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Sample records for penile small arteries

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

    DEFF Research Database (Denmark)

    Király, István; Pataricza, János

    2013-01-01

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

  2. Penile angiography and superselective embolization therapy in arterial priapism

    International Nuclear Information System (INIS)

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

  3. [Potency disorders before and after pelvic artery reconstruction: objectification by measuring penile artery pressure].

    Science.gov (United States)

    Schweiger, H; Zirngibl, H; Raithel, D

    1984-02-01

    Penile artery pressure was measured in 38 patients before and after aorto-iliac reconstruction using the Doppler technique. In 14 patients a markedly reduced penile pressure was found preoperatively which was significantly enhanced in 71% after operation. In 16% of all cases postoperative penile pressure was lower than the preoperative value. An improvement of sexual impairment was observed in 37% of the patients, while 26% reported a decrease of sexual function after operation. The reason seems to be an operative damage to the preaortal nerve plexus in most cases. Therefore, in younger patients with unilateral iliac artery occlusive disease an extraanatomical reconstruction is recommended. PMID:6714015

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

    DEFF Research Database (Denmark)

    SchjØrring, Olav; Kun, Attila

    2012-01-01

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

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

    OpenAIRE

    Necati Gürbüz; Bedi Özbay; Nadir Kalfazade; Serdar Karada?; Eray Kemahl?; Muzaffer Ba?; Ali ?hsan Ta?ç?

    2009-01-01

    Microsurgical penile reimplantation was performed in a 24 years old man with chronic schizophrenia after a complete penile self-amputation. Urethra, corpora cavernosa and right deep dorsal penile artery were anastomosed microsurgically 6 hours after trauma. Skin necrosis on postoperative day 4 and distal urethral defect at the end of the first week developed. Necrotic tissues were debrided and a free skin graft was laid on the defect. During long-term follow-up, there was a distal urethral de...

  6. Penile fracture and penile reconstruction.

    Science.gov (United States)

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

    2011-12-01

    The past decade has seen a significant development in penile reconstruction techniques, and the management of penile fracture has progressively shifted from a conservative approach to early surgical repair. The radial artery-based free flap phalloplasty now represents the gold-standard procedure for total phallic reconstruction both in men and in female-to-male transsexuals. PMID:21647621

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

    Directory of Open Access Journals (Sweden)

    Necati Gürbüz

    2009-01-01

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

  8. [A case report of progressive penile necrosis].

    Science.gov (United States)

    Haba, Tomomi; Koike, Hiroshi

    2014-05-01

    The penis is provided with blood by multiple arteries. Penile necrosis is uncommon. Penile necrosis sporadically occurs in patients with progressive diabetes mellitus and/or end stage renal failure. Penile necrosis is often considered a poor prognostic feature. We present a case of penile necrosis in a patient with mild diabetes mellitus. PMID:24894863

  9. Penile abnormalities

    Directory of Open Access Journals (Sweden)

    Yunus Söylet

    2010-05-01

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

  10. Selective Embolization of Bilateral Arterial Cavernous Fistulas for Posttraumatic Penile Arterial Priapism

    International Nuclear Information System (INIS)

    A 22-year-old man suffered a hiking accident with perineal trauma and developed a nonpainful priapism secondary to bilateral arterial-cavernosal fistulas. To minimize the risk of impotence in this young patient, successive selective embolizations with autologous blood clot were performed to close the fistulas. This led to an uncomplicated full recovery. No fistula was detectable on Doppler ultrasonography at 1-year follow-up. Review of the literature confirms the safety of embolization with autologous clot

  11. 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)

  12. 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.)

  13. Role of Neural NO Synthase (nNOS) Uncoupling in the Dysfunctional Nitrergic Vasorelaxation of Penile Arteries from Insulin-Resistant Obese Zucker Rats

    Science.gov (United States)

    Sánchez, Ana; Contreras, Cristina; Martínez, María Pilar; Climent, Belén; Benedito, Sara; García-Sacristán, Albino; Hernández, Medardo; Prieto, Dolores

    2012-01-01

    Objective Erectile dysfunction (ED) is considered as an early sign of vascular disease due to its high prevalence in patients with cardiovascular risk factors. Endothelial and neural dysfunction involving nitric oxide (NO) are usually implicated in the pathophysiology of the diabetic ED, but the underlying mechanisms are unclear. The present study assessed the role of oxidative stress in the dysfunctional neural vasodilator responses of penile arteries in the obese Zucker rat (OZR), an experimental model of metabolic syndrome/prediabetes. Methods and Results Electrical field stimulation (EFS) under non-adrenergic non-cholinergic (NANC) conditions evoked relaxations that were significantly reduced in penile arteries of OZR compared with those of lean Zucker rats (LZR). Blockade of NO synthase (NOS) inhibited neural relaxations in both LZR and OZR, while saturating concentrations of the NOS substrate L-arginine reversed the inhibition and restored relaxations in OZR to levels in arteries from LZR. nNOS expression was unchanged in arteries from OZR compared to LZR and nNOS selective inhibition decreased the EFS relaxations in LZR but not in OZR, while endothelium removal did not alter these responses in either strain. Superoxide anion production and nitro-tyrosine immunostaining were elevated in the erectile tissue from OZR. Treatment with the NADPH oxidase inhibitor apocynin or acute incubation with the NOS cofactor tetrahydrobiopterin (BH4) restored neural relaxations in OZR to levels in control arteries, while inhibition of the enzyme of BH4 synthesis GTP-cyclohydrolase (GCH) reduced neural relaxations in arteries from LZR but not OZR. The NO donor SNAP induced decreases in intracellular calcium that were impaired in arteries from OZR compared to controls. Conclusions The present study demonstrates nitrergic dysfunction and impaired neural NO signalling due to oxidative stress and nNOS uncoupling in penile arteries under conditions of insulin resistance. This dysfunction likely contributes to the metabolic syndrome-associated ED, along with the endothelial dysfunction also involving altered NO signalling. PMID:22540017

  14. Penile replantation.

    Science.gov (United States)

    Krishnakumar, K S; Petkar, Kiran S; Lateef, Sameer; Vyloppilli, Suresh

    2013-01-01

    Penile amputation is rare and hence the paucity of experience and publication. We present our case of self-inflicted penile amputation, which was successfully managed with microsurgical replantation, with relevant literature review. PMID:23960324

  15. Penile replantation

    OpenAIRE

    Krishnakumar, K. S.; Petkar, Kiran S.; Lateef, Sameer; Vyloppilli, Suresh

    2013-01-01

    Penile amputation is rare and hence the paucity of experience and publication. We present our case of self-inflicted penile amputation, which was successfully managed with microsurgical replantation, with relevant literature review.

  16. 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)

  17. Penile arteriography in vasculogenic impotence

    International Nuclear Information System (INIS)

    Bifurcation aortography and selective internal pudendal arteriography were performed in 70 impotent men under the impression of vasculogenic impotence. Age range was 6 to 63 years old(average 32). 54 patients had the history of pelvic trauma. The studies were performed under local anesthesia and simultaneous intracavernosal and intraarterial Papavertine injection before filming. To reduce pain and arterial spasm, intraarterial Lidocaine and low osmolarity non-ionic contrast media were used. Arterial lesions were found in 50(93%) traumatic patients and 7(44%) non-traumatic patients. Internal iliac arterial lesion that causing pelvic steal syndrome was noted in 3 traumatic patients. Among trauma related cases there were bilateral arterial lesion in 19 patients and one axis lesion in 31 patients respectively. Among 16 non traumatic patients there were bilateral arterial lesions in 2 patients and unilateral lesion in 5 patients. Irrespective or bilaterally or unilaterally of the lesion, majority of arterial lesions were found at the distal internal pudendal artery or common penile artery level in traumatic patients. On the contrary, penile branch lesion was predominant site in non traumatic patients. With the improved arteriographic technique, selective penile arteriography appears accurate method in the diagnosis of arterial impotence

  18. 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 ...

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

    International Nuclear Information System (INIS)

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

  20. 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

  1. Non-invasive methods of penile lengthening: fact or fiction?

    Science.gov (United States)

    Oderda, Marco; Gontero, Paolo

    2011-04-01

    What's known on the subject? and What does the study add? Penile lengthening methods remain a controversial issue. Surgical procedures of "lengthening phalloplasty" are characterized by poorly defined indications and an unacceptably high rate of complications, as recently outlined by a literature review, while non-surgical techniques are largely popularized by the media but often lack scientific evidence. In the literature we found only ten articles/abstracts of studies pertaining to the topic of our review. With our review, we aimed to explore whether non-surgical methods of penile lengthening may have some scientific background. We focused specifically on penile extenders, which among conservative methods are those whose efficacy is supported by some scientific evidence. It seems that penile traction devices should be proposed as the first-line treatment option for patients seeking a penile lengthening procedure. Penile size is a matter of great interest among men who are affected by 'short penis syndrome' or just believe themselves to have a small penis, even though the dimensions of the organ fall within the normal range. Surgical procedures of 'lengthening phalloplasty' lack standardized indications and carry a high risk of complications. Several non-invasive methods of penile lengthening have been described, such as vacuum devices, penile traction devices and penoscrotal rings; even 'physical exercises' have been popularized through the media. Most of these techniques, however, are not supported by any scientific evidence. We briefly analyse the efficacy and scientific background of such non-surgical methods of penile lengthening. It seems that penile extenders represent the only evidence-based technique of penile elongation. Results achieved do not seem to be inferior to surgery, making these traction devices an ideal first-line treatment option for patients seeking a penile lengthening procedure. PMID:20868389

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

    International Nuclear Information System (INIS)

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

  3. 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

  4. General Information about Penile Cancer

    Science.gov (United States)

    General Information About Penile Cancer Key Points for This Section Penile cancer is a disease in which ... history : An exam of the body to check general signs of health, including checking the penis for ...

  5. 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 ...

  6. Development of Small Diameter Nanofiber Tissue Engineered Arterial Grafts

    Science.gov (United States)

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

    2015-01-01

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

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

    International Nuclear Information System (INIS)

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

  8. 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.

  9. Penile bulb imaging

    International Nuclear Information System (INIS)

    Purpose: Because of the apparent relationship between potency loss and radiation doses to the erectile bodies, there is increasing rationale for incorporating penile bulb dosimetry into treatment planning and posttreatment evaluation. Because the location and shape of the penile bulb have not been described in detail on various imaging modalities, we herein describe the anatomic boundaries of the penile bulb on computed tomography (CT), magnetic resonance imaging (MR), and transrectal ultrasound (TRUS), before and after brachytherapy. Methods and Materials: Nonenhanced axial CT images were taken on a CTi CT Scanner (General Electric Medical Systems, Milwaukee, WI) with the patient in the supine position. Settings were at 300 ma, 140 kvp, 4-s scan time per slice, and collimation of 3 mm with data obtained at 3-mm intervals. Nonenhanced MR images were obtained with a 1.5 Tesla Signa Horizon LX Scanner using fast spin-echo T1-weighted (TR/TE, 466/20) and T2-weighted (TR/TE, 8000/90) images, with a slice thickness of 2 mm and an interslice gap of 0.5 mm. TRUS images were obtained with a Siemens SONOLINE Prima ultrasound machine at 6.0 MHz and a Winston-Barzell stepper unit. Results: The penile bulb is best visualized on T2-weighted MR images in the axial, sagittal, and coronal planes, appearing as an oval-shaped, hyperintense midline structure. On axial CT imaging, the bulb of the penis is typically readily identifiable, bounded by the paired crura laterally, the corpora y the paired crura laterally, the corpora spongiosum anteriorly, and the levator ani posteriorly. The penile bulb is typically well visualized on transverse TRUS, but usually only faintly seen on sagittal TRUS. The bulb is partially obscured on postimplant CT and MR images, presumably because of implant-related edema. Bulb volumes vary markedly from patient to patient, ranging from 5.6 to 12.4 cc (median: 8.1 cc). Conclusion: Closer attention to penile erectile tissue doses should lead to improved external beam radiation and brachytherapy delivery. It will benefit the radiation oncology community to become familiar with these imaging findings, so that penile bulb dosimetry can be incorporated into our daily practice

  10. Physiologic Compliance in Engineered Small-diameter Arterial Constructs Based on an Elastomeric Substrate

    OpenAIRE

    Crapo, Peter M.; Wang, Yadong

    2009-01-01

    Compliance mismatch is a significant challenge to long-term patency in small-diameter bypass grafts because it causes intimal hyperplasia and ultimately graft occlusion. Current engineered grafts are typically stiff with high burst pressure but low compliance and low elastin expression. We postulated that engineering small arteries on elastomeric scaffolds under dynamic mechanical stimulation would result in strong and compliant arterial constructs. Compare properties of engineered arterial c...

  11. The normal distribution of thoracoabdominal aorta small branch artery ostia

    International Nuclear Information System (INIS)

    The purpose of this study was to determine the normal distribution of aortic branch artery ostia. CT scans of 100 subjects were retrospectively reviewed. The angular distributions of the aorta with respect to the center of the T3 to L4 vertebral bodies, and of branch artery origins with respect to the center of the aorta were measured. At each vertebral body level the distribution of intercostal/lumbar arteries and other branch arteries were calculated. The proximal descending aorta is posteriorly placed becoming a midline structure, at the thoracolumbar junction, and remains anterior to the vertebral bodies within the abdomen. The intercostal and lumbar artery ostia have a distinct distribution. At each vertebral level from T3 caudally, one intercostal artery originates from the posterior wall of the aorta throughout the thoracic aorta, while the other intercostal artery originates from the medial wall of the descending thoracic aorta high in the chest, posteromedially from the mid-thoracic aorta, and from the posterior wall of the aorta low in the chest. Mediastinal branches of the thoracic aorta originate from the medial and anterior wall. Lumbar branches originate only from the posterior wall of the abdominal aorta. Aortic branch artery origins arise with a bimodal distribution and have a characteristic location. Mediastinal branches of the thoracic aorta originate from the medial and anterior wall. Knowing the location of aortic branch artery ostia may help disti aortic branch artery ostia may help distinguish branch artery pseudoaneurysms from penetrating ulcers.

  12. 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

    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 normalization of blood pressure (BP).

