-old patient with stable angina pectoris, hypertension, dyslipidaemia and positive endurance test was admitted to our hospital for coronary angiography. Due to the backbone pains which also made prolonged lying in bed very uncomfortable and painful, we opted for the wrist approach (standard radial approach after both modified Allen’s tests had been performed, which gave the positive result. After sheath insertion into the right radial artery and unsuccessful advancement of the guidewire and the catheter, we performed the right forearm angiography, which revealed that the right radial artery had a small diameter and the right ulnar artery was the dominant one. Afterwards, the right ulnar artery was cannulated successfully and the coronary angiography was performed through this approach. Both sheaths were removed simultaneously immediately after the procedure and hemostasis was secured by the compression with two Terumo- bands over the puncture sites without any complications. The pulses of both arteries were checked regularly over the next 24 hours and they remained normal. A day after the procedure, the control Doppler-ultrasound check-up was performed and it confirmed the normal flow in both cannulated arteries. One-month follow-up was uneventful, and the patient did not experience any ischemic symptoms of the hand. Conclusion. This case is the proof that the ipsilateral ulnar approach can be a safe and effective alternative approach in patients with positive Allen’s test after the failure of initial radial attempt in cases where femoral approach should be avoided or the wrist approach should be maintained.

  9. 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.

  10. Quantification of penile "buckling" force.

    Science.gov (United States)

    Hahn, P M; Leder, R

    1980-01-01

    A hand-held transducer was developed for measuring penile rigidity. This instrument gives a quantitative measure of the force at which the penis "buckles." The transducer consists of a cantilever beam with strain gages that is rugged, easy to calibrate, and adaptable to most graphic recorders. PMID:7466130

  11. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... not have the best looking penis in the world, but he’ll be able to make love ... 300,000 breast implants a year? Across the world there’s only 16,000 penile implants. There’s something ...

  12. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... hole and they isolate the rest of the mouth. And I said to myself, “Well, gee, if we could do that for penile implants, maybe we’ll decrease our infection rates.” And I started looking at what is the source of infection, and looking at the literature it is clear that it is the patient’s ...

  13. 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 ...

  14. 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 ... we could have this treatment option be completely risk-less. 00:04:24 IRWIN GOLDSTEIN, MD: So ...

  15. 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.

  16. Structural and functional alterations of subcutaneous small resistance arteries in severe human obesity.

    Science.gov (United States)

    Grassi, Guido; Seravalle, Gino; Scopelliti, Francesco; Dell'Oro, Raffaella; Fattori, Luca; Quarti-Trevano, Fosca; Brambilla, Gianmaria; Schiffrin, Ernesto L; Mancia, Giuseppe

    2010-01-01

    Obese persons are at increased cardiovascular risk and exhibit increased arterial stiffness and impaired endothelial function of large- and medium-size arteries. We hypothesized that normotensive subjects suffering from severe obesity would also present remodeling and endothelial dysfunction of small resistance arteries. A total of 16 lean (age: 49.6 +/- 2.9 years, BMI: 22.9 +/- 0.3 kg/m(2), mean +/- s.e.m.) and 17 age-matched severely obese (BMI: 41.1 +/- 2.3 kg/m(2)) normotensive subjects were investigated. None had glucose or lipid metabolic abnormalities except for insulin resistance. Resistance arteries, dissected from abdominal subcutaneous tissue, were assessed on a pressurized myograph. For superimposable blood pressure, the media thickness, media cross-sectional area (CSA), and media-to-lumen ratio values of resistance arteries were markedly and significantly greater in obese compared to lean subjects (media thickness 26.3 +/- 0.6 vs. 16.2 +/- 0.6 microm, CSA 22,272 +/- 1,339 vs. 15,183 +/- 1,186 microm(2), and media-to-lumen ratio 0.113 +/- 0.006 vs. 0.059 +/- 0.001, respectively, P < 0.01). Acetylcholine-induced relaxation was impaired in vessels from obese subjects compared to the lean individuals (-40.4 +/- 1.3%, P < 0.01), whereas endothelium-independent vasorelaxation was similar in all groups. Stiffness of small arteries as assessed by the stress/strain relationship was similar in lean and severely obese subjects. We conclude that severe human obesity is associated with profound alterations in structural and functional characteristics of small arteries, which may be responsible for the presence of elevated cardiovascular risk and increased incidence of coronary, cerebrovascular and renal events reported in obesity. PMID:19521345

  17. 21 CFR 876.3630 - Penile rigidity implant.

    Science.gov (United States)

    2010-04-01

    ...2010-04-01 false Penile rigidity implant. 876.3630 Section 876.3630 Food...Devices § 876.3630 Penile rigidity implant. (a) Identification. A penile rigidity implant is a device that consists of a...

  18. 21 CFR 876.3350 - Penile inflatable implant.

    Science.gov (United States)

    2010-04-01

    ...2010-04-01 false Penile inflatable implant. 876.3350 Section 876.3350 Food...Devices § 876.3350 Penile inflatable implant. (a) Identification. A penile inflatable implant is a device that consists of...

  19. 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.

  20. Secondary penile carcinoma originated from pancreas.

    OpenAIRE

    Ahn, T. Y.; Choi, E H; Kim, K S

    1997-01-01

    Secondary penile cancers are rarely seen and most of them are originated from genitourinary and gastrointestinal tract. But metastatic penile cancer originated from pancreas are extremely rare and two cases have been reported in the literature, only one of them was pathological proven in autopsy. We report a case of secondary penile carcinoma originated from the pancreas as the primary site which was pathologically proven.

  1. Usefulness of automated feeder-detection software for identification of access routes to small pancreaticoduodenal artery aneurysms during embolotherapy.

    Science.gov (United States)

    Miyayama, Shiro; Yamashiro, Masashi; Ogi, Takahiro; Kayahashi, Masanori; Kawamura, Kenji; Yoshida, Miki; Terada, Takuro; Kosugi, Ikuko

    2015-12-01

    The mortality rate of patients with ruptured pancreaticoduodenal artery aneurysms is high; therefore, it is recommended to treat pancreaticoduodenal artery aneurysms regardless of their size. In small pancreaticoduodenal artery aneurysms, however, identification of the access route on two-dimensional arteriography is sometimes difficult because of the superimposition of many hypertrophied branches of pancreaticoduodenal arteries on the aneurysm. We report two cases of ruptured pancreaticoduodenal artery aneurysm embolized successfully with metallic coils, assisted by automated feeder-detection software using cone-beam computed tomography data. This new technology may reduce physicians' workload during the procedure. PMID:25585537

  2. Anaphylaxis of small arteries: putative role of nitric oxide and prostanoids.

    Science.gov (United States)

    Laukeviciene, Ale; Ugincius, Paulius; Korotkich, Igor; Lazauskas, Robertas; Kevelaitis, Egidijus

    2010-01-01

    This study investigated possible implication of nitric oxide and prostanoids in anaphylactic reaction in small mesenteric and coronary arteries. MATERIAL AND METHODS. Isolated arteries from guinea pigs, sensitized with 0.5 mL of horse serum or sham-sensitized, were challenged with 1% of horse serum in vitro. Contractile responses of arteries (normalized diameter, 350-450 microm) were recorded by a small blood vessel wire myograph. For inhibition of the release of NO or prostanoids, vessels were pretreated with N(G)-nitro-L-arginine methyl ester (30 microM) or indomethacin (10 microM), respectively. RESULTS. Antigen challenge was followed by contraction of both coronary and mesenteric vessels. Two patterns of contraction were observed: 1) peak contraction - an immediate transient contraction of relatively high amplitude; this was the most common pattern; 2) biphasic: the initial peak contraction was followed by a slow growing contraction with low amplitude. Biphasic pattern was observed in 60% of the mesenteric vessels and 40% of the coronary vessels. Inhibition of NO synthase significantly increased the peak contraction in the coronary vessels and the second-phase contraction in the mesenteric vessels. Inhibition of cyclooxygenase caused a decrease in the peak and second-phase contraction of both the coronary and mesenteric vessels. CONCLUSIONS. Despite anaphylactic contraction, nitric oxide seems to be released from the endothelium following antigen challenge in the small coronary and mesenteric arteries. This may contribute to the development of hypotension during anaphylaxis. Prostanoids are playing a different role - the contracting products of cyclooxygenase pathway are important for the development of anaphylactic contraction of the small isolated arteries. PMID:20234162

  3. Small artery structure is an independent predictor of cardiovascular events in essential hypertension

    DEFF Research Database (Denmark)

    Mathiassen, Ole Norling; Buus, Niels Henril; Sihm, Inger; Thybo, Niels K; Mørn, Birgitte; Schroeder, Anne P; Thygesen, Kristian; Aalkjær, Christian; Lederballe, Ole; Mulvany, Michael J.; Christensen, Kent Lodberg

    2007-01-01

    Objective Structural abnormality of resistance arteries is a characteristic pathophysiological phenomenon in essential hypertension and can be assessed in vitro as an increase in the media : lumen ratio (M : L) of isolated small arteries. We have investigated whether M: L is a risk predictor in......). Conclusion Abnormal resistance artery structure independently predicts cardiovascular events in essential hypertensive patients at moderate risk. J Hypertens 25:1021-1026 Q 2007 Lippincott Williams & Wilkins. Journal of Hypertension 2007, 25:1021-1026...... uncomplicated essential hypertensive patients. Recently, high M: L was demonstrated as a prognostic marker in patients at high cardiovascular risk, including normotensive type 2 diabetic patients. Since diabetes is associated with pressure-independent changes in M: L, the relevance of this finding to essential...

  4. AB155. High-throughput sequencing of small RNA component of penile in a post-radical prostatectomy model of erectile dysfunction

    Science.gov (United States)

    Ruan, Yajun; Luan, Yang; Zhang, Yan; Li, Hao; Li, Rui; Li, Mingchao; Wang, Tao; Liu, Jihong

    2015-01-01

    Objective The introduction of nerve-sparing radical prostatectomy represents a milestone in the treatment of prostate cancer. However, a certain percentage of cancer survivors still suffer from erectile dysfunction. Recent research has stated that using PDE 5-inhibitors after radical prostatectomy may lead to biochemical recurrence. This study was performed to identify the expression profile of small RNA in rats with neurogenic erectile dysfunction, and to investigate possible genes and signaling pathways involving in the disease. Methods Neurogenic erectile dysfunction (ED) was induced in male rats by bilateral cavernous nerve crushing injury (BCNI). After 28 days, RNA was isolated from the corpus cavernosum (CC) of both control rats and neurogenic ED rats. Small RNA sequencing was conducted using an Illumina Hiseq 2500/2000 platform. Candidate small RNAs were validated by rael-time polymerase chain reaction. Results Intracavernous pressure (ICP) was significantly decreased in BCNI group compared with SHAM group. Real time PCR validated that miR-9a-5p, miR-203a-5p, miR-378a-3p and miR-3557-5p were upregulated, and meanwhile miR-3084a-3p was downregulated. Conclusion Small RNA, including microRNA, may play an important role in the regulation of genes in CC and some certain miRs may participate in post-prostatectomy ED. Further studies will be designed to investigate the specific mechanisms of these changes.

  5. Integrative Modeling of Small Artery Structure and Function Uncovers Critical Parameters for Diameter Regulation

    OpenAIRE

    vanBavel, Ed; Tuna, Bilge Guvenc

    2014-01-01

    Organ perfusion is regulated by vasoactivity and structural adaptation of small arteries and arterioles. These resistance vessels are sensitive to pressure, flow and a range of vasoactive stimuli. Several strongly interacting control loops exist. As an example, the myogenic response to a change of pressure influences the endothelial shear stress, thereby altering the contribution of shear-dependent dilation to the vascular tone. In addition, acute responses change the stimulus for structural ...

  6. Concentrated ambient air particles induce vasoconstriction of small pulmonary arteries in rats.

    OpenAIRE

    Batalha, Joao R F; Saldiva, Paulo H.N.; Clarke, Robert W.; Coull, Brent A.; Stearns, Rebecca C; Lawrence, Joy; Murthy, G G Krishna; Koutrakis, Petros; Godleski, John J

    2002-01-01

    The objective of this study was to determine whether short-term exposures to concentrated ambient particles (CAPs) alter the morphology of small pulmonary arteries in normal rats and rats with chronic bronchitis (CB). Sprague-Dawley male rats were exposed to CAPs, using the Harvard Ambient Particle Concentrator, or to particle-free air (sham) under identical conditions during 3 consecutive days (5 hr/day) in six experimental sets. CB was induced by exposure to 276 +/- 9 ppm of sulfur dioxide ...

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

    OpenAIRE

    Annang Giri Moelyo; Melita Widyastuti

    2013-01-01

    Background Penile length is a factor for assessing abnormalities in external genitalia. To diagnose micropenis, a condition in which penile length is < - 2.5 standard deviations (SD), a reference is required for diagnosis. Age and race/ethnic groups are factors that contribute to normal penile length. To date, Indonesia does not have such a reference for normal penile length in newborns and children. Objective To assess normal penile length in newborns and children in Surakarta, Central J...

  8. Implantation of AMS 700 LGX penile prosthesis preserves penile length without the need for penile lengthening procedures.

    Science.gov (United States)

    Negro, Carlo Luigi Augusto; Paradiso, Matteo; Rocca, Alessandro; Bardari, Franco

    2016-01-01

    Implantation of an inflatable penile prosthesis (IPP) is a well-established definitive solution for erectile dysfunction when conservative treatments fail. Penile implants may shorten the penis. The AMS 700 LGX IPP is in common use but reports on its mechanical reliability, medium-term postsurgical patient satisfaction, and mean penile length preservation are lacking. We investigate the mean penile length, mechanical reliability, and patient satisfaction at 6 and 12 months after implantation of the AMS 700 LGX. This prospective study consecutively enrolled men undergoing first-time IPP implant surgery from February 2009 to April 2012. Stretched flaccid penile length, penile length at 50% and 100% of stiffness (P50 and P100) and International Index of Erectile Function (IIEF) and Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) scores, were measured at 6 and 12 months postsurgery. Of 45 patients who underwent AMS 700 LGX implantation (median age 61 years) and completed 6 months' follow-up, 36 (80%) completed the study. A significant difference in stretched flaccid penile length was seen between 6 and 12 months (P = 0.033). P100 was also significantly increased at 6 and 12 months, with a mean 10% increase (1.3 ± 0.4 cm) from baseline to 12 months. Differences in mean IIEF scores at 6 and 12 months were significant for the desired domain (P = 0.0001) and for overall satisfaction (P = 0.002); however, mean EDITS scores at 6 and 12 months were not significantly improved. AMS 700 LGX is a powerful tool for preserving penile length in men undergoing penile prosthesis implantation. PMID:26112480

  9. [Prosthetic implants for penile induration].

    Science.gov (United States)

    Zanollo, A; Beretta, G; Zanollo, L; Spinelli, M

    1990-09-01

    From 1982 to 1988 we have evaluated 283 patients affected by Peyronie's disease. 81 of these complained erectile disfunction. Semirigid penile prosthesis were inserted in 38 patients with severe induratio penis plastica. Following surgery the patients were given a sexual questionnaire in order to determine whether they had realised their expectations as well as partner acceptance. Our results appear to be favourable and prosthesis insertion in selected patients with Peronie's disease seems to be the safest, most economical and best accepted choice. PMID:2148022

  10. Penile rehabilitation after radical prostatectomy.

    Science.gov (United States)

    Cohen, David Jacques; Glina, Sidney

    2015-01-01

    Erectile dysfunction (ED) is the main and most frequent side effect after radical prostatectomy. Also, ED is the primary impact factor for quality of life after radical prostatectomy. ED post radical prostatectomy is mainly due to lesions in the neurovascular bundles which can occur by partial or total sectioning, by stretching (the most common), or by thermal lesion of the nervous fibers, leading to a condition called "neuropraxia". The term penile rehabilitation (PR) after prostatectomy has been defined as any intervention with the intent of reestablishing preoperative erectile function and includes the isolated or combined use of phosphodiesterase 5 inhibitors (PDE5i), intracavernous injection, vacuum erectile device therapy, and use of intraurethral drugs. The use of intracavernous drugs, of intraurethral prostaglandin and the use of vacuum therapy have a poorly defined role regarding postoperative penile rehabilitation and must be better investigated through further studies. The use of PDE5i as PR is strongly supported by experimental research, but most clinical trials found controversial results. PMID:25642716

  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. Angiographic Evaluation of Carotid Artery Grafting with Prefabricated Small-Diameter, Small-Intestinal Submucosa Grafts in Sheep

    International Nuclear Information System (INIS)

    The purpose of this study was to report the longitudinal angiographic evaluation of prefabricated lyophilized small-intestinal submucosa (SIS) grafts placed in ovine carotid arteries and to demonstrate a variety of complications that developed. A total of 24 grafts, 10 cm long and 6 mm in diameter, were placed surgically as interposition grafts. Graft patency at 1 week was evaluated by Doppler ultrasound, and angiography was used for follow-up at 1 month and at 3 to 4 months. A 90% patency rate was found at 1 week, 65% at 1 month, and 30% at 3 to 4 months. On the patent grafts, angiography demonstrated a variety of changes, such as anastomotic stenoses, graft diffuse dilations and dissections, and aneurysm formation. These findings have not been previously demonstrated angiographically by other investigators reporting results with small-diameter vessel grafts made from fresh small-intestinal submucosa (SIS). The complications found were partially related to the graft construction from four SIS layers. Detailed longitudinal angiographic study should become an essential part of any future evaluation of small-vessel SIS grafting.

  13. Concentrated ambient air particles induce vasoconstriction of small pulmonary arteries in rats.

    Science.gov (United States)

    Batalha, Joao R F; Saldiva, Paulo H N; Clarke, Robert W; Coull, Brent A; Stearns, Rebecca C; Lawrence, Joy; Murthy, G G Krishna; Koutrakis, Petros; Godleski, John J

    2002-12-01

    The objective of this study was to determine whether short-term exposures to concentrated ambient particles (CAPs) alter the morphology of small pulmonary arteries in normal rats and rats with chronic bronchitis (CB). Sprague-Dawley male rats were exposed to CAPs, using the Harvard Ambient Particle Concentrator, or to particle-free air (sham) under identical conditions during 3 consecutive days (5 hr/day) in six experimental sets. CB was induced by exposure to 276 +/- 9 ppm of sulfur dioxide (5 hr/day, 5 days/week, 6 weeks). Physicochemical characterization of CAPs included measurements of particle mass, size distribution, and composition. Rats were sacrificed 24 hr after the last CAPs exposure. Histologic slides were prepared from random sections of lung lobes and coded for blinded analysis. The lumen/wall area (L/W) ratio was determined morphometrically on transverse sections of small pulmonary arteries. When all animal data (normal and CB) were analyzed together, the L/W ratios decreased as concentrations of fine particle mass, silicon, lead, sulfate, elemental carbon, and organic carbon increased. In separate univariate analyses of animal data, the association for sulfate was significant only in normal rats, whereas silicon was significantly associated in both CB and normal rats. In multivariate analyses including all particle factors, the association with silicon remained significant. Our results indicate that short-term CAPs exposures (median, 182.75 micro g/m3; range, 73.50-733.00 micro g/m3) can induce vasoconstriction of small pulmonary arteries in normal and CB rats. This effect was correlated with specific particle components and suggests that the pulmonary vasculature might be an important target for ambient air particle toxicity. PMID:12460797

  14. Left anterior small thoracotomy for minimally invasive coronary artery bypass grafting.

    Science.gov (United States)

    Reser, Diana; Holubec, Tomas; Caliskan, Etem; Guidotti, Andrea; Maisano, Francesco

    2015-01-01

    Since the 1990 s, minimally invasive cardiac surgery has gained wide acceptance due to patient and economic demand. The advantages are less trauma, bleeding, wound infections, pain and faster recovery. Many studies showed that the outcomes are comparable with those of conventional sternotomy. Left anterior small thoracotomy (LAST) evolved into a routine and safe access in specialized centres for minimally invasive direct coronary artery bypass grafting. The 6-cm incision is localized above the fourth intercostal space, 3-4 cm lateral to the left sternal border and below the left mammilla. With a double-lumen tube, the left lung is deflated before entering the pleural space. The left internal mammary artery is harvested under direct vision with the use of special retractors. The anastomosis of the left anterior descending artery is performed on the beating heart as known from off-pump surgery. One chest tube is inserted. The intercostal space is closed with braided sutures to prevent lung herniation. Ropivacaine is used for local infiltration. The pectoral muscle, subcutaneous tissue and skin are closed with running sutures. Complications of the LAST approach are rare (conversion to sternotomy, re-thoracotomy, phrenic nerve palsy, wound infection and thoracic wall hernia) and well manageable. PMID:26420246

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

    DEFF Research Database (Denmark)

    Plesner, L; Juul, B; Skriver, E; Aalkjær, Christian

    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-, ...

  16. Effect of antihypertensive treatment on small arteries of patients with previously untreated essential hypertension

    DEFF Research Database (Denmark)

    Thybo, N K; Stephens, N; Cooper, A; Aalkjær, Christian; Heagerty, A M; Mulvany, M J

    1995-01-01

    In a double-blind randomized trial, the effects of treatment with an angiotensin-converting enzyme (ACE) inhibitor (perindopril) and a beta-blocker (atenolol) on small artery structure were compared in previously untreated essential hypertensive patients. Subjects (diastolic blood pressure > or = 100 and

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

    OpenAIRE

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

  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, Thomas; Kroigaard, Christel; Beck, Lilliana; Boedtkjer, Ebbe; Misfeldt, Mikkel W; Nielsen, Gorm; Schjorring, Olav; Hughes, Alun; Simonsen, Ulf

    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 us...

  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, T.; Kroigaard, C.; Beck, L.; Bødtkjer, Ebbe; Misfeldt, M. W.; Nielsen, G.; Schjorring, O.; Hughes, A.; Simonsen, U.

    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 u...

  20. Organ-Preserving Surgery for Penile Carcinoma

    OpenAIRE

    Martins, Francisco E.; Rodrigues, Raul N.; 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...

  1. Surgical or conservative treatment of penile fracture

    Directory of Open Access Journals (Sweden)

    Đorđević 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.

  2. Acute cerebral arterial embolism following pemetrexed and carboplatin treatment in non-small-cell lung cancer: A case report

    OpenAIRE

    Takeda, Masayuki; KOBAYASHI, Takehiko; MARUMO, SATOSHI; KOSHIMO, YOSHIHIKO; TERANISHI, TAKASHI; HIGAMI, YUICHI; KATO, MOTOKAZU

    2013-01-01

    Thromboembolism is a known vascular toxicity associated with tumor chemotherapy. The combination of pemetrexed and carboplatin has exhibited significant antitumor activity, with mild manageable toxicity in patients with advanced non-small-cell lung cancer (NSCLC), whereas cerebral arterial embolism has not been recognized as a side effect associated with this regimen. This is the case report of an unusual case of NSCLC, in which the patient suffered a left middle cerebral arterial embolism fo...

  3. 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; Stender, Steen; Sandager, Puk; Aalkjær, Christian

    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 nonsm...

  4. 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...

  5. Axial penile rigidity influences patient and partner satisfaction after penile prosthesis implantation

    Directory of Open Access Journals (Sweden)

    Abdulla Al Ansari

    2013-09-01

    Full Text Available Introduction: Penile prosthesis implantation is one of the treatment choices that is kept for patients who were not satisfied with other treatments. Although penile prosthesis satisfaction rates are higher, there are some dissatisfied patients. The patients’ reasons are mostly shortness and softness of implanted prosthesis. It was previously demonstrated that penile axial rigidity of more than 500 grams is enough for successful vaginal intromission. To our knowledge, there is no study comparing axial rigidity of penile prosthesis and satisfaction. Objectives: The aim of this study was to examine whether axial rigidity of penile prosthesis had impact on patient and partner satisfaction. Materials and Methods: We enrolled one hundred patients who were implanted penile prosthesis before to evaluate their penile axial rigidity. We used Rigidometry (by using the digital inflection rigidometer to assess the minimal axial pressure to bend the implanted penis. Results: We demonstrated that mean axial pressure to bend the implanted penis was 984.8 ± 268.7 grams. Overall satisfaction score with the penile prosthesis implant was 4.55 and 4.49 (out of 5 in patients and partners, respectively. In total, seven men were unsatisfied with their implant and reported a mean satisfaction score of 0.6 ± 0.48 (out of 5. All prostheses types showed good and more than 500 grams axial rigidity. The patients with Ambicor type, which were buckled at about 710.5 grams, showed worse satisfaction rates in comparison to other prostheses in two patients. Digital inflection rigidometer results of other penile prosthesis types in unsatisfied patient were 842.0, 872.0, 887.0 and 920 g. in CX700, Titan, Genesis and Titan OTR, respectively. Conclusion: We demonstrated that dissatisfaction rate was highest in Ambicor prosthesis implanted patients. Additionally, patients with 3-piece penile prosthesis were more satisfied than 2-piece or malleable ones, interestingly, although some cases had lower axial rigidity results.

  6. The impact of surgical treatment for penile cancer -- patients' perspectives.

    OpenAIRE

    Witty, K; Branney, P.; Evans, J.; Bullen, K.; White, A.; Eardley, I.

    2013-01-01

    PURPOSE OF THE RESEARCH: Penile cancer is a rare but highly treatable condition. Whilst over 80% survive for over five years, treatment can have a significant impact on quality of life. There has been little research conducted to date on men's experiences of treatment for penile cancer. The Patients Experiences of Penile Cancer study (PEPC) aimed to redress this shortfall by exploring men's experiences of surgical treatment for penile cancer. METHODS AND SAMPLE: The study used a narrative his...

  7. 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.)

  8. Integrative modeling of small artery structure and function uncovers critical parameters for diameter regulation.

    Science.gov (United States)

    VanBavel, Ed; Tuna, Bilge Guvenc

    2014-01-01

    Organ perfusion is regulated by vasoactivity and structural adaptation of small arteries and arterioles. These resistance vessels are sensitive to pressure, flow and a range of vasoactive stimuli. Several strongly interacting control loops exist. As an example, the myogenic response to a change of pressure influences the endothelial shear stress, thereby altering the contribution of shear-dependent dilation to the vascular tone. In addition, acute responses change the stimulus for structural adaptation and vice versa. Such control loops are able to maintain resistance vessels in a functional and stable state, characterized by regulated wall stress, shear stress, matched active and passive biomechanics and presence of vascular reserve. In this modeling study, four adaptation processes are identified that together with biomechanical properties effectuate such integrated regulation: control of tone, smooth muscle cell length adaptation, eutrophic matrix rearrangement and trophic responses. Their combined action maintains arteries in their optimal state, ready to cope with new challenges, allowing continuous long-term vasoregulation. The exclusion of any of these processes results in a poorly regulated state and in some cases instability of vascular structure. PMID:24497993

  9. Stent Implantation for Malignant Pulmonary Artery Stenosis in a Metastasizing Non-Small Cell Bronchial Carcinoma

    International Nuclear Information System (INIS)

    A 58-year-old patient with recently diagnosed non-small cell bronchial carcinoma was referred to us with increasing shortness of breath and orthopnea by her family practitioner. To exclude the possibility of a pulmonary embolism, contrast medium-enhanced angio-CT of the thorax was performed. This showed a large mediastinal tumor, which, on the one hand, infiltrated and occluded the left upper lobe bronchus and, on the other, constricted the left pulmonary artery over a considerable part of its length. In view of the palliative situation and massively increasing dyspnea, balloon dilatation of the obstructed left pulmonary artery followed by stent placement was performed. This resulted in an immediate improvement of the symptoms. The originally strongly oxygen-dependent and heavily dyspneic patient could be relieved of the external supply of oxygen and was able to sleep normally without additional medication within 24 h. The patient was able ambulate freely within 2 days, with a markedly improved quality of life.

  10. Priapism secondary to penile metastasis of rectal cancer

    Directory of Open Access Journals (Sweden)

    Ji Chan Park, Wook Hyun Lee, Min Kyu Kang, Suk Young Park

    2009-09-01

    Full Text Available Metastatic penile carcinoma is rare and usually originates from genitourinary tumors. The presenting symptoms or signs have been described as nonspecific except for priapism. Rectal adenocarcinoma is a very unusual source of metastatic penile carcinoma. We report a case of metastatic penile carcinoma that originated from the rectum. Symptomatic improvement occurred with palliative radiotherapy.

  11. 21 CFR 876.3630 - Penile rigidity implant.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Penile rigidity implant. 876.3630 Section 876.3630...) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Prosthetic Devices § 876.3630 Penile rigidity implant. (a) Identification. A penile rigidity implant is a device that consists of a pair of semi-rigid rods implanted in...

  12. 21 CFR 876.3350 - Penile inflatable implant.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Penile inflatable implant. 876.3350 Section 876...) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Prosthetic Devices § 876.3350 Penile inflatable implant. (a) Identification. A penile inflatable implant is a device that consists of two inflatable...

  13. 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.

  14. Small high-density lipoprotein is associated with monocyte subsets in stable coronary artery disease

    Science.gov (United States)

    Krychtiuk, Konstantin A.; Kastl, Stefan P.; Pfaffenberger, Stefan; Pongratz, Thomas; Hofbauer, Sebastian L.; Wonnerth, Anna; Katsaros, Katharina M.; Goliasch, Georg; Gaspar, Ludovit; Huber, Kurt; Maurer, Gerald; Dostal, Elisabeth; Oravec, Stanislav; Wojta, Johann; Speidl, Walter S.

    2014-01-01

    Objective: High-density lipoprotein (HDL) particles are heterogeneous in structure and function and the role of HDL subfractions in atherogenesis is not well understood. It has been suggested that small HDL may be dysfunctional in patients with coronary artery disease (CAD). Monocytes are considered to play a key role in atherosclerotic diseases. Circulating monocytes can be divided into three subtypes according to their surface expression of CD14 and CD16. Our aim was to examine whether monocyte subsets are associated with HDL subfractions in patients with atherosclerosis. Methods: We included 90 patients with angiographically stable CAD. Monocyte subsets were defined as classical monocytes (CD14++CD16-; CM), intermediate monocytes (CD14++CD16+; IM) and non-classical monocytes (CD14+CD16++; NCM). HDL subfractions were measured by electrophoresis on polyacrylamide gel. Results: Serum levels of small HDL correlated with circulating pro-inflammatory NCM and showed an inverse relationship to circulating CM independently from other lipid parameters, risk factors, inflammatory parameters or statin treatment regime, respectively. IM were not associated with small HDL. In particular, patients with small HDL levels in the highest tertile showed dramatically increased levels of NCM (14.7 ± 7% vs. 10.7 ± 5% and 10.8 ± 5%; p = 0.006) and a decreased proportion of CM (79.3 ± 7% vs. 83.7 ± 6% and 83.9 ± 6%; p = 0.004) compared to patients in the two lower tertiles. In contrast, intermediate HDL, large HDL and total HDL were not associated with monocyte subset distribution. Conclusion: Small HDL levels are associated with pro-inflammatory NCM and inversely correlated with CM. This may suggest that small HDL could have dysfunctional anti-inflammatory properties in patients with established CAD. PMID:25463093

  15. 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)

  16. 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)

  17. 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; Hansen, Vibeke Brogaard; Forman, Axel; Nilsson, Holger; Aalkjaer, Christian

    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 cur......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...... 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 micro......M 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...

  18. The vascular-disrupting agent, combretastatin-A4-phosphate, enhances neurogenic vasoconstriction in rat small arteries

    DEFF Research Database (Denmark)

    Su, Junjing; Laursen, Britt E

    2012-01-01

    Combretastatin-A4-phosphate (CA4P/CA4), an anti-cancer drug, induces tumour hypoxia by destabilizing the cytoskeleton in tumour endothelial cells. Hypertensive side effects have been observed. We hypothesized that CA4P/CA4 lead to endothelial dysfunction followed by increased vasoconstriction. Mesenteric small arteries and femoral arteries isolated from male Wistar rats were mounted in microvascular myographs for isometric tension recordings and electrical field stimulation (EFS). Immunoblotting of endothelial nitric oxide synthase (eNOS) was performed on human umbilical vein endothelial cells (HUVECs). CA4P failed per se to change vascular tone. In femoral arteries, endothelial cell removal, l-nitro-arginine (l-NNA, an inhibitor of eNOS) and CA4P enhanced phenylephrine-induced vasoconstriction, while in mesenteric arteries only l-NNA leftward shifted concentration-response curves for phenylephrine. CA4P enhanced vasoconstriction induced by low frequency (0.5-4Hz) EFS in femoral arteries, but not in mesenteric arteries. Neurogenic contractions were inhibited by prazosin, an ?(1)-adrenoceptor antagonist. In mesenteric arteries, CA4P and l-NNA inhibited vasorelaxation induced by vanadate, a tyrosine phosphatase inhibitor. CA4P did not affect acetylcholine-induced relaxation. In HUVECs, CA4P increased phosphorylation at eNOS-Thr(495), a negative regulatory site, while the positive phosphorylation site eNOS-Ser(1177) was not affected. CA4 neither influenced the actions of phenylephrine, vanadate nor acetylcholine in femoral and mesenteric arteries. In conclusion, our findings suggest that CA4P, but not CA4, enhances sympathetic adrenergic vasoconstriction probably by increasing eNOS-Thr(495) phosphorylation, in a tissue selective manner. These findings encourage further investigation to show that the hypertension and regional organ ischemia induced by CA4P can be avoided by concomitant treatment with an ?(1)-adrenoceptor antagonist.

  19. 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; Sørensen, Charlotte Mehlin; von Holstein-Rathlou, Niels-Henrik; Pedersen, Henrik Duelund; Christoffersen, Berit Ø.; Olsen, Lisbeth Høier; Ludvigsen, Trine Pagh

    2014-01-01

    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/h...

  20. Rupture of a small middle cerebral artery aneurysm into middle fossa arachnoid cyst presenting as a chronic subdural haematoma.