  13. Penile subcutaneous fibrolipoma postaugmentative phalloplasty.

    Science.gov (United States)

    Vicini, Patrizio; De Marco, Ferdinando; Letizia, Piero; Alei, Lavinia; Antonini, Gabriele; Alei, Giovanni; Gentile, Vincenzo

    2013-01-01

    Fibrolipomas are a rare subtype of lipomas. We describe a case of a man suffering from subcutaneous penile fibrolipoma, who three months earlier has been submitted to an augmentative phalloplasty due to aesthetic dysmorphophobia. After six months from the excision of the mass, the penile elongation and penile enlargement were stable, and the patient was satisfied with his sexual intercourse and sexual life. To our knowledge, this is the first reported penile subcutaneous fibrolipoma case in the literature. The diagnostics and surgical features of this case are discussed. PMID:24195003

  14. Primary Undifferentiated Penile Sarcoma in Adolescence

    OpenAIRE

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

    2012-01-01

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

  15. 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.

  16. Management of penile fractures

    International Nuclear Information System (INIS)

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

  17. Penile anomalies in adolescence.

    Science.gov (United States)

    Wood, Dan; Woodhouse, Christopher

    2011-01-01

    This article considers the impact and outcomes of both treatment and underlying condition of penile anomalies in adolescent males. Major congenital anomalies (such as exstrophy/epispadias) are discussed, including the psychological outcomes, common problems (such as corporal asymmetry, chordee, and scarring) in this group, and surgical assessment for potential surgical candidates. The emergence of new surgical techniques continues to improve outcomes and potentially raises patient expectations. The importance of balanced discussion in conditions such as micropenis, including multidisciplinary support for patients, is important in order to achieve appropriate treatment decisions. Topical treatments may be of value, but in extreme cases, phalloplasty is a valuable option for patients to consider. In buried penis, the importance of careful assessment and, for the majority, a delay in surgery until puberty has completed is emphasised. In hypospadias patients, the variety of surgical procedures has complicated assessment of outcomes. It appears that true surgical success may be difficult to measure as many men who have had earlier operations are not reassessed in either puberty or adult life. There is also a brief discussion of acquired penile anomalies, including causation and treatment of lymphoedema, penile fracture/trauma, and priapism. PMID:21399858

  18. Spectacularly Successful Microsurgical Penile Replantation in an Assaulted Patient: One Case Report

    OpenAIRE

    Youness Ahallal; Abdelhak Khallouk; Moulay Hassan Farih; Mohammed Jamal Elfassi; Mohammed Fadl Tazi

    2011-01-01

    Penile amputation is a rare condition for which immediate surgical replantation is warranted. We present herein one case of a 27-year-old male who presented to the Emergency Department after his wife cut his penis. The penis was replanted microsurgically. The deep dorsal penile veins and superficial veins were anastomosed. Although we could not reanastomose the arteries, wound healing occurred without any problem one week postoperatively and the patient regained erectile function 4 weeks ...

  19. 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 ...

  20. Pharmacologically induced erect penile length and stretched penile lengh are both good predictors of post-inflatable prosthesis penile length

    Science.gov (United States)

    Osterberg, EC; Maganty, A; Ramasamy, R; Eid, JF

    2015-01-01

    Inflatable penile prosthesis (IPP) remains the gold standard for the surgical treatment of refractory erectile dysfunction; however, current literature to aid surgeons on how best to counsel patients on their postoperative inflated penile length is lacking. The aim of this study was to identify preoperative parameters that could better predict postoperative penile length following insertion of an IPP. Twenty men were enrolled in a prospective study examining penile lengths before and after IPP surgery. Patients with Peyronie’s disease were excluded from this analysis. Baseline preoperative characteristics, including body mass index, history of hypertension, diabetes, Sexual Health Inventory for Men scores and/or prior radical prostatectomy were recorded. All patients underwent implantation with a three-piece inflatable Coloplast penile prosthesis. We compared stretched penile length to pharmacologically induced erect lengths. Postoperatively, we measured inflated penile lengths at 6 weeks and assessed patients’ perception of penile size at 12 weeks. The median (± interquartile range) stretched penile length and pharmacologically induced erect penile length was 15 (± 3) and 14.25 (± 2) cm, respectively (P = 0.5). Median post-prosthesis penile length (13.5 ± 2.13 cm) was smaller than preoperative pharmacologically induced length (P = 0.02) and preoperative stretched penile length (P = 0.01). The majority of patients (70%) had a decrease in penile length (median loss 0.5 ± 1.5 cm); however, this loss was perceptible by 43% of men. Stretched penile length and pharmacologically induced erect penile length were equally good predictors of postoperative inflated length (Spearman’s correlation 0.8 and 0.9, respectively). Pharmacologically induced erect penile length and stretched penile lengths are equal predictors of post-prosthesis penile length. The majority of men will experience some decrease in penile length following prosthesis implantation; however penile length. PMID:24430278

  1. Does kidney transplantation onto the external iliac artery affect the haemodynamic parameters of the cavernosal arteries?

    OpenAIRE

    Gontero, Paolo; Oderda, Marco; Filippini, Claudia; Fontana, Francesco; Lazzarich, Elisa; Stratta, Piero; Turello, Ernesto; Tizzani, Alessandro; Frea, Bruno

    2011-01-01

    Reduced cavernosal arterial inflow has been hypothesized to be the likely cause of erectile dysfunction after kidney transplants in recipients revascularized through end-to-end anastomosis to the internal iliac artery, suggesting that end-to-side anastomosis at the external iliac artery is preferable. The aim of this study was to prospectively evaluate the effect of the use of the external iliac artery on erectile function, hormone profiles and penile blood flow by evaluating changes in penil...

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

    International Nuclear Information System (INIS)

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

  3. 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.

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

    OpenAIRE

    Awwad, Ziad M.

    2005-01-01

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

  5. Multiple Instances of Peripheral Artery Emboli from Occult Primary Small Cell Lung Cancer

    OpenAIRE

    Gabrielli, Roberto; Rosati, Maria Sofia; Chiappa, Roberto; Vitale, Silvio; Millarelli, Massimiliano; Caselli, Giovanni

    2012-01-01

    Most peripheral artery emboli originate in the heart, and systemic neoplastic emboli are infrequently associated with bronchogenic carcinoma. To our knowledge, there have been no reports of pulmonary vein infiltration by small cell lung cancer.

  6. Systemic arterial hypertension and small airways function: acute effects of diazoxide and furosemide.

    OpenAIRE

    Bucca, Caterina; Rolla, Giovanni

    1980-01-01

    Two groups of 10 patients with systemic arterial hypertension were studied by respiratory function tests before and after acute administration of diazoxide or furosemide. Small airways obstruction was present in a high percentage of patients and was partially reversed after the acute administration either of diazoxide or of furosemide. Systemic arterial hypertension seems to influence small airways caliber, through pulmonary vascular distension and/or pulmonary interstitial edema.

  7. Penile blood flow scanning with TcO/sub 4/-99m labeled red blood cells after intracorporal papaverine injection

    International Nuclear Information System (INIS)

    Twenty impotent males were evaluated during early tumescence using TcO/sub 4/-99m-labeled red blood cells. Erections were pharmacologically induced by injecting papaverine directly into the corpora cavernosum. A penile arterial blood flow index and penile venosinusoidal transit time were generated as a function of penile counts normalized to total iliac artery counts. These indices were compared with findings in arteriography and cavernosography and with corporal pressure-flow evaluations. The penile flows scan was a significant predictor of arterial flow and venosinusoidal resistance. Four patterns were identified relating flow and resistance to the cause of impotence. Penile flow scanning may provide an excellent screening examination in evaluating impotence

  8. A review of penile metastasis

    Directory of Open Access Journals (Sweden)

    Elisabetta Nunzi

    2012-03-01

    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.

  9. 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.

  10. Penile Enhancement Procedures with Simultaneous Penile Prosthesis Placement

    OpenAIRE

    Hakky, Tariq S.; Jessica Suber; Gerard Henry; David Smith; Paul Bradley; Daniel Martinez; Carrion, Rafael E.

    2012-01-01

    Here we present an overview of various techniques performed concomitantly during penile prosthesis surgery to enhance penile length and girth. We report on the technique of ventral phalloplasty and its outcomes along with augmentation corporoplasty, suprapubic lipectomy, suspensory ligament release, and girth enhancement procedures. For the serious implanter, outcomes can be improved by combining the use of techniques for each scar incision. These adjuvant procedures are a key addition in the...

  11. Penile enhancement procedures with simultaneous penile prosthesis placement.

    Science.gov (United States)

    Hakky, Tariq S; Suber, Jessica; Henry, Gerard; Smith, David; Bradley, Paul; Martinez, Daniel; Carrion, Rafael E

    2012-01-01

    Here we present an overview of various techniques performed concomitantly during penile prosthesis surgery to enhance penile length and girth. We report on the technique of ventral phalloplasty and its outcomes along with augmentation corporoplasty, suprapubic lipectomy, suspensory ligament release, and girth enhancement procedures. For the serious implanter, outcomes can be improved by combining the use of techniques for each scar incision. These adjuvant procedures are a key addition in the armamentarium for the serious implant surgeon. PMID:22811703

  12. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... the next hour you’ll see a live panel discussion of penile implant surgery. For men with ... had a patient, for example, that came back seven years later to have his device inspected. And I ...

  13. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... the next hour you’ll see a live panel discussion of penile implant surgery. For men with ... you can see we don’t have any instruments right now, no suction catheter or Bovie; everything ...

  14. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... same – that is, placement of a penile prosthetic device in the two erection chambers of the corpora ... was the concept of getting infected after the device has been placed. And when you look at ...

  15. 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 ...

  16. 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 ...

  17. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... when you actually look at what predicts penile rigidity among the various predictors of pressure, which you ... You can always put it under the rectus muscle. There’s plenty of places for that third piece ...

  18. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... to a normal function. There’s two hotly debated topics among some of the icons of penile implantation -- ... a little bit longer. The other hotly debated topic would be the use of a scrotal drain. ...

  19. Minimally Invasive Penile Implant Surgery

    Medline Plus

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

  20. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... the next hour you’ll see a live panel discussion of penile implant surgery. For men with ... devices, you can see that this is a data on over 2,000 implants that were removed ...

  1. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... men with erectile dysfunction. While technically the initial concept is still the same – that is, placement of ... with penile implants in the past was the concept of getting infected after the device has been ...

  2. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... While technically the initial concept is still the same – that is, placement of a penile prosthetic device ... preparation or does your prep pretty much the same? 00:07:12 PAUL PERITO, MD: Our prep ...

  3. Minimally Invasive Penile Implant Surgery

    Medline Plus

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

  4. Histology of subcutaneous small arteries from patients with essential hypertension

    DEFF Research Database (Denmark)

    Korsgaard, N; Aalkjær, Christian

    1993-01-01

    The purpose of the present study was to determine the cellular basis for the increased ratio of media thickness to lumen diameter (media-lumen ratio) consistently found in the peripheral resistance arteries from patients with essential hypertension using an unbiased stereological principle (the "disector"). Segments of subcutaneous resistance arteries (approximately 200 microns internal diameter) were isolated from gluteal biopsies of skin and subcutaneous fat taken from 16 untreated patients with essential hypertension and 16 age- and sex-matched normotensive control subjects. Measured under standardized conditions (ie, relaxed and under controlled mechanical conditions) on an isometric myograph, vessels from hypertensive patients had a significant (P .05) on the basis of these measurements.(ABSTRACT TRUNCATED AT 250 WORDS)

  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. 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.)

  7. Impaired arachidonic acid-mediated dilation of small mesenteric arteries in Zucker diabetic fatty rats.

    Science.gov (United States)

    Zhou, Wei; Wang, Xiao-Li; Kaduce, Terry L; Spector, Arthur A; Lee, Hon-Chi

    2005-05-01

    Arachidonic acid (AA) is a precursor of important vasoactive metabolites, but the role of AA-mediated vasodilation in Type 2 diabetes is not known. Using Zucker diabetic fatty (ZDF) rats, we examined the effects of AA in small mesenteric arteries preconstricted with endothelin. In ZDF rat mesenteric arteries, 1 microM AA produced only one-third the amount of dilation as in vessels from lean control animals. In lean control rats, the effect of AA was significantly and predominantly inhibited by the lipoxygenase inhibitors baicalein and cinnamyl-3,4-dihydroxy-cyanocinnamate (CDC). However, baicalein and CDC had no effect on AA-mediated dilation in ZDF rat mesenteric arteries. The major [3H]AA metabolite produced by isolated mesenteric arteries in both lean and ZDF rats was 12-hydroxyeicosatetraenoic acid (12-HETE), but the amount of [3H]12-HETE produced by ZDF rat vessels was only 36% of that of control vessels. In addition, 12-HETE produced similar amounts of dilation in lean and ZDF rat mesenteric arteries. Immunoblot analysis showed an 81% reduction in 12-lipoxygenase protein in ZDF rat mesenteric arteries. Immunofluorescence labeling showed strong nitrotyrosine signals in ZDF rat mesenteric arteries that colocalized with 12-lipoxygenase in endothelium, and 12-lipoxygenase coprecipitation with anti-nitrotyrosine antibodies was enhanced in ZDF rat vessels. We conclude that AA-mediated relaxation in ZDF rat small mesenteric arteries is impaired due to reduced 12-lipoxygenase protein and activity. Increased oxidative stress and nitration of 12-lipoxygenase may underlie the impairment of AA-mediated relaxation in small mesenteric arteries of diabetic rats. PMID:15626691

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

    DEFF Research Database (Denmark)

    Nielsen, T H; Iversen, Helle Klingenberg

    1993-01-01

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

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

    OpenAIRE

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

    2004-01-01

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

  10. 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...

  11. Management of penile defects: a review.

    Science.gov (United States)

    Guizhong, Li; Feng, He; Guangling, Huang; Libo, Man; Kun, Liu; Yuming, Shen

    2012-06-01

    Penile amputation is a rare injury. Although, in principle, penile replantation can be performed using a variety of methods, few, if any, standardized procedures exist to deal with this medical emergency. The value of the various microsurgical techniques for replantation of the penis remains uncertain. This article provides a review of the management of penile defects and complications. PMID:22517572

  12. 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

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

    Science.gov (United States)

    Callens, Nina; Hoebeke, Piet

    2014-01-01

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

  14. Penile injuries: A 10-year experience.

    Science.gov (United States)

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

    2014-09-01

    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 injuries; and Group 4 (n = 7) with patients with penile soft tissue injuries. Grading of injury was done using the American Association for the Surgery of Trauma (AAST)-Organ injury scale of penile injury. Penile injuries without urethral injuries are urological emergencies which require immediate attention. PMID:25295134

  15. Penile cancer: epidemiology and treatment.

    Science.gov (United States)

    Guimarães, Gustavo Cardoso; Rocha, Rafael Malagoli; Zequi, Stenio Cassio; Cunha, Isabela Werneck; Soares, Fernando Augusto

    2011-06-01

    Penile cancer is an aggressive disease, with major psychological and social impact. The etiological factors are poor genital hygiene, the presence of phimosis, viral infection, ultraviolet radiation, smoking, balanitis xerotic obliterans, and chronic lichen. Identifying prognostic factors is important to select patients at risk for lymph node metastasis and avoid unneeded lymphadenectomy. The presence of lymph node metastasis is currently the strongest prognostic factor but its evaluation is imperfect using clinical and laboratorial methods. The treatment for invasive penile cancer is based on the treatment of primary tumor, usually with amputation and regional lymphadenectomy, treatments that have a high morbidity rate. PMID:21373986

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

    Science.gov (United States)

    Kang, Kyu-Tae

    2014-09-01

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

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

    International Nuclear Information System (INIS)

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

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

    DEFF Research Database (Denmark)

    Broegger, Torbjoern; Jacobsen, Jens Christian Brings

    2011-01-01

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

  19. Cellular hypertrophy in subcutaneous small arteries of patients with renovascular hypertension.

    Science.gov (United States)

    Rizzoni, D; Porteri, E; Guefi, D; Piccoli, A; Castellano, M; Pasini, G; Muiesan, M L; Mulvany, M J; Rosei, E A

    2000-04-01

    Structural alterations of small arteries in patients with essential hypertension are characterized by inward eutrophic remodeling. However, small arteries in patients with secondary hypertension, as well as in experimental models of hypertension with high circulating renin, are characterized by inward hypertrophic remodeling, which is characterized by smooth muscle cell hypertrophy in animal models. The aim of our study was to determine whether remodeling of subcutaneous small arteries in patients with secondary forms of hypertension is associated with smooth muscle cell hypertrophy and/or alterations in the elastic modulus of the vessel wall. Fifteen patients with renovascular hypertension, 9 with primary aldosteronism, and 13 with essential hypertension and 9 normotensive subjects were included in the study. A biopsy of subcutaneous fat was taken from all subjects. Small arteries were dissected, and morphology was determined on a micromyograph. Unbiased estimates of cell volume and number were made in fixed material. From the resting tension-internal circumference relation of the small arteries, the incremental elastic modulus was calculated and plotted as a function of wall stress. Blood pressure was greater in patients with essential hypertension, renovascular hypertension, or primary aldosteronism than in normotensive subjects, but no significant difference was observed among the 3 groups of hypertensive patients. The media/lumen ratio, the medial cross-sectional area, and the smooth muscle cell volume were significantly greater in patients with renovascular hypertension than in normotensive subjects and patients with essential hypertension. No difference in cell number or in the elastic properties was observed among the 4 groups of subjects. In conclusion, our data demonstrate for the first time that a pronounced activation of the renin-angiotensin-aldosterone system is associated with vascular smooth muscle cell hypertrophy in human hypertension in a manner similar to that found in animal models. PMID:10775564

  20. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... year? Across the world there’s only 16,000 penile implants. There’s something wrong with that disparity. Here I am, I’m putting in the drain. I bring it out through a separate stab wound. And it’s very important that you put the ...

  1. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... pump goes in. Unnecessary dilation will cause more edema, and edema causes pain and infection. You can see there’s ... so that you don’t have any penile edema. As you can see we’re a minute ...

  2. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... from workers going in and out of the operating room that actually infects the device, it’s not the ... to a normal function. There’s two hotly debated topics among some of the icons of penile implantation -- ...

  3. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... FRANCOIS EID, MD: I believe the number of physicians who only do penile implants, like Dr. Greiner [ ... just came in, and it says he’s a doctor from Miami who’s interested in undergoing training. So ...

  4. 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 ...

  5. 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 ...

  6. How Is Penile Cancer Diagnosed?

    Science.gov (United States)

    ... may order some tests. Medical history and physical exam Your doctor will need to take a complete medical history to get details about your symptoms and any possible risk factors you have. Your doctor will also look at your genital area carefully for possible signs of penile cancer ...

  7. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... 50:25 IRWIN GOLDSTEIN, MD: Urethane…it’s an alternative to silicone, and it’s basically virtually indestructible. So ... guys come and I do the penile stretch test, and they go, “Oh, I used to be ...

  8. 21 CFR 876.3350 - Penile inflatable implant.

    Science.gov (United States)

    2010-04-01

    ...2010-04-01 2010-04-01 false Penile inflatable implant. 876.3350 Section 876...Prosthetic Devices § 876.3350 Penile inflatable implant. (a) Identification. A penile inflatable implant is a device that...

  9. 21 CFR 876.3630 - Penile rigidity implant.

    Science.gov (United States)

    2010-04-01

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

  10. An internal thoracic artery homograft as a new small caliber vascular substitute.

    Science.gov (United States)

    Kitamura, M; Tagusari, O; Koyanagi, T; Nishida, H; Endo, M; Hashimoto, A; Koyanagi, H

    1994-01-01

    The authors have examined the possibility of usage of an internal thoracic artery (ITA) homograft as a new small caliber vascular substitute. Left subclavian artery to left atrial appendage shunts with fresh ITA homografts (n = 6) or ITA autografts (n = 5) were made by modified techniques of coronary artery bypass grafting in mongrel dogs (body weight, 11-16.5 kg). All recipient dogs had no anticoagulant therapy or immunosuppression. Inner diameter of the grafts was between 1.4 and 2.0 mm. Blood flow in ITA grafts was measured by electromagnetic flow meter. The graft flow was 6-14 ml/min before harvest and 67-220 ml/min just after implantation, and there was no significant difference between groups. Flow in the ITA homografts decreased significantly compared with ITA autografts 1 month after operation, but five of six ITA homografts were patent. Histopathology of the grafts showed vascular rejection in the homograft group. These results suggest that an ITA homograft with postoperative immunosuppression might be a new small caliber vascular substitute for coronary artery bypass grafting in ischemic heart disease and the systemic-pulmonary shunt operation in congenital heart diseases. PMID:8555630

  11. Shortened penis post penile prosthesis implantation treated with subcutaneous soft silicone penile implant: case report.

    Science.gov (United States)

    Shirvanian, V; Lemperle, G; Araujo Pinto, C; Elist, J J

    2014-01-01

    Penile prosthesis surgery for erectile dysfunction has the highest satisfaction rates among all treatment options but is often associated with subjective and objective loss of penile length and girth following surgery. To present a novel technique using a subcutaneous soft silicone implant for reversal of penile shortening and narrowing after prosthesis surgery, with additional gains in overall penile length and girth. Nine patients were treated with the insertion of a subcutaneous soft silicone penile implant. All patients had previously reported a loss in penile length (0.5-2?cm), and seven of nine patients also reported a loss in penile girth (0.5-2.6?cm) after penile prosthesis surgery. During a follow-up period of 4-24 months, penile length and girth measurements showed a mean increase in length of 2.4?cm (±0.75?cm) and a mean increase in girth of 3.4?cm (±0.94?cm). The additional insertion of a subcutaneous soft silicone implant in patients with decreased penile length and girth after penile prosthesis surgery is an effective treatment option that provides reversal of lost penile length and girth. PMID:24305609

  12. Technical Considerations and Outcomes in Penile Replantation

    OpenAIRE

    Biswas, Gautam

    2013-01-01

    Penile amputations are uncommon injuries, therefore, the management and outcome of these patients have been compiled from solitary case studies or short reviews. Accidental trauma during circumcision, injury inflicted by a partner following marital discord, and genital self-mutilation observed in patients with deep psychosis, account for a majority of the presentations. Initially, patients with total penile amputations were managed by resuturing the penile structures without repairing the ves...

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

    DEFF Research Database (Denmark)

    Thybo, N K; Stephens, N

    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 small arteries were dissected and mounted on a myograph for morphometry. The reduction in blood pressure with atenolol (drop in mean blood pressure 28.4 +/- 1.8 mm Hg) was greater than with perindopril (20.6 +/- 1.8 mm Hg, P <.05). Perindopril treatment caused an increase in small artery diameter (231 +/- 14 to 274 +/- 13 microns, P <.05) and a reduction in the ratio of media thickness to lumen diameter (7.94 +/- 0.65% to 5.96 +/- 0.42%, P <.05), whereas atenolol had no effect (246 +/- 14 to 231 +/- 13 microns and 7.14 +/- 0.47% to 6.79 +/- 0.45%, respectively). The change in small artery morphology caused by perindopril was not accompanied by any change in media cross-sectional area, suggesting that the change was due to "remodeling."(ABSTRACT TRUNCATED AT 250 WORDS)

  14. Preeclampsia selectively impairs endothelium-dependent relaxation and leads to oscillatory activity in small omental arteries.

    OpenAIRE

    Pascoal, I. F.; Lindheimer, M. D.; Nalbantian-brandt, C.; Umans, J. G.

    1998-01-01

    The vascular pathophysiology of preeclampsia, a hypertensive disorder unique to human pregnancy, has been postulated to be due to endothelial dysfunction, primarily manifest as deficient nitric oxide (NO) synthesis. We evaluated contraction (KCl and arginine vasopressin [AVP]) and dilation (acetylcholine and bradykinin) in small resistance-size omental arteries obtained during surgery from women with preeclampsia, postulating that these vessels would exhibit augmented contraction and diminish...

  15. Microneurovascular reimplantation in a case of total penile amputation

    OpenAIRE

    Bhatt Yogesh; Vyas Kinnari; Srivastava Rajat; Panse Nikhil

    2008-01-01

    Amputation of the penis is a rare condition reported from various parts of the world as isolated cases or small series of patients; the common aetiology is self-mutilating sharp amputation or an avulsion or crush injury in an industrial accident. A complete reconstruction of all penile structures should be attempted in one stage which provides the best chance for full rehabilitation of the patient. We report here a single case of total amputation of the penis, which was successfully reattache...

  16. [Hydrogen sulfide and penile erection].

    Science.gov (United States)

    Huang, Yi-Ming; Cheng, Yong; Jiang, Rui

    2012-09-01

    Hydrogen sulfide (H2S) is the third type of active endogenous gaseous signal molecule following nitric oxide (NO) and carbon monoxide (CO). In mammalians, H2S is mainly synthesized by two proteases, cystathionine-beta-synthase (CBS) and cystathionine-gamma-lyase (CSE). H2S plays an essential function of physiological regulation in vivo, and promotes penile erection by acting on the ATP-sensitive potassium channels to relax the vascular smooth muscle as well as by the synergistic effect with testosterone and NO to relax the corpus cavernosum smooth muscle (CCSM). At present, the selective phosphodiesterase type 5 (PDE5) inhibitor is mainly used for the treatment of erectile dysfunction (ED), but some ED patients fail to respond. Therefore, further studies on the mechanism of H2S regulating penile erection may provide a new way for the management of erectile dysfunction. PMID:23193672

  17. Bovine pericardium in penile prosthesis reimplantation

    OpenAIRE

    Lopes, Eduardo J.; Santos, Tarsila C.; Modesto Jacobino

    2007-01-01

    We present a case of a patient who underwent a late penile prosthesis implant using bovine pericardium as a complement to the tunica albuginea involved in intense fibrosis that destroyed the corpus cavernosum after an infectious manifestation. The advantages of using bovine pericardium in the substitution of the tunica albuginea are discussed and its first use as a penile prosthesis lining is reported.

  18. Small pulmonary arterial vessels of Aymara Indians from the Bolivian Andes.

    Science.gov (United States)

    Heath, D; Williams, D; Rios-Dalenz, J; Calderon, M; Gosney, J

    1990-06-01

    A study was made of the qualitative histological features of the small pulmonary arterial vessels of 25 adult citizens of La Paz, Bolivia (altitude 3600 m) coming to necropsy. Abnormalities found included muscularization of pulmonary arterioles, the development of longitudinal muscle in the intima of pulmonary arteries and arterioles, and the formation of muscular tubes lining the longitudinal muscle which extended through arterioles into the precapillaries of the lung. Arteriolar muscularization was found in three of the 13 Aymaras and in two of the 12 Mestizos studied. Intimal longitudinal muscle was present in four Aymaras and five Mestizos. Muscular tubes were found in only one case, a young Aymara. The features were very similar to those found in chronic obstructive airways disease. The appearances are consistent with a growth of new vascular smooth muscle in response to alveolar hypoxia as opposed to hypoxic vasoconstriction. PMID:2376399

  19. The contractile response of isolated small pulmonary arteries induced by activated macrophages.

    Science.gov (United States)

    Zaloudíková, M; Herget, J; Vízek, M

    2014-01-01

    To test whether macrophages can play any role in hypoxic pulmonary vasoconstriction, we tested the in vitro response of rings from small pulmonary arteries to the activation of macrophages by FMLP, a substance stimulating predominantly membrane-bound NADPH oxidase. A small vessel myograph was used to measure the responses of rings from small pulmonary arteries (300-400 microm) isolated from rat lungs. Rings from 5 rats were placed into both chambers of the myograph. The vessels were stabilized for 40 min and then normalized by automatic stretching to a wall tension equivalent to the intravascular pressure 30 mm Hg. At the start of each experiment, vessels were exposed to 80 mM K+ to obtain maximal contractile response, which was used to normalize subsequent contractile responses. 2x10(6) viable macrophages, obtained by peritoneal lavage, were added into one chamber, then 5 microM FMLP was administrated to both chambers and the tension measurement was started. The hydrogen peroxide concentration produced by stimulated macrophages was measured luminometrically. The concentrations of H2O2 in specimens from chambers containing activated macrophages rose from 3.5+/-1.5 nM to 110+/-28 nM within 25 min of stimulation, while FMLP itself didn't increase the H2O2 concentration from the baseline value (4.5+/-3 nM) in samples from control chambers. After FMLP administration, the tension of the vessel rings in the presence of macrophages reached 0.23+/-0.07 of maximal contractile response, it did not change in controls. The addition of ROS scavenger 4-hydroxy-TEMPO blocked the contractile response to the activation of macrophages. We conclude that the activation of macrophages stimulates the contraction of small pulmonary arteries and that this contraction is probably mediated by reactive oxygen species. PMID:24779609

  20. Technical considerations and outcomes in penile replantation.

    Science.gov (United States)

    Biswas, Gautam

    2013-11-01

    Penile amputations are uncommon injuries, therefore, the management and outcome of these patients have been compiled from solitary case studies or short reviews. Accidental trauma during circumcision, injury inflicted by a partner following marital discord, and genital self-mutilation observed in patients with deep psychosis, account for a majority of the presentations. Initially, patients with total penile amputations were managed by resuturing the penile structures without repairing the vessels. A high incidence of skin and glans necrosis, urethral strictures, and a failure of sensory recovery were observed, though the penile shaft sometimes survived. Presently, microsurgical replantation has markedly improved the results, though issues of skin loss and urethral stricture still persist. A series of three patients with penile amputation is presented (complete?=?2, partial?=?1); the technical considerations and outcomes are discussed. PMID:24872770

  1. Penile blood flow by xenon-133 washout

    Energy Technology Data Exchange (ETDEWEB)

    Haden, H.T.; Katz, P.G.; Mulligan, T.; Zasler, N.D.