    Science.gov (United States)

    Kocaeli, H; Korfali, E

    2008-04-01

    The rupture of an aneurysm into an arachnoid cyst and subdural space is unusual. A 25-year-old man was admitted 2 weeks after having undergone a burr hole drainage for a chronic subdural haematoma elsewhere. An angiogram revealed a small aneurysm at the bifurcation of the middle cerebral artery. The aneurysm was clipped and the cyst communicated with the basal cisterns. To the best of our knowledge, this is the first report of an association of an aneurysm of the middle cerebral artery with an arachnoid cyst presenting as a chronic subdural haematoma. PMID:18311525

  1. Clinical observation of trans-artery infusion chemotherapy with carboplatin or cisplatin in advanced non-small-cell lung cancer

    International Nuclear Information System (INIS)

    Objective: To evaluate the effect of trans-artery infusion chemotherapy with carboplatin in advanced non-small-cell lung cancer. Methods: Fifty-two patients with advanced non-small-cell lung cancer pathologically confirmed were treated by trans-artery chemotherapy. They were divided into Carbo group and CDDP group according to anti-cancer drug. The effectiveness of treatment and complication were observed respectively, ?2 test was applied for statistical analysis. Results: There were 27 patients in Carbo group and 25 in CDDP group. In Carbo group, 15 had partial remission (PR), 8 were stable (S) and progression (P) was observed in 4. A responsive rate of 55.6% was obtained. In CDDP group, 15 cases showed rumor partial remission (PR), 7 were stable (S) and 3 were progression (P). The responsive rate was 60%. There was no statistical significance between them (P>0.05). There was no statistical significance in incidence rate of myelosuppression, nausea and vomiting between Carbo group and CDDP group (P>0.05). Conclusion: Compared with CD- DP, trans-artery infusion chemotherapy with Carbo has no better therapeutic effect and no less adverse effects. We maintain CDDP as anti-cancer drag when we perform arterial infusion chemotherapy of advanced non-small-cell lung cancer. (authors)

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

    DEFF Research Database (Denmark)

    Schjerning, Jeppe; Uhrenholt, Torben R; Svenningsen, Per; Vanhoutte, Paul M; Skott, Ole; Jensen, Boye L; Hansen, Pernille B L

    2013-01-01

    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...... 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....

  3. 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

  4. Male penile propulsion into spiraled spermathecal ducts of female chrysomelid beetles: A numerical simulation approach.

    Science.gov (United States)

    Filippov, Alexander; Kovalev, Alexander; Matsumura, Yoko; Gorb, Stanislav N

    2015-11-01

    Genital diversification in animals is an interesting evolutionary phenomenon. Sexual selection is the main driving force behind the diversification. However, evolutionary mechanisms that have established and maintained variations in genitalia shape parameters observed in related species are not well understood. Here, for the first time, we used numerical simulations to test the hypothesis that variations in female spermathecal duct shapes among related beetle species mechanically interfere with penile propulsion in varying ways. Our numerical simulations showed that high curvature of the spiraled spermathecal ducts of the female have effects with a threshold-based interaction on male penile insertion. The relative size of spirals observed in the beetle, Cassida rubiginosa, studied here is not small enough to interfere with penile propulsion. But the model revealed that propulsion is impeded by the presence of reverse turns in spermathecal ducts. This type of morphology leads to an increase in the velocity of the propulsion but also to an increase in the propulsion energy cost for males. Our results showed that quantitative differences in spermathecal duct shape can mediate qualitative differences in penile motion. This explains, in part, the mechanism behind origin and maintenance of genital divergence among closely related species in general. PMID:26341386

  5. 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)

  6. 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

  7. 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

  8. Lymph Node Metastases and Prognosis in Penile Cancer

    OpenAIRE

    Zhu, Yao; Ye, Ding-Wei

    2012-01-01

    Lymph node status is a key prognostic factor in penile squamous cell carcinoma. Recently, growing evidence indicates a multimodality approach consisting of neoadjuvant chemotherapy followed by consolidation surgery improves the outcome of locally advanced penile cancer. Thus, accurate estimation of survival probability in node-positive penile cancer is critical for treatment decision making, counseling of patients and follow-up scheduling. This article reviewed evolving developments in assess...

  9. The Emerging Role and Promise of Biomarkers in Penile Cancer.

    Science.gov (United States)

    Vuichoud, Camille; Klap, Julia; Loughlin, Kevin R

    2016-02-01

    Penile cancer is a rare malignancy, which can be a source of devastating psychosexual distress because of its implication on sexual function and self-image. Current penile staging relies on invasive techniques and is often inaccurate. The authors review the promising biomarkers currently under investigation and their application to the staging and prognosis of penile cancer. Further development of such biomarkers provides the potential of improved clinical management of this disease. PMID:26614036

  10. 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; Aalkjær, Christian

    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 ...

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

    DEFF Research Database (Denmark)

    Schjerning, Jeppe; Uhrenholt, Torben R; Svenningsen, Per; Vanhoutte, Paul M; Skott, Ole; Jensen, Boye L; Hansen, Pernille B L

    2013-01-01

    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...... 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...

  12. The effect of vacuum devices on penile hemodynamics

    Energy Technology Data Exchange (ETDEWEB)

    Katz, P.G.; Haden, H.T.; Mulligan, T.; Zasler, N.D. (Medical College of Virginia, Richmond (USA))

    1990-01-01

    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.

  13. Involvement of Potassium Channels and Calcium-Independent Mechanisms in Hydrogen Sulfide-Induced Relaxation of Rat Mesenteric Small Arteries.

    Science.gov (United States)

    Hedegaard, Elise R; Gouliaev, Anja; Winther, Anna K; Arcanjo, Daniel D R; Aalling, Mathilde; Renaltan, Nirthika S; Wood, Mark E; Whiteman, Matthew; Skovgaard, Nini; Simonsen, Ulf

    2016-01-01

    Endogenous hydrogen sulfide (H2S) is involved in the regulation of vascular tone. We hypothesized that the lowering of calcium and opening of potassium (K) channels as well as calcium-independent mechanisms are involved in H2S-induced relaxation in rat mesenteric small arteries. Amperometric recordings revealed that free [H2S] after addition to closed tubes of sodium hydrosulfide (NaHS), Na2S, and GYY4137 [P-(4-methoxyphenyl)-P-4-morpholinyl-phosphinodithioic acid] were, respectively, 14%, 17%, and 1% of added amount. The compounds caused equipotent relaxations in isometric myographs, but based on the measured free [H2S], GYY4137 caused more relaxation in relation to released free H2S than NaHS and Na2S in rat mesenteric small arteries. Simultaneous measurements of [H2S] and tension showed that 15 µM of free H2S caused 61% relaxation in superior mesenteric arteries. Simultaneous measurements of smooth muscle calcium and tension revealed that NaHS lowered calcium and caused relaxation of NE-contracted arteries, while high extracellular potassium reduced NaHS relaxation without corresponding calcium changes. In NE-contracted arteries, NaHS (1 mM) lowered the phosphorylation of myosin light chain, while phosphorylation of myosin phosphatase target subunit 1 remained unchanged. Protein kinase A and G, inhibitors of guanylate cyclase, failed to reduce NaHS relaxation, whereas blockers of voltage-gated KV7 channels inhibited NaHS relaxation, and blockers of mitochondrial complex I and III abolished NaHS relaxation. Our findings suggest that low micromolar concentrations of free H2S open K channels followed by lowering of smooth muscle calcium, and by another mechanism involving mitochondrial complex I and III leads to uncoupling of force, and hence vasodilation. PMID:26493746

  14. 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

  15. Current penile-rehabilitation strategies: Clinical evidence

    Science.gov (United States)

    Segal, Robert L.; Bivalacqua, Trinity J.; Burnett, Arthur L.

    2013-01-01

    We review the current strategies used for penile rehabilitation (PR) after a radical prostatectomy, where PR is defined as the attempt to restore spontaneous erectile function so that the patient can generate erections with no need for erectile aids. We searched PubMed for relevant reports, using the keywords ‘radical prostatectomy’, ‘penile rehabilitation’, ‘phosphodiesterase inhibitors’, ‘vacuum erection device’, ‘injection therapy’, ‘urethral suppository’, and ‘erectile dysfunction’. In all, 155 articles were identified and reviewed, and had a level of evidence ranging from 1b-4. The use of PR strategies should be based on the patient’s goals after a thorough explanation of realistic expectations, and the risks and consequences of the various treatment options. While a multitude of studies suggest a benefit with PR strategies, there are no established, proven regimens. Further research is needed to establish the optimal approaches to PR.

  16. Successful penile replantation using loupe magnification.

    Science.gov (United States)

    Naraynsingh, Vijay; Harnarayan, Patrick; Hariharan, Seetharaman

    2011-06-01

    Traumatic penile amputation is a rare condition requiring urgent surgical consultation with almost immediate surgical intervention. Although seen in both paediatric and adult populations, the majority are seen in the latter age group. These injuries are penetrating in nature, usually occur with the organ flaccid and most are self-inflicted by mentally unstable patients. Currently replantation involves meticulous microsurgery to reduce skin, urethra and graft loss, but these complications may still occur. Non-microsurgical techniques have been utilised with good post-operative outcomes. This report describes penile replantation in a 24-year old mentally challenged patient using 4.5× loupe-magnification to restore a functional, fully erectile penis without tissue loss and a 20-year problem free follow-up. PMID:20490665

  17. Not all penile cancers are created equal.

    Science.gov (United States)

    Choi, Kellen; Hale, Nathan; Olsen, Daniel; Deem, Samuel

    2015-10-01

    Warty carcinoma variant of squamous cell carcinoma of the penis is a rare condition, making up 7% to 10% of all penile carcinomas. We present a case of warty carcinoma variant of squamous cell carcinoma of the penis in a 43-year-old Caucasian. The tumor presented in a locally invasive manner, requiring a total penectomy. The primary lesion measured over 15 cm x 16 cm, covering the entire perineum. The clinical features, diagnosis, surgical treatment and pathology are reviewed. In light of the locally invasive nature of warty carcinoma of the penis and high recurrence rate, early diagnosis and aggressive treatment is necessary for this type of unique penile cancer. PMID:26432973

  18. 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.

  19. 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.

  20. Three-component hydraulic penile prosthesis malfunction due to penile fibrolipoma secondary to augmentative phalloplasty: A case report

    Directory of Open Access Journals (Sweden)

    Gabriele Antonini

    2016-01-01

    Full Text Available Fibrolipomas are an infrequent type of lipomas. We describe a case of a man suffering from subcutaneous penile fibrolipoma, who twelve months earlier has been submitted to augmentative phalloplasty due to aesthetic dysmorphophobia. The same patient three years earlier has been submitted to three-component hydraulic penile prostheses implantation due to erectile dysfunction. After six months from removing of the mass, the penile elongation and penile enlargement were stable, the prostheses were correctly functioning and the patient was satisfied with his sexual intercourse and life. The diagnostics and surgical characteristics of this case are reported.

  1. Three-component hydraulic penile prosthesis malfunction due to penile fibrolipoma secondary to augmentative phalloplasty: A case report.

    Science.gov (United States)

    Antonini, Gabriele; Vicini, Patrizio; De Berardinis, Ettore; Pacchiarotti, Arianna; Gentile, Vincenzo; Perito, Paul

    2016-01-01

    Fibrolipomas are an infrequent type of lipomas. We describe a case of a man suffering from subcutaneous penile fibrolipoma, who twelve months earlier has been submitted to augmentative phalloplasty due to aesthetic dysmorphophobia. The same patient three years earlier has been submitted to three-component hydraulic penile prostheses implantation due to erectile dysfunction. After six months from removing of the mass, the penile elongation and penile enlargement were stable, the prostheses were correctly functioning and the patient was satisfied with his sexual intercourse and life. The diagnostics and surgical characteristics of this case are reported. PMID:26766813

  2. 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)

  3. 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...

  4. Penile Cancer: Clinical Practice Guidelines in Oncology

    OpenAIRE

    Clark, Peter E.; Philippe E Spiess; Agarwal, Neeraj; Biagioli, Matthew C.; Eisenberger, Mario A; Greenberg, Richard E.; Harry W. Herr; Brant A. Inman; Deborah A. Kuban; Kuzel, Timothy M; Lele, Subodh M.; Michalski, Jeff; Pagliaro, Lance; Sumanta K Pal; Patterson, Anthony

    2013-01-01

    Squamous cell carcinoma of the penis represents approximately 0.5% of all cancers among men in the United States and other developed countries. Although rare, it is associated with significant disfigurement, and only half of the patients survive beyond 5 years. Proper evaluation of both the primary lesion and lymph nodes is critical, because nodal involvement is the most important factor of survival. The NCCN Clinical Practice Guidelines in Oncology for Penile Cancer provide recommendations o...

  5. 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 trials...

  6. 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.

  7. Epidemiologic study on penile cancer in Brazil

    Directory of Open Access Journals (Sweden)

    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.

  8. Involvement of IP3-receptor activation in endothelin-1-induced Ca(2+) influx in rat pulmonary small artery.

    Science.gov (United States)

    Kato, K; Okamura, K; Hatta, M; Morita, H; Kajioka, S; Naito, S; Yamazaki, J

    2013-11-15

    We examined the endothelin-1 (ET-1)-induced increase in the intracellular free Ca(2+) concentration ([Ca(2+)]i) in fura-2-loaded rat pulmonary small arteries. ET-1 (30 nM) elicited a long-lasting increase in [Ca(2+)]i in physiological salt solution (PSS). In subsequent experiments, arteries were pretreated with BQ-788, an ETB-specific blocker, to allow us to focus on responses mediated via the ETA receptor, the existence of which was confirmed by immunohistochemistry. In Ca(2+)-free PSS, ET-1 evoked a small transient increase in [Ca(2+)]i, indicating Ca(2+) release from the SR (sarcoplasmic reticulum). After a switch to PSS (containing 2mM CaCl2), ET-1 elicited a long-lasting increase in [Ca(2+)]i that was not inhibited by 1 ?M nicardipine, an L-type Ca(2+)-channel inhibitor, suggesting involvement of a Ca(2+)-influx pathway independent of that channel. In arteries preincubated with 30 ?M cyclopiazonic acid (CPA) or 2 ?M thapsigargin (TG), the ET-1-induced Ca(2+)-release was greatly reduced, and the induced Ca(2+)-influx was attenuated. U-73122, a phospholipase C (PLC) inhibitor, had inhibitory effects similar to those of CPA and TG on the ET-1-induced Ca(2+)-release and Ca(2+)-influx, whereas U-73343, an inactive analogue of U-73122, had no such effects. Two putative membrane-permeable IP3-receptor blockers, 2-aminoethoxydiphenyl borate (2APB, 50 ?M) and Xestospongin C (20 ?M), (a) almost completely inhibited the ET-1-induced Ca(2+)-release and Ca(2+)-influx, and (b) reduced the ET-1-induced contraction. These results indicate that in rat pulmonary small arteries, ET-1 induces receptor-operated Ca(2+) influx via the ETA receptor, and that this influx interacts with InsP3-receptor activation. PMID:24157978

  9. A key role for Na+/K+-ATPase in the endothelium-dependent oscillatory activity of mouse small mesenteric arteries

    Scientific Electronic Library Online (English)

    F.R.C., Giachini; F.S., Carneiro; V.V., Lima; Z.N., Carneiro; M.W., Brands; R.C., Webb; R.C., Tostes.

    2009-11-01

    Full Text Available Oscillatory contractile activity is an inherent property of blood vessels. Various cellular mechanisms have been proposed to contribute to oscillatory activity. Mouse small mesenteric arteries display a unique low frequency contractile oscillatory activity (1 cycle every 10-12 min) upon phenylephrin [...] e stimulation. Our objective was to identify mechanisms involved in this peculiar oscillatory activity. First-order mesenteric arteries were mounted in tissue baths for isometric force measurement. The oscillatory activity was observed only in vessels with endothelium, but it was not blocked by L-NAME (100 µM) or indomethacin (10 µM), ruling out the participation of nitric oxide and prostacyclin, respectively, in this phenomenon. Oscillatory activity was not observed in vessels contracted with K+ (90 mM) or after stimulation with phenylephrine plus 10 mM K+. Ouabain (1 to 10 µM, an Na+/K+-ATPase inhibitor), but not K+ channel antagonists [tetraethylammonium (100 µM, a nonselective K+ channel blocker), Tram-34 (10 µM, blocker of intermediate conductance K+ channels) or UCL-1684 (0.1 µM, a small conductance K+ channel blocker)], inhibited the oscillatory activity. The contractile activity was also abolished when experiments were performed at 20°C or in K+-free medium. Taken together, these results demonstrate that Na+/K+-ATPase is a potential source of these oscillations. The presence of ?-1 and ?-2 Na+/K+-ATPase isoforms was confirmed in murine mesenteric arteries by Western blot. Chronic infusion of mice with ouabain did not abolish oscillatory contraction, but up-regulated vascular Na+/K+-ATPase expression and increased blood pressure. Together, these observations suggest that the Na+/K+ pump plays a major role in the oscillatory activity of murine small mesenteric arteries.

  10. 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.

  11. 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.

  12. 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

  13. Association of Small Dense LDL Serum Levels and Circulating Monocyte Subsets in Stable Coronary Artery Disease

    Science.gov (United States)

    Krychtiuk, Konstantin A.; Kastl, Stefan P.; Pfaffenberger, Stefan; Lenz, Max; Hofbauer, Sebastian L.; Wonnerth, Anna; Koller, Lorenz; Katsaros, Katharina M.; Pongratz, Thomas; Goliasch, Georg; Niessner, Alexander; Gaspar, Ludovit; Huber, Kurt; Maurer, Gerald; Dostal, Elisabeth; Wojta, Johann; Oravec, Stanislav; Speidl, Walter S.

    2015-01-01

    Objective Atherosclerosis is considered to be an inflammatory disease in which monocytes and monocyte-derived macrophages play a key role. Circulating monocytes can be divided into three distinct subtypes, namely in classical monocytes (CM; CD14++CD16-), intermediate monocytes (IM; CD14++CD16+) and non-classical monocytes (NCM; CD14+CD16++). Low density lipoprotein particles are heterogeneous in size and density, with small, dense LDL (sdLDL) crucially implicated in atherogenesis. The aim of this study was to examine whether monocyte subsets are associated with sdLDL serum levels. Methods We included 90 patients with angiographically documented stable coronary artery disease and determined monocyte subtypes by flow cytometry. sdLDL was measured by an electrophoresis method on polyacrylamide gel. Results Patients with sdLDL levels in the highest tertile (sdLDL?4mg/dL;T3) showed the highest levels of pro-inflammatory NCM (15.2±7% vs. 11.4±6% and 10.9±4%, respectively; p<0.01) when compared with patients in the middle (sdLDL=2-3mg/dL;T2) and lowest tertile (sdLDL=0-1mg/dL;T1). Furthermore, patients in the highest sdLDL tertile showed lower CM levels than patients in the middle and lowest tertile (79.2±8% vs. 83.9±7% and 82.7±5%; p<0.01 for T3 vs. T2+T1). Levels of IM were not related to sdLDL levels (5.6±4% vs. 4.6±3% vs. 6.4±3% for T3, T2 and T1, respectively). In contrast to monocyte subset distribution, levels of circulating pro- and anti-inflammatory markers were not associated with sdLDL levels. Conclusion The atherogenic lipoprotein fraction sdLDL is associated with an increase of NCM and a decrease of CM. This could be a new link between lipid metabolism dysregulation, innate immunity and atherosclerosis. PMID:25849089

  14. Peripheral arterial line (image)

    Science.gov (United States)

    A peripheral arterial line is a small, short plastic catheter placed through the skin into an artery of the arm or leg. The purpose of a peripheral arterial line is to allow continuous monitoring of blood pressure ...

  15. 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

  16. Malfunctioned and Fractured Penile Prosthesis Caused by Cross Placement: Case Report

    Directory of Open Access Journals (Sweden)

    Nihat Karakoyunlu

    2015-05-01

    Full Text Available Penile prosthesis is a functional option for patients who have erectile dysfunction after failed medical and intracavernosal treatments. Malleable penile prosthesis is a good alternative. Penile prosthesis implantation is a surgical process. Seldomly complications occur. In this study we presented a 61 y old man who has malfunctioned and broken penile prosthesis due to cross implantation.

  17. Surgical Treatment of Penile Deformity Due to Curvature Using a Subcutaneous Soft Silicone Implant: Case Report

    OpenAIRE

    James J. Elist; Vaheh Shirvanian; Gottfried Lemperle

    2014-01-01

    Introduction: Congenital and acquired penile curvature has a negative impact on penile aesthetics, sexual capabilities, and male psychology. Surgical procedures yield satisfactory correction of curvature, but are usually associated with penile shortening and palpable suture material and nodules under the skin, resulting in patient dissatisfaction. Aims: To present a novel technique using a subcutaneous soft silicone implant for surgical treatment of penile soft tissue ...

  18. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... small, it wasn’t sized properly, or the space for the reservoir wasn’t appropriately made. There ... request information” button on your webcast screen and open the door to informed medical care. 01:03: ...

  19. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... corpora. Try to spare these little tiny lateral vessels that you’ll see – superficial epigastrics – so that ... small Richardson retractor that I bent in the middle on a 45-degree angle. 00:42:04 ...

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

    DEFF Research Database (Denmark)

    Blædel, Martin Mads; Boonen, Harrie C.M.; Sams Nielsen, Anette; Sheykhzade, Majid

    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...

  1. Penile straightening maneuvers employed during penile prosthesis surgery: technical options and outcomes.

    Science.gov (United States)

    Segal, R L; Cabrini, M R; Bivalacqua, T J; Burnett, A L

    2014-01-01

    Straightening maneuvers (SM), including manual penile modeling, tunical relaxing incisions and corporal reconstruction using grafting techniques, are occasionally required during inflatable penile prosthesis (IPP) implantation to ensure functional penile straightness. The aim of this study was to compare the outcomes of men undergoing SM employed during IPP implantation compared with those wherein these maneuvers were not required. A retrospective review of 391 patients undergoing IPP implantation at the Johns Hopkins Hospital from January 2000 to December 2011 was performed. Patients in whom some SM was employed (SM, n=93, 23.9% of the overall cohort) were compared with those for whom SM was not required (IPP group, n=298). Seven patients were excluded from final analysis (6 patients with IPPs inserted in neophalli (SM group), and 1 patient with incomplete data (IPP group). Patients in whom a SM was used were younger (55.4 vs 62.3 years), more likely to have Peyronie's disease, and less likely to have prostate cancer, radical prostatectomy or to have previously used erectile aids (all Pgore-tex grafts). There were no significant differences in terms of device infection (P=0.15), mechanical failure (P=0.23) or erosion (P=0.96). Although limited in size, this cohort study suggests that IPP implantation in men with penile deformity requiring complex reconstruction to achieve straightening may be done proficiently and without increased adverse outcome risk. PMID:24646675

  2. 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.

  3. 5-hydroxytryptamine receptors mediating contraction in human small muscular pulmonary arteries: importance of the 5-HT1B receptor

    OpenAIRE

    Morecroft, Ian; Heeley, Robert P; Prentice, Howard M.; KIRK, Alan; MacLean, Margaret R.

    1999-01-01

    The 5-hydroxytryptamine (5-HT) receptors mediating vasoconstriction in isolated human small muscular pulmonary arteries (SMPAs) were determined using techniques of wire myography and reverse transcription-polymerase chain reaction (RT–PCR).The agonists 5-HT, 5-carboxamidotryptamine (5-CT, unselective for 5-HT1 receptors) and sumatriptan (selective for 5-HT1B/D receptors) all caused contraction and were equipotent (pEC50s: 7.0±0.2, 7.1±0.3 and 6.7±0.1, respectively) suggesting the presence of ...

  4. Involvement of K channels and calcium-independent mechanisms in hydrogen sulfide-induced relaxation of rat mesenteric small arteries

    DEFF Research Database (Denmark)

    Hedegaard, Elise R; Gouliaev, Anja; Winther, Anna K; Arcanjo, Daniel D R; Aalling, Mathilde; Sivasubramaniam, Nirthika; Wood, Mark E; Whiteman, Matthew; Skovgaard, Nini; Simonsen, Ulf

    2015-01-01

    Endogenous hydrogen sulfide (H2S) is involved in the regulation of vascular tone. We hypothesized that lowering of calcium and opening of K channels as well as calcium-independent mechanisms are involved in H2S-induced relaxation in rat mesenteric small arteries. Amperometric recordings revealed that free [H2S] after addition to closed tubes of NaSH, Na2S, and GYY4137 were, respectively, 14%, 17%, and 1% of added amount. The compounds caused equipotent relaxations in isometric myographs, but bas...

  5. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... can see that you end up with a beautiful watertight closure just using your stay sutures to approximate it, as long as you’ve made it a small corporotomy. The other thing I want you to notice is that – and ...

  6. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... do not want that lockout mechanism to be bent, the neck of the reservoir to be bent, because that’ll render the lockout mechanism, which ... is a very small Richardson retractor that I bent in the middle on a 45-degree angle. ...

  7. Small artery structure adapts to vasodilatation rather than to blood pressure during antihypertensive treatment

    DEFF Research Database (Denmark)

    Mathiassen, Ole N; Buus, Niels H; Larsen, Mogens L; Mulvany, Michael J; Christensen, Kent L

    2007-01-01

    OBJECTIVE: Correction of the abnormal structure of resistance arteries in essential hypertension may be an important treatment goal in addition to blood pressure (BP) reduction. We investigated how this may be achieved in a prospective clinical study. METHODS: Plethysmography was used to measure forearm resting vascular resistance (Rrest) and minimum vascular resistance (Rmin) as a measure of vascular structure. Two different groups of patients with essential hypertension were examined at baseli...

  8. 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. 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

  9. Penile cancer: Perspective from a Canadian tertiary care centre

    Science.gov (United States)

    Beech, Benjamin; Izawa, Jonathan; Pautler, Stephen; Chin, Joseph; Power, Nicholas

    2015-01-01

    Introduction: Penile squamous cell carcinoma (SCC) is rare in North America; however, the morbidity can be devastating. This analysis represents the first reported penile cancer experience at a tertiary care centre in Canada. Methods: We carried out a retrospective review of all patients who received care at our centre for penile SCC from 2005 until the present time. Epidemiological and clinical data were collected for all patients. Survival analysis was performed using Kaplan-Meier methods with log-rank test and Cox regression for univariate and multivariate analysis, respectively. Results: We identified 42 patients who were treated at our centre for penile SCC. Of these, 29% underwent excisional biopsy, 38% had partial penectomy, and 33% had total penectomy. Five patients with high-risk tumours underwent modified inguinal lymph node dissection (ILND), while 7 patients had radical ILND for clinically palpable disease. Overall, the median cancer specific survival (CSS) was undefined, with a 60% survival at 102 months. However CSS was significantly correlated to pT stage, pN stage, and tumour grade. The median follow-up was 25 months (interquartile range: 11–48). Conclusion: These findings confirm the poor CSS of patients with positive lymph nodes in penile SCC. Patients with pN0 after ILND had a durable CSS. Risk factors for penile SCC were confirmed as elevated body mass index, positive smoking history, and lack of circumcision. This first epidemiologic report on penile SCC from a Canadian tertiary care centre should be expanded to other national centres.

  10. Proteome Analysis of Human Arterial Tissue Discloses Associations Between the Vascular Content of Small Leucine-Rich Repeat Proteoglycans and Pulse Wave Velocity

    DEFF Research Database (Denmark)

    Lyck Hansen, Maria; Beck, Hans Christian

    2015-01-01

    OBJECTIVES: We hypothesized that arterial stiffness is associated with changes in the arterial protein profile, particularly of extracellular matrix components. We aimed at determining differentially expressed proteins by quantitative proteome analysis in arterial tissue from patients with different degrees of arterial stiffness. APPROACH AND RESULTS: Arterial stiffness, assessed by carotid-femoral pulse wave velocity (PWV), central blood pressure and augmentation index by pulse wave analysis were measured the day before surgery in a group of patients undergoing coronary artery bypass grafting. Protein extracts of well-defined, homogenous, nonatherosclerotic individual samples of the left mammary artery from 10 of these patients with high PWV and 9 with low PWV were compared by quantitative proteome analysis, using tandem mass tag labeling and nano-liquid chromatography mass spectrometry/mass spectrometry. Of 418 quantified proteins, 28 were differentially expressed between the groups with high and low PWV (P<0.05). Three of 7 members of the extracellular matrix family of small leucine-rich repeat proteoglycans displayed significant differences between the 2 groups (P=0.0079; Fisher exact test). Three other ECM proteins were differentially regulated, that is, collagen, type VIII, ?-1 and ?-2 and collagen, type IV, ?-1. Several proteins related to smooth muscle cell function and structure were also found in different amounts between the 2 groups. CONCLUSIONS: Changes in the arterial amounts of small leucine-rich proteoglycans, known to be involved in collagen fibrillogenesis, and of some nonfibrillar collagens in combination with alterations in proteins related to functions of the human arterial smooth muscle are associated with arterial stiffness, as determined by PWV.

  11. Modified T-Graft for Extracorporeal Membrane Oxygenation in a Patient with Small-Caliber Femoral Arteries

    Science.gov (United States)

    Calderon, Daniel; El-Banayosy, Aly; Koerner, Michael M.; Reed, Amy B.

    2015-01-01

    Extracorporeal membrane oxygenation (ECMO) is generally used as a last resort to provide cardiopulmonary support in patients whose advanced cardiac or respiratory failure does not respond to less invasive treatments. Lower-limb ischemia secondary to the large diameter of the arterial cannula is one of ECMO's major limitations: in patients who have small-caliber arteries, the cannulas can reduce native blood flow. The creation of a T-graft—a well-described technique to avoid limb ischemia—enables flow into the ECMO cannula without jeopardizing blood flow to the limb. However, leaving the graft exposed through an open groin wound can result in dislodgment, and it increases the risk of infection. We describe our modification of a conventional T-graft in an 18-year-old woman who had systolic heart failure, acute respiratory distress syndrome, and small-caliber femoral vessels. We tunneled a polytetrafluoroethylene graft inside a Dacron graft, then ran the combined graft through a subcutaneous tunnel similar to that created for a peripheral bypass. Thus, the graft was protected from environmental exposure and the risk of infection. Our technique seems safer and more secure than the original T-graft technique, and we recommend its consideration during ECMO cannulation. PMID:26664305

  12. Role of Schwann cells in the regeneration of penile and peripheral nerves.

    Science.gov (United States)

    Wang, Lin; Sanford, Melissa T; Xin, Zhongcheng; Lin, Guiting; Lue, Tom F

    2015-01-01

    Schwann cells (SCs) are the principal glia of the peripheral nervous system. The end point of SC development is the formation of myelinating and nonmyelinating cells which ensheath large and small diameter axons, respectively. They play an important role in axon regeneration after injury, including cavernous nerve injury that leads to erectile dysfunction (ED). Despite improvement in radical prostatectomy surgical techniques, many patients still suffer from ED postoperatively as surgical trauma causes traction injuries and local inflammatory changes in the neuronal microenvironment of the autonomic fibers innervating the penis resulting in pathophysiological alterations in the end organ. The aim of this review is to summarize contemporary evidence regarding: (1) the origin and development of SCs in the peripheral and penile nerve system; (2) Wallerian degeneration and SC plastic change following peripheral and penile nerve injury; (3) how SCs promote peripheral and penile nerve regeneration by secreting neurotrophic factors; (4) and strategies targeting SCs to accelerate peripheral nerve regeneration. We searched PubMed for articles related to these topics in both animal models and human research and found numerous studies suggesting that SCs could be a novel target for treatment of nerve injury-induced ED. PMID:25999359

  13. 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.

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

    Science.gov (United States)

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

    2011-08-01

    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 adenosine from ATP released by shear-stressed endothelial cells. Mechanistically, we demonstrate that shear stress-mediated elevated adenosine functions through the adenosine A(2B) receptor (A(2B)R) to activate the PI3K/AKT signaling cascade and subsequent increased endothelial nitric oxide synthase (eNOS) phosphorylation. These in vitro studies led us to discover further that adenosine was induced during sustained penile erection and contributes to PI3K/AKT activation and subsequent eNOS phosphorylation via A(2B)R signaling in intact animal. Finally, we demonstrate that lowering adenosine in wild-type mice or genetic deletion of A(2B)R in mutant mice significantly attenuated PI3K/AKT activation, eNOS phosphorylation, and subsequent impaired penile erection featured with the reduction of ratio of maximal intracavernosal pressure to systemic arterial pressure from 0.49 ± 0.03 to 0.41 ± 0.05 and 0.38 ± 0.04, respectively (both P<0.05). Overall, using biochemical, cellular, genetic, and physiological approaches, our findings reveal that adenosine is a novel molecule signaling via A(2B)R activation, contributing to penile erection via PI3K/AKT-dependent eNOS activation. These studies suggest that this signaling pathway may be a novel therapeutic target for erectile disorders. PMID:21566208

  15. Penile Replantation After Five Hours of Warm Ischemia

    Directory of Open Access Journals (Sweden)

    Fernando N. Facio Jr.

    2015-05-01

    Full Text Available Although a rare occurrence, this event may occur as a result of self-mutilation among individuals with psychiatric disturbances or due to work-related accidents, iatrogenic injuries or the actions of individuals motivated by jealously, rage and feelings of betrayal. In western societies, most penile amputations are the result of self-aggression during a psychotic episode, the treatment of victims involves resuscitation, stabilization and immediate psychiatric support. The amputated tissue must be preserved under hypothermic conditions. Micro-surgery is currently the most widely employed method for penile replantation. This paper describes a successful case of penile replantation following 5 hours of warm ischemia.

  16. Increased contractility to noradrenaline and normal endothelial function in mesenteric small arteries from the goto-kakizaki rat model of type 2 diabetes

    DEFF Research Database (Denmark)

    Brøndum, Emil Toft; Kold-Petersen, H; Nilsson, H; Flyvbjerg, Allan; Aalkjaer, C

    2008-01-01

    Type 2 diabetes is associated with many circulatory manifestations, including alteration in endothelial function and hypertension. In this study we investigate the morphology and contractile response as well as the endothelial function of resistance arteries from the spontaneously diabetic Goto-Kakizaki (GK) rat, a model of lean type 2 diabetes expressing glucose intolerance. METHODS: Isolated mesenteric small arteries were investigated under isometric conditions in a wire myograph system using ...

  17. 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.