    1989-06-01

    Penile erectile failure is often attributed to abnormalities of vascular supply or drainage, but few direct measurements of penile blood flow have been made. We describe the xenon washout method for measurement of penile blood flow, and present the results obtained in a group of normal and impotent subjects. The procedure was performed with standard nuclear imaging equipment. Flaccid-state penile blood flow in the impotent patients studied was not significantly different from the normal group, suggesting that flaccid-state measurements may not be helpful in evaluation of erectile failure. However, this method can be used to measure penile venous outflow with stimulated or induced erection, and may provide a method for detecting abnormal venous leakage.

  2. Penile blood flow by xenon-133 washout

    International Nuclear Information System (INIS)

    Penile erectile failure is often attributed to abnormalities of vascular supply or drainage, but few direct measurements of penile blood flow have been made. We describe the xenon washout method for measurement of penile blood flow, and present the results obtained in a group of normal and impotent subjects. The procedure was performed with standard nuclear imaging equipment. Flaccid-state penile blood flow in the impotent patients studied was not significantly different from the normal group, suggesting that flaccid-state measurements may not be helpful in evaluation of erectile failure. However, this method can be used to measure penile venous outflow with stimulated or induced erection, and may provide a method for detecting abnormal venous leakage

  3. Comparison of penile brachial index and penile arteriography

    International Nuclear Information System (INIS)

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

  4. Small caliber arterial endothelial cells calcium signals elicited by PAR2 are preserved from endothelial dysfunction.

    Science.gov (United States)

    Hennessey, John C; Stuyvers, Bruno D; McGuire, John J

    2015-03-01

    Endothelial cell (EC)-dependent vasodilation by proteinase-activated receptor 2 (PAR2) is preserved in small caliber arteries in disease states where vasodilation by muscarinic receptors is decreased. In this study, we identified and characterized the PAR2-mediated intracellular calcium (Ca(2+))-release mechanisms in EC from small caliber arteries in healthy and diseased states. Mesenteric arterial EC were isolated from PAR2 wild-type (WT) and null mice, after saline (controls) or angiotensin II (AngII) infusion, for imaging intracellular calcium and characterizing the calcium-release system by immunofluorescence. EC Ca(2+) signals comprised two forms of Ca(2+)-release events that had distinct spatial-temporal properties and occurred near either the plasmalemma (peripheral) or center of EC. In healthy EC, PAR2-dependent increases in the densities and firing rates of both forms of Ca(2+)-release were abolished by inositol 1,4,5- trisphosphate receptor (IP3R) inhibitor, but partially reduced by transient potential vanilloid channels inhibitor ruthenium red (RR). Acetylcholine (ACh)-induced less overall Ca(2+)-release than PAR2 activation, but enhanced selectively the incidence of central events. PAR2-dependent Ca(2+)-activity, inhibitors sensitivities, IP3R, small- and intermediate-conductance Ca(2+)-activated potassium channels expressions were unchanged in EC from AngII WT. However, the same cells exhibited decreases in ACh-induced Ca(2+)-release, RR sensitivity, and endothelial nitric oxide synthase expression, indicating AngII-induced dysfunction was differentiated by receptor, Ca(2+)-release, and downstream targets of EC activation. We conclude that PAR2 and muscarinic receptors selectively elicit two elementary Ca(2+) signals in single EC. PAR2-selective IP3R-dependent peripheral Ca(2+)-release mechanisms are identical between healthy and diseased states. Further study of PAR2-selective Ca(2+)-release for eliciting pathological and/or normal EC functions is warranted. PMID:25729579

  5. 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.

  6. Selective Arterial Embolization of Idiopathic Priapism

    International Nuclear Information System (INIS)

    We report a case of idiopathic priapism that was only identified as high-flow or arterial priapism after drainage of the corpora cavernosa. Following failure of conservative and surgical treatment attempts, two consecutive embolizations of a unilateral penile artery were performed with gelgoam particles

  7. [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

  8. Phalloplasty and penile implant surgery.

    Science.gov (United States)

    Caso, Jorge R; Myers, Michael D; Wiegand, Lucas; Rodriguez, Alejandro; Hann, Shan; Carrion, Rafael

    2009-11-01

    Impotence is often accompanied by loss of phallic length. To enhance penile prosthesis surgery, it is possible to perform simple adjuvant procedures that will increase perceived or true length. This article presents an overview of these techniques, which may be categorized as involving removal or fixation of tissue above or below the shaft of the penis; division of the suspensory ligament; and augmentation of the corpora cavernosa through stretch or grafting. We believe that the use of these techniques will become increasingly commonplace as patient satisfaction is reported. PMID:19863860

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

    DEFF Research Database (Denmark)

    Andersen, Malene R; Uldbjerg, Niels

    2011-01-01

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

  10. Novel optical system for in vitro quantification of full surface strain fields in small arteries: I. Theory and design.

    Science.gov (United States)

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

    2011-03-01

    Recent advances in vascular biology and pathophysiology have revealed the need to understand better the genetic basis of arterial stiffness, disease progression and responses to clinical intervention. Towards this end, in vitro experiments on arteries from genetically modified mice promise to provide significantly increased insight into both health and disease. The need to test small arteries, often of complex shape, necessitates new methods for experimental arterial mechanics, however, ones that can provide information on local changes in geometry and strain. In this paper, we present a theoretical framework for a new panoramic digital image correlation-based method sufficient to collect such information and we demonstrate the utility of this approach via validation studies on phantoms having dimensions on the order of 500-1000 ?m, similar to those of large mouse arteries. In particular, we show that placing the specimen within a conical mirror and imaging the specimen via a gimbal-mounted mirror using a single camera yields stereo information sufficient to quantify the size, shape and deformation along the full length and around the entire circumference of small arteries. In a companion paper, we show further that this approach can be implemented effectively while testing arteries within a physiological solution that maintains native biomechanical properties. PMID:21347912

  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 SciELO Chile | Language: Spanish Abstract in spanish 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. 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...

  13. The action of dopamine and vascular dopamine (DA1) receptor agonists on human isolated subcutaneous and omental small arteries.

    OpenAIRE

    Hughes, A. D.; Sever, P. S.

    1989-01-01

    1. Human small arteries were obtained from surgical specimens and studied in vitro by use of a myograph technique. Following induction of tone with a potassium depolarizing solution, dopamine in the presence of beta-adrenoceptor and catecholamine uptake blockade relaxed isolated omental and subcutaneous arteries. Preincubation of tissues with phentolamine increased the maximum relaxation in response to dopamine. 2. The selective vascular dopamine receptor agonists, fenoldopam and SKF 38393 al...

  14. Dynamic imaging of a small artery underneath skin surface of a human finger by optical coherence tomography

    OpenAIRE

    Masamitsu Haruna; Masato Ohmi; Mitsuo Kuwabara

    2013-01-01

    OCT is a powerful tool for detection of physiological functions of micro organs underneath the human skin surface, besides the clinical application to ophthalmology, as recently demonstrated by the authors’ group. In particular, dynamics of peripheral vessels can be observed clearly in the time-sequential OCT images. Among the vascular system, only the small artery has two physiological functions both for the elastic artery and for muscle-controlled one. It, therefore, is important for dyn...

  15. Elevated lipoprotein (a), small apolipoprotein (a), and the risk of arterial ischemic stroke in North American children

    OpenAIRE

    Goldenberg, Neil A.; Bernard, Timothy J.; Hillhouse, Jasper; Armstrong-wells, Jennifer; Galinkin, Jeffrey; Knapp-clevenger, Rhonda; Jacobson, Linda; Marcovina, Santica M.; Manco-johnson, Marilyn J.

    2013-01-01

    Lipoprotein (a) is a risk factor for adult cardiovascular events, in which the apolipoprotein (a) component is thought to promote atherogenesis and impair fibrinolysis. We investigated whether elevated plasma lipoprotein (a) concentration and small predominant apolipoprotein (a) isoform size (number of kringle-4 domains) are risk factors for childhood arterial ischemic stroke and correlate with plasma fibrinolytic function. Patients who had had an arterial ischemic stroke in childhood (29 day...

  16. Measurement of spiral artery jets: general principles and differences observed in small-for-gestational-age pregnancies.

    OpenAIRE

    Collins, Sl; Birks, Js; Stevenson, Gn; Papageorghiou, At; Noble, Ja; Impey, L.

    2012-01-01

    OBJECTIVE: To investigate whether the jets of blood from the mouths of the spiral arteries could be measured reliably, as well as their relationship with the uterine artery (UtA) and any differences in small-for-gestational-age (SGA) pregnancies. METHODS: Participants underwent serial ultrasound scans, from 11 weeks' gestation. Pulsatility index (PI) and resistance index (RI) of jets into the intervillous space (IVS) and UtA were recorded at every visit. Intra- and interobserver variability s...

  17. Early penile metastasis from primary bladder cancer as the first systemic manifestation: a case report

    OpenAIRE

    So?nmez, Nurettin Cem; Cos?kun, Burhan; Arisan, Serdar; Gu?ney, Soner; Dalk?l?c?, Ayhan

    2009-01-01

    Metastatic involement of penis is an exceptionally rare condition. 77% of the metastases are originated from the pelvic region; prostate and bladder are the most frequent primary locations. Retrograde venous route, retrograde lymphatic route, arterial spread, direct extension, implantation and secondary to instrumentation are the mechanisms of metastasis. Approximately two thirds of all penile metastasis are detected at a mean time of 18 months after the detection of the primary tumor and the...

  18. Diagnosis of vasculogenic impotence: Combination of penile xenon-133 washout and papaverine tests

    International Nuclear Information System (INIS)

    The present study evaluates both penile xenon-133 washout (XWT) and papaverine tests (PT) in the diagnosis of vasculogenic impotence. XWT was accomplished by subcutaneous injection of xenon-133 (1-2 mCi in 0.1 mL saline solution) into the dorsal coronal prepuce. Abnormal XWT was suggested in patients whose clearance time (T1/2) was longer than 7.5 minutes and whose penile blood flow rate (Q) was less than 6 mL/100 g tissue/min. PT was done by intracavernous injection of papaverine (60 mg in 20 mL normal saline). Abnormal PT was indicated in patients whose onset of full erection was more than ten minutes after papaverine injection and whose duration of erection was less than one hour. Ten young and 11 older normal volunteers were examined with XWT only; all showed normal results. A total of 60 impotent patients were examined with both XWT and PT and were classified into four groups: in 2 patients (3.3%) both XWT and PT were normal (group I); in 8 (13.3%) XWT was abnormal and PT normal (group II); in 14 (23.3%) XWT was normal and PT abnormal (group III); and in 36 (60%) both XWT and PT were abnormal (group IV). On further examination with bilateral hypogastric arteriography in 10 XWT-abnormal patients and on surgical correction of abnormal curvature in 5 XWT-abnormal patients, all (100%) were proved to have penile arterial insufficiency. Erection cavernosography performed in 15 PT-abnormal patients confirmed penile venous insufficiency in 80 percent. We conclude both XWiciency in 80 percent. We conclude both XWT and PT are simple and effective for evaluation of the penile arterial blood flow and venous competence, respectively

  19. [Comparison of biomechanical behavior of cerebral and mesenteric small arteries of simulated microgravity rats].

    Science.gov (United States)

    Cheng, Jiu-Hua; Boscolo, Macro; Lin, Le-Jian; Bai, Yun-Gang; Zhang, Xiang; Ma, Jin; Zhang, Li-Fan

    2009-08-25

    The aim of the present study was to further elucidate the mechanisms of vascular adaptation to microgravity and its gravity-based countermeasure by a biomechanical approach. Active (the dissected vessel segment was superfused with PPS) and passive (while it was superfused with Ca(2+)-free PPS) biomechanical properties of mesenteric third-order small arteries and middle cerebral arteries isolated from 3-day simulated microgravity (SUS), countermeasure (STD, daily 1 h of -G(x) gravitation), and control (CON) groups of rats were studied. The following mechanical parameters were calculated: the overall stiffness parameter of passive vessels (beta), circumferential stress (sigma(theta))-strain (epsilon(theta)) relationship, and pressure-dependent incremental elastic modulus (E(inc,p)) of both active and passive vessels, and vascular smooth muscle (VSM) activity-dependent incremental modulus (E(inc,a)). Results from the analysis of active biomechanical properties revealed the contribution of vascular smooth muscle (VSM) tone during the early adaptation to microgravity: (1) For mesenteric small arteries, active circumferential sigma(theta) -epsilon(theta) curve of SUS group was comparable with that of the passive vessels, indicating that the function of VSM to restore the normal stress distribution is compromised; however, this mal-adaptation was fully prevented by the countermeasure of daily 1 h of -G(x) gravitation; (2) For the middle cerebral arteries, active circumferential sigma(theta) -epsilon(theta) relation of SUS group was shifted to the left side of the passive curve and epsilon(theta) was kept at a nearly constant level with the corresponding sigma(theta) being at its normal range; furthermore, the enhanced myogenic tone responsiveness was not prevented by daily short-duration -G(x). Analysis of the passive biomechanical properties has suggested remodeling changes in matrix components of different types of vessels, which might be significant if the exposure duration was further prolonged. In brief, studies of vascular biomechanics are of particular importance in elucidating the mechanisms underlying vascular adaptation to microgravity and its gravity-based countermeasure. PMID:19701592

  20. Cuerpos extraños en pene / Penile foreign bodies

    Scientific Electronic Library Online (English)

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

    2009-08-01

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

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

    DEFF Research Database (Denmark)

    Mathiassen, Ole Norling; Buus, Niels Henril

    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 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 hypertension has been uncertain. Methods We conducted a follow-up survey of 159 essential hypertensive patients, who had previously been submitted to a M: L evaluation while participating in a clinical trial. They composed a homogeneous moderate-risk group, with no concomitant diseases, and represented 1661 years of follow-up. Results Thirty patients suffered a documented predefined cardiovascular event during follow-up. Increased relative risk (RR) was associated withM: L>-0.083 (mean level of the hypertensive cohort), RRU2.34 [95% confidence interval (CI) 1.11-4.95], and with M: L>-0.098 (mean level of a normotensive control groupR2SD), RRU2.49 (95% CI 1.21-5.11). Both results remained significant (RRU2.19, 95% CI 1.04-4.64, and RRU2.20, 95% CI 1.06-4.56, respectively) when adjusted for Heart Score level (10-year mortality risk-estimate, integrating age, gender, systolic blood pressure, cholesterol and smoking). 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

  2. Organ-Preserving Surgery for Penile Carcinoma

    OpenAIRE

    Martins, Francisco E.; Rodrigues, Raul N.; Lopes, Tom Amp M.

    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...

  3. Penile cancer: a case for guidelines.

    OpenAIRE

    Munro, N. P.; Thomas, P. J.; Deutsch, G. P.; Hodson, N. J.

    2001-01-01

    INTRODUCTION: Aspects of the management of penile cancer remain controversial. In the management of early T1 N0 disease, treatments are divided between amputation and a variety of penis conserving techniques (PCT); local excision, laser techniques, chemotherapy and radiotherapy. We report on a retrospective series of patients with penile cancer. PATIENTS AND METHODS: Thirty-seven patients were diagnosed between 1987-1996. All patients records were retrieved. Data recorded included TNM stage, ...

  4. Bovine pericardium in penile prosthesis reimplantation

    Scientific Electronic Library Online (English)

    Eduardo J., Lopes; Tarsila C., Santos; Modesto, Jacobino.

    2007-02-01

    Full Text Available SciELO Brazil | Language: English Abstract in english We present a case of a patient who underwent a late penile prosthesis implant using bovine pericardium as a complement to the tunica albuginea involved in intense fibrosis that destroyed the corpus cavernosum after an infectious manifestation. The advantages of using bovine pericardium in the substi [...] tution of the tunica albuginea are discussed and its first use as a penile prosthesis lining is reported.

  5. Bovine pericardium in penile prosthesis reimplantation

    Directory of Open Access Journals (Sweden)

    Eduardo J. Lopes

    2007-02-01

    Full Text Available We present a case of a patient who underwent a late penile prosthesis implant using bovine pericardium as a complement to the tunica albuginea involved in intense fibrosis that destroyed the corpus cavernosum after an infectious manifestation. The advantages of using bovine pericardium in the substitution of the tunica albuginea are discussed and its first use as a penile prosthesis lining is reported.

  6. Penile traction therapy in Peyronie's disease

    OpenAIRE

    Greenfield, Jason M.

    2009-01-01

    Penile traction therapy has traditionally been implemented to increase penile length but has recently been investigated for reducing the curvature associated with Peyronie's disease. The results of a few initial investigations have been conflicting, and further research is needed to confirm the true benefit of such therapy and its potential role in treating Peyronie's disease as both a monotherapy and in combination with other therapeutic options.

  7. Penile Cancer Metastases to the Groin

    Directory of Open Access Journals (Sweden)

    Yong He

    2014-02-01

    Full Text Available Penile cancer is a relatively uncommon cancer in the United States, spreading locally and through lymphatic channels. Metastatic disease is rare but has been reported in the liver, lungs, bone, brain, heart, and skin. Here we report a case of penile squamous cell carcinoma that had metastasized to the groin and presented as a chronic non-healing wound. [Arch Clin Exp Surg 2014; 3(1.000: 56-58

  8. Subcutaneous metallic mercury injection for penile augmentation.

    Science.gov (United States)

    Oh, Kyung Jin; Park, Kwangsung; Kang, Taek Won; Kwon, Dong Deuk; Ryu, Soo Bang

    2007-01-01

    Mercury intoxication is rare. Most often it is associated with occupational exposure or suicide attempts. We present the case of a 72-year-old patient who received a subcutaneous injection of metallic mercury into his penis for the purpose of penile aesthetic augmentation. Total phallectomy and perineal urethrostomy was performed, followed by chelation therapy. To our knowledge, this is the first report of penile subcutaneous mercury injection for aesthetic augmentation. PMID:17270654

  9. Dynamic imaging of a small artery underneath skin surface of a human finger by optical coherence tomography

    Directory of Open Access Journals (Sweden)

    Masamitsu Haruna

    2013-03-01

    Full Text Available OCT is a powerful tool for detection of physiological functions of micro organs underneath the human skin surface, besides the clinical application to ophthalmology, as recently demonstrated by the authors’ group. In particular, dynamics of peripheral vessels can be observed clearly in the time-sequential OCT images. Among the vascular system, only the small artery has two physiological functions both for the elastic artery and for muscle-controlled one. It, therefore, is important for dynamic analysis of blood flow and circulation. In the time-sequential OCT images obtained with 25 frames/sec, it is found that the small artery makes a sharp response to sound stress for contraction and expansion while it continues pulsation in synchronization with the heartbeats. This result indicates that the small artery exhibits clearly the two physiological functions for blood flow and circulation. In response to sound stress, blood flow is controlled effectively by thickness change of the tunica media which consists of five to six layers of smooth muscles. It is thus found that the thickness of the tunica media changes remarkably in response to external stress, which shows the activity of the sympathetic nerve. The dynamic analysis of the small artery presented here will allow us not only to understand the mechanism of blood flow control and also to detect abnormal physiological functions in the whole vascular system.

  10. 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.)

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

    International Nuclear Information System (INIS)

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

  12. Painful penile induration: imaging findings and management.

    Science.gov (United States)

    Bertolotto, Michele; Pavlica, Pietro; Serafini, Giovanni; Quaia, Emilio; Zappetti, Roberta

    2009-01-01

    A number of benign and malignant diseases with different causes, clinical features, management, and outcome can manifest as painful penile induration. The most common such conditions are active Peyronie disease, inflammation, trauma, venous or corporal thrombosis, acute ischemic disorders, and primary or secondary tumors. In patients with painful penile induration, a preliminary differential diagnosis is based on the patient's history and results of laboratory studies, penile inspection, and palpation. Imaging is often required to confirm the clinical diagnosis, assess the extent of disease, and determine patient treatment. A basic clinical investigation comprising penile inspection and palpation should be performed by the radiologist before imaging; such an evaluation is a great help in selecting the best imaging modality and examination technique. Moreover, acquisition of preliminary clinical information eases interpretation of the imaging features and facilitates identification of clinically relevant information that may result in a change in patient treatment. In standard clinical practice, color Doppler ultrasonography is often the first imaging modality used to evaluate patients with painful penile induration. This technique clearly demonstrates normal penile anatomy and its corresponding changes in most of the clinically relevant situations. Magnetic resonance imaging is the optimal imaging modality for tumor staging. Other imaging modalities are required less frequently. PMID:19325060

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

    Science.gov (United States)

    Massenio, Paolo; Di Fino, Giuseppe; Mancini, Vito; Carrieri, Giuseppe

    2014-01-01

    Penile prosthesis implantation is the recommended treatment in patients with penile curvature and severe erectile dysfunction (ED) not responding to pharmacotherapy. Most patients with mild-to-moderate curvature can expect cylinder insertion to correct both ED and penile curvature. In patients with severe curvature and in those with persistent curvature after corporeal dilation and prosthesis placement, intraoperative penile “modelling” over the inflated prosthesis has been introduced as an effective treatment. We report for the first time the long-term results of a patient treated with combined penile plication and placement of an inflatable penile prosthesis. PMID:24790766

  14. 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.

  15. Surgical or conservative treatment of penile fracture

    Directory of Open Access Journals (Sweden)

    ?or?evi? D.

    2008-01-01

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

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

    DEFF Research Database (Denmark)

    Stankevicius, Edgaras; Dalsgaard, Thomas

    2011-01-01

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

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

    DEFF Research Database (Denmark)

    Stankevicius, Edgaras; Dalsgaard, T.

    2011-01-01

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

  18. Adenosine mediates relaxation of human small resistance-like coronary arteries via A2B receptors.

    Science.gov (United States)

    Kemp, B K; Cocks, T M

    1999-04-01

    1. The receptor subtype and mechanisms underlying relaxation to adenosine were examined in human isolated small coronary arteries contracted with the thromboxane A2 mimetic, 1,5,5-hydroxy-11alpha, 9alpha-(epoxymethano)prosta-5Z, 13E-dienoic acid (U46619) to approximately 50% of their maximum contraction to K+ (125 mM) depolarization (Fmax). Relaxations were normalized as percentages of the 50% Fmax contraction. 2. Adenosine caused concentration-dependent relaxations (pEC50, 5.95+/-0.20; maximum relaxation (Rmax), 96.7+/-1.4%) that were unaffected by either combined treatment with the nitric oxide inhibitors, NG-nitro-L-arginine (L-NOARG; 100 microM) and oxyhaemoglobin (HbO; 20 microM) or the ATP-dependent K+ channel (KATP) inhibitor, glibenclamide (10 microM). The pEC50 but not Rmax to adenosine was significantly reduced by high extracellular K+ (30 mM). Relaxations to the adenylate cyclase activator, forskolin, however, were unaffected by high K+ (30 mM). 3. Adenosine and a range of adenosine analogues, adenosine, 2-chloroadenosine (2-CADO), 5'-N-ethyl-carboxamidoadenosine (NECA), R(-)-N6-(2-phenylisopropyl)-adenosine (R-PIA), S(+)-N6-(2-phenylisopropyl)-adenosine (S-PIA), N6-cyclopentyladenosine (CPA), 1-deoxy-1-[6-[[(3-iodophenyl)methyl]amino]-9H-purin-9-yl]-N-methyl-beta- D-ribofuranuronamide (IB-MECA), 2-p-(2-carboxyethyl)phenethylamino-5'-N-ethylcarboxamido adenosine hydrochloride (CGS 21680), relaxed arteries with a rank order of potency of NECA= 2-CADO >adenosine= IB-MECA = R-PIA= CPA > S-PIA)> CGS 21680. 4. Sensitivity but not Rmax to adenosine was significantly reduced approximately 80 and 20 fold by the non-selective adenosine receptor antagonist, 8-(p-sulphophenyl)theophylline (8-SPT) and the A2 receptor antagonist, 3,7-dimethyl-1-propargylxanthine (DMPX). By contrast, the A1-selective antagonist, 1,3-dipropyl-8-cyclopentylxanthine (DPCPX) had no effect on pEC50 or Rmax to adenosine. 5. These results suggest that A2B receptors mediate relaxation to adenosine in human small coronary arteries which is independent of NO but dependent in part on a K+-sensitive mechanism. PMID:10372822

  19. What Are the Key Statistics about Penile Cancer?

    Science.gov (United States)

    ... factors for penile cancer? What are the key statistics about penile cancer? The American Cancer Society estimates ... Symptoms of Cancer Treatments & Side Effects Cancer Facts & Statistics News About Cancer Expert Voices Blog Programs & Services ...

  20. 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)

  1. 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...

  2. Successful Replantation of Amputated Penile Shaft following Industrial Injury

    OpenAIRE

    Ariafar, A.; Salehipour, M.

    2010-01-01

    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.

  3. Successful replantation of amputated penile shaft following industrial injury.

    Science.gov (United States)

    Salehipour, M; Ariafar, A

    2010-10-01

    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. PMID:23022809

  4. Priapism secondary to penile metastasis of rectal cancer

    OpenAIRE

    Ji Chan Park, Wook Hyun Lee

    2009-01-01

    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.

  5. 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.

  6. C-arm Lipiodol CT in transcatheter arterial chemoembolization for small hepatocellular carcinoma

    Science.gov (United States)

    Li, Jian-Jun; Zheng, Jia-Sheng; Cui, Shi-Chang; Cui, Xiong-Wei; Hu, Cai-Xia; Fang, Da; Ye, Lin-Chao

    2015-01-01

    AIM: To investigate the value of C-arm Lipiodol computed tomography (CT) for intra-procedural hepatocellular carcinoma (HCC) lesion detection during transcatheter arterial chemoembolization (TACE). METHODS: Forty patients (37 male, 3 female; mean age, 52.6 ± 12.5 years, age range: 25-82 years) diagnosed with HCC were enrolled in this study. All patients underwent 64-slice CT 1-2 wk before TACE. During the procedure, hepatic angiography was performed first. Following diagnostic embolization with Lipiodol injected into the hepatic artery, a C-arm CT scan was immediately conducted (C-arm Lipiodol CT). If new HCC lesions were confirmed, gelfoam particles were super-selectively injected into the tumor-nourishing blood vessel. A Lipiodol CT scan was performed 7-14 d after TACE. All images acquired from 64-slice CT, digital subtraction angiography (DSA), C-arm Lipiodol CT and Lipiodol CT were retrospectively reviewed by four radiologists and the number of detected lesions in each examination was counted, respectively. The results of Lipiodol CT were taken as the diagnostic reference. Alpha-fetoprotein values were examined both before and after TACE. This study only takes into account the lesions that were not found or were considered suspicious on 64-slice CT before TACE. RESULTS: Preprocedural 64-slice CT detected a total of 13 suspicious lesions in the 40 patients. DSA detected ten definite and four suspicious lesions. C-arm Lipiodol CT detected 71 lesions in total and Lipiodol CT confirmed 67 lesions with a diameter range of 3-12 mm. Four false-positive lesions, which were detected by C-arm Lipiodol CT, were considered to be hepatic artery-portal vein fistulas. The average alpha-fetoprotein values before and after TACE were significantly different (452.3 ± 192.6 ng/mL vs 223.8 ± 93.2 ng/mL; P = 0.039). CONCLUSION: C-arm Lipiodol CT has a higher diagnostic sensitivity for small HCC lesions. This technique may help physicians make intraprocedural decisions to provide patients with earlier treatment.