  18. Pulmonary Artery Invasion, High-Dose Radiation, and Overall Survival in Patients With Non-Small Cell Lung Cancer

    International Nuclear Information System (INIS)

    Purpose: To investigate whether high-dose radiation to the pulmonary artery (PA) affects overall survival (OS) in patients with non-small cell lung cancer (NSCLC). Methods and Materials: Patients with medically inoperable/unresectable NSCLC treated with definitive radiation therapy in prospective studies were eligible for this study. Pulmonary artery involvement was defined on the basis of pretreatment chest CT and positron emission tomography/CT fusion. Pulmonary artery was contoured according to the Radiation Therapy Oncology Group protocol 1106 atlas, and dose-volume histograms were generated. Results: A total of 100 patients with a minimum follow-up of 1 year for surviving patients were enrolled: 82.0% underwent concurrent chemoradiation therapy. Radiation dose ranged from 60 to 85.5 Gy in 30-37 fractions. Patients with PA invasion of grade ?2, 3, 4, and 5 had 1-year OS and median survival of 67% and 25.4 months (95% confidence interval [CI] 15.7-35.1), 62% and 22.2 months (95% CI 5.8-38.6), 90% and 35.8 months (95% CI 28.4-43.2), and 50% and 7.0 months, respectively (P=.601). Two of the 4 patients with grade 5 PA invasion died suddenly from massive hemorrhage at 3 and 4.5 months after completion of radiation therapy. Maximum and mean doses to PA were not significantly associated with OS. The V45, V50, V55, and V60 of PA were correlated significantly with a worse OS (P<.05). Patients with V45 >70% or V60 >37% had significantly worse OS (13.3 vs 37.9 months, P<.001, and 13.8 vs 37.9 months, P=.04, respectively). Conclusions: Grade 5 PA invasion and PA volume receiving more than 45-60 Gy may be associated with inferior OS in patients with advanced NSCLC treated with concurrent chemoradiation

  19. 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.

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

    Directory of Open Access Journals (Sweden)

    Milan Bjekic

    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 clinical 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.

    Science.gov (United States)

    Fode, Mikkel; Ohl, Dana A; Ralph, David; Sønksen, Jens

    2013-11-01

    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. PMID:23826962

  2. Combination of bronchial artery infusion chemotherapy and radiation therapy for locally advanced non-small cell lung cancer

    International Nuclear Information System (INIS)

    Objective: To compare the efficacy between bronchial artery infusion (BAI) chemotherapy plus radiation therapy and systemic chemotherapy plus radiation for locally advanced non-small cell lung cancer (NSCLC). Methods: One hundred and twenty-one patients with stage III NSCLC were randomized into treatment group (58 cases) and control group (63 cases). In the treatment group, all patients were administered with BAI for 2-3 sessions, followed by irradiation 4-7 days after BAI. In the control group, altogether 4-6 cycles of standard systemic chemotherapy were given. Radiation was delivered alternately between the cycles of chemotherapy. Results: The short-term, long-term survival, median response duration and median survival time were similar between the two groups, except patients with stage IIIb who had a higher distant metastasis rate in the treatment group. The major side effects of chemotherapy and radiotherapy were hematological, gastrointestinal toxicities, pneumonitis, mediastinitis, and esophagitis, respectively. The side effects were milder, better tolerated and did not influence the regimen schedule in the treatment group, as compared with the control group. Seven patients withdrew from the control group, and in 28 patients, the scheduled chemotherapy and radiation was delayed or canceled. Conclusions: Bronchial artery infusion plus radiation is more advantageous over systemic chemotherapy plus radiation in less toxicities, better compliance, shorter treatment courses and more cost-effectiveness

  3. 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.

  4. Penile Prosthesis Implantation for Treatment of Postpriapism Erectile Dysfunction

    OpenAIRE

    Akbar A Jalal; Mohammed H Durazi

    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...

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

    OpenAIRE

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

    2010-01-01

    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 prosthesis 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 underg...

  6. 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...

  7. Histologic findings after in vivo placement of small intestine submucosal vascular grafts and saphenous vein grafts in the carotid artery in dogs.

    OpenAIRE

    Sandusky, G E; S F Badylak; Morff, R. J.; Johnson, W. D.; Lantz, G.

    1992-01-01

    A small caliber vascular graft from porcine small intestine submucosa (SIS) was implanted in a canine carotid artery (n = 24) and compared with an autogenous saphenous vein graft that was implanted in the contralateral carotid artery. In this study, four grafts were evaluated at the following times after surgery: 2, 7, 14, 28, 90, and 180 days. One SIS graft thrombosed at 2 days, two SIS and two saphenous vein grafts were thrombosed at 90 days, and one SIS and one saphenous vein graft were th...

  8. Evaluation of small ischemic lesions after carotid artery stenting: the usefulness of thin-slice diffusion-weighted MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Yamatogi, Shigenari; Furukawa, Matakazu; Iida, Etsushi; Takahashi, Shotaro; Matsunaga, Naofumi [Yamaguchi University Graduate School of Medicine, Department of Radiology, Ube, Yamaguchi (Japan); Ishihara, Hideyuki; Kato, Shoichi; Suzuki, Michiyasu [Yamaguchi University Graduate School of Medicine, Department of Neurosurgery, Ube, Yamaguchi (Japan)

    2011-04-15

    There has been concern regarding the usefulness of diffusion-weighted imaging (DWI) to evaluate the ischemic lesions associated with carotid artery stent placement (CAS). Some small lesions may be detected not by standard DWI but by thin-slice DWI alone, since most of the cerebral lesions are very small in size and clinically silent. The purpose of this study is to compare the detectability of the small ischemic lesions after CAS by standard and thin-slice DWI. Both standard DWI with slice thickness of 6 mm and thin-slice DWI with slice thickness of 2 mm were obtained at the same MR examination within 2 to 7 days after 20 procedures of CAS in 17 patients. Number and measured diameter size of the detected lesions on both DWI were compared. All CAS procedures in 17 patients were successfully completed. The focal ischemic lesions were detected in 14 of 20 on thin-slice DWI and seven examinations on standard DWI. The total numbers of hyperintense lesions were 31 on thin-slice DWI and ten on standard DWI (p < 0.001). The sizes of these ten lesions on thin-slice DWI were larger than those of standard DWI, and the mean size of the thin-slice DWI and that of standard DWI were significantly different (p < 0.005). Thin-slice DWI was able to detect small cortical lesions better than standard DWI. Thin-slice DWI may be useful to evaluate small silent ischemic lesions after CAS. (orig.)

  9. AB023. Penile augmentation surgery: characteristics of artificial graft material and preoperative preparation

    Science.gov (United States)

    Lee, Woong Hee

    2015-01-01

    Penile augmentation surgical procedure includes diverse graft materials such as artificial collagen material as well as dermo-fat graft. Important factors of postoperative satisfaction are natural appearance of genitalia at the flaccid state and minimal resorption of graft volume. Artificial collagen materials and acellular dermal matrix are available for surgical procedure with variable size. History of penile augmentation surgery: Pediatric penile surgical procedure for lengthening and reconstructive surgery was developed as penile plastic surgical procedure combined with dermo-fat graft. In 1971, Kelly, Eraklis et al. reported preservation of dorsal neurovascular bundle and division of corporal crus from ischiopubic ramus for penile lengthening procedure. In 1974, Johnson reported the surgical cases in epispadias patient as division of crus from ischiopubic ramus and penile skin graft. The procedures include division of suspensory ligament and blunt dissection of fundiform ligament. In 1970’s Horton reported suprapubic fat resection and Z-plasty with anchoring on Scarpa’s fascia for lengthening procedure. In 1980’s several fat injection procedures in Darto’s fascia have been reported for girth enhancement but they were lack of reproducibility. (1year Resorption 50%) Later reports the result of cystic nodule, lump formation and fat migration. In 1990’s V-Y plasty for lengthening was reported. Historically illegal liquid injection materials with non-medical hands were reported as correction or reconstructive procedures for removal and treatment of deformed genitalia. In 1992 Horton reported flank abdominal free dermo-fat graft to Darto’s fascia. This procedure showed fair graft survival rate and developed to buttock skin crease dermo-fat graft. Medical grade silicone; long-term implantable; Gortex plate, polytetrafluoroethylene (PTFE); Acelluar dermal graft/(Alloderm, Surederm); Acellular xenogeniccollagen structure/(Lyoplant, Terudermis); Autologous tissue culture procedure with PLGA scaffold; Complex synthetic collagen with elastin (Matriderm); SIS (small intestine submucosa, porcine SIS). 48-72 h; Tissue fluid diffusion, 4 days; circulation and beginning of collagen accumulation. Initial graft survival depends on tissue condition and vascular supply of recipient bed. For stable vascular permeability graft should be anchored to recipient bed tissue. The prerequisites for wound healing; no infection, no hematoma, no seroma. Skin suture with no tension. Dermo-fat thickness less than 1 cm. Minimal incision on Darto’s fascia (external pudendal system). Graft anchoring between internal pudendal system and Buck’s fascia. Successful penile augmentation procedure means not only excellent surgical procedure and good wound healing process, but also patient subjective satisfaction. Preoperative interview with the patient is important for understanding the anatomy, procedure and goal of augmentation surgery. Also the proper selection of graft material is also important factor of successful girth enhancement with graft survival.

  10. Extracellular Calcium-Dependent Modulation of Endothelium Relaxation in Rat Mesenteric Small Artery: The Role of Potassium Signaling

    Science.gov (United States)

    Hangaard, Lise; Jessen, Peter B.; Kamaev, Dmitrii; Aalkjaer, Christian; Matchkov, Vladimir V.

    2015-01-01

    The nature of NO- and COX-independent endothelial hyperpolarization (EDH) is not fully understood but activation of small- and intermittent-conductance Ca2+-activated K+ channels (SKCa and IKCa) is important. Previous studies have suggested that the significance of IKCa depends on [Ca2+]out. Also it has been suggested that K+ is important through localized [K+]out signaling causing activation of the Na+,K+-ATPase and inward-rectifying K+ channels (Kir). Here we tested the hypothesis that the modulating effect of [Ca2+]out on the EDH-like response depends on [K+]out. We addressed this possibility using isometric myography of rat mesenteric small arteries. When [K+]out was 4.2?mM, relaxation to acetylcholine (ACh) was stronger at 2.5?mM [Ca2+]out than at 1?mM [Ca2+]out. Inhibition of IKCa with TRAM34 suppressed the relaxations but did not change the relation between the relaxations at the low and high [Ca2+]out. This [Ca2+]out-dependence disappeared at 5.9?mM [K+]out and in the presence of ouabain or BaCl2. Our results suggest that IKCa are involved in the localized [K+]out signaling which acts through the Na+,K+-ATPase and Kir channels and that the significance of this endothelium-dependent pathway is modulated by [Ca2+]out. PMID:26504829

  11. Spatial resonance in a small artery excited by vibration input as a possible mechanism to cause hand-arm vascular disorders

    Science.gov (United States)

    Pattnaik, Shrikant; Banerjee, Rupak; Kim, Jay

    2012-04-01

    Hand-arm vibration syndrome (HAVS) is collectively a vasospastic and neurodegenerative occupational disease. One of the major symptoms of HAVS is vibration white finger (VWF) caused by exaggerated vasoconstriction of the arteries and skin arterioles. While VWF is a very painful and costly occupational illness, its pathology has not been well understood. In this study a small artery is modeled as a fluid filled elastic tube whose diameter changes along the axial direction. Equations of motion are developed by considering interactions between the fluid, artery wall and soft-tissue bed. It is shown that the resulting wave equation is the same as that of the basilar membrane in the cochlea of mammals. Therefore, the artery system shows a spatial resonance as in the basilar membrane, which responds with the highest amplitude at the location determined by the vibration frequency. This implies that a long-term use of one type of tool will induce high-level stresses at a few identical locations of the artery that correspond to the major frequency components of the tool. Hardening and deterioration of the artery at these locations may be a possible cause of VWF.

  12. Supplementation with n3 fatty acid ethyl esters increases large and small artery elasticity in obese adults on a weight loss diet.

    Science.gov (United States)

    Wong, Annette T Y; Chan, Dick C; Barrett, P Hugh R; Adams, Leon A; Watts, Gerald F

    2013-04-01

    Increased arterial stiffness is associated with enhanced risk of cardiovascular disease in obese individuals. Whether n3 fatty acid ethyl ester (FAEE) supplementation improves arterial stiffness in obese participants on a weight loss diet has not yet been investigated. The objective of the study was to carry out a 12-wk randomized, single-blind trial to test the effect of a 25% energy deficit weight loss diet alone (WL) (n = 12) or WL plus 4 g/d Omacor (46% EPA and 38% DHA) supplementation (WL+FAEE) (n = 13) on arterial elasticity in obese adults. Large (C1) and small artery elasticity (C2) were measured by pulse contour analysis of the radial artery. WL alone reduced (P FAEE intervention significantly reduced body weight (-4%), waist circumference (-4%), systolic (-8%) and diastolic (-5%) blood pressures, pulse pressure (-5%), heart rate (-8%), plasma TG concentration (-36%), and HOMA score (-12%) and increased stroke volume (+3%), plasma HDL cholesterol (+6%) and adiponectin concentrations (+28%), and C1 (+20%) and C2 (+22%) artery elasticity. The changes in systolic blood pressure, heart rate, plasma TGs, C1, and C2 were significantly greater in the WL+FAEE group than in the WL group. Supplementation with n3 FAEEs improves C1 and C2 independently of weight loss in obese adults. PMID:23365106

  13. Penile fracture and its treatment: Is retrograde urethrograghy necessary for management of penile fracture?

    Directory of Open Access Journals (Sweden)

    Kamalati Ali

    2014-12-01

    Full Text Available ?Abstract?Objective: Penile fracture, being defined as rupture of the tunica albuginea of the corpus cavernosum, is uncommon. Here, we analyze fi ndings on our patients during a 10-year period and evaluate the role of retrograde urethrography. Methods: From February 2002 to April 2012, 116 patients were admitted with penile fracture at Ghaem Medical Center. Patient history and physical examination were taken at their admittance to detect probable urethral injury. Before surgery, retrograde urethrography was performed in all patients. The size and site of the tunical rupture were recorded. Then the rupture of tunica albuginea was sutured with nonabsorbable (3-0 nylon sutures and the ties were placed on the internal surface (continuous method. All patients were followed up for 12 months. Results: Patients' mean age was(32.78±10.61 years and ranged (16-62 years. The mechanism of trauma was sexual intercourse in 103 patients (89% and sturbation in 13 patients (11%. The most common site of injury found after exploration was right (55% and lateral (74% of the corpus cavernosum. The size of the tunical rupture was from 0.5 to 3.0 cm (mean 0.88±0.72. Three of the patients had Marphan's syndrome. Urethral injury was detected by retrograde urethrography in 4 patients (3% who had macroscopic hematuria and urethrorrhagia. During 12 months follow-up, no complication was seen. Conclusion: There is no need to perform retrograde urethrography unless the patients have gross hematuria or urethrorrhagia. The key to success in treatment of penile fracture is to achieve a rapid diagnosis based on history and a physical examination, avoid unnecessary imaging tests and perform immediate surgery to reconstruct the site of injury. Key words: Penis; Radiography; Urogenital system; Treatment outcome

  14. Intraoperative localization of vascular malformation of small bowel by selective intra-arterial dye injection

    Directory of Open Access Journals (Sweden)

    Eshpuniyani Priya

    2010-01-01

    Full Text Available Angiomatous malformation is the most common vascular abnormality, accounting for 30-40% cases of obscure GI bleeding from small bowel. Surgical resection is the treatment of choice in severe or recurrent hemorrhage requiring multiple blood transfusions. However, the diffuse nature of the lesions poses a challenge to localize them accurately preoperatively, for exact resection. We present a case in which we have used selective mesenteric angiography with selective cannulation and exact localization of the lesion by injecting dye such as methylene blue, indigo carmine, and fluorescein, to localize the angiomatous malformation before surgical resection and also to determine the exact resection to be done.

  15. 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.)

  16. 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

  17. Penile augmentation with resultant foreign material granuloma and sequalae.

    Science.gov (United States)

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

    2012-10-01

    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, which cannot achieve erection. Local complications of penile lipogranuloma include infection, ulceration, local migration, and cavernosal invasion; leading to functional impairment. Meanwhile, systemic complications include foreign body embolization, organ infarct, and death. Penile lipogranuloma is best treated surgically. Granulomatous skin needs to be completely excised; wound closure with a scrotal skin flap, Cecil's inlay operation and split thickness skin graft commonly used options. Our case series has shown that penile lipogranuloma, induced by subcutaneous foreign body injections into the penile shaft, and its subsequent adverse outcomes to patients and their partners. PMID:23613653

  18. Identification of somatic gene mutations in penile squamous cell carcinoma.

    Science.gov (United States)

    Ferrándiz-Pulido, Carla; Hernández-Losa, Javier; Masferrer, Emili; Vivancos, Ana; Somoza, Rosa; Marés, Roso; Valverde, Claudia; Salvador, Carlos; Placer, Jose; Morote, Juan; Pujol, Ramon M; Ramon y Cajal, Santiago; de Torres, Ines; Toll, Agusti; García-Patos, Vicente

    2015-10-01

    There is a lack of studies on somatic gene mutations and cell signaling driving penile carcinogenesis. Our objective was to analyze somatic mutations in genes downstream of EGFR in penile squamous cell carcinomas, especially the mTOR and RAS/MAPK pathways. We retrospectively analyzed somatic mutations in 10 in situ and 65 invasive penile squamous cell carcinomas by using Sequenom's Mass Spectrometry iPlex Technology and Oncocarta v1.0 Panel. The DNA was extracted from FFPE blocks and we identified somatic missense mutations in three in situ tumors and in 19 invasive tumors, mostly in PIK3CA, KRAS, HRAS, NRAS, and PDGFA genes. Somatic mutations in the PIK3CA gene or RAS family genes were neither associated with tumor grade, stage or outcome, and were equally often identified in hrHPV positive and in hrHPV negative tumors that showed no p53 expression. Mutations in PIK3CA, KRAS, and HRAS are frequent in penile squamous cell carcinoma and likely play a role in the development of p53-negative tumors. Although the presence of these mutations does not seem to correlate with tumoral behavior or outcome, they could be biomarkers of treatment failure with anti-EGFR mAb in patients with penile squamous cell carcinoma. PMID:26216163

  19. Penile Dysmorphic Disorder: Development of a Screening Scale.

    Science.gov (United States)

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

    2015-11-01

    Penile dysmorphic disorder (PDD) is shorthand for men diagnosed with body dysmorphic disorder, in whom the size or shape of the penis is their main, if not their exclusive, preoccupation causing significant shame or handicap. There are no specific measures for identifying men with PDD compared to men who are anxious about the size of their penis but do not have PDD. Such a measure might be helpful for treatment planning, reducing unrealistic expectations, and measuring outcome after any psychological or physical intervention. Our aim was, therefore, to validate a specific measure, termed the Cosmetic Procedure Screening Scale for PDD (COPS-P). Eighty-one male participants were divided into three groups: a PDD group (n = 21), a small penis anxiety group (n = 37), and a control group (n = 23). All participants completed the COPS-P as well as standardized measures of depression, anxiety, social phobia, body image, quality of life, and erectile function. Penis size was also measured. The final COPS-P was based on nine items. The scale had good internal reliability and significant convergent validity with measures of related constructs. It discriminated between the PDD group, the small penis anxiety group, and the control group. This is the first study to develop a scale able to discriminate between those with PDD and men anxious about their size who did not have PDD. Clinicians and researchers may use the scale as part of an assessment for men presenting with anxiety about penis size and as an audit or outcome measure after any intervention for this population. PMID:25731908

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    Youngsik Lim

    2015-04-01

    Full Text Available 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.

  2. 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

  3. Penile cutaneous horn: An enigma-newer insights and perspectives

    Directory of Open Access Journals (Sweden)

    Kaliaperumal Karthikeyan

    2015-01-01

    Full Text Available Cutaneous horn refers to unusually cohesive keratinized material and not a true pathologic diagnosis. Though cutaneous horn has been described at various sites, horn over the penis is very rare and represents the most unusual site. The role of chronic irritation, phimosis, surgical trauma and radiotherapy have been implicated in penile horn formation. Penile horns present as elongated, keratinous, white or yellowish projections that range from a few millimeters to centimeters in size arising from the glans penis. Histopathology of the keratotic mass reveals nothing but keratin. The underlying mass may vary from verruca vulgaris to squamous cell carcinoma. The treatment is based on the pathology.

  4. Silicone-induced Penile Sclerosing Lipogranuloma: Magnetic Resonance Imaging Findings

    Science.gov (United States)

    Tsili, Athina C; Xiropotamou, Olga N; Nomikos, Michael; Argyropoulou, Maria I

    2016-01-01

    Sclerosing lipogranuloma is a rare benign disease, representing a peculiar granulomatous reaction of fatty tissue. The majority of cases are secondary to injection of exogenous foreign bodies, such as silicone, paraffin, mineral, or vegetable oils. To the best of our knowledge, we present the first case of a silicone-induced penile lipogranuloma in a 52-year-old man evaluated with a multiparametric magnetic resonance imaging (MRI) protocol, including diffusion-weighted imaging, magnetization transfer imaging, and dynamic contrast-enhanced MRI. MRI of the penis by combining both conventional and functional information represents an important imaging tool in the preoperative workup of silicone-induced penile lipogranuloma.

  5. 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.

  6. 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

  7. Isolated Penile Fournier's Gangrene Presenting with Glans Penis Involvement.

    Science.gov (United States)

    Temiz, Mustafa Zafer; Yuruk, Emrah; Aykan, Serdar; Tuken, Murat; Kandirali, Engin

    2015-10-01

    Fournier's Gangrene (FG) is a type of necrotizing infection or gangrene usually affecting the perineum. Penile gangrene is a rare disease because of rich collateral circulation and blood flow in the perineum and lower abdomen. We report an unusual and rare presentation of FG with isolated glans penis necrosis in a 62-year-old man. The patient underwent subtotal penectomy and closure of the wound with penile skin flap after covering the spongious tissue with dartos fascial flap enclosing the urethra. The recovery phase was uneventful and the patient had no urinating symptoms during follow-up. PMID:26522204

  8. 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).

  9. 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.

  10. 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.

  11. Antiphase oscillations of endothelium and smooth muscle [Ca2+]i in vasomotion of rat mesenteric small arteries

    DEFF Research Database (Denmark)

    Rahman, Awahan; Matchkov, Vladimir; Hughes, Alun; Nilsson, Holger; Aalkjær, Christian

    2007-01-01

    The mechanisms leading to vasomotion in the presence of noradrenaline and inhibitors of the sarcoplasmic/endoplasmic reticulum calcium ATPase were investigated in isolated rat mesenteric small arteries. Isobaric diameter and isometric force were measured together with membrane potential in endothelial cells and smooth muscle cells (SMC). Calcium in the endothelial cells and SMC was imaged with confocal microscopy. In the presence of noradrenaline and cyclopiazonic acid, ryanodine-insensitive osc...

  12. 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; Johansen, Julia; Christensen, Ib Jarle; Skibsted, Lillian

    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 a...

  13. Dysfunctional penile cholinergic nerves in diabetic impotent men

    Energy Technology Data Exchange (ETDEWEB)

    Blanco, R.; Saenz de Tejada, I.; Goldstein, I.; Krane, R.J.; Wotiz, H.H.; Cohen, R.A. (Boston Univ. School of Medicine, MA (USA))

    1990-08-01

    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.

  14. 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.

  15. 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.].

  16. 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.

  17. 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

  18. Assessment of arterial tumor vascularity in small hepatocellular carcinoma. Comparison between color Doppler ultrasonography and radiographic imagings with contrast medium: dynamic CT, angiography, and CT hepatic arteriography

    International Nuclear Information System (INIS)

    Hepatocellular carcinoma (HCC) is characterized by tumor vascularization from the hepatic artery. The objective of our work was to compare color Doppler ultrasonography (CDU), including power Doppler ultrasonography (PDU) with radiographic imagings with contrast medium in regard to the detection of the arterial tumor vascularity of small hepatocellular carcinomas (HCC). We examined 42 small HCC lesions 2 cm or less in diameter in 37 patients for arterial tumor vascularity by conventional CDU, PDU, dynamic computed tomography (dCT), digital subtraction angiography (DSA), and CT hepatic arteriography (CTA). Color images were detected in 25 (59.5%) and 28 (66.7%) of the 42 lesions with conventional CDU and PDU, respectively, and tumor vascularity was detected in 26 (61.9%) by dCT, 23 (54.8%) by DSA, and 29 (69.0%) by CTA. Tumor vascularity could be detected in 51.9% by PDU and CTA, more than by conventional CDU, dCT, and DSA (44.4, 44.4, and 33.3%, respectively) in well-differentiated HCC, whereas the detection rates by these techniques were almost equal (86.7% by CDU, 93.3% by PDU, dCT, and DSA, 100% by CTA, respectively) in moderately and poorly differentiated HCC. PDU is superior to CDU, dCT and DSA and equal to CTA for the detection of tumor vascularity in small HCC, particularly in well-differentiated HCC

  19. Penile prosthesis implant with bi-triangular excision and graft for surgical therapy of Peyronie's disease: A case report.

    Science.gov (United States)

    De Freitas Miranda, Alexandre; Lopes Cançado Machado, Bruno

    2016-01-01

    We present a case of a 65-year-old man, who presented with moderate erectile dysfunction and a dorsal penile deviation of 60° caused by Peyronie's disease. The patient underwent bi-triangularshaped plaque excision, followed by grafting and implantation of inflatable penile prosthesis. Complete penile straightening, without mechanical or geometric abnormalities, was achieved using bi-triangular excision and grafting. Postoperatively, the patient reported high satisfaction with the results and could perform sexual intercourse naturally. This novel technique corrects any degree of penile curvature, permits malleable and semi-rigid penile prosthesis implantation, avoids penile length loss, and eliminates additional incisions. To our knowledge, this case is the first in the literature in which the bi-triangular technique was successfully used for penile prosthesis implantation secondary to Peyronie's disease. This new technique appears to be a good solution to correct penile curvature during penile prosthesis implantation for the treatment of Peyronie's disease associated with erectile dysfunction. PMID:26766812

  20. Pulmonary adenocarcinoma presenting with penile metastasis: a case report

    Directory of Open Access Journals (Sweden)

    Karanikas Christos

    2012-08-01

    Full Text Available Abstract Introduction Penile metastases are an extremely rare occurrence, and most primary malignancies are located in the urinary bladder, prostate, rectum, and rectosigmoid. Although very few cases of penile metastases have been reported, those of lung cancer as the primary tumor are very rare. Among the latter, squamous cell carcinomas constitute the majority, whereas adenocarcinomas are almost exceptions. To the best of our knowledge, only two cases have been reported. Case presentation We report the case of a 59-year-old Greek man who presented with persistent cough and chest pain that had started one month prior to a medical appointment. A physical examination, complete laboratory work-up, computed tomography scanning (of the chest, brain, and abdomen, pelvic magnetic resonance imaging, penile ultrasonography, bone scanning, and histological analyses were conducted. Afterward, a lung adenocarcinoma metastatic to the bones, brain, adrenals, lymph nodes, and penis was diagnosed. The primary lesion was a mass of 4cm in diameter in the apical segment of the lower lobe of the right lung. The patient was treated with bone and brain radiotherapy and various cycles of first- and second-line chemotherapy, and partial response was achieved five months after the initial appointment. Conclusions Although these metastatic sites are well known to occur from a primary pulmonary malignancy, penile metastasis is extremely rare. Its identification requires prompt awareness by the physician despite the dismal prognosis. Furthermore, since the penis usually is omitted from the physical examination and lung cancer is the leading cause of cancer-related deaths, more penile metastases may be detected in the future, making early detection and appropriate management of great importance.

  1. [Trans-Arterial Chemoembolization Therapy for Refractory Advanced Non-Small Cell Lung Cancer with Spherical Embolic Material-A Single Case Report].

    Science.gov (United States)

    Kennoki, Norifumi; Hori, Shinichi; Yuki, Takeo; Sueyoshi, Satoshi; Hori, Atsushi

    2015-11-01

    Here, we report the use of trans-arterial chemoembolization for primary lung cancer. The patient was a 56-year-old woman with refractory Stage ? non-small cell lung cancer who had been treated with repeated systemic chemotherapy. The primary lesion in the right lower lobe was 75mm in size, with multiple lung metastases. It invaded the right main bronchus and caused severe cough. Radiotherapy was not indicated because of the size and extent of the lesion. During a period of 6 months, chemoembolization of the bilateral bronchial arteries using cisplatin 20 mg, docetaxel 20 mg, and 5-FU 250 mg with HepaSphere(super-absorbent polymer microspheres)was performed 5 times. Twenty mg of docetaxel was loaded onto 25 mg of HepaSphere. The microspheres were between 50 and 100 microns in the dry state. The endpoint of embolization was not stasis but the reduction of arterial flow. There were no serious complications during or after the procedure. Immediately after the first session, the patient's cough was significantly improved. After 5 sessions of the same treatment, the primary lesion was reduced to 48mm and the level of CEA was reduced from 9.8 to 4.3 ng/mL. The invasion to the right main bronchus was reduced. The patient has been well without any symptoms for 9 months after initiation of trans-arterial chemoembolization. PMID:26805186

  2. 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.

  3. 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; Kroigaard, Christel; Beck, Lilliana; Boedtkjer, Ebbe; Misfeldt, Mikkel W; Nielsen, Gorm; Schjorring, Olav; Hughes, Alun; Simonsen, Ulf

    2011-01-01

    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...

  4. [Surgical peculiarities of gunshot injuries to arteries of the extremities caused by modern small arms and light weapons].

    Science.gov (United States)

    Samokhvalov, I M; Reva, V A; Denisov, A V; Ozeretskovski?, L B; Pronchenko, A A

    2014-10-01

    The aim of the given study was development of surgical tactics in case of femoral artery injury, caused by medium-calibre bullet, on the basis acute experiment on large biological objects. Experimental animals were shot into mid third of the femora by a rifle cartridge in 7,62-mm calibre (AK-47 made in 1943). The analysis of microstructure, made in 5 cross-sections performed every 1-centimetre way from the wound canal, showed that there were no any damages of arterial wall. Authors came to conclusion that the surgical debridement of the gunshot wound, made by a rifle cartridge in 7,62-mm calibre of AK-47, should consist of exsection of devitalized section of artery. PMID:25532307

  5. The contribution of intrapulmonary shunts to the alveolar-to-arterial oxygen difference during exercise is very small

    DEFF Research Database (Denmark)

    Vogiatzis, Ioannis; Zakynthinos, Spyros; Boushel, Robert; Athanasopoulos, Dimitris; Guenette, Jordan A; Wagner, Harrieth; Roussos, Charis; Wagner, Peter D

    2008-01-01

    Exercise is well known to cause arterial PO2 to fall and the alveolar-arterial PO2 difference(Aa PO2 ) to increase. Until recently, the physiological basis for this was considered to be mostly ventilation/perfusion ((.)VA/(.)Q) inequality and alveolar-capillary diffusion limitation. Recently, arterio-venous shunting through dilated pulmonary blood vessels has been proposed to explain a significant part of the Aa PO2 during exercise. To test this hypothesis we determined venous admixture during 5...

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

    DEFF Research Database (Denmark)

    Matchkov, Vladimir; Larsen, Per; Kold-Petersen, Henrik Houmann; Bouzinova, Elena V.; Bødtkjer, Donna Marie Briggs; Andresen, Jørgen; Aalkjær, Christian

    2008-01-01

    . 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 α1C 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...

  7. 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.

  8. 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...

  9. 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

  10. AB023. Penile augmentation surgery: characteristics of artificial graft material and preoperative preparation

    OpenAIRE

    Lee, Woong Hee

    2015-01-01

    Penile augmentation surgical procedure includes diverse graft materials such as artificial collagen material as well as dermo-fat graft. Important factors of postoperative satisfaction are natural appearance of genitalia at the flaccid state and minimal resorption of graft volume. Artificial collagen materials and acellular dermal matrix are available for surgical procedure with variable size. History of penile augmentation surgery: Pediatric penile surgical procedure for lengthening and reco...

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

    DEFF Research Database (Denmark)

    Lindeborg, Lisa; Fode, Mikkel; Fahrenkrug, Lasse; Sønksen, Jens

    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 wa...

  12. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Schwartz, A.N.; Graham, M.M. (Univ. of Washington Medical Center, Seattle (USA))

    1991-03-01

    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.

  14. Isolated pump erosion of an inflatable penile prosthesis through the scrotum in a diabetic patient

    Directory of Open Access Journals (Sweden)

    Raidh A. Talib

    2013-04-01

    Full Text Available Isolated pump erosion is a rare complication in patients with inflatable penile prosthesis. We describe a case of a diabetic patient who underwent inflatable penile prosthesis implantation with subsequent isolated pump erosion. Repeated attempts of conservative repair of the erosion failed. Finally, the inflatable penile prosthesis was replaced with a malleable one to avoid new pump erosion. In case of isolated pump erosion, replacement of the inflatable penile prosthesis with a malleable one looks to be a good alternative salvage treatment for the patient.

  15. 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 flap 6?c...

  16. Our 8 Years Experience on Penile Fractures: The Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    Mustafa Gunes

    2012-10-01

    Full Text Available Aim: The purpose of this study to present our experience with diagnosis and treatment management of penile fracture. Material and Method: Patients who were admitted our clinic with complaints of sudden penile swelling and pain during 8 years were screened. Clinical information of 30 patients aged between 16 and 45 retrospectively analyzed. The patients had applied to emergency room during the first 10 hours following penile swelling and pain. Results: Penile fracture was detected in 28 patients and dorsal penile vein rupture mimicking penile fracture was detected in 2 patients. The most common etiologies of penile fracture were coitus and manually bending the penis for detumescence. Diagnoses were made based on history and physical examination. The treatment was surgical in 28 cases with subcoronal circumferential degloving incision and 2 patients were treated with vein ligation due to dorsal vein rupture. Erectile dysfunction or penile curvature were not detected (except the last five cases during a mean follow up of 18.7 months (range 8-28. Discussion: Although conservative treatment options were adviced, many authors prefer surgery because of the rapid recovery, short hospitalization duration, less morbidity and less penil curvature during the long term period.

  17. Value of positron emission tomography in diagnosing synchronous penile metastasis from urothelial bladder cancer.

    Science.gov (United States)

    Rouanne, M; Alhammadi, A; Vilain, D; Radulescu, C; Lebret, T

    2015-01-01

    Metastases to the penis are extremely rare events. Most frequently, penile metastases come from the urogenital system (bladder, prostate) or the rectum-sigmoid colon. Usually painful, penile lesions may be asymptomatic, making diagnosis more challenging. Hence, we report the adding value of (18)F-fludeoxyglucose-positron emission tomography/computed tomography ((18)F-FDG PET/CT) in the detection of penile metastases originating from urothelial carcinoma of the bladder. Arguably, penile metastases must be considered as an advanced disease requiring essentially palliative care. Therefore, accurate staging of clinically localized muscle-invasive bladder cancer is crucial to avoid useless curative intent radical surgery. PMID:26376852

  18. A delayed foreskin-sparing approach to the management of penile fractures in uncircumcised Jamaican men

    Directory of Open Access Journals (Sweden)

    Dean P. Wong

    2015-01-01

    Conclusion: Delayed repair of penile fractures results in foreskin preservation, facilitates elective ambulatory care under local anaesthesia and decreases the incidence of negative surgical explorations.

  19. A Contemporary Review of HPV and Penile Cancer.

    Science.gov (United States)

    Stratton, Kelly L; Culkin, Daniel J

    2016-03-15

    Human papillomavirus (HPV) is a widespread sexually transmitted infection. In both men and women, HPV infection can result in a spectrum of genitourinary manifestations ranging from genital warts to cancer. Cervical cancer is nearly always associated with high-risk HPV infection. For men, penile cancer can develop following or independently of HPV infection. Basaloid and warty subtypes of penile squamous cell carcinoma are most frequently associated with HPV infection. Further research into the molecular alterations caused by HPV infection may provide prognostic markers and future treatment targets. Until an effective treatment for HPV infection is developed, prevention will remain the focus of disease control. For women, vaccination is increasingly utilized to prevent HPV infection and subsequent cervical cancer development. New recommendations for routine male vaccination may further reduce cancers for both men and women. PMID:26984219

  20. Sex therapy and the penile prosthesis: a synthesis.

    Science.gov (United States)

    Schover, L R; von Eschenbach, A C

    1985-01-01

    Although the availability of the penile prosthesis has changed the evaluation and treatment of erectile dysfunction, urologists and sex therapists have not combined their skills to develop comprehensive treatment plans. This paper describes one effort to use sex therapy techniques in evaluating and treating candidates for a penile prosthesis. The preoperative assessment focuses on multiaxial diagnosis of sexual problems in patient and partner and on the effects a prosthesis might have on their sexual and marital relationship. Men at high risk for a negative psychological reaction after surgery are offered presurgical sex therapy. Routine follow-up visits are scheduled for all patients during postoperative recovery and at 2-3 months postsurgery. If sexual dysfunction or dissatisfaction persists, sex therapy is again recommended. A case history exemplifies our methods, and the issue of financial costs of counseling vs. predicted benefits in terms of patient satisfaction is discussed. PMID:4039371

  1. Penile gangrene following condom catheter urinary drainage : A case report

    Directory of Open Access Journals (Sweden)

    Sandhya Gupta

    2016-04-01

    Full Text Available External urine collecting devices have been a boon to patients of urinary incontinence since their invention in late 90s. They have replaced the need for uncomfortable indwelling catheters in these patients. As safe as they may be, ghastly complications have occurred infrequently, mostly due to their inappropriate application. Such penile and urethral complications add to the morbidity of the patients significantly. They can be easily avoided by following few simple steps of catheter care, thus emphasizing the need to aware clinicians and health care workers about the correct application methods. Here we discuss a case of 60 year old male who developed penile skin necrosis and urethral fistula due to chronic use of condom catheter.

  2. 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), ...

  3. Penile involvement in Systemic Sclerosis: New Diagnostic and Therapeutic Aspects

    OpenAIRE

    Antonio Aversa; Roberto Bruzziches; Davide Francomano; Edoardo Rosato; Felice Salsano; Giovanni Spera

    2010-01-01

    Systemic Sclerosis (SSc) is a connective tissue disorder featuring vascular alterations and an immunological activation leading to a progressive and widespread fibrosis of several organs such as the skin, lung, gastrointestinal tract, heart, and kidney. Men with SSc are at increased risk of developing erectile dysfunction (ED) because of the evolution of early microvascular tissutal damage into corporeal fibrosis. The entity of penile vascular damage in SSc patients has been demonstrated by u...

  4. 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...

  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. Penile Prosthesis: What Should We Do about Complications?

    OpenAIRE

    Bettocchi, C.; Ditonno, P.; Palumbo, F.; Lucarelli, G; Garaffa, G.; Giammusso, B.; Battaglia, M.(Lawrence Berkeley National Laboratory and University of California, 94720, Berkeley, California, USA)

    2008-01-01

    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 l...

  7. 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.

  8. 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.

  9. Novel optical system for in vitro quantification of full surface strain fields in small arteries: II. Correction for refraction and illustrative results.

    Science.gov (United States)

    Genovese, K; Lee, Y U; Humphrey, J D

    2011-03-01

    In a companion paper, we described a theoretical foundation for and initial experimental implementation of a novel stereo-digital image correlation (DIC) method for quantifying the size, shape and deformation of small cylindrical specimens along their full length and around their entire circumference. In this paper, we further show that this panoramic-DIC method can be used to study mouse carotid arteries without affecting their native mechanical properties and show the advantage of the approach in studying more complex mouse aorta. In particular, we first resolve the ubiquitous issue of refraction in non-contacting optical measurements of strain while tissues are immersed in physiologic saline and we show that surface preparation for DIC does not affect the inferred mechanical properties either qualitatively or quantitatively, the latter via the use of a four-fibre family hyperelastic constitutive relation and associated estimation of material parameters using nonlinear regression. We thus submit that panoramic-DIC-based strain measurement has significant potential to increase our understanding of arterial mechanics in genetic models of arterial health and disease by allowing investigators to exploit advances in transgenic mice. PMID:21347913

  10. 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.

  11. 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.)

  12. 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; Stausbøl-Grøn, B; Buus, N H; Aalkjær, Christian

    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 lysopho...

  13. Accessory renal arteries: a case report

    OpenAIRE

    Billakanti Prakash Babu; Anjali Roy; Hemalatha Bangera

    2014-01-01

    During dissection of abdomen by the undergraduate medical students three accessory renal arteries were observed on the right side. The superior accessory artery was a small vessel arising from aorta just above the normal renal artery. It entered the anterior surface of kidney just below the upper pole. The middle and inferior arteries were caudal to the normal renal artery. The middle artery was arising from testicular artery and entered the anterior surface of kidney below the hilum. The inf...

  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. Penile injury due to blunt trauma after circumcision in a male child: A case report

    Directory of Open Access Journals (Sweden)

    Hulya Ozturk

    2014-08-01

    Full Text Available Injury in the case presented here is different from the cause of penile trauma. Our case has been exposed to blunt trauma after circumcision. Type developments of the penile trauma, treatment, and precautions have been discussed with the literature.

  17. 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.

  18. DNA Copy Number Aberrations, and Human Papillomavirus Status in Penile Carcinoma. Clinico-Pathological Correlations and Potential Driver Genes.

    Science.gov (United States)

    La-Touche, Susannah; Lemetre, Christophe; Lambros, Maryou; Stankiewicz, Elzbieta; Ng, Charlotte K Y; Weigelt, Britta; Rajab, Ramzi; Tinwell, Brendan; Corbishley, Cathy; Watkin, Nick; Berney, Dan; Reis-Filho, Jorge S

    2016-01-01

    Penile squamous cell carcinoma is a rare disease, in which somatic genetic aberrations have yet to be characterized. We hypothesized that gene copy aberrations might correlate with human papillomavirus status and clinico-pathological features. We sought to determine the spectrum of gene copy number aberrations in a large series of PSCCs and to define their correlations with human papillomavirus, histopathological subtype, and tumor grade, stage and lymph node status. Seventy formalin-fixed, paraffin embedded penile squamous cell carcinomas were centrally reviewed by expert uropathologists. DNA was extracted from micro-dissected samples, subjected to PCR-based human papillomavirus assessment and genotyping (INNO-LiPA human papillomavirus Genotyping Extra Assay) and microarray-based comparative genomic hybridization using a 32K Bacterial Artificial Chromosome array platform. Sixty-four samples yielded interpretable results. Recurrent gains were observed in chromosomes 1p13.3-q44 (88%), 3p12.3-q29 (86%), 5p15.33-p11 (67%) and 8p12-q24.3 (84%). Amplifications of 5p15.33-p11 and 11p14.1-p12 were found in seven (11%) and four (6%) cases, respectively. Losses were observed in chromosomes 2q33-q37.3 (86%), 3p26.3-q11.1 (83%) and 11q12.2-q25 (81%). Although many losses and gains were similar throughout the cohort, there were small significant differences observed at specific loci, between human papillomavirus positive and negative tumors, between tumor types, and tumor grade and nodal status. These results demonstrate that despite the diversity of genetic aberrations in penile squamous cell carcinomas, there are significant correlations between the clinico-pathological data and the genetic changes that may play a role in disease natural history and progression and highlight potential driver genes, which may feature in molecular pathways for existing therapeutic agents. PMID:26901676

  19. DNA Copy Number Aberrations, and Human Papillomavirus Status in Penile Carcinoma. Clinico-Pathological Correlations and Potential Driver Genes

    Science.gov (United States)

    Lambros, Maryou; Stankiewicz, Elzbieta; Ng, Charlotte K. Y.; Weigelt, Britta; Rajab, Ramzi; Tinwell, Brendan; Corbishley, Cathy; Watkin, Nick; Berney, Dan; Reis-Filho, Jorge S.

    2016-01-01

    Penile squamous cell carcinoma is a rare disease, in which somatic genetic aberrations have yet to be characterized. We hypothesized that gene copy aberrations might correlate with human papillomavirus status and clinico-pathological features. We sought to determine the spectrum of gene copy number aberrations in a large series of PSCCs and to define their correlations with human papillomavirus, histopathological subtype, and tumor grade, stage and lymph node status. Seventy formalin-fixed, paraffin embedded penile squamous cell carcinomas were centrally reviewed by expert uropathologists. DNA was extracted from micro-dissected samples, subjected to PCR-based human papillomavirus assessment and genotyping (INNO-LiPA human papillomavirus Genotyping Extra Assay) and microarray-based comparative genomic hybridization using a 32K Bacterial Artificial Chromosome array platform. Sixty-four samples yielded interpretable results. Recurrent gains were observed in chromosomes 1p13.3-q44 (88%), 3p12.3-q29 (86%), 5p15.33-p11 (67%) and 8p12-q24.3 (84%). Amplifications of 5p15.33-p11 and 11p14.1-p12 were found in seven (11%) and four (6%) cases, respectively. Losses were observed in chromosomes 2q33-q37.3 (86%), 3p26.3-q11.1 (83%) and 11q12.2-q25 (81%). Although many losses and gains were similar throughout the cohort, there were small significant differences observed at specific loci, between human papillomavirus positive and negative tumors, between tumor types, and tumor grade and nodal status. These results demonstrate that despite the diversity of genetic aberrations in penile squamous cell carcinomas, there are significant correlations between the clinico-pathological data and the genetic changes that may play a role in disease natural history and progression and highlight potential driver genes, which may feature in molecular pathways for existing therapeutic agents. PMID:26901676

  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. Hipertensão arterial e saúde da família: atenção aos portadores em município de pequeno porte na região Sul do Brasil / Arterial hypertension and family care: care provided to hypertensive individuals in a small municipality in Southern Brazil

    Scientific Electronic Library Online (English)

    Luciano Burigo de, Sousa; Regina Kazue Tanno de, Souza; Maria José, Scochi.

    2006-10-01

    Full Text Available OBJETIVO: A partir da análise de indicadores, que expressem aproximação à lógica das ações programáticas, foi desenvolvido um estudo transversal com o objetivo de avaliar o desempenho de uma Equipe de Saúde da Família na atenção às pessoas portadoras de hipertensão arterial em município de pequeno p [...] orte. MÉTODOS: A pesquisa foi realizada a partir da análise das fichas de cadastro, Ficha A do Sistema de Informação de Atenção Básica, de 418 pessoas portadoras de hipertensão arterial, do registro de informações em 351 prontuários, localizados na unidade básica de saúde, em 376 entrevistas realizadas com os residentes na área de atuação da equipe, no ano de 2003. Foram estudadas as seguintes variáveis: sexo, idade, renda familiar, condições de moradia, serviço de saúde utilizado, presença de diabete melito, cobertura e concentração de atendimento. RESULTADOS: Mulheres com idade acima de sessenta anos predominaram: (65,7% dos casos). A taxa de prevalência de hipertensão arterial referida foi de 18%, sendo distinta entre os sexos: nas mulheres foi de 22,3%, a cobertura foi de 64,1% para consultas médicas, 32,4% para consultas de enfermagem e 36,4% para atendimentos médicos domiciliares. Os registros em prontuário revelaram que 25,8% dos portadores não foram atendidos em 2003 e 52,7% não receberem atendimento no último semestre. A concentração de atendimentos foi abaixo da preconizada. CONCLUSÃO: As informações revelaram distanciamento da organização da atenção na lógica da vigilância à saúde, prevalecendo o atendimento à demanda espontânea, expressando despreparo na utilização dos sistemas de informação para o planejamento e avaliação das ações. Abstract in english OBJECTIVE: This transversal study was developed from the analysis of indicators which express the desirable approach for programmatic actions, with the objective of evaluating the performance of a Family Healthcare Center in its attendance to patients suffering from arterial hypertension living in a [...] small municipal district. METHODS: The research was carried out starting from the analysis of the records of enrollment in the program, Record A from SIAB (Primary Care Information System), of 418 individuals suffering from arterial hypertension. It was also analyzed the information of 351 files from the health center. In addition, 376 interviews were carried out with individuals living in the vicinity of the health center, in the year of 2003. The following variables were studied: gender, age, family income, home conditions, health services used presence of diabetes mellitus, average number of individuals attended and attendance concentration. RESULTS: Women above 60 years of age prevailed in 65.7% of the cases. The hypertension prevalence rate on individuals who searched for care was of 18%, being different among gender, among women it was of 22.3%. The average number of appointments with a doctor was of 64.1%; 32.4% for appointments with a nurse, and 36.4% for home medical attendance. The information on files revealed that 25.8% of the individuals were not assisted in 2003 and 52.7% received no assistance in the last semester. The concentration of services was below preconization. CONCLUSION: The information revealed no organization on the attention to the preventive health care, focusing the assistance to a spontaneous demand, expressing unpreparedness in the use of information systems for the planning and evaluation of the actions.

  2. Effects of Bolus and Continuous Nasogastric Feeding on Gastric Emptying, Small Bowel Water Content, Superior Mesenteric Artery Blood Flow, and Plasma Hormone Concentrations in Healthy Adults

    Science.gov (United States)

    Chowdhury, Abeed H.; Murray, Kathryn; Hoad, Caroline L.; Costigan, Carolyn; Marciani, Luca; Macdonald, Ian A.; Bowling, Timothy E.; Lobo, Dileep N.

    2016-01-01

    Objective: We aimed to demonstrate the effect of continuous or bolus nasogastric feeding on gastric emptying, small bowel water content, and splanchnic blood flow measured by magnetic resonance imaging (MRI) in the context of changes in plasma gastrointestinal hormone secretion. Background: Nasogastric/nasoenteral tube feeding is often complicated by diarrhea but the contribution of feeding strategy to the etiology is unclear. Methods: Twelve healthy adult male participants who underwent nasogastric intubation before a baseline MRI scan, received 400?mL of Resource Energy (Nestle) as a bolus over 5 minutes or continuously over 4?hours via pump in this randomized crossover study. Changes in gastric volume, small bowel water content, and superior mesenteric artery blood flow and velocity were measured over 4?hours using MRI and blood glucose and plasma concentrations of insulin, peptide YY, and ghrelin were assayed every 30 minutes. Results: Bolus nasogastric feeding led to significant elevations in gastric volume (P?insulin (P?=?0.0024) and peptide YY (P?small bowel water content, thus fluid flux within the small bowel is not a major contributor to the etiology of tube feeding-related diarrhea. PMID:25549202

  3. Hair coil penile tourniquet syndrome in an unusual age.

    Science.gov (United States)

    Zengin, Kursad; Ozdamar, Mustafa Yasar; Albayrak, Sebahattin; Tanik, Serhat; Atar, Muhittin; Bakirtas, Hasan; Imamoglu, Muhammed Abdurrahim; Gurdal, Mesut

    2015-01-01

    Penile tourniquet syndrome (PTS), a rare urologic emergency, may lead to undesirable results including necrosis and amputation of penis, if not diagnosed and treated appropriately. Sometimes these injuries may be accepted as a forensic case. Miscellaneous objects used for strangulation can be metallic or nonmetallic. Of all ages, the most vulnerable period is infancy. Telogen effluvium is the most common cause of PTS in infants who are 0-6 years old. In the literature, telogen effluvium as a reason of PTS was not found except for this age group. Therefore, we aimed to present a boy who is 8 years old diagnosed as PTS because of his mother's hair coil. PMID:25763288

  4. Hair Coil Penile Tourniquet Syndrome in an Unusual Age

    Science.gov (United States)

    Zengin, Kursad; Ozdamar, Mustafa Yasar; Albayrak, Sebahattin; Tanik, Serhat; Atar, Muhittin; Bakirtas, Hasan; Imamoglu, Muhammed Abdurrahim; Gurdal, Mesut

    2015-01-01

    Penile tourniquet syndrome (PTS), a rare urologic emergency, may lead to undesirable results including necrosis and amputation of penis, if not diagnosed and treated appropriately. Sometimes these injuries may be accepted as a forensic case. Miscellaneous objects used for strangulation can be metallic or nonmetallic. Of all ages, the most vulnerable period is infancy. Telogen effluvium is the most common cause of PTS in infants who are 0–6 years old. In the literature, telogen effluvium as a reason of PTS was not found except for this age group. Therefore, we aimed to present a boy who is 8 years old diagnosed as PTS because of his mother's hair coil. PMID:25763288

  5. 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.

  6. Comparative penile morphology of East African galagos of the genus Galagoides (family Galagidae): implications for taxonomy.

    Science.gov (United States)

    Perkin, Andrew

    2007-01-01

    Recent studies on the comparative penile morphology of galagos have revealed complex patterns that vary among both genera and species, and help with species identification. So far the penile morphologies of 14 galago species have been described and an identification key has been proposed. The present study extends and revises previous work. Wild Galagoides cocos, G. granti, G. zanzibaricus and G. rondoensis from the Eastern Arc Mountains and coastal forests of Tanzania and Kenya were live-trapped, and one species (G. orinus) was examined using a museum specimen. Penile morphology was photographed, traced, and described qualitatively. All of the mature males had penile spines. Spines were absent or indistinct in immature males of all of the species. The penile morphologies of G. cocos, G. granti, and G. zanzibaricus are similar in their overall distribution and type of spines, but differ in the shape of the glans penis. Both G. orinus and G. rondoensis have divergent penile morphologies compared to all other galagos, and are probably phylogenetically distinct. The results support other recent morphological and behavioral studies that consider these five galagos to be distinct species. The evolution of the baculum and spines is thought to be linked to sexual selection in multimale mating systems, but the mechanisms involved are not entirely understood. Adult male G. rondoensis appear to display the penile spines by exposing the distal section of the penis. PMID:17171678

  7. Human papillomavirus genotype prevalence in invasive penile cancers from a registry-based United States population

    Directory of Open Access Journals (Sweden)

    BrendaYHernandez

    2014-02-01

    Full Text Available Background. Human papillomavirus (HPV is estimated to play an etiologic role in 40%-50% of penile cancers worldwide. Estimates of HPV prevalence in U.S. penile cancer cases are limited. Methods. HPV DNA was evaluated in tumor tissue from 79 invasive penile cancer patients diagnosed in 1998-2005 within the catchment areas of 7 U.S. cancer registries. HPV was genotyped using PCR-based Linear Array and INNO-LiPA assays and compared by demographic, clinical, and pathologic characteristics and survival. Histological classification was also obtained by independent pathology review. Results. HPV DNA was present in 50 of 79 (63% of invasive penile cancer cases. Sixteen viral genotypes were detected. HPV 16, found in 46% (36/79 of all cases (72% of HPV-positive cases was the most prevalent genotype followed equally by HPV 18, 33, and 45, which each comprised 5% of all cases. Multiple genotypes were detected in 18% of viral positive cases. HPV prevalence did not significantly vary by age, race/ethnicity, population size of geographic region, cancer stage, histology, grade, penile subsite, or prior cancer history. Penile cases diagnosed in more recent years were more likely to be HPV positive. Overall survival did not significantly vary by HPV status. Conclusions. The relatively high prevalence of HPV in our study population provides limited evidence of a more prominent and, possibly, increasing role of infection in penile carcinogenesis in the U.S. compared to other parts of the world.

  8. 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

  9. Report of 84 cases of penile Fracture inBeheshti Hospital center

    Directory of Open Access Journals (Sweden)

    H. Shafi

    2005-01-01

    Full Text Available Background and purpose : Penile fracture is the rupture of the corpus cavernousum due to trauma to the erect penis , which has various background etiologies in different countries according to their habits. The aim of this study was to determine and evaluate the frequency, etiologies and complications of penile fracture in our geographic area.Material and Methods : This analytical-cross sectional study was performed via census sampling among men referred to Sh. Beheshti Hospital of Babol Medical University during 1995 to 2004. Data were analyzed by Chi-Square, Fisher`s exact and T-test using SPSS release 12.Results : 84 patients with penile fracture (mean age of 18.1 years were studied. The frequency was higher in single patients (78% than married ones. The most important complaint of patients with penile fracture was penile pain (36%, hematoma (30%, and penile swelling (12%. Background factors were manipulation of erect penis (74%, sexual intercourse (18% trauma to erect pennies (8%. Urethral ruptures were seen in 8% of all patients with feacture. There were significant differences between urethral rupture and background etiologies (P=0.000 and marrital status (p=0.000 as 90% of the cases were single patient, referred to hospital due to manipulation of erect pennies (P=0.000.Conclusion : High frequency of penile manipulation among young boys in the study area in comparison with other studies results in penile fracture but subsequent urethral rupture was uncommon among men. Better and earlier diagnosis of penile fracture is related to determination of background etologies in the patients.

  10. 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)

  11. 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; Sørensen, Charlotte Mehlin; von Holstein-Rathlou, Niels-Henrik; Pedersen, Henrik Duelund; Christoffersen, Berit Ø.; Olsen, Lisbeth Høier; Ludvigsen, Trine Pagh

    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...

  12. Penile Rehabilitation After Radical Prostatectomy: Important Therapy or Wishful Thinking?

    Science.gov (United States)

    Dall’Era, Joseph E; Mills, Jesse N; Koul, Hari K; Meacham, Randall B

    2006-01-01

    On the basis of data accumulated thus far, it is reasonable to discuss the implementation of a “penile rehabilitation” program with patients undergoing radical prostatectomy. Central to discussions of penile rehabilitation after radical prostatectomy is evidence demonstrating significant fibrotic changes in the corpus cavernosum that occur postoperatively. Several studies have been published evaluating the efficacy of various pro-erectogenic agents. The limited data regarding intracavernous injections and vacuum constriction devices suggest that an increased percentage of treated patients experienced a return of natural erections compared with patients who received no treatment. Longer, prospective, randomized, placebo-controlled studies will be needed to confirm the utility of these treatments. Data from contemporary studies evaluating the chronic use of oral phosphodiesterase type 5 inhibitors suggest a beneficial effect on endothelial cell function among men suffering from erectile dysfunction due to a variety of causes. Limited data suggest that this effect might be seen among post-prostatectomy patients, implying a possible role for these agents in enhancing the return of sexual function in such individuals. PMID:17192800

  13. 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.)

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

    Directory of Open Access Journals (Sweden)

    Naser Sadeghian

    2009-04-01

    Full Text Available 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, bilateral descended testis, normally located anus, urethral opening in anus, 46xy karyotype and associated anomalies. In 2 cases parents refused any surgical interventions, but in 6 cases we did perform different operations (transforming five cases to females and one case to male gender. Conclusion:We recommend feminizing operations in newborns or infants, but in older patients, regarding the childs psychology, it is advised to perform masculinizing operations, and finally, no surgical intervention should be undertaken before counseling the parents.

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

    Directory of Open Access Journals (Sweden)

    Alireza Mirshemirani

    2009-06-01

    Full Text Available 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, bilateral descended testis, normally located anus, urethral opening in anus, 46xy karyotype and associated anomalies. In 2 cases parents refused any surgical interventions, but in 6 cases we did perform different operations (transforming five cases to females and one case to male gender.Conclusion:We recommend feminizing operations in newborns or infants, but in older patients, regarding the child's psychology, it is advised to perform masculinizing operations, and finally, no surgical intervention should be undertaken before counseling the parents.

  16. A penal problem: the increasing incidence of implantation of penile foreign bodies.

    Science.gov (United States)

    Flynn, Ryan M; Mostafa, Hesham I; Khan, Omar A; Haselhuhn, Gregory D; Jain, Samay

    2014-12-01

    Our objective is to describe a novel presentation of subcutaneous penile insertion of foreign bodies. This is a practice performed globally and mostly has been reported outside of the United States. We present three cases of incarcerated males that implanted sculpted dominos into the penile subcutaneous tissue. The patients presented with erosion of the foreign bodies through the skin without evidence of infection. We believe that insertion of foreign bodies into penile subcutaneous tissue by incarcerated American males for sexual enhancement is more widespread than previously reported. Erosion is a novel presentation. PMID:25483769

  17. Male Circumcision and Anatomic Sites of Penile High-Risk Human Papillomavirus in Rakai, Uganda

    OpenAIRE

    Tobian, Aaron A R; Kong, Xiangrong; Gravitt, Patti E.; Eaton, Kevin P.; Kigozi, Godfrey; SERWADDA, David; Oliver, Amy E.; Nalugoda, Fred; Makumbi, Frederick; Chen, Michael Z.; Wawer, Maria J.; Quinn, Thomas C; GRAY, RONALD H.

    2011-01-01

    Male circumcision (MC) reduces penile high-risk human papillomavirus (HR-HPV) on the coronal sulcus and urethra. HR-HPV varies by anatomic site, and it is unknown whether MC decreases HR-HPV on the penile shaft. We assessed the efficacy of MC to reduce HR-HPV on the penile shaft and compared it to known efficacy of MC to reduce HR-HPV on the coronal sulcus. HIV-negative men randomized to receive immediate circumcision (intervention) or circumcision delayed for 24 months (control) were evaluat...

  18. Human papillomavirus genotype prevalence in invasive penile cancers from a registry-based United States population

    OpenAIRE

    BrendaYHernandez; MarcTGoodman; ElizabethUnger; CharlesF.Lynch; WendyCozen; EdwardSPeters; EdwardJWilkinson; GlennCopeland; ClaudiaHopenhayn; YoujieHuang; MegWatson; SeanFAltekruse; ChristopherLyu

    2014-01-01

    Background. Human papillomavirus (HPV) is estimated to play an etiologic role in 40%-50% of penile cancers worldwide. Estimates of HPV prevalence in U.S. penile cancer cases are limited. Methods. HPV DNA was evaluated in tumor tissue from 79 invasive penile cancer patients diagnosed in 1998-2005 within the catchment areas of 7 U.S. cancer registries. HPV was genotyped using PCR-based Linear Array and INNO-LiPA assays and compared by demographic, clinical, and pathologic characteristics and ...

  19. Human Papillomavirus Genotype Prevalence in Invasive Penile Cancers from a Registry-Based United States Population

    OpenAIRE

    Hernandez, Brenda Y; Goodman, Marc T.; Unger, Elizabeth R; Steinau, Martin; Powers, Amy; Lynch, Charles F; Cozen, Wendy; Saber, Maria Sibug; Peters, Edward S.; Wilkinson, Edward J.; Copeland, Glenn; Hopenhayn, Claudia; Huang, Youjie; Watson, Meg; Altekruse, Sean F.

    2014-01-01

    Background: Human papillomavirus (HPV) is estimated to play an etiologic role in 40–50% of penile cancers worldwide. Estimates of HPV prevalence in U.S. penile cancer cases are limited. Methods: HPV DNA was evaluated in tumor tissue from 79 invasive penile cancer patients diagnosed in 1998–2005 within the catchment areas of seven U.S. cancer registries. HPV was genotyped using PCR-based Linear Array and INNO-LiPA assays and compared by demographic, clinical, and pathologic characteristics ...

  20. Proteome Analysis of Human Arterial Tissue Discloses Associations Between the Vascular Content of Small Leucine-Rich Repeat Proteoglycans and Pulse Wave Velocity

    DEFF Research Database (Denmark)

    Lyck Hansen, Maria; Beck, Hans Christian; Irmukhamedov, Akhmadjon; Jensen, Pia Søndergaard; Olsen, Michael Hecht; Rasmussen, Lars Melholt

    2015-01-01

    OBJECTIVES: We hypothesized that arterial stiffness is associated with changes in the arterial protein profile, particularly of extracellular matrix components. We aimed at determining differentially expressed proteins by quantitative proteome analysis in arterial tissue from patients with...... grafting. Protein extracts of well-defined, homogenous, nonatherosclerotic individual samples of the left mammary artery from 10 of these patients with high PWV and 9 with low PWV were compared by quantitative proteome analysis, using tandem mass tag labeling and nano-liquid chromatography mass...

  1. 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)

  2. Mechanisms of vasorelaxation induced by the cannabidiol analogue compound O-1602 in the rat small mesenteric artery.

    Science.gov (United States)

    Al Suleimani, Y M; Al Mahruqi, A S; Hiley, C R

    2015-10-15

    Atypical cannabinoid O-1602 (5-Methyl-4-[(1R,6R)-3-methyl-6-(1-cyclohexen-1-yl]-1,3-benzenediol) induces vasorelaxation and activates the orphan G protein-coupled receptor GPR55 in human endothelial cells. This study investigates the underlying mechanisms of vasorelaxation induced by this compound. The vasodilator activity was assessed in the rat third order branch of the superior mesenteric artery using a wire myograph. The vasorelaxation was partially endothelium-dependent (pEC50%=5.8±0.3). The endothelial component was antagonized by the putative endothelial receptor antagonists rimonabant (3 µM; pEC50%=5.1±0.2) and O-1918 (10 µM; pEC50%=5.3±0.2) but not by the CB1 and CB2 receptors antagonists AM 251 (10 µM) and AM 630 (10 µM), respectively. The vasorelaxation was not pertussis toxin-sensitive and not mediated through TRPVI receptors or by the release of NO, but was reduced by inhibition of Ca2+ sensitive K+ channels (KCa). In endothelium-denuded vessels, O-1602 abolished CaCl2-induced contraction and the inhibition was apparently reversed by O-1918. O-1602 mediates its vasorelaxant effects partly by an endothelium-dependent pathway involving rimonabant- and O-1918-sensitive targets that are distinct from the classical CB1 and CB2 cannabinoid receptors and might involve activation of KCa. The endothelium-independent relaxation might involve interfering with Ca2+ entry. PMID:26297305

  3. 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 be important when individualizing penile revascularization procedures. In a limited number of highly selected individuals PR can be successful for the long-term. Randomized controlled trials examining different PR techniques are needed to better examine the PR techniques.

  4. Hpv-Associated Penile Pigmented Lesion

    Directory of Open Access Journals (Sweden)

    Ananiev J.

    2014-06-01

    Full Text Available HPV infection is involved in the etiology of a number of nonmalignant, premalignant and malignant cutaneous lesions. One of them is the so-called giant condyloma of Buschke-Löwenstein type (Buschke-Löwenstein tumor, BLT, which sometimes can imitate clinically other tumors or tumor-like conditions. Clinicians face a particular challenge in cases of BLT where, clinically, the lesions demonstrate a permanent brown hyperpigmentation in parallel with the dermatoscopic lack of the characteristic melanocytic network, globules or regression zones. There are uncommon clinical presentations with solitary, sharply demarcated pigmented lesions. In these cases the histopathological verification of the lesion is obligatory and the most efficient treatment method in the early period of the disease is the complete surgical excision. We report a case of a 74-year-old man who was admitted to the University Hospital “Lozenetz” in connection with profuse variceal bleeding of the esophagus associated with liver cirrhosis of unknown etiology. He underwent a consultative examination at the department of dermatology because of suspected advanced stage melanoma of the prepuce. Computed tomographic analysis indicated diffuse bone metastases located in the small pelvis and femur, as well as metastatic disease in the left inguinal lymph nodes. However, the subsequent histopathologic examination of the lesion, rather than showing melanoma, confirmed the presence of HPV-associated giant condyloma of Buschke and Löwenstein in initial stage, without histopathological evidence for invasive and destructive tumor growth. After his death, the patient’s relatives did not give consent for an autopsy, and therefore the genesis of the metastases, demonstrated by nuclear magnetic resonance imaging (NMR, remained unclear. In some cases, the clinical picture of the malignant and premalignant cutaneous lesions in the genital area could be problematic. The complete surgical excision with a subsequent histopathological verification is the best way to find out the exact diagnosis

  5. 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.