  7. 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.

  8. Combined therapy with transcatheter arterial chemoembolization and percutaneous microwave coagulation for small hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Wei-Zhu Yang, Na Jiang, Ning Huang, Jing-Yao Huang, Qu-Bin Zheng, Quan Shen

    2009-02-01

    Full Text Available AIM: To assess the efficacy of combined transcatheter arterial chemoembolization (TACE and percutaneous microwave coagulation therapy (PMCT for small hepatocellular carcinoma (HCC.METHODS: Thirty-five patients with a total of 41 HCC nodules (? 3 cm in diameter were treated with TACE followed by computed tomograghy (CT-guided percutaneous microwave coagulation therapy (PMCT within 1-3 wk.RESULTS: By biopsies and enhanced CT scans, complete necrosis of the tumor and 3-5 mm of the surrounding non-cancerous area were observed in 34 foci. In seven foci, incomplete necrosis of the surrounding parenchyma was observed. Serum alpha-fetoprotein (AFP levels returned to normal 10 d after treatment in 25 patients who originally had high serum AFP levels. The follow-up period was 6-31 mo, and all patients remained alive. One patient had a recurrence in the subsegments of the liver, and another patient had a recurrence near the original lesion.CONCLUSION: Combined therapy with TACE and PMCT is a safe and effective treatment without severe complications for small HCC.

  9. 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)

  10. Isolated small uterine arteries from non-pregnant and term pregnant rats exhibit regulatory responses to elevations in extravascular pressure.

    Science.gov (United States)

    Withers, S; Taggart, M; Austin, C

    2013-01-01

    An adequate blood supply is essential for the maintenance of uterine function and fetal health during parturition. However, labouring uterine contractions will impart compressive forces on small uterine arteries (SUA). We demonstrate that isolated, pressurised rat SUA arteries, pre-constricted with arginine vasopressin or high potassium solution, exhibit regulatory responses to elevations in extravascular pressure (EVP) which maintain internal diameter constant at EVPs of 0-40 mm Hg. This response is endothelium independent and is not modulated by pregnancy. No regulation was observed in calcium free solution. SUA myogenic responses to elevated EVP likely represents a mechanism for limiting reductions in uterine blood flow during uterine contraction. PMID:23195572

  11. Technical recommendations for penile replantation based on lessons learned from penile reconstruction.

    Science.gov (United States)

    Roche, Nathalie A; Vermeulen, Bob T; Blondeel, Phillip N; Stillaert, Filip B

    2012-05-01

    Penile amputation is an exceptional surgical emergency. Immediate replantation yields a high success and low complication rate. We report a case of a self-inflicted penile amputation treated with successful microsurgical replantation. Postoperative edema caused minor skin slough and temporary venous congestion was treated with medicinal leech therapy. Follow-up at 18 months showed normal subjective sensation; voiding and erectile function were present. Surgical management and technique refinements are discussed, based on a review of the literature and on our experience in penile reconstruction. PMID:22399258

  12. [NPT: nocturnal penile tumescence test].

    Science.gov (United States)

    Colombo, F; Fenice, O; Austoni, E

    1994-09-01

    The recording of the variations of penile tumescence and rigidity during nocturnal unconscious erections that usually occur with the REM phases of sleep, has been considered the diagnostic tool of choice in the workup of erectile disturbances for a number of years. Such a success is partly due to its absence of invasiveness. Moreover this test was believed to allow to differentiate between the psychogenic and organic origin of impotence. As some authors have recently reported, anxiety state (common among patients who undergo invasive andrological procedure in the office) can at times influence the content of the dream state, thus negatively affecting the spontaneous nocturnal erections. Besides, sleep disturbances such as apnea and motor agitation can also induce erroneous interpretations of NPT graphs. Further, dysfunctions at the level of the cortex and the spine still allow the occurrence of nocturnal tumescence but determine an erectile deficit in the awake state. Clinically, all this poses new questions about the effectiveness of the NPT test in the study of the origin of impotence. The diagnostic methods, despite its world-wide diffusion, remains, under certain aspects, obscure: the operative details and, above all, its interpretative criteria. All this impedes the achievement of uniformity in the evaluation of the results obtained thanks to this test (e.g. the number and duration of erectile episodes, the interpretation of tumescence on its own, of the basal-apical dissociation, of the erectile episodes occurring immediately before waking, and of those of short duration). PMID:7951352

  13. Penile strangulation: report of a fatal case.

    Science.gov (United States)

    Morentin, Benito; Biritxinaga, Begoña; Crespo, Lourdes

    2011-12-01

    Penile strangulation or entrapment is an unusual entity that requires urgent treatment due to its potential complications. Several cases have been reported in the medical literature, some of them describing serious injuries such as necrosis, gangrene, and amputation of the penis. However, as far as we know, no fatal cases have been described before. We present the death of an adult male secondary to the complications due to penile strangulation with a plastic bottle neck. The time of incarceration was unknown, but according to a witness it could be about 10 to 14 days. The findings of autopsy were penile strangulation, necrosis of the penis, acute pyelonephritis, and bronchopneumonia. The subject's refusal to ask for medical help was the cause of this atypical evolution. PMID:22101437

  14. Penile and generalised calciphylaxis in peritoneal dialysis.

    Science.gov (United States)

    Sarkis, Edmond

    2015-01-01

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

  15. 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)

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

    DEFF Research Database (Denmark)

    Maigaard, S; Forman, Axel

    1985-01-01

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

  17. Penile lymphoma presenting as an advanced penile cancer: report of a case

    OpenAIRE

    Konstantinos Stamatiou; Hippocrates Moschouris; Athanasios Marinis; Drosos Karageorgopoulos; Kassiani Manoloudaki

    2012-01-01

    Penile lymphoma is a very rare neoplasm. We report the case of an 82-year-old man who presented with phimosis. The patient also complained of frequent and painful urination. Upon examination a painless penile ulcer and multiple inguinal lymph nodes were found. The shaft of the penis and the prostate were hard on palpation. Abdominal and transrectal ultrasound examination confirmed the involvement of the penis shaft and the prostate and also revealed involvement of the urinary bladder. Biopsy ...

  18. Elevated lipoprotein (a), small apolipoprotein (a), and the risk of arterial ischemic stroke in North American children

    Science.gov (United States)

    Goldenberg, Neil A.; Bernard, Timothy J.; Hillhouse, Jasper; Armstrong-Wells, Jennifer; Galinkin, Jeffrey; Knapp-Clevenger, Rhonda; Jacobson, Linda; Marcovina, Santica M.; Manco-Johnson, Marilyn J.

    2013-01-01

    Lipoprotein (a) is a risk factor for adult cardiovascular events, in which the apolipoprotein (a) component is thought to promote atherogenesis and impair fibrinolysis. We investigated whether elevated plasma lipoprotein (a) concentration and small predominant apolipoprotein (a) isoform size (number of kringle-4 domains) are risk factors for childhood arterial ischemic stroke and correlate with plasma fibrinolytic function. Patients who had had an arterial ischemic stroke in childhood (29 days - 90th percentile of race-specific reference values and apolipoprotein (a) <10th percentiles [odds ratio=14.0 (95% confidence interval: 1.0–184), P=0.05 and odds ratio=12.8 (1.61–101), P=0.02]. Statistically significant but weak correlations were observed between euglobulin lysis time and both lipoprotein (a) level (r=0.18, P=0.03) and apolipoprotein (a) size (r= ?0.26, P=0.002). In conclusion, elevated lipoprotein (a) and small apolipoprotein (a) potently increase the risk of recurrent arterial ischemic stroke in children, with a mechanism only partially attributable to impaired fibrinolysis. Collaborative studies are warranted to investigate these findings further and, more broadly, to establish key risk factors for incident and recurrent arterial ischemic stroke in children. PMID:23349301

  19. VEGF immunoexpression in penile carcinoma

    Directory of Open Access Journals (Sweden)

    Antonio Carlos Pereira Martins

    2002-01-01

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

  20. Penile and scrotum swelling in juvenile dermatomyositis.

    Science.gov (United States)

    Sallum, A M Elias; Silva, M F Castro; Michelin, C M; Duarte, R J; Baroni, R Hueb; Aikawa, N E; Silva, C A

    2011-01-01

    Edema is a well-known feature of juvenile dermatomyositis (JDM). However, to our knowledge localized penile and scrotum swelling was not previously reported. During a 27-year period, 5,506 patients were followed up at the Pediatric Rheumatology Unit of our University Hospital and 157 patients (2.9%) had JDM. One of them (0.6%) had concomitant localized penile and scrotum swelling. He had severe disease activity since he was 7-year-old, manifested by diffuse cutaneous vasculitis, recurrent localized edema (limbs or face) and only one episode of generalized edema. At the age of 10, he presented edema of the genitalia associated with mild skin erythema. Penis, scrotum and testicular ultrasound as well as magnetic resonance imaging showed skin edema without testicular involvement. He was taking prednisone, methotrexate, cyclosporin, hydroxychloroquine and thalidomide. Improvement of skin rash, penile and scrotum swelling was noticed only with rituximab therapy. No adverse event was observed during anti-CD20 infusions and after six months of follow up. Penile and scrotum edema was a rare manifestation of JDM which improved with anti-CD20 monoclonal antibody treatment. PMID:21841738

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

    OpenAIRE

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

    1994-01-01

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

  2. Intracellular sodium, membrane potential, and contractility of rat mesenteric small arteries

    DEFF Research Database (Denmark)

    Mulvany, M J; Aalkjær, Christian

    1984-01-01

    We have investigated effects of altered extracellular sodium, intracellular sodium concentration, and membrane potential on the contractile responses of rat isolated mesenteric small arteries (internal diameter ca. 200 microns), when mounted as ring preparations on an isometric myograph. To avoid possible neural effects, all vessels were denervated in vitro using 6-hydroxydopamine. In unstimulated vessels, exposure to low-Na+ solutions (25 mM sodium, sucrose, or choline-substituted) did not cause any response nor did exposure to ouabain (1 mM) for 1 hour [when intracellular sodium concentration increased to 64 mmol/(liter-cell)]. However, a response was obtained if ouabain-exposed vessels were subjected to low-sodium solutions (ca. 15% of maximal response). The magnitude of the response was dependent on the ratio of intracellular to extracellular sodium and was not inhibitable by the calcium blockers, felodipine (1 nM) or D600 (10 microM). This response could therefore be explained in terms of Na-Ca exchange mechanism. The responses of activated vessels to ouabain and to low-sodium solutions were also investigated. The responses of vessels to submaximal doses of noradrenaline or potassium were potentiated acutely by ouabain (by 10-30% of the maximal response), even if the extracellular sodium was reduced to 25 mM. In all cases, the potentiation by ouabain was accompanied by a depolarization (3-12 mV). However, only in the case of noradrenaline-activated vessels with normal extracellular sodium was the potentiation accompanied by an increase in intracellular sodium [by ca. 7 mmol/(liter-cell)]. Moreover, the latter response was inhibited by felodipine and D600. The results suggest that Na-Ca exchange mechanisms may be present in these vessels but that they only play a role under extreme conditions; under normal conditions the effect of ouabain on activated vessels seems to be primarily due to its depolarizing effect, and not to its effect on intracellular sodium.

  3. 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.

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

    Science.gov (United States)

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

    2015-03-01

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

  5. Recurrent idiopathic high-flow priapism treated with selective arterial embolization after repeated initial treatments for low-flow priapism

    OpenAIRE

    Wallis, Christopher J. D.; Hoag, Nathan; Pommerville, Peter J.; Huk, Michael E.

    2009-01-01

    High-flow priapism is most often seen following perineal and penile trauma. We report the case of a 32-year-old man who presented with recurrent idiopathic priapism initially treated as low-flow priapism on 8 previous emergency department visits. Pelvic angiography revealed an abnormal communication between the left cavernosal artery and the left corpus cavernosum and led to the diagnosis of high-flow priapism. Treatment involved embolization of the left common penile artery, which resulted i...

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

    Science.gov (United States)

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

    2015-03-01

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

  7. 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.

    1058-10-01

    Full Text Available SciELO Brazil | Language: English Abstract in english 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.

  8. 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

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

    DEFF Research Database (Denmark)

    Schjerning, Jeppe; Uhrenholt, Torben R

    2013-01-01

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

  10. A case of carcinosarcoma arising in irradiated penile glans

    International Nuclear Information System (INIS)

    A 46-year-old man, who had received the radiotherapy on his penile cancer about 8 years ago, suffered again from the tumor of his penile glans, which was thought to consist of recurrent cancer and postirradiation sarcoma. The patient underwent a radical amputation of penis combined with a postoperative chemotherapy, and is still alive wthout the recurrence of his tumor. Although more than 20 cases of penile sarcoma were reported in Japan, no case arising after radiotherapy was found. (author)

  11. Case of carcinosarcoma arising in irradiated penile glans

    Energy Technology Data Exchange (ETDEWEB)

    Takasaki, Etsuji; Murahashi, Isao; Toyoda, Masao; Yamada, Takashi (Dokkyo Univ. School of Medicine Tochigi (Japan)); Takayasu, Hisao

    1983-09-01

    A 46-year-old man, who had received the radiotherapy on his penile cancer about 8 years ago, suffered again from the tumor of his penile glans, which was thought to consist of recurrent cancer and postirradiation sarcoma. The patient underwent a radical amputation of penis combined with a postoperative chemotherapy, and is still alive wthout the recurrence of his tumor. Although more than 20 cases of penile sarcoma were reported in Japan, no case arising after radiotherapy was found.

  12. 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...

  13. 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.

  14. 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.

  15. The protective effect of intra-arterial vasopressin injections on the small bowel during fractionated abdominal irradiation

    International Nuclear Information System (INIS)

    The radioprotective effect of vasopressin-induced intestinal ischemia was investigated in pigs. A bolus injection in the cranial mesenteric artery, of a vasopressin solution, 0.05 IU/kg body weight, was followed by irradiation of the small intestine with 6 MV roentgen rays. Three different fraction schedules were used. Weight changes in the animals and the histologic appearance of their intestines were recorded two weeks after irradiation and compared with the findings in untreated animals. Intra-arterial vasopressin was very effective in protecting the intestine. Vasopressin treatment given before 2 fractions with relatively high radiation doses in a 6-fraction regimen was so effective that it may form the basis of a treatment model applicable in man. (orig.)

  16. Measurement of endothelial dysfunction via peripheral arterial tonometry predicts vasculogenic erectile dysfunction.

    Science.gov (United States)

    Kovac, J R; Gomez, L; Smith, R P; Coward, R M; Gonzales, M A; Khera, M; Lamb, D J; Lipshultz, L I

    2014-01-01

    Endothelial cell dysfunction is associated with cardiovascular disease and vasculogenic erectile dysfunction (ED). Measured via peripheral artery tonometry (PAT), endothelial dysfunction in the penis is an independent predictor of future cardiovascular events. The aim of the study was to determine whether measurement of endothelial dysfunction differentiates men with vasculogenic ED identified by duplex ultrasound from those without. A total of 142 men were retrospectively assessed using patient history, penile duplex ultrasonography (US) and PAT (EndoPAT 2000). ED was self-reported and identified on history. Vasculogenic ED was identified in men who exhibited a peak systolic velocity (PSV) of ? 25 cm s(-1) at 15 min following vasodilator injection. The reactive hyperemia index (RHI), a measurement of endothelial dysfunction in medium/small arteries, and the augmentation index (AI), a measurement of arterial stiffness, were recorded via PAT. Penile duplex US was used to categorize men into those with ED (n = 111) and those without ED (n = 31). The cohort with ED had a PSV of 21 ± 1 cm s(-1) (left cavernous artery) and 22 ± 1 cm s(-1) (right cavernous artery). The control group without ED had values of 39 ± 2 cm s(-1) (left) and 39 ± 2 cm s(-1) (right). Given the potential for altered endothelial function in diabetes mellitus, we confirmed that hemoglobin A1c, urinary microalbumin and vibration pulse threshold were not different in men with vasculogenic ED and those without. RHI in patients with ED (1.85 ± 0.06) was significantly decreased compared to controls (2.15 ± 0.2) (P<0.05). The AI was unchanged when examined in isolation, and when standardized to heart rate. Measurement of endothelial function with EndoPAT differentiates men with vasculogenic ED from those without. RHI could be used as a non-invasive surrogate in the assessment of vasculogenic ED and to identify those patients with higher cardiovascular risk. PMID:24784889

  17. Type 2 diabetes: increased expression and contribution of IKCa channels to vasodilation in small mesenteric arteries of ZDF rats.

    Science.gov (United States)

    Schach, Christian; Resch, Markus; Schmid, Peter M; Riegger, Guenter A; Endemann, Dierk H

    2014-10-15

    Impaired endothelial function, which is dysregulated in diabetes, also precedes hypertension. We hypothesized that in Type 2 diabetes, the impaired endothelium-dependent relaxation is due to a loss of endothelium-derived hyperpolarization (EDH) that is regulated by impaired ion channel function. Zucker diabetic fatty (ZDF), Zucker heterozygote, and homozygote lean control rats were used as the experimental models in our study. Third-order mesenteric arteries were dissected and mounted on a pressure myograph; mRNA was quantified by RT-PCR and channel proteins by Western blotting. Under nitric oxide (NO) synthase and cyclooxygenase inhibition, endothelial stimulation with ACh fully relaxes control but not diabetic arteries. In contrast, when small-conductance calcium-activated potassium (KCa) channels and intermediate- and large-conductance KCa (I/BKCa) are inhibited with apamin and charybdotoxin, NO is able to compensate for ACh-induced relaxation in control but not in diabetic vessels. After replacement of charybdotoxin with 1-[(2-chlorophenyl)diphenylmethyl]-(1)H-pyrazole (TRAM-34; IKCa inhibitor), ACh-induced relaxation in diabetic animals is attenuated. Specific inhibition with TRAM-34 or charybdotoxin attenuates ACh relaxation in diabetes. Stimulation with 1-ethyl-2-benzimidazolinone (IKCa activator) shows a reduced relaxation in diabetes. Activation of BKCa with 1,3-dihydro-1-[2-hydroxy-5-(trifluoromethyl)phenyl]-5-(trifluoromethyl)-(2)H-benzimidazol-2-one NS619 leads to similar relaxations of control and diabetic arteries. RT-PCR and Western blot analysis demonstrate elevated mRNA and protein expression levels of IKCa in diabetes. Our results suggest that the compensatory effect of NO and EDH-associated, endothelium-dependent relaxation is reduced in ZDF rats. Specific blockade of IKCa with TRAM-34 reduces NO and EDH-type relaxation in diabetic rats, indicating an elevated contribution of IKCa in diabetic small mesenteric artery relaxation. This finding correlates with increased IKCa mRNA and protein expression in this vessel. PMID:25128173

  18. Successful microsurgical penile replantation following self amputation in a schizophrenic patient

    OpenAIRE

    Gyan, Saurabh; Sushma, Sagar; Maneesh, Singhal; Rajesh, Sagar; Misra, Mc

    2010-01-01

    Amputation of the penis is a rare condition reported from various parts of the world as isolated cases or small series of patients; the common etiology is self-mutilating sharp amputation or an avulsion or crush injury in an industrial accident. A complete reconstruction of all penile structures should be attempted in one stage which provides the best chance for full rehabilitation of the patient. We report here a single case of total amputation of the penis in an acute paranoid schizophrenic...

  19. [Thrombosis of the deep penile venous system in a patient with a malignant disease.

    Science.gov (United States)

    Ghasemi, Habib; Ajan, Rullah

    2014-10-01

    Thrombosis of the deep penile venous system is extremely rare and must be clearly distinguished from superficial thrombosis because it may cause serious clinical complications. We present a 76-year-old man with thrombosis of the vena dorsalis penis profunda three months after being diagnosed with disse-m--inated non-small cell lung cancer. Total remission of the thrombosis was achieved with daily subcutaneous injections with heparin for four weeks. PMID:25331659

  20. Microneurovascular reimplantation in a case of total penile amputation

    Directory of Open Access Journals (Sweden)

    Bhatt Yogesh

    2008-01-01

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

  1. The direction and severity of penile curvature does not have an impact on concomitant vasculogenic erectile dysfunction in patients with Peyronie's disease.

    Science.gov (United States)

    Serefoglu, E C; Trost, L; Sikka, S C; Hellstrom, W J G

    2015-01-01

    Although the association between Peyronie's disease (PD) and erectile dysfunction (ED) is well established, limited data are available correlating penile curvature and penile hemodynamic parameters. We sought to examine this association in a cohort of PD men undergoing penile duplex Doppler ultrasound (PDDU). PD patients were retrospectively evaluated to correlate the extent and direction of penile curvature with measured vascular parameters. Demographic variables, disease characteristics and PDDU parameters were tabulated and statistically compared based on extent (? 45° and >45°) and direction (dorsal, ventral, lateral, ventrolateral, dorsolateral) of curvature. A total of 220 PD patients (mean age of 55.0 ± 9.2 years) underwent PDDU at one institution from January 2008 to December 2010. Overall, 69.5% of patients were found to have vasculogenic ED (arterial insufficiency (AI): 10%; veno-occlusive dysfunction (VOD): 43.2%; AI + VOD: 16.4%). Mean curvature was similar among all PDDU groups (AI: 41.7 ± 5.2°; VOD: 41.3 ± 2.5°; AI+VOD: 37 ± 4.1°; no-ED: 37.3 ± 3°; P > 0.85). No significant differences were noted in the presence or type of ED among various directions of curvature (P = 0.34) or when curvatures were stratified by ? 45° and >45°. The direction and extent of penile curvature are not associated with altered rates of vasculogenic ED on PDDU in PD patients. PMID:25030909

  2. [Three cases of penile self-mutilation].

    Science.gov (United States)

    Yoneda, Suguru; Kinjo, Takanori; Oida, Takeshi; Takezawa, Kentaro; Nomura, Hironori; Tei, Norihide; Takada, Shingo; Matsumiya, Kiyomi

    2012-11-01

    Penile self-mutilation is rare. We report our experience with 3 cases of penile self-amputation. One case was in a 48-year-old man who had no background history of mental disorders. He amputated his penis using a utility knife. He was referred to our hospital and underwent suture of the wound, but he took his own life one week after the surgery. Another case was in a 42-year-old man who had intelligence impairment. He amputated his penis using a kitchen knife. The other case was in a 41-year-old man who had schizophrenia. He amputated his penis using a piece of broken glass. PMID:23254788

  3. 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

  4. The condom: an effective penile dressing.

    Science.gov (United States)

    Kelly, J D; Best, B G

    1998-08-01

    An effective penile dressing should support the wound, prevent contamination, and minimize edema and hematoma formation. Traditional penile dressings are cumbersome to apply and hard to secure. This report describes use of a condom to provide support after operations on the adult penis. After surgery, the penis is loosely wrapped with sterile gauze and a condom is rolled down over the dressing to the base of the penis. The tip of the condom is cut off and the ring of latex at its base is divided to prevent constriction. Patients can urinate through the excised tip. In 12 patients who received this regimen, the dressing remained in place for the desired duration and condom removal was painless. The most common indication for use of this dressing has been Nesbit's procedure. PMID:9722770

  5. 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.

  6. 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)

  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. Epidemiologic study on penile cancer in Brazil

    OpenAIRE

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

    2008-01-01

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

  9. An effective treatment for penile strangulation.

    Science.gov (United States)

    Li, Chao; Xu, Yue-Min; Chen, Rong; Deng, Chen-Liang

    2013-07-01

    The aim of this study was to present our experience of patients with penile strangulation. The clinical data of 6 patients (mean age, 36 years; range, 18-72 years) with penile strangulation caused by a metal hoop are provided, where the duration of strangulation was between 3 h and 1 month. Among these patients, the case of a 22-year-old patient with a steel hoop entrapment on his penis for 5 days is described; due to serious injury of the skin at the root of penis, an intermediate split?thickness thigh skin graft was used to repair the skin loss. A review of the literature is also provided in this study, and current treatment options and outcomes are evaluated. In all the cases described, the metal hoops were successfully removed, without gangrene of the penis. These patients were discharged 2-27 days later with a satisfactory outcome. Penile strangulation is an unusual clinical condition and the consequences may be severe. The choice of method for removal depends on the type and size of metal hoop, incarceration time, trauma grade and availability of equipment. Early treatment is essential to avoid potential complications, including ischemic necrosis and autoamputation. PMID:23652299

  10. Sole stenting technique for the treatment of uncoilable very small aneurysms in the intracranial internal carotid artery.

    Science.gov (United States)

    Lee, Jae Il; Ko, Jun Kyeung; Lee, Tae Hong; Choi, Chang Hwa; Lee, Sang Weon; Cho, Won Ho

    2013-01-01

    The treatment of very small aneurysms with diameter of less than 3 mm remains a challenge for both endovascular and surgical treatment. Endovascular treatment of these lesions may be difficult and is associated with a high risk of complications because of their small size. The present study evaluated the safety, feasibility, and efficacy of the endovascular treatment using sole stenting technique for uncoilable very small aneurysms of the intracranial internal carotid artery (ICA). From August 2004 through January 2010, eight very small aneurysms of intracranial ICA in eight patients were treated with endovascular sole stenting technique. All very small aneurysms were ruptured (n = 3) or aneurysms associated with another ruptured (n = 2) and unruptured aneurysms (n = 3) in the same artery. Stents were Neuroform and balloon expandable coronary stents. Stent deployment was carried out without difficulty in all patients. Single stent deployment was done for six aneurysms, and double stents in two aneurysms. The immediate angiographic results were partial occlusion in one case and no occlusion in seven cases. One direct carotid-cavernous fistula occurred during coronary stenting without permanent neurological deficit. No neurological deterioration or hemorrhagic complication was seen during the follow-up period in seven patients. Follow-up angiography (mean 9 months) was available in six patients and revealed complete occlusion in four and no occlusion in two cases. Sole stenting technique may be a feasible and effective therapeutic alternative for uncoilable very small aneurysms. The long-term efficacy and durability of stenting for these lesions remains to be determined in a large series. PMID:23708222

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

    OpenAIRE

    Elist, James J.; 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 ...

  12. Vimentin positive acantholytic penile squamous cell carcinoma with rhabdoid features.

    Science.gov (United States)

    Chavan, Ramesh Y; Bali, Akshay; Savita, K S; Chethan, J V

    2014-01-01

    Acantholytic variant of penile squamous cell carcinoma (SCC) is an exceedingly rare and associated with bad prognosis. Histologically it mimics angiosarcoma due to pseudovascular spaces. Vimentin immunopositivity in such cases represent epithelial to mesenchymal transition manifested by cellular discohesion. We describe a case of vimentin positive acantholytic penile SCC in a 55-year-old patient. PMID:25022397

  13. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... PERITO, MD: It’s almost in place right now. Wait, let me see. I’ll go back while ... about it being too small. The longer you wait to get this fixed, the shorter your penis ...

  14. 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.

  15. Penile fracture: experience in 56 cases

    Scientific Electronic Library Online (English)

    Leandro, Koifman; André G., Cavalcanti; Carlos Henrique, Manes; Daibes, R. Filho; Luciano A., Favorito.

    2003-02-01

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

  16. Penile brachytherapy: Results for 49 patients

    International Nuclear Information System (INIS)

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

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

  18. Does kidney transplantation onto the external iliac artery affect the haemodynamic parameters of the cavernosal arteries?