  6. Usefulness of Cone-Beam Computed Tomography During Ultraselective Transcatheter Arterial Chemoembolization for Small Hepatocellular Carcinomas that Cannot be Demonstrated on Angiography

    International Nuclear Information System (INIS)

    This study evaluated the usefulness of cone-beam computed tomography (CBCT) during ultraselective transcatheter arterial chemoembolization (TACE) for hepatocellular carcinomas (HCC) that could not be demonstrated on angiography. Twenty-eight patients with 33 angiographically occult tumors (mean diameter 1.3 ± 0.3 cm) were enrolled in the study. The ability of CBCT during arterial portography (CBCTAP), during hepatic arteriography (CBCTHA), and after iodized oil injection (LipCBCT) to detect HCC lesions was retrospectively analyzed. The technical success of TACE was divided into three grades: complete (the embolized area included the entire tumor with at least a 5-mm wide margin), adequate (the embolized area included the entire tumor but without a 5-mm wide margin in parts), and incomplete (the embolized area did not include the entire tumor) according to computed axial tomographic (CAT) images obtained 1 week after TACE. Local tumor progression was also evaluated. CBCTAP, CBCTHA, and LipCBCT detected HCC lesions in 93.9% (31 of 33), 96.7% (29 of 30), and 100% (29 of 29) of patients, respectively. A single branch was embolized in 28 tumors, and 2 branches were embolized in five tumors. Twenty-seven tumors (81.8%) were classed as complete, and 6 (18.2%) were classed as adequate. None of the tumors were classed as incomplete. Twenty-five tumors (75.8%) had not recurred during 12.0 ± 6.2 months. Eight tumors (24.2%), 5 (18.5%) of 27 complete success and 3 (50%) of 6 adequate success, recurred during 10.1 ± 6.2 months. CBCT during TACE is useful in detecting and treating small HCC lesions that cannot not be demonstrated on angiography.

  7. Concurrent chemoradiotherapy with bronchial arterial infusion of CDDP for the treatment of locally-advanced non-small cell lung cancer

    International Nuclear Information System (INIS)

    The standard treatment for locally advanced (stage III) non-small cell lung cancer (NSCLC) is concurrent use of chemoradiotherapy containing cisplatinum (CDDP). To enhance the local control and reduce the systemic adverse effects, we have been performing intraarterial infusion of CDDP from the bronchial arteries (BAI of CDDP) instead of intravenous administration. In principle, we administered 80 mg/m2 of CDDP intra- arterially twice during the conventionally fractionated radiation therapy of 60 to 70 Gy. The dose of CDDP was changed according to the patient's renal function. Between 1996 and 2001 40 cases with stage III NSCLC were treated definitively. Median age was 75 years. There were 28 squamous cell carcinoma (Sqcca) and 9 adenoca. There were 7 stage IIIA and 33 stage IIIB cases. Average total RT dose was 63.4 Gy and median total CDDP dose was 220 mg. Median follow-up period was 63 months. Median survival time was 27 months. Five-year overall, relapse-free and cause-specific survival rates were 41%, 33% and 56%, respectively. Five-year local relapse-free rate was 57%. As for acute complications, we had only six (15%) grade 3 hematological and 2 (5%) grade 3 pulmonary complications, and we had no severe esophageal complications, which is often a dose-limiting factor. Our survival results of concurrent radiotherapy and BAI of CDDP for the treatment of stage III NSCLC have been promising with a low rate of severe adverse effects. Judging from the high rate of long-term disease-free survivors, disease clearance by chemoradiotherapy might be quite essential to improve the treatment results. (author)

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

    OpenAIRE

    Van der Horst, C.; F.J. Martinez Portillo; C Seif; Musial, A.; Alken, P.; Jünemann, K.P.

    2003-01-01

    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 Schro...

  9. Malignant priapism secondary to isolated penile metastasis from a renal pelvic carcinoma

    OpenAIRE

    LIU, SULAI; Zeng, Fuhua; Qi, Lin; Jiang, Shusuan; Tan, Pingping; Zu, Xiongbing; Xie, Yu; HAN, WEIQING

    2014-01-01

    We report a case of isolated penile metastasis from renal pelvic carcinoma in a 69-year-old man with malignant priapism. The patient had radical resection of the renal pelvic carcinoma 2 months earlier with urothelial carcinoma (UC) and sarcomatoid differentiation histology. Physical examination showed no visible skin lesions, but a palpable hard nodule was present over the penile shaft. The imaging studies did not reveal other metastases. Cavernous-Glans shunt and nodule resection were perfo...

  10. 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...

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

    OpenAIRE

    Leonardo O. Reis; Marcelo Cartapatti; Rafael Marmiroli; Eduardo Jeronimo de Oliveira Júnior; 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. 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.

  13. Own Experience in Treatment of Patients with Penile Cancer Using Photodynamic Therapy

    OpenAIRE

    Filonenko, Elena; Kaprin, Andrey; Alekseev, Boris; Urlova, Antonina

    2015-01-01

    Penile cancer is a rare pathology. For penile cancer surgical treatment, radiotherapy, chemotherapy, and combined modality treatment are available. Because of great importance of this organ for mental condition of patient, the development of organ-preserving methods allowing to minimize impact on patient's quality of life without compromising of oncological results is desirable. In the Center of Laser and Photodynamic diagnosis and treatment of tumors in P.A. Herzen Moscow Cancer Research Ins...

  14. Distal penile prosthesis extrusion: treatment with distal corporoplasty or Gortex windsock reinforcement.

    Science.gov (United States)

    Carson, C C; Noh, C H

    2002-04-01

    Subcutaneous extrusion of penile prosthesis cylinders beneath the glans penis is an unusual but difficult complication of penile prosthesis. Without surgical repair, extrusion, infection, and corporeal fibrosis may ensue. Twenty-eight patients with distal corporeal extrusion were reviewed to identify the optimum treatment outcome for these penile prosthesis complications. Records of 28 men with subcutaneous distal penile prosthesis cylinder extrusion were reviewed. Mean age was 56.2 y. Etiology of erectile dysfunction was diabetes mellitus in 11, vasculogenic in 10, Peyronie's disease in five, radical pelvic surgery in five. Duration of penile prosthesis was 8-72 months (mean 42.6). No patient had penile prosthesis infection or device exposure through the skin. Distal corporoplasty was treated on 18/28 men using cylinder repositioning and direct tunica albuginea repair. Ten men underwent repair using a Gortex windsock. 8/18 corporoplasty and 6/10 windsock patients required glans fixation for treatment of hypermobile glans following cylinder relocation. In two patients with windsock repair, extrusion recurrence occurred 6 and 18 months following surgery and 1/6 had post operative infection requiring prosthesis removal. Mean surgical time for corporoplasty was 52.8 minutes while windsock reconstruction was 89.6 minutes. Distal subcutaneous penile prosthesis cylinder extrusion produces coital pain and predisposes to cylinder exposure and infection. Early repair with or without additional prosthetic materials will return penile prostheses to a normal functioning state. Distal corporoplasty with cylinder repositioning appears to be a simple, low morbidity solution to this difficult dilemma. Outcomes with distal corporoplasty result in better function, less pain, and fewer recurrences than Gortex windsock repair. PMID:11979321

  15. 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.

  16. 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)

  17. 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.

  18. Semi-rigid penile prosthesis as a salvage management of idiopathic ischemic stuttering priapism

    Directory of Open Access Journals (Sweden)

    Faddan AA

    2015-09-01

    Full Text Available Amr A Faddan, Alexey V Aksenov, Carsten M Naumann, Klaus P Jünemann, Daniar K Osmonov Department of Urology and Pediatric Urology, University Hospital Schleswig-Holstein, Kiel, Germany Introduction: Priapism is the persistent erection resulting from dysfunction of the mechanisms that regulate penile swelling, stiffness, and sagging. It is a full or partial erection that persists for a period more than 4 hours beyond sexual stimulation and/or orgasm or is unrelated to sexual stimulation. Ischemic priapism should be managed in a step-by-step fashion. Objective: To demonstrate step-by-step management of stuttering refractory ischemic priapism. We report a case of stuttering refractory ischemic priapism. Moreover, we reviewed different approaches to priapism management in the literature. Case presentation: A 53-year-old male presented with a painful erection of 29 hours’ duration, probably caused by consumption of alcohol. The penile blood gas showed a pH of 7.08, PCO2 of 75 mmHg and PO2 of 39 mmHg. Aspiration was followed by irrigation of an ?-adrenergic, Winter and T-shunt operations were preformed, and finally a semi-rigid penile prosthesis was implanted to overcome the refractory stuttering ischemic priapism. Conclusion: In case of stuttering refractory ischemic priapism, immediate implantation of a penile prosthesis is a simple and effective procedure that manages both the acute episode and the inevitable erectile dysfunction that would otherwise occur, while preserving penile length. Keywords: priapism, stuttering priapism, shunting operation, penile prosthesis 

  19. Human papillomavirus-associated increase in p16INK4A expression in penile lichen sclerosus and squamous cell carcinoma

    Science.gov (United States)

    Prowse, DM; Ktori, EN; Chandrasekaran, D; Prapa, A; Baithun, S

    2008-01-01

    Background Human papillomaviruses (HPVs) are sexually transmitted human carcinogens that may play a role in the oncogenesis of penile cancer. Objectives To investigate the role of HPV infection and expression of the tumour suppressor protein p16INK4A in the pathogenesis of penile cancer. Methods By means of polymerase chain reaction amplification and reverse hybridization line probe assay to detect HPV infection, and immunohistochemical staining for p16INK4A and Ki67, we analysed 26 penile squamous cell carcinomas (SCCs) and 20 independent penile lichen sclerosus (LS) lesions from 46 patients. Results HPV DNA was found in 54% of penile SCCs and 33% of penile LS cases in single and multiple infections. High-risk HPV 16 was the predominant HPV type detected. No relationship between Ki67 expression and HPV infection was observed. Strong immunostaining for p16INK4A correlated with HPV 16/18 infection in both penile LS and penile SCC. In our penile SCC series the cancer margins were also associated with penile LS in 13 of 26 lesions, and HPV was detected in seven of the 13 SCC cases associated with LS and in six of the 11 SCC lesions not involving LS. Conclusions Our study shows a high prevalence of HPV 16 and p16INK4A expression in penile lesions, consistent with an active role for HPV in interfering with the retinoblastoma pathway. High-risk HPV infection could be involved in the tumorigenic process in 50% of penile cancers, and the use of prophylactic HPV vaccines has the potential to prevent these cancers. PMID:18047520

  20. The relationship between the localization and etiology in children’s penile tourniquet syndrome: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Mustafa Yasar Ozdamar

    2014-04-01

    Full Text Available Though the penile tourniquet syndrome is rarely seen, it is a disease which causes complications from a simple edema to severe necrosis and amputation. Whether simple or complicated, the penile strangulation that is the causative factor, except babies, whom are usually questionable. Our aim is to investigate the relation between perpetrators and location of disease in the penile tourniquet syndrome.

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

    OpenAIRE

    Aboseif, Sherif R.; Jocelyn M. Rieder; Tran, Viet Q.; Brusky, John P.

    2008-01-01

    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- o...

  2. Penile pyoderma gangrenosum successfully treated with topical Imiquimod

    Directory of Open Access Journals (Sweden)

    Santosh P Rathod

    2011-01-01

    Full Text Available Pyoderma gangrenosum(PG is a rare ulcerating inflammatory neutrophilic dermatosis. Genital involvement has been rarely reported. We report such a case of 24- year- old, male patient living with HIV/AIDS(PLHIV who presented with progressive genital ulceration, not responding to oral antibiotics and aciclovir, gradually increasing in size over 15-18 months. Repeated biopsies showed acute on chronic inflammation. The lesion partially responded to oral and topical corticosteroids but soon increased in size after tapering the dosage of the steroids.Then patient was given Imiquimod 5% cream to be applied over the lesion once daily for 2-4 weeks. Lesion cleared completely in 4 weeks and is in remission since last 6 months. The case report highlights the successful use of topical Imiquimod 5% cream in the treatment of penile PG.

  3. 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.

  4. 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; Boonen, H C; Aalkjær, Christian

    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 fo...

  5. Coronary arteries

    International Nuclear Information System (INIS)

    Coronary angiography (CA) is presently considered the gold standard for the assessment of the coronary arteries. However, the presence of ionizing radiation, its invasiveness and the small associated risk of morbidity prompted long ago the development of more patient-friendly imaging modalities. A promising technique, magnetic resonance imaging (MRI), has been regarded as the major modality in the coming decade. Although still in its infancy qualitatively, its flexibility and non-invasiveness opens the door for a comprehensive evaluation of the heart and the coronary arteries in one single sitting with high anatomical definition and excellent soft tissue contrast capabilities, double-oblique tomographic sections and the possibility to quantify an innumerable number of cardiovascular physiological parameters. Numerous ideas have been assessed, comprising breath-hold and free-breathing two-dimensional and three-dimensional measurements. New ongoing trials with intravascular contrast agents may provide for all these techniques the long-awaited essential boost for reliable magnetic resonance coronary angiography (MRCA). Introduction of parallel MRI acquisition techniques, such as simultaneous acquisition of spatial harmonics (SMASH) and sensitivity encoding (SENSE) may provide the speed enhancement required to shorten imaging time for all techniques explored to date. (orig.)

  6. 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

  7. 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.)

  8. 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.

  9. 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.

  10. 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.

  11. Own experience in treatment of patients with penile cancer using photodynamic therapy.

    Science.gov (United States)

    Filonenko, Elena; Kaprin, Andrey; Alekseev, Boris; Urlova, Antonina

    2015-01-01

    Penile cancer is a rare pathology. For penile cancer surgical treatment, radiotherapy, chemotherapy, and combined modality treatment are available. Because of great importance of this organ for mental condition of patient, the development of organ-preserving methods allowing to minimize impact on patient's quality of life without compromising of oncological results is desirable. In the Center of Laser and Photodynamic diagnosis and treatment of tumors in P.A. Herzen Moscow Cancer Research Institute the methods of photodynamic therapy in patients with penile cancer have been developed. From 2011 to 2013 the treatment was conducted in 11 patients with precancer and cancer of penile. The average age was 56.6. According to morphological diagnosis photodynamic therapy (PDT) was performed using two methods. One method included topical application of agent for PDT and the second intravenous administration of photosensitizer. For topical application alasens was used and for intravenous injection we applied radachlorine. All patients had no complications. Complete regression was achieved in 9 patients, and partial regression in 2. Thus, the results showed that photodynamic therapy for penile cancer stage Tis-1N0M0 permits performing organ-preserving treatment with satisfactory oncological results and no impairment of patient's quality of life. PMID:25834812

  12. Coronary Artery Imaging in Children

    OpenAIRE

    Goo, Hyun Woo

    2015-01-01

    Coronary artery problems in children usually have a significant impact on both short-term and long-term outcomes. Early and accurate diagnosis, therefore, is crucial but technically challenging due to the small size of the coronary artery, high heart rates, and limited cooperation of children. Coronary artery visibility on CT and MRI in children is considerably improved with recent technical advancements. Consequently, CT and MRI are increasingly used for evaluating various congenital and acq...

  13. Penile squamous cell carcinoma: anatomic, pathologic and viral studies in Paraguay (1993-2007).

    Science.gov (United States)

    Velazquez, Elsa F; Cubilla, Antonio L

    2007-08-01

    In developed countries, penile squamous cell carcinoma (SCC) account for subtypes of penile carcinomas have been described. Most SCCs are of the usual type (60%). Less frequent variants include basaloid (10%), warty (10%), papillary (15%), verrucous (3%), sarcomatoid (4%) and adenosquamous (1%). Mixed forms also exist. Because there is a correlation between histologic subtype and biologic behavior, accurate subtyping is important. The prevalence of human papillomavirus (HPV) in invasive SCC is approximately 42%, with a strong association of HPV and basaloid and warty variants. Among the most important prognostic factors are histologic grade and depth of invasion. It is important for surgical pathologists to know the anatomy of the penis and possible routes of tumor spread because negative resection margins are crucial to avoid local recurrences. The most frequently involved margins are the urethra and periurethral tissues, including Buck's fascia. Probable precursor lesions of penile carcinoma include squamous hyperplasia, low and high grade squamous intraepithelial neoplasia and lichen sclerosus. PMID:17879626

  14. Corporoplasty using bovine pericardium grafts in complex penile prosthesis implantation surgery

    Scientific Electronic Library Online (English)

    Eduardo J. A., Lopes; Andre Y., Kuwano; Andreia N., Guimaraes; Jesuino P., Flores; Modesto A. O., Jacobino.

    2009-02-01

    Full Text Available Purpose: This paper is the first, to our knowledge, to propose the use of a bovine pericardium graft in corporoplasty for penile prosthesis implantation. The advantages of bovine pericardium graft have been demonstrated by its use in cardiac surgery, including low cost, biocompatibility, impermeabil [...] ity, resistance to dilatation, flexibility, low likelihood of retraction, absence of antigenic reaction and natural absorption of the tissue. In this paper, we propose the use of this heterologous material graft in corporoplasty for penile prosthesis implantation. Materials and Methods: Five patients with a history of erosion, infection and fibrosis, mean time of follow-up 32 months (range 9-48 months). Bovine pericardium was used to cover large areas of implanted penile prostheses when use of the tunica albuginea was unfeasible. Results: The surgical procedure resulted in no complications in all patients. Conclusions: Bovine pericardium may substitute synthetic and autologous material with the additional advantages of lower cost and greater availability.

  15. Complete Penile Necrosis in a Patient With Heparin-induced Thrombocytopenia: A Case Report

    Directory of Open Access Journals (Sweden)

    Anne-Sophie Blais

    2014-01-01

    Full Text Available Penile necrosis is a rare condition that has been mostly described in association with diabetes mellitus and end-stage renal disease. We report an unusual case of acute penile necrosis because of heparin-induced thrombocytopenia. A 75-year-old man presented with acute renal failure and experienced cardiac complications during the hospitalization. The patient was treated twice with intravenous heparin. He developed symptoms of penile necrosis 4 days after the reintroduction of heparin. At that moment, the platelet count dropped by 61%, and the analysis of heparin-pf4 antibodies was positive for heparin-induced thrombocytopenia. The patient underwent a total penectomy and a perineal urethrostomy.

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

    Directory of Open Access Journals (Sweden)

    Athanasios Bantis

    2014-11-01

    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.

  17. he relationship of body mass index to penile length and testicular volume in adolescent boys

    Directory of Open Access Journals (Sweden)

    Rizky Adriansyah

    2012-09-01

    Full Text Available Background Evidence suggests that obesity may be related to early onset of puberty in girls. However, few studies have found a link between body mass index (BMI and puberty onset in boys. More study is needed to assess the relationship of BMI to penile length and testicular volume. Objective To investigate the relationship of BMI to penile length and testicular volume in adolescent boys. Methods A cross-sectional study was carried out on adolescent boys aged 9 to 14 years in Secanggang District, Langkat Regency, North Sumatera Province in August 2009. Subject's BMIs were calculated by dividing body weight (BW in kilograms by body height (BH in meters squared. Penile length (cm was measured with a spatula. We took the average of three measurements from the symphysis pubis to the tip of the glans penis. Testicular volume (mL was estimated by palpation using an orchidometer. Pearson's correlation test (r was used to assess the relationship of BMI to penile length and BMI to testicular volume. Results There were 108 participants, consisting of 64 primary school students and 44 junior high school students. Subjects' mean age was 11.7 (SD 1.62 years,; mean BW was 35.2 (SD 8.84 kg; mean testicular volume was 3.6 (SD 1.20 mL. We found no significant association between BMI and penile length (r=-0.25, P= 0.006, nor between BMI and testicular volume (r=-021; P=0.09. Conclusion There was no significant relationship of BMI to penile length nor BMI to testicular volume in adolescent boys. [

  18. PENILE STRANGULATION BY A HARD PLASTIC BOTTLE NECK: A CASE REPORT

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    Lingaraju

    2013-05-01

    Full Text Available Abstract: Application of Various metallic and non-metallic c onstricting objects on the external male genitalia for increasing sexual performance or beca use of autoerotic intentions is an unusual practice that can potentially lead to penile strang ulation with severe consequences. To remove such an object is a challenge as the chances of injury t o the surgeon and the patient were high. Here with we report a 65 year old male who presented in our h ospital with a hard plastic bottle neck at the base of penis which led to penile strangulation. The con stricting agent was successfully removed. The patient had an uneventful recovery.

  19. 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.)

  20. Penile plaque as predictor of an advanced anorectal carcinoma: A case report.

    Science.gov (United States)

    Fabiani, Andrea; Filosa, Alessandra; Fioretti, Fabrizio; Mammana, Gabriele

    2015-06-01

    The secondary involvement of the penis by tumors from others organs is a rare event representing only 0.8% of overall metastasis in the genitourinary tract. The most frequent clinical findings is priapism, but occasionally, solitary metastases to the penile skin, mucosa of the glans, corpus spongiosum or lesions of the albuginea mimicking an induratio penis have been reported. We report a case of penile plaque predicting the relapse of an anorectal carcinoma. The precise etiology of this particular manifestation is not well understood and the prognosis is poor. There are no individual treatments with curative intent. PMID:26150041

  1. Human papillomavirus infection induces NF-?B activation in cervical cancer: A comparison with penile cancer

    OpenAIRE

    Senba, Masachika; Buziba, Nathan; Mori, Naoki; FUJITA, SHUICHI; MORIMOTO, KONOSUKE; WADA, AKIHIRO; TORIYAMA, KAN

    2010-01-01

    This study aimed to determine the relationship between human papillomavirus (HPV) and nuclear factor-?B (NF-?B) in cervical cancer using 62 tissues of cervical cancer, and to compare the findings to penile cancer. HPV-DNA integration is a crucial factor for malignant transformation in cervical cancer and can be identified using in situ hybridization. Of the 62 cases, HPV infection was detected in 28 (45.2%). This frequency was lower than in penile cancer (68.2%) as shown by our previous study...

  2. Pannus Is the New Prepuce? Penile Cancer in a Buried Phallus

    Science.gov (United States)

    Manwaring, Jared; Vourganti, Srinivas; Nikolavsky, Dmitriy; Valente, Alfredo L.; Byler, Timothy

    2015-01-01

    Two males presented to our urology department with complaints of bleeding and malodor from buried phallus within a suprapubic fat pad. Although both men had neonatal circumcisions, advanced penile carcinoma was found in both men. Formal penectomies showed high grade, poorly differentiated squamous cell carcinoma invading the corporal bodies and urethra. Buried penis represents a difficulty in early detection of suspicious lesions but may also provide an environment susceptible to poor hygiene and subsequent chronic inflammation. Patients with buried penis may be at a higher risk for development of invasive penile cancer and may benefit from regular and thorough genital exams. PMID:26446361

  3. 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...

  4. Microflora of the penile skin-lined neovagina of transsexual women

    OpenAIRE

    Claeys Geert; De Backer Ellen; Saerens Bart; dos Santos Lopes Santiago Guido; Monstrey Stan; Gerris Jan; Verstraelen Hans; Weyers Steven; Vaneechoutte Mario; Verhelst Rita

    2009-01-01

    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...

  5. Increased adenosine contributes to penile fibrosis, a dangerous feature of priapism, via A2B adenosine receptor signaling.

    Science.gov (United States)

    Wen, Jiaming; Jiang, Xianzhen; Dai, Yingbo; Zhang, Yujin; Tang, Yuxin; Sun, Hong; Mi, Tiejuan; Phatarpekar, Prasad V; Kellems, Rodney E; Blackburn, Michael R; Xia, Yang

    2010-03-01

    Priapism is a condition of persistent penile erection in the absence of sexual excitation. Of men with sickle cell disease (SCD), 40% display priapism. The disorder is a dangerous and urgent condition, given its association with penile fibrosis and eventual erectile dysfunction. Current strategies to prevent its progression are poor because of a lack of fundamental understanding of the molecular mechanisms for penile fibrosis in priapism. Here we demonstrate that increased adenosine is a novel causative factor contributing to penile fibrosis in two independent animal models of priapism, adenosine deaminase (ADA)-deficient mice and SCD transgenic mice. An important finding is that chronic reduction of adenosine by ADA enzyme therapy successfully attenuated penile fibrosis in both mouse models, indicating an essential role of increased adenosine in penile fibrosis and a novel therapeutic possibility for this serious complication. Subsequently, we identified that both mice models share a similar fibrotic gene expression profile in penile tissue (including procollagen I, TGF-beta(1), and plasminogen activator inhibitor-1 mRNA), suggesting that they share similar signaling pathways for progression to penile fibrosis. Thus, in an effort to decipher specific cell types and underlying mechanism responsible for adenosine-mediated penile fibrosis, we purified corpus cavernosal fibroblast cells (CCFCs), the major cell type involved in this process, from wild-type mice. Quantitative RT-PCR showed that the major receptor expressed in these cells is the adenosine receptor A(2B)R. Based on this fact, we further purified CCFCs from A(2B)R-deficient mice and demonstrated that A(2B)R is essential for excess adenosine-mediated penile fibrosis. Finally, we revealed that TGF-beta functions downstream of the A(2B)R to increase CCFC collagen secretion and proliferation. Overall, our studies identify an essential role of increased adenosine in the pathogenesis of penile fibrosis via A(2B)R signaling and offer a potential target for prevention and treatment of penile fibrosis, a dangerous complication seen in priapism.-Wen, J., Jiang, X., Dai, Y., Zhang, Y., Tang, Y., Sun, H., Mi, T., Phatarpekar, P. V., Kellems, R. E., Blackburn, M. R., Xia, Y. Increased adenosine contributes to penile fibrosis, a dangerous feature of priapism, via A(2B) adenosine receptor signaling. PMID:19858092

  6. Doppler ultrasound of the uterine arteries: the importance of bilateral notching in the prediction of pre-eclampsia, placental abruption or delivery of a small-for-gestational-age baby.

    Science.gov (United States)

    Harrington, K; Cooper, D; Lees, C; Hecher, K; Campbell, S

    1996-03-01

    The use of Doppler studies of the uterine arteries in the prediction of pre-eclampsia and intrauterine growth retardation has had mixed success. The introduction of color Doppler imaging and the use of the "notch' to define an abnormal waveform have helped to improve the predictive value of uterine artery Doppler screening. The aim of this study was to evaluate the use of uterine artery Doppler in a group of women of mixed race and parity. This study was a prospective, cross-sectional analysis of 1326 unselected women who were screened with continuous wave uterine Doppler at 19-21 weeks, as part of a fetal anomaly/dating scan. A total of 214 women with abnormal uterine artery waveforms (notching) were referred for assessment at 24 weeks; 191 attended and had color Doppler imaging/pulsed Doppler studies of both uterine arteries. Data from 185 pregnancies were suitable for analysis. There were abnormal uterine Doppler findings (uni- or bilateral notching) in 110 patients at 24 weeks; 48 had bilateral notching. The sensitivity of notching for the prediction of proteinuric pregnancy-induced hypertension (PPIH) was similar in primiparas (76.9%), multiparas (77.7%), African-Caribbean women (82.6%) and Caucasian women (71.4%). The sensitivity of bilateral notching for the prediction of PPIH requiring delivery before 34 weeks was 81.2%, and 57.6% for babies small for gestational age (SGA), with positive predictive values of 27% (PPIH), 31.2% (SGA) and 37.5% (any complication). Patients with persistent bilateral notching are particularly at risk of developing PPIH or delivering an SGA baby before 34 weeks' gestation; they warrant increased surveillance, and may be a group that could benefit from prophylactic therapies. PMID:8705410

  7. Variant arteries at the base of the brain

    Directory of Open Access Journals (Sweden)

    Nayak SB

    2009-06-01

    Full Text Available Abnormalities of the important arteries at the base of brain can lead to serious clinical conditions like stroke or other functional deficits. We report here a variant pattern of arteries seen at the base of the brain. The left internal carotid artery was slightly larger than the right and it terminated by dividing into anterior and middle cerebral arteries. It gave an abnormally large posterior communicating artery, which was almost equal in size to that of the middle cerebral artery. This posterior communicating artery replaced the distal part of the left posterior cerebral artery. The proximal part of the left posterior cerebral artery was very small. There were two anterior communicating arteries. The left vertebral artery was larger than the right vertebral artery. The knowledge of these anomalous arteries may be useful for radiologists, neurosurgeons and clinicians in general.

  8. Quantitation of pharmacologically-induced penile erections: the value of radionuclide phallography in the objective evaluation of erectile haemodynamics.

    Science.gov (United States)

    Siraj, Q H; Bomanji, J; Akhtar, M A; Rana, M H; Sadiq, M; Ahmed, M

    1990-06-01

    This study combines the pharmacologically-induced penile erection (PIPE) technique with radionuclide phallography (RNP) for the non-invasive study of penile haemodynamic changes during erection. Penile erections produced by the intracavernosal injections of two different vasoactive drugs, prostaglandin E1 (PGE1) and papaverine HCl (PPV) were assessed by quantitation of the dynamic RNP and parameters of erection were defined and compared. PGE1 intracavernosal injections were seen to elicit a better erectile response than PPV. Dynamic radionuclide phallography was performed using 99Tcm-labelled autologous RBCs in five normally potent volunteers, sixteen patients with psychogenic impotence, seven patients with vasculogenic impotence (three arteriogenic, four venous leakage) and one patient with neurogenic impotence. Physical parameters of erection including the penile length and circumference changes during erection and the erectile angle were compared with the indices of penile blood flow and volume derived through quantitation of the RNP. There was a close correlation between the penogram index (an index of penile blood volume) and penile circumference increase during erection (r = 0.77, p less than 10(-6). The erectile angle, a measure of penile rigidity, correlated strongly (r = 0.82, p less than 10(-6) with the flow index, a measure of penile blood volume. Patterns specific to various categories of impotence were observed and these aided in the diagnosis, especially in equivocal cases with a suboptimal clinical response to the intracavernosal injection. Quantitative RNP offers a non-invasive method which allows direct objective assessment of the erectile response providing several quantitative parameters for analysis. PMID:2385430

  9. Accessory renal arteries: a case report

    Directory of Open Access Journals (Sweden)

    Billakanti Prakash Babu

    2014-04-01

    Full Text Available During dissection of abdomen by the undergraduate medical students three accessory renal arteries were observed on the right side. The superior accessory artery was a small vessel arising from aorta just above the normal renal artery. It entered the anterior surface of kidney just below the upper pole. The middle and inferior arteries were caudal to the normal renal artery. The middle artery was arising from testicular artery and entered the anterior surface of kidney below the hilum. The inferior artery was arising from aorta just above its bifurcations and entered the lower pole of kidney. The importance of accessory renal arteries in surgical procedures of the posterior abdominal wall and renal transplantation are discussed. [Int J Res Med Sci 2014; 2(2.000: 765-768

  10. 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.

  11. Human Papilloma Virus: Prevalence, distribution and predictive value to lymphatic metastasis in penile carcinoma

    Scientific Electronic Library Online (English)

    Aluizio Goncalves da, Fonseca; Fernando Augusto, Soares; Rommel Rodriguez, Burbano; Rodrigo Vellasco, Silvestre; Luis Otavio Amaral Duarte, Pinto.

    2013-07-01

    Full Text Available Objectives To evaluate the prevalence, distribution and association of HPV with histological pattern of worse prognosis of penile cancer, in order to evaluate its predictive value of inguinal metastasis, as well as evaluation of other previous reported prognostic factors. Material and Methods Tum [...] or samples of 82 patients with penile carcinoma were tested in order to establish the prevalence and distribution of genotypic HPV using PCR. HPV status was correlated to histopathological factors and the presence of inguinal mestastasis. The influence of several histological characteristics was also correlated to inguinal disease-free survival. Results Follow-up varied from 1 to 71 months (median 22 months). HPV DNA was identified in 60.9% of sample, with higher prevalence of types 11 and 6 (64% and 32%, respectively). There was no significant correlation of the histological characteristics of worse prognosis of penile cancer with HPV status. Inguinal disease-free survival in 5 years did also not show HPV status influence (p = 0.45). The only independent pathologic factors of inguinal metastasis were: stage T ? T1b-T4 (p = 0.02), lymphovascular invasion (p = 0.04) and infiltrative invasion (p = 0.03). conclusions HPV status and distribution had shown no correlation with worse prognosis of histological aspects, or predictive value for lymphatic metastasis in penile carcinoma.

  12. Incidence and cost of anal, penile, vaginal and vulvar cancer in Denmark

    DEFF Research Database (Denmark)

    Olsen, J.; Jorgensen, T. R.; Kofoed, K.; Larsen, H. K.

    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...

  13. Penile Hygiene: Puberty, Paraphimosis and Personal Care for Men and Boys with an Intellectual Disability

    Science.gov (United States)

    Wilson, N. J.; Cumella, S.; Parmenter, T. R.; Stancliffe, R. J.; Shuttleworth, R. P.

    2009-01-01

    Background: Supporting men and boys with an intellectual disability (ID) to meet their penile hygiene needs is perhaps one of the least acknowledged but most confronting issues facing care staff. The delivery of intimate hygiene can be a challenging topic particularly as it has been drawn into the emerging sexuality discourse and the ongoing abuse…

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

    DEFF Research Database (Denmark)

    Lindeborg, Lisa; Fode, Mikkel; Fahrenkrug, Lasse; Sønksen, Jens

    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 orga...

  15. Penile vibratory stimulation in the treatment of post-prostatectomy incontinence

    DEFF Research Database (Denmark)

    Fode, Mikkel; Sønksen, Jens

    2015-01-01

    AIMS: To examine penile vibratory stimulation (PVS) in the treatment of post-prostatectomy urinary incontinence (UI). METHODS: Patients with post-prostatectomy UI were included in a 12-week trial. A 24-hr pad test and a 72-hr voiding diary were collected at baseline. Participants were randomized ...

  16. 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.

  17. 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

  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. Patient and partner outcome of inflatable and semi-rigid penile prosthesis in a single institution

    Directory of Open Access Journals (Sweden)

    Ibrahim Halil Bozkurt

    2015-06-01

    Full Text Available ABSTRACTIntroduction:Penile prostheses are subject to a continuous development and have gained better mechanical reliability and safety during the last decades. In this study, we aimed to investigate the outcomes and satisfaction rates of inflatable penile prosthesis (IPP and semirigid penile prosthesis (SPP implantation.Materials and Methods:From August 2001 to June 2012, 257 men with erectile dysfunction (ED underwent penile prosthesis implantation (PPI at our institution. Of the 257 patients, 118 underwent implantation of IPP and 139 underwent SPP implantation. The pre-operative and post-operative erectile status of the patients were assessed by international index of erectile function (IIEF questionnaire. The satisfaction of patients and partners were evaluated by a telephone interview using the erectile dysfunction inventory of treatment satisfaction (EDITS questionnaire and EDITS partner survey.Results:The overall major complication rate was higher in IPP group. PPI led to a significant improvement in IIEF scores in both groups. For IPP and SPP groups the average EDITS scores were 78±11and 57±8, respectively, and that for the partners were 72±10 and 49±7, respectively (pConclusion:Although the IPP implantation have better satisfaction rates, the SPP implantation is still a viable treatment option in the surgical treatment of ED because of low cost and high durability with acceptable satisfaction rates.

  20. Penile Metastasis Secondary to Bladder Cancer: A Report of Two Cases

    OpenAIRE

    Narendra Kumar; Tapesh Bhattacharyya; A.K. Mandal; Nalini Gupta; A Rajwanshi; Ritesh Kumar

    2014-01-01

    Penile metastasis secondary to primary bladder cancer is a rare entity and represents a challenging problem. The common mode of spread to the penis is by retrograde venous route. The overall outcome is dismal and most patients will die within 1 year even after optimum treatment. Here, we report two such cases.

  1. Penile metastasis secondary to bladder cancer: A report of two cases

    Directory of Open Access Journals (Sweden)

    Narendra Kumar

    2014-01-01

    Full Text Available Penile metastasis secondary to primary bladder cancer is a rare entity and represents a challenging problem. The common mode of spread to the penis is by retrograde venous route. The overall outcome is dismal and most patients will die within 1 year even after optimum treatment. Here, we report two such cases.

  2. Penile Metastasis Secondary to Bladder Cancer: A Report of Two Cases

    Science.gov (United States)

    Kumar, Narendra; Bhattacharyya, Tapesh; Mandal, A K; Gupta, Nalini; Rajwanshi, A; Kumar, Ritesh

    2014-01-01

    Penile metastasis secondary to primary bladder cancer is a rare entity and represents a challenging problem. The common mode of spread to the penis is by retrograde venous route. The overall outcome is dismal and most patients will die within 1 year even after optimum treatment. Here, we report two such cases. PMID:24600185

  3. Penile carcinoma presenting as inguinal bubo, masquerading as a venereal disease.

    Science.gov (United States)

    Gupta, Vishal; Rai, Ajay; Mutha, Shreyans; Firdaus Ali, Mohammad; Sharma, Vinod K

    2016-03-01

    We report a case of penile carcinoma presenting as an inguinal bubo in a young man. The associated painful genital ulcer and history of high-risk sexual behaviour raised a strong suspicion of a sexually transmitted infection. We review the literature for similar cases, highlight the similarities with venereal disease and discuss the differential diagnosis of inguinal bubo. PMID:25999165

  4. Oral treatment with herbal formula B401 alleviates penile toxicity in aging mice with manganism

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    Hsu CH

    2015-05-01

    Full Text Available Chih-Hsiang Hsu,1 Ching-Lung Lin,1 Sheue-Er Wang,1 Shuenn-Jyi Sheu,2 Chiang-Ting Chien,1 Chung-Hsin Wu1 1Department of Life Science, National Taiwan Normal University, 2Brion Research Institute of Taiwan, Taipei, Taiwan Abstract: The present study aims to elucidate the roles of nitric oxide synthase activity, oxidative stress, inflammation, and apoptosis in penile toxicity of aging mice associated with excess manganese (Mn treatment and to investigate the effect of oral treatment with the herbal formula B401 in this respect. ICR strain mice were divided into two groups: the vehicle (sham group and the B401 (50 mg/kg group. The mice were orally treated for 5 days; then a high single dose of MnCl2 (100 mg/kg was given by intraperitoneal injection to the mice. One day after MnCl2 treatment, corpora cavernosal tissues of both Mn-treated mice and their controls were simultaneously sampled to examine their immunohistochemical staining and Western blot analysis. Nitric oxide (NO production, levels of neuronal nitric oxide synthase (nNOS and endothelial nitric oxide synthase (eNOS, expression levels of factors governing angiogenesis (vascular endothelial growth factor, oxidative stress (catalase, superoxide dismutase 2,4-hydroxynonenal, inflammation (tumor necrosis factor alpha, apoptosis (B-cell lymphoma 2 [Bcl-2], Bcl-2-associated X protein [Bax], cleaved poly(adenosine diphosphate-ribose polymerase [c-PARP], cytochrome C, caspase-12, and caspase-3 were evaluated in penile corpus cavernosum of the mice. We found that penile toxicity in the mice was enhanced under excess Mn treatment through reduction of NOS activity and increase in oxidative stress, inflammation, and apoptosis in the penile cavernous tissue. Furthermore, the penile toxicity in mice with manganism was alleviated by oral B401 treatment through enhancement of both nitric oxide synthesis and angiogenesis, with simultaneous reduction of oxidative stress, inflammation, and apoptosis in penile corpus cavernosum. We suggest that the herbal formula B401 may serve as a potential dietotherapeutic supplement for penile toxicity or dysfunction in aging males. Keywords: manganism, herbal formula, oxidative stress, inflammation, apoptosis

  5. Long term patient satisfaction and quality of life with AMS700CX inflatable penile prosthesis

    Directory of Open Access Journals (Sweden)

    Antonio Vitarelli

    2013-09-01

    Full Text Available Objective: Penile prosthesis implantation is the solution of choice in patients who have failed or present contraindication to the use of all conservative treatment for erectile dysfunction (ED. Overall, satisfaction rates are high, with more than 80% of patients and partners fully satisfied with cosmetic and functional result of surgery. Chronic postoperative pain, penile shortening, soft or hyposensitive glans, pencil like penis syndrome and difficulty to cycle the device represent the most common causes of patient’s dissatisfaction. Satisfaction rates are better assessed with the use of validated questionnaires such as the International Index of Erectile Function (IIEF and the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS The aim of our study was to analyze the long-term mechanical reliability of the AMS 700CX/CXM inflatable penile prosthesis and the patient’s satisfaction rate using IIEF and EDITS questionaire as standard reference. Materials and methods: A retrospective case notes review of all patients who have undergone implantation of a three pieces inflatable penile prosthesis AMS 700 CX and CXR between October 1997 and December 2010. Overall, 80 patients have undergone implantation of 3 pieces inflatable penile prosthesis AMS 700 CX InhibiZone. Patients have been administered the IIEF-5 and EDITS questionnaires in combination with a non validated 9 domain questionnaire that assesses penile rigidity, sensation, orgasmic function, frequency of intercourse, impact of surgery on the quality of life, satisfaction rate. Results: Overall 10 years survival estimate according to the Kaplan Meier method of AMS 700 CX touch pump and AMS 700 CX momentary squeeze pump are respectively 77.6% and 82.5%. The median postoperative IIEF5 and EDITS score were respectively 21.46 and 73.11, which show a high level of satisfaction. 59 patients (90.8% were able to cycle the device and were engaging in penetrative sexual intercourse. Conclusions: Penile prosthesis implantation yields excellent results in terms of cosmetic and functional outcome and therefore has a significant impact on patients’ satisfaction, sex life and overall quality of life. Overall, long term reliability has been significantly improved and complication rates are low in the hands of experienced surgeons.

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

    Directory of Open Access Journals (Sweden)

    C Van Der Horst

    2003-08-01

    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.

  7. Penile prosthesis surgery in out-patient setting: Effectiveness and costs in the “spending review” era

    Directory of Open Access Journals (Sweden)

    Nicola Mondaini

    2014-09-01

    Full Text Available Introduction: Penile implant patients are required to remain in the hospital after the operation for monitoring, antibiotic and analgesia administration. Cost containment, however, has resulted in the increased use of ambulatory surgery settings for many surgical procedures. Few studies have studied the feasibility of performing penile prosthesis insertion in an outpatient setting. The results are controversial and nowadays, in the most of centers that deal with prosthetic surgery, patients are still hospitalized. Aim: The aim of our investigation was to compare the feasibility of the performance as well as the complication profiles of penile implant surgery performed in an in-patient and an outpatient setting at a single center by a single surgeon. Methods: From January 2009 to June 2014, 50 patients of the same uro-andrological unit underwent penile prosthesis implantation performed by a single surgeon (N.M.. Twenty implantations were performed in an ambulatory day surgery setting. Main outcome measures: Effectiveness and costs of outpatient setting versus the in-patient setting of the penile prosthesis surgery. Results: There were some differences between the two groups in the intra-operative parameters, such as, operating time. Time lost from work was similar in both groups approximating 14 days. The mean number of analgesic pills ingested by the patients post-operatively was similar in both groups, averaging just under 25 pills per patient. There weren’t post-operative complications in the outpatient group. Cost were 17% less in outpatient clinic. Conclusions: The outpatient setting for this surgery is safe and effective even in patients with comorbidities or in case of secondary procedures. Costs are reduced by 17%.

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

    DEFF Research Database (Denmark)

    Lindeborg, Lisa; Fode, Mikkel

    2014-01-01

    Abstract 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.

  9. Comparing caudal and penile nerve blockade using bupivacaine in hypospadias repair surgeries in children

    Directory of Open Access Journals (Sweden)

    Mahin Seyedhejazi

    2011-01-01

    Full Text Available Background: Caudal anaesthesia is recommended for most surgical procedures of the lower part of the body, mainly below the umbilicus. It has been well established that a dorsal penile nerve block immediately after surgery decreases postoperative pain in children undergoing hypospadias repair. This study aimed to compare caudal or penile nerve block using bupivacaine in postoperative pain control in hypospadias repair in children. Patients and Methods: After local ethical committee approval and obtaining informed parental consent, 85 American society of Anesthesiologists status I and II patients, aged 6 months to 6 years old, undergoing hypospadias repair, were prospectively enrolled in this study. The patients were randomly divided into the following two groups: Caudal block was performed in 44 and penile block was performed in 41 patients. Cardiorespiratory systems data, analgesic requirement and complications were compared between the groups. Results: There were statistically significant haemodynamic (blood pressureand heart rate alteration during operation in each group (P<0.01. The haemodynamic parameters were stable during operation in successful blocks in both groups. Caudal block success rate is 97.7%, whereas in penile block is 92.6%. Nineteen of 43 patients (44% in caudal group and 29 of 41 patients (70% in penile group received analgesia in the postoperative period and this difference was significant between the two groups (P = 0.025. Conclusions: Without ultrasonography and with blind block, with anatomic landmarks only, the caudal block success rate is high and if there is no contraindication for caudal block, it is the best choice in children under 6 years old (or 25 kg for hypospadias repai.

  10. Age-dependent impact of CaV 3.2 T-type calcium channel deletion on myogenic tone and flow-mediated vasodilatation in small arteries

    DEFF Research Database (Denmark)

    Mikkelsen, Miriam F; Björling, Karl; Jensen, Lars Jørn

    2016-01-01

    The myogenic response and flow-mediated vasodilatation are important regulators of local blood perfusion and total peripheral resistance, and are known to entail a calcium influx into vascular smooth muscle cells (VSMCs) and endothelial cells (ECs), respectively. CaV 3.2 T-type calcium channels a......-mediated vasomotor responses to prevent excess arterial tone, protect against cardiovascular disease. This article is protected by copyright. All rights reserved....

  11. Continuing EGFR-TKI treatment in combination with super-selective arterial infusion chemotherapy beyond disease progression for patients with advanced EGFR-mutant non-small cell lung cancer.

    Science.gov (United States)

    Qi, Huiwei; Jiang, Sen; Yu, Dong; Ni, Huijuan; Hu, Qiong; Zhang, Jie

    2015-12-01

    Regional therapy has shown promising results in patients with an oligo-metastasis after the occurrence of resistance to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs). This study evaluated the efficacy and safety of continuing EGFR-TKI therapy concurrently with arterial infusion chemotherapy in 6 patients (median age 55.9 years) with advanced EGFR-mutant non-small cell lung cancer (NSCLC) who had a locally progressive, centrally located lung lesion after EGFR-TKI therapy. The patients received a super-selective arterial infusion of docetaxel (75 mg/m(2)) every 28 days concurrently with EGFR-TKI therapy until further progressive disease (PD) or unacceptable adverse effects (AEs) occurred. Treatment outcomes were assessed via progression-free survival (PFS) times (PFS-1: time to PD after EGFR-TKI therapy; PFS-2: time to further PD after arterial infusion chemotherapy with EGFR-TKI therapy), the occurrence of treatment-related AEs, and patient responses to the QLQ-LC13 quality-of-life questionnaire. Three of the 6 patients achieved partial responses, and three had stable disease. The median PFS-1 was 10.42 months, and the median PFS-2 was 4.1 months (range, 2.1-5.7 months). The median overall survival (OS) was 28.6 months (range, 24.1-32.9 months). All AEs were either grade 1 or grade 2 in severity, and no unexpected AEs were observed. One patient died of lung cancer. The patients reported significant reductions from baseline in symptoms of cough, chest pain, dyspnea, and hemoptysis (P < 0.05 for all comparisons). Thus, continuing EGFR-TKI therapy in combination with super-selective arterial infusion chemotherapy beyond PD for patients with advanced EGFR-mutant NSCLC is feasible, and this approach warrants further investigation. PMID:26496741

  12. Arterial embolism

    Science.gov (United States)

    ... the affected artery Shedding (sloughing) of skin Skin erosion ( ulcer ) Tissue death (necrosis; skin is dark and ... of the following tests: Euglobulin lysis time (ELT) Factor VIII assay Isotope study of the affected organ ...

  13. [Arterial heterogeneity].

    Science.gov (United States)

    Gouëffic, Y; Davaine, J-M; Merlini, T; Rimbert, A; Hérisson, F; Heymann, M-F; Heymann, D; Steenman, M; Lambert, G

    2013-01-01

    More and more clinical observations and trials support the concept of heterogeneity of atheroma according to the arterial bed. In a pilot study named "Étude Comparative des Lésions Athéromateuses" (ECLA), we have shown that carotid and femoral plaques possess different characteristics. Carotid arteries display increased lipid content compared to femoral arteries whereas femoral arteries are more prone to calcify and to develop osteoid metaplasia. These observations should lead the researcher and the clinician to look at the cellular and molecular mechanisms governing the heterogeneity of atheromas. At last, a better understanding of the characteristics of plaques should help us to determine plaque stability, to prevent cardiovascular events and to choose the best medical, endovascular or surgical option. PMID:23159822

  14. 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.

  15. Wedding ring in the wrong place: an unusual presentation of penile incarceration in a child with a wedding ring

    OpenAIRE

    Raza, Kazim; Khadim, Muhammad F; Naqvi, Gohar Abass; Ahmed, Iftikhar

    2009-01-01

    An unusual case of penile incarceration in a 13-year-old boy is presented, with lessons to be learned for Accident and Emergency Department junior doctors in particular and for all in general. The presentation was misleading and the condition would have gone undiagnosed with fatal consequences without a team effort. The object used was a wedding ring in this case. Penile incarceration is not common in routine practice. The need for development of necessary paediatric history taking and examin...

  16. Desire for Penile Girth Enhancement and the Effects of the Self-Injection of Hyaluronic Acid Gel

    OpenAIRE

    Coskuner, Enis Rauf; Canter, Halil Ibrahim

    2012-01-01

    Penile girth enhancement is a controversial subject but demands for enhancement are increasing steadily. Although various fillers have been widely used for soft tissue augmentation, there is no reliable material for this particular situation. Here we report a case of an acute hypersensitivity reaction in a man after his first self-injection of a filler material, which, he claimed, was hyaluronic acid gel for penile girth enhancement and glans penis augmentation.

  17. Desire for penile girth enhancement and the effects of the self-injection of hyaluronic acid gel

    Directory of Open Access Journals (Sweden)

    Enis Rauf Coskuner

    2012-01-01

    Full Text Available Penile girth enhancement is a controversial subject but demands for enhancement are increasing steadily. Although various fillers have been widely used for soft tissue augmentation, there is no reliable material for this particular situation. Here we report a case of an acute hypersensitivity reaction in a man after his first self-injection of a filler material, which, he claimed, was hyaluronic acid gel for penile girth enhancement and glans penis augmentation.

  18. Carotid artery surgery

    Science.gov (United States)

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... through the catheter around the blocked area during surgery. Your carotid artery is opened. The surgeon removes ...

  19. Decompression sickness in breath-hold diving, and its probable connection to the growth and dissolution of small arterial gas emboli.

    Science.gov (United States)

    Goldman, Saul; Solano-Altamirano, J M

    2015-04-01

    We solved the Laplace equation for the radius of an arterial gas embolism (AGE), during and after breath-hold diving. We used a simple three-region diffusion model for the AGE, and applied our results to two types of breath-hold dives: single, very deep competitive-level dives and repetitive shallower breath-hold dives similar to those carried out by indigenous commercial pearl divers in the South Pacific. Because of the effect of surface tension, AGEs tend to dissolve in arterial blood when arteries remote from supersaturated tissue. However if, before fully dissolving, they reach the capillary beds that perfuse the brain and the inner ear, they may become inflated with inert gas that is transferred into them from these contiguous temporarily supersaturated tissues. By using simple kinetic models of cerebral and inner ear tissue, the nitrogen tissue partial pressures during and after the dive(s) were determined. These were used to theoretically calculate AGE growth and dissolution curves for AGEs lodged in capillaries of the brain and inner ear. From these curves it was found that both cerebral and inner ear decompression sickness are expected to occur occasionally in single competitive-level dives. It was also determined from these curves that for the commercial repetitive dives considered, the duration of the surface interval (the time interval separating individual repetitive dives from one another) was a key determinant, as to whether inner ear and/or cerebral decompression sickness arose. Our predictions both for single competitive-level and repetitive commercial breath-hold diving were consistent with what is known about the incidence of cerebral and inner ear decompression sickness in these forms of diving. PMID:25598211

  20. Arterial vascular scleroses in the mammogram

    International Nuclear Information System (INIS)

    From 1974 to April 1979 5571 mammographies were made in the Department of Radiology of the University of Ulm. In 319 cases (5,7%) we observed calcifications of the mammarian arteries. The incidence of arterial calcifications in mammography in patients up to 60 years of age was higher than coronary calcifications could be diagnosed by chest fluoroscopy or in an autopsy series by other authors. As the small mammarian arteries show an equal histological structure as the coronary arteries, they must show the same type of calcification. Therefore we consider that calcifications of the mammarian arteries could be a sign of general arteriosclerosis. (orig.)

  1. 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.

  2. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Carillo, Viviana [Department of Medical Physics, San Raffaele Scientific Institute, Milano (Italy); Cozzarini, Cesare [Department of Radiotherapy, San Raffaele Scientific Institute, Milano (Italy); Perna, Lucia; Calandra, Mauro [Department of Medical Physics, San Raffaele Scientific Institute, Milano (Italy); Gianolini, Stefano [Medical Software Solutions GmbH, Hagendorn (Switzerland); Rancati, Tiziana [Prostate Cancer Program, IRCCS National Institute of Cancer, Milano (Italy); Spinelli, Antonello Enrico [Department of Medical Physics, San Raffaele Scientific Institute, Milano (Italy); Vavassori, Vittorio [Department of Radiotherapy, Cliniche Gavazzeni Humanitas, Bergamo (Italy); Villa, Sergio [Department of Radiotherapy 1, IRCCS National Institute of Cancer, Milano (Italy); Valdagni, Riccardo [Prostate Cancer Program, IRCCS National Institute of Cancer, Milano (Italy); Department of Radiotherapy 1, IRCCS National Institute of Cancer, Milano (Italy); Fiorino, Claudio, E-mail: fiorino.claudio@hsr.it [Department of Medical Physics, San Raffaele Scientific Institute, Milano (Italy)

    2012-11-01

    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, 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.

  4. An explosive course of squamous cell penile cancer in an AIDS patient.

    Science.gov (United States)

    Théodore, C; Androulakis, N; Spatz, A; Goujard, C; Blanchet, P; Wibault, P

    2002-03-01

    We report the case of a 37-year-old man in whom penile cancer was discovered while he was treated for AIDS 4 years after a human papillomavirus (HSV) infection. Despite initially localised disease with T1 N0 staging, he died of metastasis within 3 years. A brief review of the literature regarding HPV-related cancer in HIV-infected patients is presented and therapeutic options are discussed. PMID:11996481

  5. Detection of human papillomavirus DNA by PCR in semen from patients with and without penile warts.

    OpenAIRE

    Green, J.; Monteiro, E; Bolton, V N; Sanders, P.; Gibson, P. E.

    1991-01-01

    OBJECTIVES--To determine the prevalence of urethral HPV infection, as indicated by the presence of HPV DNA in semen, in males with and without penile warts. DESIGN--Prevalence study of HPV types 6/11 and 16 DNA using PCR and Southern blot hybridisation analysis of semen. SETTING--Department of Genitourinary Medicine, Blundell Street Clinic, Leeds General Infirmary and the Assisted Conception Unit (ACU) Kings' College, London. SUBJECTS--Patients attending the Genitourinary Clinic for treatment...

  6. 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.

  7. Early history of inflatable penile prosthesis surgery: a view from someone who was there

    OpenAIRE

    Mobley, David F

    2014-01-01

    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 introduc...

  8. 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...

  9. Petroleum jelly-induced penile paraffinoma with inguinal lymphadenitis mimicking incarcerated inguinal hernia

    OpenAIRE

    Sejben, István; Rácz, András; Svébis, Mihály; Patyi, Márta; Cserni, Gábor

    2012-01-01

    Chronic granulomatous inflammation may develop after injecting foreign oily substances into the penis. The disorder affects mainly the site of administration, but regional lymphadenopathy or even systemic disease can occur. We present a 39-year-old man with petroleum jelly-induced penile lesion and unilateral inguinal lymphadenitis mimicking incarcerated inguinal hernia. At hernioplasty no hernial sac was found, but enlarged lymph nodes suspicious for malignancy were identified. The histopath...

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

    OpenAIRE

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

    2013-01-01

    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 c...

  11. Congenital penile urethrocutaneous fistula: A rare anomaly and review of literature

    Science.gov (United States)

    Shukla, Ram Mohan; Mukhopadhyay, Biswanath; Mandal, Kartik Chandra; Barman, Shib Sankar

    2011-01-01

    Congenital penile urethrocutaneous fistula is described as an unusual developmental anomaly in children who present with an abnormal opening on the ventral aspect of penis with a normal foreskin and an absence of chordee and hypospadias. The authors present a discussion on the etiology, embryology, and management of this entity along with a description of three cases. We emphasize meticulous clinical examination for the diagnosis and to rule out other associated anomalies. PMID:21976932

  12. High CRP values predict poor survival in patients with penile cancer

    International Nuclear Information System (INIS)

    High levels of circulating C-reactive protein (CRP) have recently been linked to poor clinical outcome in various malignancies. The aim of this study was to evaluate the prognostic significance of the preoperative serum CRP level in patients with squamous cell carcinoma (SCC) of the penis. This retrospective analysis included 79 penile cancer patients with information about their serum CRP value prior to surgery who underwent either radical or partial penectomy at two German high-volume centers (Ulm University Medical Center and Hannover Medical School) between 1990 and 2010. They had a median (mean) follow-up of 23 (32) months. A significantly elevated CRP level (>15 vs. ? 15 mg/l) was found more often in patients with an advanced tumor stage (?pT2) (38.9 vs. 11.6%, p=0.007) and in those with nodal disease at diagnosis (50.0 vs. 14.6%, p=0.007). However, high CRP levels were not associated with tumor differentiation (p=0.53). The Kaplan-Meier 5-year cancer-specific survival (CSS) rate was 38.9% for patients with preoperative CRP levels above 15 mg/l and 84.3% for those with lower levels (p=0.001). Applying multivariate analysis and focusing on the subgroup of patients without metastasis at the time of penile surgery, both advanced local tumor stage (?pT2; HR 8.8, p=0.041) and an elevated CRP value (>15 mg/l; HR 3.3, p=0.043) were identified as independent predictors of poor clinical outcome in patients with penile cancer. A high preoperative serum CRP level was associated with poor survival in patients with penile cancer. If larger patient populations confirm its prognostic value, its routine use could enable better risk stratification and risk-adjusted follow-up of patients with SCC of the penis

  13. Corporoplasty using bovine pericardium grafts in complex penile prosthesis implantation surgery

    OpenAIRE

    Eduardo J. A. Lopes; Andre Y. Kuwano; Andreia N. Guimaraes; Jesuino P. Flores; Modesto A. O. Jacobino

    2009-01-01

    Purpose: This paper is the first, to our knowledge, to propose the use of a bovine pericardium graft in corporoplasty for penile prosthesis implantation. The advantages of bovine pericardium graft have been demonstrated by its use in cardiac surgery, including low cost, biocompatibility, impermeability, resistance to dilatation, flexibility, low likelihood of retraction, absence of antigenic reaction and natural absorption of the tissue. In this paper, we propose the use of this heterologous ...

  14. Timing of androgen receptor disruption and estrogen exposure underlies a spectrum of congenital penile anomalies.

    Science.gov (United States)

    Zheng, Zhengui; Armfield, Brooke A; Cohn, Martin J

    2015-12-29

    Congenital penile anomalies (CPAs) are among the most common human birth defects. Reports of CPAs, which include hypospadias, chordee, micropenis, and ambiguous genitalia, have risen sharply in recent decades, but the causes of these malformations are rarely identified. Both genetic anomalies and environmental factors, such as antiandrogenic and estrogenic endocrine disrupting chemicals (EDCs), are suspected to cause CPAs; however, little is known about the temporal window(s) of sensitivity to EDCs, or the tissue-specific roles and downstream targets of the androgen receptor (AR) in external genitalia. Here, we show that the full spectrum of CPAs can be produced by disrupting AR at different developmental stages and in specific cell types in the mouse genital tubercle. Inactivation of AR during a narrow window of prenatal development results in hypospadias and chordee, whereas earlier disruptions cause ambiguous genitalia and later disruptions cause micropenis. The neonatal phase of penile development is controlled by the balance of AR to estrogen receptor ? (ER?) activity; either inhibition of androgen or augmentation of estrogen signaling can induce micropenis. AR and ER? have opposite effects on cell division, apoptosis, and regulation of Hedgehog, fibroblast growth factor, bone morphogenetic protein, and Wnt signaling in the genital tubercle. We identify Indian hedgehog (Ihh) as a novel downstream target of AR in external genitalia and show that conditional deletion of Ihh inhibits penile masculinization. These studies reveal previously unidentified cellular and molecular mechanisms by which antiandrogenic and estrogenic signals induce penile malformations and demonstrate that the timing of endocrine disruption can determine the type of CPA. PMID:26598695

  15. Radiotherapy for node positive penile cancer: Experience of the leeds teaching hospitals

    OpenAIRE

    Franks, KN; Kancherla, K; Sethugavalar, B; Whelan, P.; Eardley, I.; Kiltie, AE

    2011-01-01

    Purpose: We studied the outcomes in patients with node positive penile cancer who received radiotherapy to inguinal and pelvic nodes. Although half of node positive cases are cured by lymphadenectomy, little data are available on the potential further benefits and toxicities of postoperative radiotherapy. Materials and Methods: We retrospectively audited the clinical notes and electronic records of 23 patients referred to a specialist center from 2002 to 2008 who received radiotherapy to the ...

  16. The Clinical Features of Penile Cancer Patients at Sanglah General Hospital Bali-Indonesia

    Directory of Open Access Journals (Sweden)

    Eka Kusmawan

    2012-01-01

    Full Text Available Objectives: To explore clinical characteristics, treatment modalities and outcomes after the follow-up of penile cancer patients. Method: We reviewed penile cancer patients during 8 years, started from April 1993 to March 2001. The data collected through medical record consisted of patient identities, history takings, physical and pathological findings, treatment modalities and their follow-up after 3±4 years Results: During eight years of study there were 46 patients aged 58+3 years. Out of 46 patients, 33 patients (72% have history of urogenital infection and 40 patients (87% with phymosis. With regard to physical examination, 24 patients (52% presented as stage III (Jackson classification. Pathological findings showed that 100% patients were keratinizing squamous cell carcinoma. Partial penectomy alone was carried out in 21 patients (46%, total penectomy alone was done in 17 patients (37%, and total penectomy with lymph node dissection was done in 8 patients (17%. During the follow-up, majority of the patients (42 showed no complications or recurrence; only 2 patients showed recurrent tumor and the rest 2 were lost to follow-up. Conclusions: During eight years at Sanglah General Hospital there were 46 penile cancer patients, mean of age was 58±3 years. Predispositioning factors were urogenital infection and phymosis. All of them were keratinizing squamous cell carcinoma. Total or partial penectomy with or without lymph node dissection was carried out with good results.

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

    Science.gov (United States)

    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 hemodynamics and erectile function in patients with vasculogenic ED. LIST is effective in patients who are responsive to phosphodiesterase 5 inhibitors (PDE5i) and can also convert PDE5i nonresponders to responders. The response to LIST wanes gradually over time, and after 2 years, about half of the patients maintain their function. Extensive research is needed to understand the effect of LIST on erectile tissue, to modify the treatment protocol to maximize its outcomes, and to identify the patients who will benefit the most from this treatment. PMID:24868332

  18. Penile low-intensity shock wave therapy: a promising novel modality for erectile dysfunction.

    Science.gov (United States)

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

    2014-05-01

    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 hemodynamics and erectile function in patients with vasculogenic ED. LIST is effective in patients who are responsive to phosphodiesterase 5 inhibitors (PDE5i) and can also convert PDE5i nonresponders to responders. The response to LIST wanes gradually over time, and after 2 years, about half of the patients maintain their function. Extensive research is needed to understand the effect of LIST on erectile tissue, to modify the treatment protocol to maximize its outcomes, and to identify the patients who will benefit the most from this treatment. PMID:24868332

  19. Prognostic factors in Taiwanese patients with penile-invasive squamous cell carcinoma.

    Science.gov (United States)

    Geng, Jiun-Hung; Huang, Shu-Pin; Huang, Chao-Yuan

    2015-10-01

    In Taiwanese patients, carcinoma of the penis is an uncommon disease. We retrospectively reviewed potential prognostic factors in Taiwanese patients with invasive-penile squamous cell carcinoma (SCC). From 1997 to 2009, 52 patients were enrolled. The median patient age at diagnosis was 66.5 years and the peak incident occurred during the 6(th) and 7(th) decades of life. Thirteen patients (25%) died of penile cancer, with a mean follow-up time of 45 months (interquartile range: 15-64 months). The 5-year cumulative cancer-specific survival rate was 81%, with 100% for those with Stage I, 90% for those with Stage II, 60% for those with Stage III, and 14% for those with Stage IV. Eleven variables, including grade, tumor, node, metastasis (TNM) stage, involvement of corpus spongiosum or corpora cavernosa, lymphovascular or perineural invasion, lymphadenectomy, and palpable lymph node, with p < 0.05 using univariate analysis were chosen for multivariate regression analysis. Three of these potential prognostic factors, including histological grade, distant metastasis, and lymphovascular invasion, remained statistically significant. Our study is the first report using the latest TNM classification (2009) to determine these potential predictors with penile SCC in Taiwan. PMID:26520691

  20. 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.

  1. Use of chitosan and polypropylene for the surgical correction of penile deviation in bulls: clinical and histological aspects Uso de chitosan y polipropileno en la corrección quirúrgica de la desviación del pene en toros: aspectos clínicos e histológicos

    OpenAIRE

    RR Rabelo; LAB Brito; AP Rodrigues; AM Moraes; Damasceno, A.; VAS Vulcani; LAF Silva; CRO Lima

    2012-01-01

    Problems in the reproductive tract may result in difficulty or inability to copulate. Premature penile deviation is an important cause of impotency in male bovines. The aim of the study was to perform clinical and histological evaluation of the correction of surgically induced penile deviation in bulls by fixing the penile apical ligament in the tunica albuginea using synthetic or biological implants. Twenty-one animals with normal penile conformation were subjected to surgical induction of p...

  2. 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.

  3. Segmented Coronary Artery Aneurysms and Kawasaki Disease

    Directory of Open Access Journals (Sweden)

    Hamid Reza Ghaemi

    2011-05-01

    Full Text Available Kawasaki disease (KD is an acute vasculitis syndrome of unknown etiology. It occurs in infants and young children,affecting mainly small and medium-sized arteries, particularly the coronary arteries. Generalized microvasculitis occurs in the first 10 days, and the inflammation persists in the walls of medium and small arteries, especially the coronary arteries, and changes to coronary artery aneurysms.We report the case of a 10-month-old girl referred to our center three months after the onset of disease due to the aneurysmsof the coronary arteries. During the acute phase of her illness, she received 2 gr/kg intravenous gamma globulin; and afterher referral to us, the patient was treated by antiaggregant doses of acetylsalicylic acid (ASA (5 mg/kg and Warfarin (1 mg/daily. At three months’ follow-up, the aneurysms still persisted in the echocardiogram.

  4. 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.

  5. Concordance of lymphovascular invasion diagnosed in penile carcinoma with and without the immunohistochemical markers ERG and CD31.

    Science.gov (United States)

    Feng, Megan A; Ebel, Joshua J; Shabsigh, Ahmad; Zynger, Debra L

    2016-03-01

    Lymphovascular invasion (LVI) is an independent predictor of metastatic lymph node disease in penile carcinoma and is one factor used to guide clinical management. The presence of LVI with and without the use of the endothelial immunohistochemical (IHC) markers, ERG and CD31, was retrospectively assessed in 46 penectomy cases containing invasive penile carcinoma (43 squamous cell carcinoma and 3 non-squamous cell carcinoma). Concordance for the detection of LVI between the original report, upon pathology review, and with the use of IHC was determined and histologic pitfalls were identified. For penile squamous cell carcinoma, LVI was diagnosed in 27.9% of tumors in the original reports, 16.3% upon pathology review, and in 16.3% with use of ERG and CD31. Concordance of LVI identification in the original report compared to IHC was 74.4% while concordance of review compared to IHC was 95.3%. Using IHC data as the reference, false positive LVI diagnoses were more common in the original report than false negatives. Histologic mimickers of LVI including involvement of the penile corpora cavernosum or spongiosum vasculature, seromucinous colonization, and a nested pattern of tumor invasion were identified. We demonstrated that it was not uncommon for LVI in penile carcinoma to be overdiagnosed or underdiagnosed. The use of endothelial IHC markers, such as ERG or CD31, or additional pathology consultation is recommended for penectomy cases in which LVI is difficult to histologically discern. PMID:26452171

  6. Coronary artery disease in severe haemophilia.

    OpenAIRE

    Small, M; Jack, A. S.; Lowe, G.D.; Mutch, A F; Forbes, C. D.; Prentice, C R

    1983-01-01

    It has been suggested that the coagulation defect in haemophilia A protects these patients from coronary artery disease. We report two patients with severe haemophilia, who each had severe atheroma localised to the coronary arteries. Both patients had received only small amounts of factor VIII concentrates in their lifetime because of various social reasons. In one case death resulted from myocardial infarction secondary to an occlusive thrombus in a coronary artery. The implications of these...

  7. Graft arterial stenosis in kidney en bloc grafts from very small pediatric donors: incidence, timing, and role of ultrasound in screening.

    Science.gov (United States)

    Bent, C; Fananapazir, G; Tse, G; Corwin, M T; Vu, C; Santhanakrishnan, C; Perez, R V; Troppmann, C

    2015-11-01

    In previous studies with different donor selection criteria and noncontemporary surgical techniques, graft arterial stenosis (GAS) has been reported to occur more frequently in adult recipients of pediatric en bloc renal allografts (EBKT) as compared to single adult donor allografts. The purpose of our study was to evaluate the incidence of GAS within our EBKT recipient population and to evaluate clinical and imaging features of those cases with GAS. In a retrospective cohort study, we analyzed 182 EBKT performed at a single institution. We identified cases of suspected GAS based on clinical factors, lab results, and noninvasive imaging. Diagnosis of GAS was confirmed by digital subtraction angiography. Two EBKT recipients (1.1% of 182) had angiographically confirmed GAS at 2.5 and 4.5 months after transplant. In both cases, the stenoses were short segment within the proximal (perianastomotic) donor aorta, color Doppler ultrasound demonstrated peak systolic velocities of >400?cm/s, and poststenotic parvus tardus waveforms were present. Both patients underwent angioplasty and demonstrated postintervention improvement in renal function and blood pressure. Restenosis did not occur during follow up. In conclusion, recipients of EBKT have a low incidence of GAS, similar to the lowest reported for adult single allografts. PMID:26153092

  8. Identifying the needs of penile cancer sufferers: A systematic review of the quality of life, psychosexual and psychosocial literature in penile cancer

    Directory of Open Access Journals (Sweden)

    Lau Maurice M

    2009-08-01

    Full Text Available Abstract Background Penile cancer is an uncommon malignancy with an incidence of 1 per 100,000. Conservative and radical treatments can be disfiguring and may have an impact on sexual function, quality of life (QOL, social interactions, self-image and self-esteem. Knowledge of how this disease affects patients is paramount to developing a global, multi-disciplinary approach to treatment. Methods A Medline/PubMed literature search was conducted using the terms "sexual function penis cancer"; "quality of life penis cancer" and "psychological effects penis cancer" from 1985 to 2008. Articles containing quantitative data on QOL, sexual function or psychological well-being were included. Results 128 patients from 6 studies were included. 5 studies contained retrospective data whilst 1 study collected prospective data on erectile function. In the 6 studies 13 different quantitative tools were used to assess psychological well-being, QOL and sexual function. The General Health Questionnaire (GHQ showed impaired well-being in up to 40% in 2 studies. Patients undergoing more mutilating treatments were more likely to have impaired well-being. The Hospital Anxiety and Depression Score (HADS demonstrated pathological anxiety up to 31% in 2 studies. 1 study used the Diagnostic and Statistical Manual of Mental Disorders of psychiatric illness (DSM III-R with 53% exhibiting mental illness, 25% avoidance behaviour and 40% impaired well-being. 12/30 suffered from post-traumatic stress disorder. The IIEF-15 was the commonest tool used to assess sexual function. The results varied from 36% in 1 study with no sexual function to 67% in another reporting reduced sexual satisfaction to 78% in another reporting high confidence with erections. Conclusion The treatment of penile cancer results in negative effects on well-being in up to 40% with psychiatric symptoms in approximately 50%. Up to two-thirds of patients report a reduction in sexual function. This study demonstrates that penile cancer sufferers can exhibit significant psychological dysfunction, yet no standardised tools or interventional pathways are available. Therefore, there is a need to identify and assess adequate tools to measure psychological and sexual dysfunction in this group of patients.

  9. 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 padronizados co...

  10. Penile Cancer in Cali, Colombia: 10 Years of Casuistry in a Tertiary Referral Center of a Middle-Income Country

    Directory of Open Access Journals (Sweden)

    Lina M. Rengifo

    2015-10-01

    Full Text Available Background: Penile cancer is a rare disease in Colombia; in Cali, it represents 0.7% of all cancers. Penile cancer has been associated with old age, bad hygiene, smoking and lack of circumcision. This study aimed to describe the sociodemographic and clinical characteristics of patients with penile cancer who consulted to a tertiary referral hospital. Methods: A case series of all penile cancer cases at a reference institution in Cali during 2001-2010. Socioeconomic, demographic and clinical features of patients were described, and bivariate analyses were carried out. Results: There were 46 penile cancer cases. The average age was 60 ± 16.9 years. The main reason for consultation was an exophytic mass on the penis (75.0%. The most common location was the glans (69.6%, and the more frequent histology type was the squamous cell carcinoma (95.7%. With regard to risk factors, 65.5% of the patients had history of smoking and 90.9% did not have circumcision. Patients who underwent radical amputation had higher rates of positive nodes (55% vs. 13.5%, p=0.015 and ulcerative lesions (77.8% vs. 29.7%, p=0.018 than those who did not have the procedure done. Recurrence was associated with the presence of lymphadenopathy (p=0.02 and history of circumcision (p=0.015. Conclusion: Most of the patients with penile cancer found in this study had old age, history of tobacco use and lack of circumcision. Patients who presented with lymph node metastasis had to undergo more radical procedures and suffered a greater rate of recurrence compared with those without lymph node involvement. Robust studies to determine the risk factors among low-income populations are required.

  11. 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; Tom F Lue; 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...

  12. [Destruction of a penile urethra resulting from a snake bite: Uretroplasty using inguinal flap of Mac Gregor].

    Science.gov (United States)

    Kossoko, H; Allah, C; Assi Djè Bi Djè, V; Yéo, S; Gagne, M; Richard Kadio, M

    2011-02-01

    Following a snake bite to the penis, a 69 years old man presented a large defect of hemicircumferential ventral penis, destroying the penile urethra along its entire length exposing the erectile bodies. The authors proposed a two-stage reconstruction of the urethra with an inguinal axial pedicle flap of Mac Gregor. This well-vascularized flap thick after degreasing helped repair the penile urethra along its entire length and make up losses of substance with a good functional and aesthetic result. PMID:21067854

  13. Doppler Ultrasound and Magnetic Resonance Imaging Findings of Penile Mondor’s Disease: Case Report and Literature Review

    Science.gov (United States)

    Kantarc?, Umut Hasan; Dirik, Alper; Öztürk, Yasemin Erdem; Kiri?, ?lker; Duymu?, Mahmut

    2016-01-01

    Summary Background Penile involvement is a rare, self-limiting, benign genital condition. In Mondor’s disease the underlying pathology is thrombophlebitis of a superficial vein. Case Report In this case report, we want to present a rare Penile Mondor’s disease with literature review. Conclusions While the diagnosis can be based on history, physical examination and Doppler ultrasound, the necessity of both MRI, MR angiography and intracavernosal vasoactive agent administration can be questioned. Both MRI and intravenous vasoactive agent administration may be helpful in suspicious cases for differential diagnosis and to eliminate other etiologies like pelvic mass or thrombosis.

  14. Psychological/psychiatric trauma in patients with penile cancer and partial or total penectomy

    Directory of Open Access Journals (Sweden)

    Novac B.

    2013-01-01

    Full Text Available Penile cancer, which is a considerable challenge for countries in the developing world, is a mutilated affection for the patient, considering both the local modifications that are determined by it, as well as from the treatment point of view. In this way, for the more advanced disease phase, aggressive therapy with partial or total penectomy is still the conventional and necessary treatment. There are very few studies about the extent and nature of the psychological effects of penile cancer. Thus, considering that psychological/psychiatric dysfunctions in patients with penectomy are likely to be common and taking into account the current contradictions that exist regarding this area of research, we decided to evaluate the impact of penile cancer and/or partial or total penectomy on levels of anxiety and depression, as studied through some specific scales such as the Hamilton Rating Scale for Depression (HAM-D and the Hamilton Anxiety Rating Scale (HAM-A. We found increased anxiety and depression, especially in the case of the group with total penectomy, but also in the biopsy group, which comprised patients that had lesions in the terminal stage, such as an inextirpable tumor. The most reduced levels of depression and anxiety were observed in the postectomy group. Our findings presented here and further knowledge about the psychological, social and sexual aspects of these specific patients will help health professionals and organizations to identify treatment options and/or make recommendations for rehabilitation and support services. Additionally, there is a continuous need to identify and assess proper scales to measure the psychological/psychiatric trauma in this group of patients, as well as focusing on the identification of the exact patients that require professional psychological intervention.

  15. 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

  16. 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.)

  17. 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

  18. Penile density and globally used chemicals in Canadian and Greenland polar bears

    DEFF Research Database (Denmark)

    Sonne, Christian; Dyck, Markus; Rigét, Frank F; Beck Jensen, Jens-Erik; Hyldstrup, Lars; Letcher, Robert J.; Gustavson, Kim; Gilbert, M. Thomas P.; Dietz, Rune

    2015-01-01

    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 penilebones and risk of fractures. Based on this, future......-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...

  19. Incidence and cost of anal, penile, vaginal and vulvar cancer in Denmark

    DEFF Research Database (Denmark)

    Olsen, J.; Jorgensen, T. R.; Kofoed, K.; Larsen, H. K.

    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, peni...

  20. Minimizing Penile Implant Infection: A Literature Review of Patient and Surgical Factors.

    Science.gov (United States)

    Holland, Bradley; Kohler, Tobias

    2015-12-01

    Inflatable penile prosthesis (IPP) is an effective treatment for erectile dysfunction in patients' refractory to oral or injectable treatment. While the rate of infection has decreased over the past decade, it is still the most feared complication of IPP placement. Here, we assemble possible patient and surgical factors attributing to the risk of infection. Studies have been gathered addressing each of these factors, and an Oxford Level of Evidence is assigned to each recommendation based on strength of the study. The goal of this review is to inform surgeons of possible risks in order to further reduce the risk of infection and thus increase success of IPP placement. PMID:26480830

  1. 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.

  2. Glans reconstruction with the use of an inverted urethral flap after distal penile amputation for carcinoma.

    Science.gov (United States)

    Sansalone, Salvatore; Garaffa, Giulio; Vespasiani, Giuseppe; Zucchi, Alessandro; Kuehhas, Franklin Emmanuel; Herwig, Ralf; Silvani, Mauro; Pecoraro, Stefano; Loreto, Carla; Leonardi, Rosario

    2013-03-01

    Restoration of adequate cosmesis and preservation of sexual and urinary function are the main goals of penile reconstructive surgery following amputation for carcinoma. Split thickness skin grafts and oral mucosa grafts have been widely used for the creation of a pseudoglans with excellent cosmetic and functional results. The main drawbacks associated with the use of grafts are donor site morbidity, the lack of engorgement of the pseudoglans and the risk of poor graft take, which may lead to contracture and poor cosmetic results. In the present series the long term cosmetic and functional outcomes of glans reconstruction with an inverted distal urethral flap are described. PMID:23695401

  3. Glans reconstruction with the use of an inverted urethral flap after distal penile amputation for carcinoma

    Directory of Open Access Journals (Sweden)

    Salvatore Sansalone

    2013-04-01

    Full Text Available Restoration of adequate cosmesis and preservation of sexual and urinary function are the main goals of penile reconstructive surgery following amputation for carcinoma. Split thickness skin grafts and oral mucosa grafts have been widely used for the creation of a pseudoglans with excellent cosmetic and functional results. The main drawbacks associated with the use of grafts are donor site morbidity, the lack of engorgement of the pseudoglans and the risk of poor graft take, which may lead to contracture and poor cosmetic results. In the present series the long term cosmetic and functional outcomes of glans reconstruction with an inverted distal urethral flap are described.

  4. Mesenteric artery ischemia

    Science.gov (United States)

    ... ischemia is often seen in people who have hardening of the arteries in other parts of the ... long-term (chronic) mesenteric artery ischemia caused by hardening of the arteries ( atherosclerosis ): Abdominal pain after eating ...

  5. Coronary artery disease (image)

    Science.gov (United States)

    ... through these arteries is critical for the heart. Coronary artery disease usually results from the build-up of fatty material and plaque, a condition called atherosclerosis. As the coronary arteries narrow, the flow of blood to the ...

  6. Heart transplantation and arterial elasticity

    Directory of Open Access Journals (Sweden)

    Colvin-Adams M

    2013-12-01

    Full Text Available Monica Colvin-Adams,1 Nonyelum Harcourt,1 Robert LeDuc,2 Ganesh Raveendran,1 Yassir Sonbol,3 Robert Wilson,1 Daniel Duprez11Cardiovascular Division, University of Minnesota, Minneapolis, MN, USA; 2Division of Biostatistics University of Minnesota, Minneapolis, MN, USA; 3Cardiovascular Division, St Luke's Hospital System, Sugar Land, TX, USAObjective: Arterial elasticity is a functional biomarker that has predictive value for cardiovascular morbidity and mortality in nontransplant populations. There is little information regarding arterial elasticity in heart transplant recipients. This study aimed to characterize small (SAE and large (LAE artery elasticity in heart transplant recipients in comparison with an asymptomatic population free of overt cardiovascular disease. A second goal was to identify demographic and clinical factors associated with arterial elasticity in this unique population.Methods: Arterial pulse waveform was registered noninvasively at the radial artery in 71 heart transplant recipients between 2008 and 2010. SAEs and LAEs were derived from diastolic pulse contour analysis. Comparisons were made to a healthy cohort of 1,808 participants selected from our prevention clinic database. Multiple regression analyses were performed to evaluate associations between risk factors and SAE and LAE within the heart transplant recipients.Results: LAE and SAE were significantly lower in heart transplant recipients than in the normal cohort (P <0.01 and P < 0.0001, respectively. Female sex and history of ischemic cardiomyopathy were significantly associated with reduced LAE and SAE. Older age and the presence of moderate cardiac allograft vasculopathy were also significantly associated with reduced SAE. Transplant duration was associated with increased SAE.Conclusion: Heart transplants are associated with peripheral endothelial dysfunction and arterial stiffness, as demonstrated by a significant reduction in SAE and LAE when compared with a healthy population. Furthermore, cardiac allograft vasculopathy is associated with a significant reduction in SAE, suggesting a potential use in screening heart transplant recipients at risk for developing this complication.Keywords: heart transplant, endothelial function, arterial elasticity, cardiac allograft vasculopathy

  7. Arterial stenosis following radiotherapy

    International Nuclear Information System (INIS)

    Published reports of arterial stenosis following radiotherapy are reviewed. In oncological practice, this complication is rare but experimental studies have demonstrated the role of irradiation in producing arterial lesions. The histological specificity and the mechanisms of radiation and related arterial lesions are discussed. Atherosclerosis risk factors and chemotherapy could have a synergic role on artery stenosis. Cases reported of arterial stenosis after radiotherapy include subclavicular artery after breast cancer, carotid artery after head and neck cancer, coronary artery and abdominal aorta or its trunks after pelvic and abdominal irradiation. The radiotherapy parameters described are not unusual. Therapeutical modalities and their indications are presented

  8. Radial Artery Catheterization

    Science.gov (United States)

    ... by Shah, P. B. Related Content Load related Internet Resources information Social Bookmarking ... This Article Top Introduction Advantages of Radial Artery Catheterization The Radial Artery Catheterization ...

  9. Penile cancer chemotherapy: twelve years' experience at Institut Gustave-Roussy.

    Science.gov (United States)

    Kattan, J; Culine, S; Droz, J P; Fadel, E; Court, B; Perrin, J L; Wibault, P; Haie-Meder, C

    1993-11-01

    Between 1980 and 1992, 14 patients (median age 50 years) with penile carcinoma were treated with multidrug combination chemotherapy in our institution. Twelve patients had Stage IV (Jackson classification) tumor, 1 patient each had Stage III and Stage II. All patients received cisplatin-based chemotherapy. Cisplatin was associated with either 5-fluorouracil (4 patients), methotrexate and bleomycin (4 patients), methotrexate (3 patients), Adriamycin (1 patient), bleomycin and vinblastine (1 patient), or bleomycin and epirubicin (1 patient). Thirteen patients were evaluable for response. Objective response was encountered in 2 patients (15%) with 1 complete response and 1 partial response. Response duration was difficult to determine because of additive radio-therapy or patient was lost to follow-up. There were 2 patients with long-term evidence of no disease among 12 patients with Stage IV disease. These 2 patients received complementary irradiation in association with the chemotherapy. The response rate was dismal in our series. Methotrexate-based regimens seem to be the most active. The bimodality treatment with multidrug chemotherapy and radiotherapy for advanced penile cancer could offer a survival advantage in the management of these patients. PMID:7694417

  10. A common presentation to an uncommon disease. Penile Mondor's disease: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Walsh JC

    2014-10-01

    Full Text Available John C Walsh,1 Sabré Poimboeuf,2 Daniel S Garvin1 1Naval Air Station Lemoore, Lemoore, CA, USA; 2Lemoore Naval Hospital, Lemoore, CA, USA Abstract: Penile Mondor's disease, or superficial thrombophlebitis of the dorsal vein of the penis, is a relatively uncommon but potentially anxiety-inducing self-limiting condition that should be easily recognizable by any primary care practitioner. It typically presents with a cord-like mass and pain to the dorsal penis and has a myriad of causes, including trauma, excessive sexual activity, excessive exercise, or malignancy. Although Penile Mondor’s disease is typically a clinical diagnosis, Doppler ultrasound is the initial imaging modality of choice if there is question or doubt about the diagnosis. Accurate diagnosis and reassurance about the condition's benign and self-limiting nature assuages most patients' fears. Treatment is primarily symptomatic but may vary depending on possible underlying disease processes. Keywords: thrombophlebitis, cord-like mass, penis, dorsal vein

  11. Penile Metastases of Recurrent Prostatic Adenocarcinoma without PSA Level Increase: A Case Report

    Directory of Open Access Journals (Sweden)

    Antonio Pierro

    2012-01-01

    Full Text Available We report a case of penile metastases from recurrent prostatic adenocarcinoma that was the first sign of a widespread metastatic disease in the absence of any increase in prostate-specific antigen (PSA level. In April 2011, an 80-year-old man presented to our Radiotherapy Unit with multiple palpable hard nodules in the penis, dysuria, and moderate perineal pain, 7 years after he had received radiotherapy for prostate cancer. Nodules in the penis had appeared in February 2011. The ultrasound and magnetic resonance (MR imaging suggested the diagnosis of multiple penile metastases. A total body computed tomography scan revealed a systemic spread of the disease, with multiple metastases in the liver, bones, and lungs. PSA level was 0.126 ng/ml. A fine needle aspiration biopsy of the liver lesion was undertaken, and the histopathologic examination revealed the prostatic origin of the metastases, so androgen deprivation therapy was started. The diagnosis of metastases should be considered in a patient with prior history of prostate malignancies presenting with solid nodules in the penis, even if the PSA level is low.

  12. 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.

  13. 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.

  14. [Laser and ultrasonic therapy in simultaneous emission for the treatment of plastic penile induration].

    Science.gov (United States)

    Felipetto, R; Viganò, L; Pagni, G L; Minervini, R

    1995-03-01

    Induratio penis plastica (IPP) or Peyronie's Disease is characterized by the presence of one or more fibrous patches in the tunica albuginea or intercavernous septum. IPP is a slowly evolving disease which may cause a bending of the penis as well as pain during erection. As an alternative to the numerous pharmacological therapies already existing, or in association with them, some kinds of physical treatments, such as ionophoresis, ultrasound therapy and laser therapy, have recently been used. In this study we have evaluated the effectiveness of physical therapy combined with laser and Ultrasounds in the treatment of IPP. Sixty-eight patients were randomly divided into three groups: the first group was treated with orgotein infiltrations, the second with laser and Ultrasounds and the third with an association of both treatments. On the basis of this study, we can affirm that the effectiveness of laser therapy associated with ultrasounds in treating painful symptomatology of IPP at its initial phase overlaps that of orgotein infiltrations. No measurable modifications were documented neither in patch dimensions nor in their echostructures and in no case remarkable modifications of the penile bending were evidenced. Therefore laser therapy associated with ultrasounds represents at the moment an efficacious alternative to medical treatment of IPP at the initial phase, as it does not present any kind of contraindications and it is surely better tolerated than any treatment with penile infiltrations. PMID:7570257

  15. 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.

  16. 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

  17. 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)

  18. Aspectos clínico-epidemiológicos associados ao câncer de pênis / Clinico-epidemiological aspects associated with penile cancer

    Scientific Electronic Library Online (English)

    Angela Adamski da Silva, Reis; Leonardo Barcelos de, Paula; Adriano Augusto Peclat de, Paula; Vera Aparecida, Saddi; Aparecido Divino da, Cruz.

    2010-06-01

    Full Text Available O objetivo desta revisão bibliográfica foi descrever a epidemiologia, o comportamento biológico dos tumores e os fatores de risco para o câncer de pênis, como a infecção pelo HPV. A fimose e os processos de irritação crônica relacionados à má higiene estão comumente associados com esse tumor, enquan [...] to a circuncisão neonatal protege contra a aparição da doença. Existe forte evidência da associação dos HPV 16 e 18 com o carcinoma peniano em mais de 50% dos casos. Pacientes com lesões penianas suspeitas devem se submeter ao exame físico, geralmente sendo este suficiente para determinar o diagnóstico e o estadiamento, assim como auxiliar na escolha terapêutica. Abstract in english The general objective of this article is to review the current literature regarding the epidemiology, biological behavior and risk factors for penile cancer development, such as HPV infection. Phimosis and chronic irritation related to poor hygiene are commonly associated with penile cancer, whereas [...] neonatal circumcision reduces the relative risk for the disease. There is strong evidence that HPV types 16 and 18 are associated with penile carcinoma in as many as 50% of cases. Patients with penile lesions should undergo physical examination, which is often sufficient to diagnose and to define tumor stagging, as well as contributes to decision-making regarding therapeutical approaches and case management.

  19. Percutaneous transluminal angioplasty (PTA) of supra-aortic arteries especially the internal carotid artery

    Energy Technology Data Exchange (ETDEWEB)

    Kachel, R.; Basche, S. (Medizinische Akademie, Erfurt (Germany, F.R.). Radiologische Klinik); Heerklotz, I.; Grossmann, K. (Medizinische Akademie, Erfurt (Germany, F.R.). Klinik fuer Innere Medizin); Endler, S. (Medizinische Akademie, Erfurt (Germany, F.R.). Klinik fuer Neurologie und Psychiatrie)

    1991-06-01

    We present our experience with 105 patients in whom percutaneous transluminal angioplasty was performed in 112 stenosed or occluded supra-aortic arteries. Symtoms of cerebrovascular and/or vertebrobasilar insufficiency were present in 104 of the 105 patients. The angioplasty was successful in 35 stenoses of the internal carotid artery, 2 stenoses of the common carotid artery, 1 stenosis of the external carotid artery, 15 stenoses of the vertebral artery, 3 stenoses of the innominate artery and 44 stenoses of the subclavian artery. There were only 4 minor-complications (2 haematomas, 1 transient ischemic attack, 1 small thrombus of the internal carotid artery which was detected by 111-indium platelet scintigraphy and treated by thrombendarterectomy before the appearance of neurological symptoms). All patients were symptom free after angioplasty. During the observations period of 3 to 109 months (average 58 months) there were only two cases with re-stenosis after subclavian angioplasty. The results of more than 700 personal and international published percutaneous transluminal angioplasties of supra-aortic arteries are presented. The results suggest that angioplasty of supra-aortic arteries is an effective method. On strict definition of the indications, the complication rate for angioplasty of the supra-aortic arteries is not likely to be higher than that for operative treatment. (orig.).

  20. Percutaneous transluminal angioplasty (PTA) of supra-aortic arteries especially the internal carotid artery

    International Nuclear Information System (INIS)

    We present our experience with 105 patients in whom percutaneous transluminal angioplasty was performed in 112 stenosed or occluded supra-aortic arteries. Symtoms of cerebrovascular and/or vertebrobasilar insufficiency were present in 104 of the 105 patients. The angioplasty was successful in 35 stenoses of the internal carotid artery, 2 stenoses of the common carotid artery, 1 stenosis of the external carotid artery, 15 stenoses of the vertebral artery, 3 stenoses of the innominate artery and 44 stenoses of the subclavian artery. There were only 4 minor-complications (2 haematomas, 1 transient ischemic attack, 1 small thrombus of the internal carotid artery which was detected by 111-indium platelet scintigraphy and treated by thrombendarterectomy before the appearance of neurological symptoms). All patients were symptom free after angioplasty. During the observations period of 3 to 109 months (average 58 months) there were only two cases with re-stenosis after subclavian angioplasty. The results of more than 700 personal and international published percutaneous transluminal angioplasties of supra-aortic arteries are presented. The results suggest that angioplasty of supra-aortic arteries is an effective method. On strict definition of the indications, the complication rate for angioplasty of the supra-aortic arteries is not likely to be higher than that for operative treatment. (orig.)

  1. Bilateral vertebral artery occlusion

    International Nuclear Information System (INIS)

    We studied 9 patients with bilateral vertebral artery occlusion (BVAO). BVAO was confirmed using angiography in order to clarify its clinical feature, mechanism, and long term prognosis. We divided the patients into 4 groups according to MRI findings, as follows: Group 1 with no abnormal finding on MRI; Group 2 with deep pontine infarcts and non-territorial small cerebellar infarcts; Group 3 with extended pontine infarcts; and Group 4 with cerebellar cortical artery infarcts, deep pontine infarcts, and non-territorial small cerebellar infarcts. Six of the patients had vertebro-basilar symptoms after being in the upright position, including all the patients in Groups 2 and 4, which had cerebellar border zone/terminal zone infarcts. These results indicate that the hemodynamic mechanism plays an important role in BVAO. The prognosis was not always grave. Four of the patients could walk independently, 2 could walk with a cane, and 3 were bed ridden (2 of which died). Long-term follow-up data were obtained in all patients. In the patients who could walk, one had asymptomatic cerebellar infarcts, and one had TIAs frequently. Patients with BVAO often also have TIAs and/or preceding episode and show cerebellar border zone/terminal zone infarction. (K.H.)

  2. Isolated iliac artery aneurysms

    DEFF Research Database (Denmark)

    Levi, N; Schroeder, T V

    1998-01-01

    To assess our experience with isolated iliac artery aneurysms and to assess the blood transfusion requirement in patients undergoing surgery for iliac artery aneurysms.......To assess our experience with isolated iliac artery aneurysms and to assess the blood transfusion requirement in patients undergoing surgery for iliac artery aneurysms....

  3. Hepatic artery aneurysm.

    OpenAIRE

    Curran, F T; Taylor, S. A.

    1986-01-01

    We describe a 58 year old woman who had an aneurysm involving the common hepatic artery, the right and left hepatic arteries and the cystic artery which had ruptured into the liver. It was successfully treated by proximal ligation. The features and management of hepatic artery aneurysm are discussed.

  4. 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. Data were stored (Microsoft Access and analyzed using Epi-info software. RESULTS: We evaluated 1,168 individuals, with a predominance of the female sex - 63.2% and a mean age of 43.2 ± 14.9 years. There was a prevalence of overweight in 33.7% of the individuals and obesity in 16.0% of the individuals. There was a prevalence of altered WC in 51.8% demand of smoking in 23.2%. A sedentary life style at work and leisure activities was present in 67.6% and 64.8% of the individuals, respectively, with a higher proportion seen among the women. Alcohol consumption was observed in 33.3% of the sample. The prevalence of AH was 32.7%, higher among the men (35.8% than among the women (30.9%. A positive correlation with AH was identified with BMI, WC and age range. A negative correlation was observed between AH and level of schooling, with 18.2% of hypertensive individuals with 9 or more years of schooling. CONCLUSION: A high prevalence of AH, overweight and WC alteration was identified. The female sex represented a protective factor for the risk of AH. A positive correlation was found between AH and BMI, WC and age range; a negative correlation was identified between AH and level of schooling.

  5. Regional differences in the response to vasoconstrictor agents of dog and monkey isolated coronary arteries.

    OpenAIRE

    Miwa, K.; Toda, N

    1984-01-01

    Contractile responses to vasoconstrictor agents were compared in helical strips of dog and monkey epicardial coronary arteries of different sizes. Contractions of large, medium and small arteries induced by KCl ( 30mM ) were virtually identical. Contractions induced by 5-hydroxytryptamine (5-HT) (10(-9) - 2 X 10(-6) M) were in the order of large greater than medium greater than small arteries in dogs, and large = medium greater than small arteries in monkeys. Cinanserin suppressed these respo...

  6. Complication after arterial bypass grafting.

    Science.gov (United States)

    Dizon, M; Wallach, P; Matfin, G; Adelman, H M

    1998-10-15

    A 57-year-old man experienced sudden onset of pleuritic chest pain and respiratory distress 10 days after undergoing four-vessel coronary artery bypass grafting (CABG). The surgery was performed after cardiac catheterization had shown right coronary artery dominance and the presence of lesions occluding 40% of the mid right coronary artery, 20% of the left main coronary artery, and 99% of the lower left anterior descending artery and its first diagonal branch. The patient had initially presented with acute dyspnea following an episode of crushing, nonradiating pain in the left chest and was diagnosed as having a non-Q-wave myocardial infarction after cardiac enzyme testing. His hospital course before and immediately after CABG was uneventful. The first sign of difficulty was detected one week after surgery, on day 17. An echocardiogram showed a small pericardial effusion, moderate to severe concentric thickening of the left ventricle, a left ventricular ejection fraction of 0.60 (normal, 0.67 +/- 0.08), normal valves, and normal segmental wall motion. The pleural chest pains began two days later, on day 19. PMID:9793541

  7. Is V-Y plasty necessary for penile lengthening? Girth enhancement and increased length solely through circumcision: description of a novel technique.

    Science.gov (United States)

    Mertziotis, Nikos; Kozyrakis, Diomidis; Bogris, Elias

    2013-11-01

    Our objective is to describe a novel ligamentolysis approach using a subcoronal incision technique and to determine its safety and efficacy. During the last 7 years, 82 consecutive patients had penile augmentation surgery. Ligamentolysis, through a lower abdominal incision (V-Y plasty) in the first 35 males, was performed (Group A), followed by circumcision ligamentolysis in the next 47 males (Group B). The operation time, complications, and the preoperative and postoperative values of penile length and girth along with the self-esteem and relations questionnaire score as well as satisfaction score was calculated before and after the surgery, and a comparison was conducted between the groups. The mean age at presentation was 32 years (range: 18-56 years). Seventy-nine patients suffered from penile dysmorphophobia, and three patients had micropenises (length cosmetic appearance without any compromise in the gained penile size. PMID:23792340

  8. 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.

  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. 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.

  11. 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.

  12. Clinical significance of subclavian artery angiography in arterial embolization for hemoptysis

    International Nuclear Information System (INIS)

    Objective: To study the subclavian artery angiography for hemoptysis and its clinical value. Methods: Thirty-eight cases of hemoptysis undertook subclavian artery angiography after embolization of bronchial arteries and branches of thoracic aorta. Group A: 4 recurrent cases underwent subclavian artery angiography (unilateral: n=2, bilateral: n=2). Group B: 16 cases underwent subclavian artery angiography according to the manifestation on X-ray and CT (right: n=10, left:n=6). Group C: 18 cases underwent bilateral subclavian artery angiography. Results of subclavian artery angiography were divided into three classes: normal (-), chaotic and hyperplasia of small branchi vessels (+), obviously bleeding (++). Some of the obviously bleeding cases were embolized and analysed for clinical efficacy and complications. Results: Bleeding cases accounted for 63.2%(24/38) and bleeding subclavian arteries accounted for 50%(29/58), including (++): 37.9% (22/58) and (+): 12.1%(7/58). Positive rate of chronic fibro-cavitary pulmonary tuberculosis was the highest. Bleeding sites were coincided with lung lesions. Twelve cases were embolized with the immediate cessation rate of hemoptysis reaching 100%. Eight cases with long-term follow-up showed 5 cured, 1 with significant effect and 2 recurrent. The complications occurred with fever, vomiting, chest pain, hiccup and dyspnoea. Conclusions: Subclavian artery angiography has important clinical value in artery embolization for hemoptysis, especially for lesions in the upper lobes of lungs and with more fruitful result for chronic fibro-cavitary pulmonary tuberculosis. (authors)

  13. 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.

  14. Standardization of Penile Plethysmography Testing in Assessment of Problematic Sexual Interests.

    Science.gov (United States)

    Murphy, Lisa; Ranger, Rebekah; Fedoroff, J Paul; Stewart, Hannah; Dwyer, R Gregg; Burke, William

    2015-09-01

    Penile plethysmography (PPG) is an objective measure of sexual arousal for men, commonly used to assess sexual arousal to both abnormal (i.e., paraphilic) and normal stimuli. While PPG has become a standard measure in the assessment and treatment of male sex offenders and men with paraphilic interests in both Canada and the United States, there is a lack of standardization of stimulus sets and interpretation of results between sites. The current article critically reviews the current state of the art while highlighting clinical and research efforts that may be undertaken in an attempt to reduce issues arising from lack of standardization across sites. Types and themes of stimulus sets, assessment apparatuses, laboratory preparation, and testing procedures are discussed. The continued development of standardized testing protocol and procedures across multiple international sites continues to be encouraged to promote unified PPG administration and interpretation, thus further enhancing the practical utility of the measurements and decreasing inter-rater discrepancies and error. PMID:26350584

  15. Sentinel-lymph node procedure in breast, uterine cervix, prostate, vulva and penile cancers: Practical methodology

    International Nuclear Information System (INIS)

    The nodal status is the strongest prognostic factor in early stage cancers. The sentinel-lymph node (S.L.N.) is defined as the first draining lymph node of an organ; the lymph node status is determined by the histological results of S.L.N.. The lymphadenectomy, with high morbidity, is realised only in case of metastatic S.L.N.. The S.L.N. identification, in most of cases, is performed using the combination of blue dye and radiocolloid 99mTc injections. The purpose of this article is to give some practical details about the S.L.N. isotopic procedure in breast cancer, vulva and penile cancer, uterine cervix and prostate cancer. (author)

  16. Petroleum jelly-induced penile paraffinoma with inguinal lymphadenitis mimicking incarcerated inguinal hernia.

    Science.gov (United States)

    Sejben, István; Rácz, András; Svébis, Mihály; Patyi, Márta; Cserni, Gábor

    2012-08-01

    Chronic granulomatous inflammation may develop after injecting foreign oily substances into the penis. The disorder affects mainly the site of administration, but regional lymphadenopathy or even systemic disease can occur. We present a 39-year-old man with petroleum jelly-induced penile lesion and unilateral inguinal lymphadenitis mimicking incarcerated inguinal hernia. At hernioplasty no hernial sac was found, but enlarged lymph nodes suspicious for malignancy were identified. The histopathologic findings of these nodes were consistent with mineral oil granuloma. Paraffinoma of the male genitalia can cause various clinical features posing a differential diagnostic dilemma. Regional lymphadenitis may be the main clinical characteristic. Patient's history, physical and histopathological examination are required to establish the diagnosis. PMID:23093564

  17. Early history of inflatable penile prosthesis surgery: a view from someone who was there.

    Science.gov (United States)

    Mobley, David F

    2015-01-01

    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. PMID:25432494

  18. A rare case of metachronous penile and urethral metastases from a rectal mucinous adenocarcinoma.

    Science.gov (United States)

    Christodoulidou, Michelle; Sahdev, Varun; Muneer, Asif; Nigam, Raj

    2015-01-01

    Metastatic lesions in the penis are uncommon in patients with prostate or bladder cancer but penile metastatic lesions from rectal tumours are rare with only 65 cases reported in the literature. We describe the case of a 70-year-old man who developed metastatic lesions within his corpus cavernosum 2?years after being diagnosed and treated for a mucinous adenocarcinoma of the rectum and a year after a wedge resection of an isolated lung metastasis. He proceeded with total penectomy and intraoperatively two skip lesions were also found within the wall of his urethra; histological analysis proved that these were also metastatic lesions. A perineal urethrostomy was formed with the remaining macroscopically healthy urethra. He made a good recovery from his operation and continued his treatment under the oncology team. PMID:26546626

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

    Science.gov (United States)

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

    2014-03-01

    Fracture of the penis, a relatively uncommon emergency in Urology, consists in the traumatic rupture of the tunica albuginea of the corpus cavernosum. Examination and clinical history can be highly suspicious of penile fracture in the majority of cases and ultrasonography (USS) can be useful to identify the exact location of the tunical rupture, which is proximal in 2/3 of cases and therefore manageable through a penoscrotal approach. Although expensive and not readily available in the acute setting, Magnetic Resonance Imaging (MRI) may play a role in the differential diagnosis with rupture of a circumflex or dorsal vein of the penis or when the tunical rupture is not associated with tear of the overlying Buck's fascia. This form of imaging is more sensitive than USS at identifying the presence of a tunical tear. The treatment of choice is immediate surgical repair, which allows preserving erectile function and minimizing corporeal fibrosis. PMID:24704930

  20. Superior mesenteric artery syndrome.

    Science.gov (United States)

    Gebhart, Timothy

    2015-01-01

    Superior mesenteric artery (SMA) syndrome is an uncommon and potentially fatal cause of small bowel obstruction where the third portion of the duodenum is compressed between the abdominal aorta and the superior mesenteric artery. This is most frequently seen after sudden and significant weight loss, but other etiologies can also cause this duodenal compression. This syndrome can lead to food aversion, poor intake, and weight loss that exacerbate symptoms in a vicious cycle. SMA syndrome is often a diagnosis of exclusion due to nonspecific symptoms, including abdominal pain and distention, feelings of fullness after meals, and bilious emesis. Diagnosis may be assisted with radiography, tomography, endoscopy, and ultrasound imaging. Once SMA syndrome is identified, treatment is directed toward symptom management and nutritional support. If conservative measures fail, symptoms are severe, or the duodenum is compromised, several effective surgical procedures are routinely considered. This article provides an overview of SMA syndrome including history, pathophysiology, signs and symptoms, diagnostic testing, medical and surgical treatment, and implications for nursing staff. PMID:26035775

  1. 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.

  2. 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

  3. Pulmonary Arterial Hypertension: The Clinical Syndrome

    OpenAIRE

    Lai, Yen-Chun; Potoka, Karin C.; Champion, Hunter C.; Mora, Ana L.; Gladwin, Mark T

    2014-01-01

    Pulmonary arterial hypertension (PAH) is a progressive disorder in which endothelial dysfunction and vascular remodeling obstruct small pulmonary arteries, resulting in increased pulmonary vascular resistance and pulmonary pressures. This leads to reduced cardiac output, right heart failure, and ultimately death. In this review, we attempt to answer some important questions commonly asked by patients diagnosed with PAH pertaining to the disease, and aim to provide an explanation in terms of c...

  4. Penile Trauma

    Science.gov (United States)

    ... What is Urology? The Urinary Tract System Free Patient Education Materials We provide free patient education materials on ... be ejaculated into the vagina. Share Causes Advertisement Patient Education Materials We provide free patient education materials on ...

  5. Traumatic Axillary Artery Dissection with Radial Artery Embolism

    International Nuclear Information System (INIS)

    This report describes a case of pathologically proven traumatic arterial dissection, presenting as complete occlusion of the axillary artery with radial artery embolism. Occlusion of the axillary artery by traumatic dissection mimicked transection and radial artery embolism mimicked congenital absence of the radial artery on the initial angiogram, but these were correctly diagnosed with the following sonogram

  6. 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

  7. Resistant metastatic penile carcinoma and response to biochemotherapy with paclitaxel and epidermal growth factor receptor monoclonal antibody, nimotuzumab

    Directory of Open Access Journals (Sweden)

    Avinash Pandey

    2013-01-01

    Full Text Available Carcinoma penis is one of the common malignancies in developing world especially among rural population. Multimodality treatment with surgery, radiation and chemotherapy for advanced penile carcinoma with groin nodal metastasis is crucial to optimise the outcome. Cisplatin, fluorouracil, methotrexate, vinorelbine, bleomycin and paclitaxel are the common chemotherapeutic agents used along with local therapy. Paucity of data to show superiority of one chemotherapeutic regime over another and only modest response to any combination chemotherapy. Progression of disease after surgery, radiation and chemotherapy is associated with poor outcome and quality of life. Nimotuzumab, Anti EGFR monoclonal antibody, along with paclitaxel in our case of resistant metastatic penile carcinoma has shown good symptomatic palliation and clinical response.

  8. 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.

  9. Sex-related penile fracture with complete urethral rupture: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Marco Garofalo

    2015-09-01

    Full Text Available Objective: To present the management of a patient with partial disruption of both cavernosal bodies and complete urethral rupture and to propose a non-systematic review of literature about complete urethral rupture. Material and method - Case report: A 46 years old man presented to our emergency department after a blunt injury of the penis during sexual intercourse. On physical examination there was subcutaneous hematoma extending over the proximal penile shaft with a dorsal-left sided deviation of the penis and urethral bleeding. Ultrasound investigation showed an hematoma in the ventral shaft of the penis with a discontinuity of the tunica albuginea of the right cavernosal corporum. The patient underwent immediate emergency surgery consisted on evacuation of the hematoma, reparation the partial defect of both two cavernosal bodies and end to end suture of the urethra that resulted completely disrupted. Results: The urethral catheter was removed at the 12-th postoperative day without voiding symptoms after a retrograde urethrography. 6 months postoperatively the patients was evaluated with uroflowmetry demonstrating a max flow rate of 22 ml/s and optimal functional outcomes evaluated with validated questionnaires. 8 months after surgery the patients was evaluated by dynamic magnetic resonance (MRI of the penis showing only a little curvature on the left side of the penile shaft. Conclusion: Penile fracture is an extremely uncommon urologic injury with approximately 1331 reported cases in the literature till the years 2001. To best of our knowledge from 2001 up today, 1839 more cases have been reported, only in 159 of them anterior urethral rupture was associated and in only 22 cases a complete urethral rupture was described. In our opinion, in order to prevent long term complications, in case of clinical suspicion of penile fracture, especially if it is associated to urethral disruption, emergency surgery should be the first choice of treatment.

  10. 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 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

  11. 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

  12. Remodelling of the microarchitecture of resistance arteries in cardiovascular diseases

    DEFF Research Database (Denmark)

    Bloksgaard, Maria; Brewer, Jonathan R.; Leurgans, Thomas; Jensen, Pia Søndergaard; Bagatolli, Luis; Irmukhamedov, Akhmadjon; Rasmussen, Lars Melholt; De Mey, Jo

    Small resistance artery structure is an independent predictor of cardiovascular events in essential hypertension [1, 2] and diabetes (types I and II) [3, 4]. In particular, the media-to-lumen ratio (M:L) is predictive of cardiovascular events. The exact nature of this resistance artery remodeling...... tissue in comparison to other well-studied microvascular beds (e.g. rat mesentery). In the future we aim to compare the microarchitecture of small resistance arteries from parietal pericardial biopsies between patients with and without (treated) hypertension, diabetes and/or ischemic heart disease. 1....... Buus, N.H., et al., Small artery structure during antihypertensive therapy is an independent predictor of cardiovascular events in essential hypertension. J Hypertens, 2013. 31(4): p. 791-7. 2. Mathiassen, O.N., et al., Small artery structure is an independent predictor of cardiovascular events in...

  13. Vertebral artery aneurysms.

    Directory of Open Access Journals (Sweden)

    Ravi Kumar C

    2000-04-01

    Full Text Available Vertebral artery (VA aneurysms are rare. We present our experience with three cases of VA aneurysms. Two aneurysms were located close to the origin of basilar artery while the third patient had a giant posterior inferior cerebellar artery aneurysm. These aneurysms were operated by the far lateral inferior suboccipital approach with good results.

  14. Coronary Artery Bypass Grafting

    Science.gov (United States)

    ... location of the heart. Figure B shows how vein and artery bypass grafts are attached to the heart. Overview CABG is ... if blockages form in the grafted arteries or veins or in arteries that weren't blocked before. Taking medicines and making ... NEXT >> Updated: February ...

  15. Arterial hypoxaemia in cirrhosis

    DEFF Research Database (Denmark)

    Møller, S; Hillingsø, Jens; Christensen, E; Henriksen, J H

    1998-01-01

    BACKGROUND: Although low arterial oxygen tension (Po2) has been claimed to occur in one to two thirds of patients with cirrhosis, hypoxaemia appears to be rare in clinical practice. AIMS: To assess the frequency of arterial hypoxaemia in cirrhosis in relation to clinical and haemodynamic characte...... of differing severity seems lower than previously reported, and patients with severe arterial hypoxaemia are rare....

  16. 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.

  17. Uptake of 3H-choline and synthesis of 3H-acetylcholine by human penile corpus cavernosum

    International Nuclear Information System (INIS)

    The neuroeffectors which relax penile smooth muscle and lead to erection are unknown; physiological studies of human corpus cavernosum, in vitro, have suggested a significant role of cholinergic neurotransmission. To further characterize the importance of cholinergic nerves, biopsies of human corpus cavernosum were obtained at the time of penile prosthesis implantation. Tissues were incubated in 3H-choline (10-5M, 80 Ci/mmol) in oxygenated physiological salt solution at 370C, pH 7.4 for 1 hour. Radiolabelled compounds were extracted with perchloric acid (0.4 M) and acetylcholine and choline were separated by HPLC; 14C-acetylcholine was used as internal standard. 3H-choline was accumulated by the tissues (20 +/- 1.9 fmol/mg), and 3H-acetylcholine was synthesized (4.0 +/- 1.1 fmol/mg). In control experiments, heating of the tissue blocked synthesis of 3H-acetylcholine. Inhibition of high affinity choline transport by hemicholinium-3 (10-5M) diminished tissue accumulation of 3H-choline and significantly reduced the synthesis of 3H-acetylcholine (0.5 +/ 0.2 fmol/mg, p < 0.05). These results provide direct evidence of neuronal accumulation of choline and enzymatic conversion to acetylcholine in human corpus cavernosum. Taken together with the physiological studies, it can be concluded that cholinergic neurotransmission in human corpus cavernosum plays a role in penile erection

  18. The application of a penile block before circumcision: effects on the postoperative FLACC score and analgesic requirement

    Directory of Open Access Journals (Sweden)

    Sacit Nuri Görgel

    2013-03-01

    Full Text Available Objective: We aimed to evaluate the effect of the application of a penile block before circumcision on the postoperative Face, Legs, Activity, Cry, and Consolability (FLACC score and the analgesic requirement.Material and methods: In this study, 240 patients were included, age range 1 to 9 years, between April 2012 and August 2012. A penile block was performed in 125 of the 240 patients (Group 1 and was not performed in 115 of the 240 patients (Group 2. Both groups were compared in terms of age, operation times, FLACC score and analgesic requirement.Results: The mean age of the patients was 4.8±2.1 years in Group 1 and 5.3±3.1 years in group 2 (p=0.126. The mean operation time was 14.9±5.1 min in Group 1 and 15.2±6.2 min in Group 2 (p=0.242. The mean FLACC score of the patients was 3.1±1.9 (0-6 in group 1 and 6.4±3.3 (3-10 in group 2 (p<0.05. There was a postoperative analgesic requirement in 20 patients (16% of Group 1 and 75 patients (65% of Group 2. Early complications were not observed in any patients.Conclusion: We detected a significantly lower postoperative analgesic requirement and a mean FLACC score in patients with the application of a penile block before circumcision.

  19. 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.

  20. 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

  1. 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.

  2. 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.

  3. ROLE OF IN VIVOVASCULAR REDOX IN RESISTANCE ARTERIES

    OpenAIRE

    Hilgers, Rob H. P.; Das, Kumuda C

    2014-01-01

    Vascular thiol redox state has been shown to modulate vasodilator functions in large conductance Ca2+-activated K+ channels and other related channels. However, the role of vascular redox in small resistance arteries is unknown. To determine how in vivo modulation of thiol redox state impacts small resistance arteries relaxation we generated a transgenic mouse strain that overexpress thioredoxin (Trx), a small redox protein (Trx-Tg) and another strain that is Trx-deficient (dnTrx-Tg). The red...

  4. The Molecular Genetics and Cellular Mechanisms Underlying Pulmonary Arterial Hypertension

    OpenAIRE

    Machado, Rajiv D

    2012-01-01

    Pulmonary arterial hypertension (PAH) is an incurable disorder clinically characterised by a sustained elevation of mean arterial pressure in the absence of systemic involvement. As the adult circulation is a low pressure, low resistance system, PAH represents a reversal to a foetal state. The small pulmonary arteries of patients exhibit luminal occlusion resultant from the uncontrolled growth of endothelial and smooth muscle cells. This vascular remodelling is comprised of hallmark defects, ...

  5. Superior Mesenteric Artery Syndrome: An Infrequent Complication of Scoliosis Surgery

    OpenAIRE

    Metin Keskin; Turgut Akgül; Adem Bayraktar; Fatih Dikici; Emre Bal?k

    2014-01-01

    Superior mesenteric artery syndrome is a rare condition that causes a proximal small intestinal obstruction due to contraction of the angle between the superior mesenteric artery and the aorta. Scoliosis surgery is one of the 15 reasons for superior mesenteric artery syndrome, which can present with acute or chronic manifestations. Although conservative treatment is usually possible, surgical treatment is required in certain cases that cannot be treated using conservative methods. In this pap...

  6. 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.

  7. 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 penilebones 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.

  8. 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.

  9. Ischemic stroke: carotid and vertebral artery disease

    International Nuclear Information System (INIS)

    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.)

  10. IA-DSA using brachial artery

    International Nuclear Information System (INIS)

    It is proved to be advantageous that (trans-brachial DSA) TB-DSA can perform in the outpatient cases and further more, an excellent image quality can be obtained even in a small amount of contrast medium use. From a review of 113 TB-DSA studies in 108 cases, 38 cases of which are the out-patients, the distinctive feature is summarized as follows. 1) TB-DSA can demonstrate excellently the posterior fossa lesions by the selective vertebral artery injection if a catheter-tip is placed in the subclavian artery. 2) TB-DSA can also produce excellent demonstration of the vascular disease in the kidneys, the pelvic cavity or the lower legs by the abdominal aorta injection if a catheter is advanced to just above the renal arteries through the thoracic aorta. This procedure should not be indicated in the case of dissecting aortic aneurysm and occlusion or severe stenosis of the bilateral subclavian artery. (author)

  11. 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.)

  12. Priapism as the initial symptom of primary penile lymphoma: A case report.

    Science.gov (United States)

    Gong, Zhaohua; Zhang, Ying; Chu, Hongjin; Lian, Peiwen; Zhang, Liangming; Sun, Ping; Chen, Jian

    2014-11-01

    Primary penile lymphoma presenting with priapism as the initial symptom is extremely rare. In total, <10 cases have been previously reported. The diagnosis can be difficult and patients often develop metastasis. The current study reports the case of a 48-year-old male, who presented with a one-month history of painless priapism. On admission to Yantai Yuhuangding Hospital Affiliated to Qingdao University (Yantai, China), examination revealed an erect penis, enlarged lymph nodes in the bilateral inguinal and swelling in the thighs. A biopsy was taken from the right inguinal lymph node and the pathological diagnosis confirmed a diffuse large B-cell type of non-Hodgkin's lymphoma, while an enhanced computed tomography scan of the chest revealed evidence of the invasion of malignant lymphoma cells. Priapism disappeared two days following the completion of the first cycle of chemotherapy with the E-CHOP regimen (cyclophosphamide, vincristine, prednisone, epirubicin and etoposide); however, evidence of brain metastases was observed one month later, which was confirmed by magnetic resonance imaging. The patient received cranial radiotheraphy and systemic treatment for cerebral edema. The patient did not respond well to treatment and succumbed to the disease three months following the initial diagnosis of lymphoma. Lymphoma may be difficult to diagnose, depending on the initial symptoms; therefore, the patient history must be carefully assessed so as to determine an early diagnosis and prevent metastasis, thus improving the prognostic outcome. PMID:25289080

  13. 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.

  14. 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

  15. 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.

  16. Right coronary artery aneurysm

    OpenAIRE

    Luz, A; Silveira, J.; Cyrne-Carvalho, H.; Gomes, L.

    2007-01-01

    Int J Cardiol. 2007 Jan 18;114(3):e122-3. Epub 2006 Oct 16. Right coronary artery aneurysm. Luz A, Silveira J, Carvalho H, Gomes L. Abstract Coronary artery aneurysms, characterized by abnormal dilatations of a localized portion of the coronary artery, are an uncommon finding during angiography. We present a case where a giant right coronary aneurysm was detected during angiography, in a patient admitted with a inferior wall myocardial infarction. PMID: 17049395 [PubMed - inde...

  17. Hepatic Artery Infusion Chemotherapy

    OpenAIRE

    Tuchmann, A.; Schüller, 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 weeks. There ...

  18. 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.

  19. Ruptured visceral artery aneurysms.

    Science.gov (United States)

    Chiaradia, M; Novelli, L; Deux, J-F; Tacher, V; Mayer, J; You, K; Djabbari, M; Luciani, A; Rahmouni, A; Kobeiter, H

    2015-01-01

    Visceral artery aneurysms are rare but their estimated mortality due to rupture ranges between 25 and 70%. Treatment of visceral artery aneurysm rupture is usually managed by interventional radiology. Specific embolization techniques depend on the location, affected organ, locoregional arterial anatomy, and interventional radiologist skill. The success rate following treatment by interventional radiology is greater than 90%. The main complication is recanalization of the aneurysm, showing the importance of post-therapeutic monitoring, which should preferably be performed using MR imaging. PMID:26054246

  20. Duplicated middle cerebral artery

    OpenAIRE

    Perez, Jesus; Machado, Calixto; Scherle, Claudio; Hierro, Daniel

    2009-01-01

    Duplicated middle cerebral artery (DMCA) is an anomalous vessel arising from the internal carotid artery. The incidence DMCA is relatively law, and an association between this anomaly and cerebral aneurysms has been documented. There is a controversy whether DMCA may have perforating arteries. This is an important fact to consider in aneurysm surgery. We report the case of a 34-year-old black woman who suffered a subarachnoid hemorrhage and the angiography a left DMCA, and an aneurysm in an i...

  1. 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.)

  2. Arterial waveform analysis.

    Science.gov (United States)

    Esper, Stephen A; Pinsky, Michael R

    2014-12-01

    The bedside measurement of continuous arterial pressure values from waveform analysis has been routinely available via indwelling arterial catheterization for >50 years. Invasive blood pressure monitoring has been utilized in critically ill patients, in both the operating room and critical care units, to facilitate rapid diagnoses of cardiovascular insufficiency and monitor response to treatments aimed at correcting abnormalities before the consequences of either hypo- or hypertension are seen. Minimally invasive techniques to estimate cardiac output (CO) have gained increased appeal. This has led to the increased interest in arterial waveform analysis to provide this important information, as it is measured continuously in many operating rooms and intensive care units. Arterial waveform analysis also allows for the calculation of many so-called derived parameters intrinsically created by this pulse pressure profile. These include estimates of left ventricular stroke volume (SV), CO, vascular resistance, and during positive-pressure breathing, SV variation, and pulse pressure variation. This article focuses on the principles of arterial waveform analysis and their determinants, components of the arterial system, and arterial pulse contour. It will also address the advantage of measuring real-time CO by the arterial waveform and the benefits to measuring SV variation. Arterial waveform analysis has gained a large interest in the overall assessment and management of the critically ill and those at a risk of hemodynamic deterioration. PMID:25480767

  3. Imaging the vertebral artery

    International Nuclear Information System (INIS)

    Although conventional intraarterial digital subtraction angiography remains the gold standard method for imaging the vertebral artery, noninvasive modalities such as ultrasound, multislice computed tomographic angiography and magnetic resonance angiography are constantly improving and are playing an increasingly important role in diagnosing vertebral artery pathology in clinical practice. This paper reviews the current state of vertebral artery imaging from an evidence-based perspective. Normal anatomy, normal variants and a number of pathological entities such as vertebral atherosclerosis, arterial dissection, arteriovenous fistula, subclavian steal syndrome and vertebrobasilar dolichoectasia are discussed. (orig.)

  4. BILATERAL DUPLICATION OF RENAL ARTERIES

    OpenAIRE

    Prajkta A Thete; Mehera Bhoir; M. V. Ambiye

    2014-01-01

    Routine dissection of a male cadaver revealed the presence of bilateral double renal arteries. On the right side the accessory renal artery originated from the abdominal aorta just above the main renal artery. On the left side the accessory renal artery originated from the abdominal aorta about 1 cm above the main renal artery. Knowledge of the variations of renal vascular anatomy has importance in exploration and treatment of renal trauma, renal transplantation, renal artery embolization, su...

  5. Coronary Artery Bypass

    Science.gov (United States)

    ... Revascularization Valve Repair or Replacement Vascular Access for Hemodialysis Ventricular Assist Devices Coronary Artery Bypass | Share Bypass surgery is the most common type of heart surgery with more than 500,000 procedures performed each year in the United States. Arteries ...

  6. Heritability of cilioretinal arteries

    DEFF Research Database (Denmark)

    Taarnhøj, Nina Charlotte; Munch, Inger C; Kyvik, Kirsten O; Sander, Birgit; Kessel, Line; Sørensen, Thorkild I A; Hougaard, Jesper L; Larsen, Michael

    2005-01-01

    healthy monozygotic and dizygotic twins were examined using digital fundus photography and visual assessment of grayscale fundus photographs and color transparencies to detect the presence of cilioretinal arteries. RESULTS: Cilioretinal arteries were present in 45.1% of participants and 28.8% of eyes. The...

  7. 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)

  8. 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.)

  9. Expression of the androgen receptor gene in rat penile tissue and cells during sexual maturation.

    Science.gov (United States)

    Gonzalez-Cadavid, N F; Swerdloff, R S; Lemmi, C A; Rajfer, J

    1991-09-01

    The cessation of rat and human penile growth at completion of sexual maturation appears to be related to a tissue-specific decrease in the number of androgen receptors (AR) in the penis. To find out whether this is due to either transcriptional or translational regulation of the AR gene, we determined the levels of AR mRNA by Northern blots in the corpora cavernosa from groups of 16-, 19-, 22-, 27-, 52-, and 90-day-old rats. The AR mRNA rapidly decreases with age and is nearly undetectable in the 52- and 90-day-old rats, paralleling the decline in AR number. The persistence of a low amount of AR mRNA in the adult penis was confirmed by reverse transcription/polymerase chain reaction amplification of total RNA, and its level was estimated by a semiquantitative modification of this procedure at less than 1/25th of that found in the youngest rats. Smooth muscle cells derived from the 16- and 90-day-old corpora cavernosa express in the AR gene in vitro in approximately the same levels, suggesting that there are factors in culture that up-regulate the AR mRNA. Our results are compatible with the assumption that the age-dependent decrease in AR in the rat penis is due to transcriptional regulation, although they do not exclude the less likely alternative of a selective effect on AR mRNA stability and support the use of this model for studying tissue-specific factors controlling the developmental expression of the AR gene. PMID:1874196

  10. 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.

  11. A Rare Coronary Artery Anomaly; Double Right Coronary Artery

    Directory of Open Access Journals (Sweden)

    Orhan Önalan

    2010-12-01

    Full Text Available A double right coronary artery is an extremely rare coronary artery anomaly. Difficulties in diagnosis might cause underestimation of the incidence of double right coronary artery. Interestingly, most of the cases about this anomaly were reported from Turkey. In this case report, we aimed to present double right coronary artery in a patient who was admitted with atypic chest pain.

  12. Excess adenosine in murine penile erectile tissues contributes to priapism via A2B adenosine receptor signaling.

    Science.gov (United States)

    Mi, Tiejuan; Abbasi, Shahrzad; Zhang, Hong; Uray, Karen; Chunn, Janci L; Xia, Ling Wei; Molina, Jose G; Weisbrodt, Norman W; Kellems, Rodney E; Blackburn, Michael R; Xia, Yang

    2008-04-01

    Priapism, abnormally prolonged penile erection in the absence of sexual excitation, is associated with ischemia-mediated erectile tissue damage and subsequent erectile dysfunction. It is common among males with sickle cell disease (SCD), and SCD transgenic mice are an accepted model of the disorder. Current strategies to manage priapism suffer from a poor fundamental understanding of the molecular mechanisms underlying the disorder. Here we report that mice lacking adenosine deaminase (ADA), an enzyme necessary for the breakdown of adenosine, displayed unexpected priapic activity. ADA enzyme therapy successfully corrected the priapic activity both in vivo and in vitro, suggesting that it was dependent on elevated adenosine levels. Further genetic and pharmacologic evidence demonstrated that A2B adenosine receptor-mediated (A2BR-mediated) cAMP and cGMP induction was required for elevated adenosine-induced prolonged penile erection. Finally, priapic activity in SCD transgenic mice was also caused by elevated adenosine levels and A2BR activation. Thus, we have shown that excessive adenosine accumulation in the penis contributes to priapism through increased A2BR signaling in both Ada -/- and SCD transgenic mice. These findings provide insight regarding the molecular basis of priapism and suggest that strategies to either reduce adenosine or block A2BR activation may prove beneficial in the treatment of this disorder. PMID:18340377

  13. 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

  14. Sexual scripting of heterosexual penile-anal intercourse amongst participants in an HIV prevention trial in South Africa, Uganda and Zimbabwe.

    Science.gov (United States)

    Duby, Zoe; Hartmann, Miriam; Montgomery, Elizabeth T; Colvin, Christopher J; Mensch, Barbara; van der Straten, Ariane

    2016-01-01

    Sexual risk-taking is influenced by individual, interpersonal and social factors. This paper presents findings from a qualitative follow-up study to a clinical trial evaluating biomedical HIV prevention products among African women, explored participants' perceptions and experiences of heterosexual penile-anal intercourse, as well as the gendered power dynamics and relationship contexts in which this sexual behaviour occurs. In-depth interviews were conducted with 88 women from South Africa, Uganda and Zimbabwe. Findings reveal that despite its social stigmatisation, women engage in penile-anal intercourse for reasons including male pleasure, relationship security, hiding infidelity, menstruation, vaginal infections, money and beliefs that it will prevent HIV transmission. In addition, participants described experiences of non-consensual penile-anal intercourse. We used sexual scripting theory as an analytical framework with which to describe the sociocultural and relationship contexts and gendered power dynamics in which these practices occur. These data on the distinct individual, dyadic and social contexts of heterosexual penile-anal intercourse, and the specific factors that may contribute to women's HIV risk, make a unique contribution to our understanding of heterosexual behaviour in these sub-Saharan countries, thereby helping to inform both current and future HIV prevention efforts for women in the region. PMID:26223703

  15. Total Arterial Myocardial Revascularization

    International Nuclear Information System (INIS)

    Total arterial myocardial revascularization is an attempt to overcome the problems of late vein graft atherosclerosis occlusion and need for coronary re-operations. Despite increasing evidence of efficacy, the use of arterial conduits has not been accepted. as primary practice in most of the centers in Pakistan for various reasons. We analyze our initial experience to assess the feasibility of total arterial revascularization as a primary strategy in patients requiring first time coronary artery bypass grafting. Two hundred patients undergoing first time CABG at our institution, from January 2000 to April 2001, were studied. Group one consisted of 100 patients undergoing total arterial revascularization (using bilateral internal thoracic and radial arteries) and group two consisted of 100 patients undergoing conventional CABG (using one internal thoracic artery and supplemental veins).Thirty day mortality and early morbidity with particular reference to resternotomy for bleeding, cerebrovascular accidents, renal failure, and sternal dehiscence were the main outcome measures. Patients in Group 1 were younger (56.2+-10.4 vs. 60.3+-9.8 years; P<0.001), had lower Parsonnet scores (4.8+-0.4 vs. 9.6+-1.8; P<0.001), and had better left ventricular function. Both groups received a similar number of grafts. The percentage of patients undergoing total arterial revascularization rose from 20% in the first three months to over 65% in three later three-months period. Overall 30-day mortality was 1.5%, one patient (1%) in Group1 and two patients (2%) in Group2. There was similar incidence of postoperative complications and length of median postoperative stay in both groups. Total arterial revascularization can be adopted as a primary strategy in most patients undergoing CABG with no increase in mortality or morbidity. (author)

  16. 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.

  17. Renal artery stenosis

    International Nuclear Information System (INIS)

    Renal artery disease is a potentially correctable cause of hypertension. Previous studies have suggested the utility of duplex sonography in accurately detecting and grading the severity of renal artery stenosis. The purpose of this paper is to evaluate color flow Doppler for this use. Forty-three kidneys were examined by color-flow Doppler and conventional duplex sampling in patients with suspected renovascular hypertension or those undergoing aortography for unrelated reasons. Doppler tracings were obtained from the renal arteries and aorta with calculation of the renal aortic ratio (RAR) and resistive index (RI). Results of Doppler sampling with color flow guidance were compared with aortograms in a blinded fashion

  18. Isolated right pulmonary artery discontinuity

    OpenAIRE

    Turner, DR; Vincent, JA; Epstein, ML

    2000-01-01

    Unilateral “absence” of the pulmonary artery is an uncommon malformation frequently associated with congenital heart disease. In fact, the pulmonary artery is typically discontinuous from the main pulmonary artery, not absent. We report a case of right pulmonary artery discontinuity not associated with congenital heart disease and review the embryogenesis and treatment of this rare congenital cardiac anomaly.

  19. Energetic and spatial constraints of arterial networks

    Directory of Open Access Journals (Sweden)

    Sandro Rossitti

    1995-06-01

    Full Text Available The principle of minimum work (PMW is a parametric optimization model for the growth and adaptation of arterial trees. A balance between energy dissipation due to frictional resistance of laminar flow (shear stress and the minimum volume of the blood and vessel wall tissue is achieved when the vessel radii are adjusted to the cube root of the volumetric flow. The PMW is known to apply over several magnitudes of vessel calibers, and in many different organs, including the brain, in humans and in animals. Animal studies suggest that blood flow in arteries is approximately proportional to the cube of the vessel radius, and that arteries alter their caliber in response to sustained changes of blood flow according to PMW. Remodelling of the retinal arteriolar network to long-term changes in blood flow was observed in humans. Remodelling of whole arterial networks occurs in the form of increase or diminishing of vessel calibers. Shear stress induced endothelial mediation seems to be the regulating mechanism for the maintenance of this optimum blood flow/vessel diameter relation. Arterial trees are also expected to be nearly space filing. The vascular system is constructed in such a way that, while blood vessels occupy only a small percentage of the body volume leaving the bulk to tissue, they also crisscross organs so tightly that every point in the tissue lies on the boundary between an artery and a vein. This review describes how the energetic optimum principle for least energy cost for blood flow is also compatible with the spatial constraints of arterial networks according to concepts derived from fractal geometry.

  20. Atherosclerotic femoral artery aneurysms

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Schroeder, T V

    1996-01-01

    Based on a clinical suspicion of an increase in the proportion of deep femoral aneurysms, we reviewed the case records of patients who underwent reconstructive procedures for femoral aneurysms to investigate if this could be confirmed and explained by selection of patient or modality of diagnosis....... A study was made of 17 atherosclerotic femoral aneurysms operations occurring in 17 patients from 1989 to 1994. Eleven associated aneurysms were found. Eleven patients presented with an expanding swelling, 4 with rupture 3 with thrombosis and 2 were asymptomatic. Fourteen aneurysms involved the...... common femoral artery and 3 the deep femoral artery. The proportion of deep femoral aneurysm was therefore 3/17 = 18%. Previous series report that aneurysms of the profunda femoris artery occurs in only 1% to 2.6% of all femoral artery aneurysms. No explanation was found for this significant increase (p...