    Science.gov (United States)

    Gontero, Paolo; Oderda, Marco; Filippini, Claudia; Fontana, Francesco; Lazzarich, Elisa; Stratta, Piero; Turello, Ernesto; Tizzani, Alessandro; Frea, Bruno

    2012-07-01

    Reduced cavernosal arterial inflow has been hypothesized to be the likely cause of erectile dysfunction after kidney transplants in recipients revascularized through end-to-end anastomosis to the internal iliac artery, suggesting that end-to-side anastomosis at the external iliac artery is preferable. The aim of this study was to prospectively evaluate the effect of the use of the external iliac artery on erectile function, hormone profiles and penile blood flow by evaluating changes in penile colour Doppler ultrasound parameters in a consecutive series of 22 recipients before and after end-to-side external iliac artery transplantation. The mean International Index of Erectile Function-Erectile Function (IIEF-EF) domain score decreased significantly 3 months after transplant (18.09±6.33 vs. 22.50±7.09, P=0.01). The reduction in peak systolic velocity (PSV) was significant for the cavernous artery homolateral to the side of transplant (42.60±18.77 vs. 52.01±19.91, P=0.01). The mean postoperative end diastolic velocity (EDV) did not differ significantly from the preoperative value (P=0.74). No statistical differences were found in the serum levels of testosterone or prolactin. Kidney grafts anastomosed at the external iliac artery produced significant (P=0.01) reductions in arterial inflow at the homolateral cavernosal artery that remained above the normal threshold. Whether these haemodynamic changes can explain the worsening of postoperative erectile function remains to be proven. PMID:22198628

  19. Ca2+ signaling in arterioles and small arteries of conscious, restrained, optical biosensor mice

    Science.gov (United States)

    Fairfax, Seth T.; Mauban, Joseph R. H.; Hao, Scarlett; Rizzo, Mark A.; Zhang, Jin; Wier, W. Gil

    2014-01-01

    Two-photon fluorescence microscopy and conscious, restrained optical biosensor mice were used to study smooth muscle Ca2+ signaling in ear arterioles. Conscious mice were used in order to preserve normal mean arterial blood pressure (MAP) and sympathetic nerve activity (SNA). ExMLCK mice, which express a genetically-encoded smooth muscle-specific FRET-based Ca2+ indicator, were equipped with blood pressure telemetry and immobilized for imaging. MAP was 101 ± 4 mmHg in conscious restrained mice, similar to the freely mobile state (107 ± 3 mmHg). Oscillatory vasomotion or irregular contractions were observed in most arterioles (71%), with the greatest oscillatory frequency observed at 0.25 s?1. In a typical arteriole with an average diameter of ~35 ?m, oscillatory vasomotion of a 5–6 ?m magnitude was accompanied by nearly uniform [Ca2+] oscillations from ~0.1 to 0.5 ?M, with maximum [Ca2+] occurring immediately before the rapid decrease in diameter. Very rapid, spatially uniform “Ca2+ flashes” were also observed but not asynchronous propagating Ca2+ waves. In contrast, vasomotion and dynamic Ca2+ signals were rarely observed in ear arterioles of anesthetized exMLCK biosensor mice. Hexamethonium (30 ?g/g BW, i.p.) caused a fall in MAP to 74 ± 4 mmHg, arteriolar vasodilation, and abolition of vasomotion and synchronous Ca2+ transients. Summary: MAP and heart rate (HR) were normal during high-resolution Ca2+ imaging of conscious, restrained mice. SNA induced continuous vasomotion and irregular vasoconstrictions via spatially uniform Ca2+ signaling within the arterial wall. FRET-based biosensor mice and two-photon imaging provided the first measurements of [Ca2+] in vascular smooth muscle cells in arterioles of conscious animals. PMID:25339912

  20. 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.; Badylak, S. F.; 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...

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

    Directory of Open Access Journals (Sweden)

    Önder YAVA?CAN

    2012-01-01

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

  2. Penile cutaneous horn ten years after treatment of verrucous squamous cell carcinoma on penile glans: case report.

    Science.gov (United States)

    Mokos, Ivica; Bukvi? Mokos, Zrinka; Ljubojevi?, Suzana; Cori?, Marijana; Grce, Magdalena; Michal, Michal

    2012-01-01

    Penile cutaneous horn is a clinical term that describes protruding hyperkeratosis, usually conical in shape, located on penile glans. Penile localization of this lesion, predominantly located on sun-exposed areas, is very rare. The association with malignancy on the penis makes proper identification of these lesions essential. We present a 45-year-old man with a cutaneous horn, 25 mm in size, located on the basis of penile glans. The patient had a history of phimosis, pseudoepitheliomatous balanoposthitis, surgical excision of penile verrucous squamous cell carcinoma (SCC) and postoperative radiotherapy of carcinoma in situ on the same localization, ten years before. Complete surgical removal of the horn with separate excision of the margins and base was done. Pathologic examination revealed squamous hyperplasia with suspicion of carcinoma in situ. Additional negative p16(INK4a) immunohistochemical analysis confirmed benign proliferative lesion. DNA polymerase chain reaction for human papilloma virus infection was negative. These findings suggested sparing surgical procedure in our patient, without indication for partial penile amputation, but with mandatory follow-up. Our case confirmed the association of pseudoepitheliomatous balanoposthitis with verrucous SCC, as well as the possible influence of radiotherapy on the development of penile cutaneous horn. Additionally, we showed the important role p16(INK4a) immunohistochemical analysis in the differential diagnosis of alterations adjacent to invasive SCC of the penis. PMID:22507472

  3. Penile urethral reconstruction: concepts and concerns.

    Science.gov (United States)

    Barbagli, Guido; Palminteri, Enzo; Bracka, Aivar; Caparrós Sariol, Joan

    2003-06-01

    Reconstruction of the penile urethra is a challenging exercise, and for many surgeons an ungratifying experience. The past three decades have seen us move from predominantly 2-staged surgery, through foreskin grafts, and then single stage flap reconstructions, and now in the 3rd millennium, for some situations 2-stage repair has again become the favoured option. Satisfying short-term solutions have sometimes resulted in poor long-term outcomes when reviewed 10 years later. Clearly there are still problems to be resolved, hence the need for continuing evolution in our surgical management. Lessons have been learned from the treatment of Lichen Sclerosus, from strictures following hypospadias repair, and strictures associated with severe spongiofibrosis. Management of these problems has traditionally been associated with not only a high incidence of restricture and fistula formation, but also with poor cosmetic results, something that men today find increasingly difficult to accept. Several considerations are fundamental to achieving the best functional and aesthetic results. These include the presence or absence of Lichen Sclerosus, the extent of urethral disease and its grade (i.e. mucosal disease or with accompanying spongiofibrosis); furthermore the use of non-genital grafts for urethral reconstruction when the local penile tissues are deficient or unhealthy. In arriving at our present strategy, a collaborative approach that integrates established urological practice with the different perspectives of a plastic surgeon (A.B.) has proved constructive and beneficial. PMID:12918316

  4. Cutaneous Myeloid Sarcoma of the Penile Foreskin.

    Science.gov (United States)

    Afrose, Ruquiya; Nebhnani, Deepa; Wadhwa, Neelam

    2014-06-10

    Myeloid sarcoma, considered to herald the onset of a blast crisis in the setting of chronic myeloproliferative neoplasm/dysplasia, typically presents during the course of the disorder. Cutaneous involvement is uncommon and lesions on genital skin are seldom seen. We present a case of a well-differentiated myeloid sarcoma in the penile foreskin in an apparently healthy 29-year-old male presenting with phimosis. The unusual composition of the inflammatory cell infiltrate, and characteristic sparing of dermal blood vessels, nerves and smooth muscle fibres led to the correct diagnosis. Absence of commonly observed changes in the circumcision skin like those of balanitis xerotica was also helpful. Detailed hematological work up revealed a previously undiagnosed chronic myeloid leukemia in chronic phase. The patient also had simultaneous priapism, another rare presentation of chronic myeloid leukemia. One year hence, the patient is in hematological remission with no evidence of extramedullary disease. Although priapism has been described as a rare presenting symptom in chronic myeloid leukemia, the present case is unique as this is the first time a cutaneous myeloid sarcoma has been documented in the penile foreskin. PMID:24913300

  5. Curative effect of bronchial arterial infusion and CT guided percutaneous ethanol injection in advanced non-small cell lung cancer

    International Nuclear Information System (INIS)

    Objective: To observe the therapeutic effect of chemotherapy combined bronchial arterial infusion (BAI) with CT guided percutaneous ethanol injection (PEI) in advanced non small cell lung cancer (NSCLC). Methods: Data of 36 cases with NSCLC treated by BAI from Oct, 2004 to Oct, 2005 were retrospectively analyzed. Among them, 21 cases were also treated by PEI (group A). 15 cases received BAI only (group B). Results: The efficient rate was 81% for group A (3 CR, 14 PR and 4 S) and 60% for group B (no CR, 9 PR, 4 S, 2 P ). Significant difference developed between group A and group B in efficient rate and half or one year survival rates, with group A higher than that of group B. Conclusion: Combining interventional therapy of BAI and PEI showed good therapeutic effect in the treatment of advanced lung cancer, without severe side-effect. (authors)

  6. Partial penile amputation due to penile tourniquet syndrome in a child troubled with primary nocturnal enuresis--a rare emergency.

    Science.gov (United States)

    Pahwa, Harvinder Singh; Kumar, Awanish; Srivastava, Rohit; Kumar, Suresh; Goel, Apul; Ahmad, Arshad

    2013-03-01

    Penile tourniquet syndrome (PTS) or acquired constriction ring syndrome (ACRS) is a rare emergency that can lead to a wide range of vascular and soft tissue injuries in the penis. We are presenting a case of penile tourniquet syndrome in an 8-year-old child who had tied a thread around his penis due to primary nocturnal enuresis. On exploration, a constricting thread ring was noticed that was causing partial circumferential distal penile amputation. The thread ring was cut and debridement with primary repair of the wound was done in layers. Prevention of complications needs early diagnosis, timely intervention, and removal of the constriction. PMID:23290150

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

    DEFF Research Database (Denmark)

    Kroigaard, C.; Dalsgaard, T.

    2012-01-01

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

  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. Carcinoma prostate with penile metastases. A case report.

    Science.gov (United States)

    Geetha, G; Nagarajan, V; Tulasi, N R; Nagarajan, M

    2002-06-01

    Prostatic carcinoma metastasizing to the penis is rare. The prognosis is also poor. A case of carcinoma prostate with penile metastases where successful palliation was achieved with external radiation therapy is reported. PMID:12789729

  10. Surgical reimplantation of penile glans amputation in children during circumcision

    OpenAIRE

    Khaireddine, Bouassida; Adnen, Hidoussi; Khaled, Ben M.; Adel, Slama

    2014-01-01

    Circumcision is one of the oldest and most commonly performed surgical procedures. Unfortunately, various complications may occur during circumcision, ranging from trivial to tragic such as penile amputation which is a serious complication and a challenging injury to treat. We describe two cases of non-microsurgical successful reattachment of a distal penile glans which were amputated during circumcision. In the first case, a 5-year-old child underwent circumcision by an urologist under local...

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

    OpenAIRE

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

  12. An unusual surgical success with a defective penile prosthesis

    OpenAIRE

    Zhao, Chen; Choi, Bo Ram; Jeong, Young Beom; Park, Jong Kwan

    2011-01-01

    A defective penile prosthesis is disconcerting for the surgeon performing an implantation in a patient with erectile dysfunction. We became aware of the defective Titan penile prosthesis just after insertion of the left cylinder, which had an abnormal rotation (180 degrees) due to abnormal rotated tubing, which occurred at the manufacturing plant. We successfully performed the implantation by cutting and re-connecting the tubing between the cylinder and pump with a spare connector. When the s...

  13. Penile prosthesis in the surgical treatment of Peyronie's disease

    OpenAIRE

    Ateia, D.; Voinescu, O.; Geavlete, R.

    2012-01-01

    Peyronie's disease appears to be a condition of middle-aged men. In many of them, the disease is accompanied by erectile dysfunction, which, until recently, was attributed to penile deformity. Later, it turned out that the erectile dysfunction has the same causes as in men without Peyronie's disease with vascular and psychological components. In all cases, the pathology of the disease is characterized by the formation of a fibrous plaque, which will lead to penile curvature at different de...

  14. 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.

  15. Multimodality imaging of penile cancer: what radiologists need to know.

    Science.gov (United States)

    Suh, Chong Hyun; Baheti, Akshay D; Tirumani, Sree Harsha; Rosenthal, Michael H; Kim, Kyung Won; Ramaiya, Nikhil H; Shinagare, Atul B

    2015-02-01

    The purpose of this article is to provide a comprehensive update on the role of imaging in the diagnosis and management of penile cancer. Imaging plays a major role in the initial assessment, treatment planning, and follow-up of patients with penile carcinoma. MRI helps in assessing the T staging of the primary and in detecting local recurrence. PET/CT and CT are useful for detecting regional nodal and distant metastases. PMID:25117563

  16. Sentinel node lymophoscintigraphy in penile cancer

    International Nuclear Information System (INIS)

    Objectives: To identify the value of sentinel node (SN) detection by lymphoscintigraphy in the penile cancer patients. Methods: Lymphoscintigraphy was performed in 19 patients (mean age 58.8 years, range 37-78 years) with squamous cell carcinoma of the penis. Tumor stage was T1N0 in 5 patients (26.3%), T1N1 in 1 patients (5.3%), T2N0 in 11 patients (57.9%), and T2N1 in 2 patients (10.5%). Technetium-99m nanocolloid with mean dose of 18.5 MBq, in a volume of 0.3-0.5 ml was injected subdermally at both sides of the tumor. Shortly after injection, a 30-min dynamic study was performed with a single-head gamma camera. Subsequent static anterior and lateral images of the pelvis were obtained at 30 min and 1 hour. Skin marking at SN was also done for intraoperative gamma probe guided biopsy. Results: The scintigraphy at 30 minutes revealed 55 SNs in 38 inguinal regions, including 1 or more unilateral nodes in 5 patients and bilateral lymphatic drainage in 11 patients. However, the study at 30 minutes revealed negative for SN in 3 patients. A total of 87 SNs in 18 patients were visualized (46 in the right groin, 41 in the left groin) and negative for SN in 1 patient at one hour after injection. The SN visualization rate was 94.7% (18/19). The lymphatic drainage was noted bilaterally in 57.9% of the patients (11/19). Visualization of the SNs before 30 min occurred in 15 patients (78.9%). At surgery, a total of 71 SNs (43 from the right groin, 28 from the left groin) were ident groin, 28 from the left groin) were identified and removed. All removing nodes were identified by the gamma probe detection. Two patients (10.5%) had a tumor positive SN and underwent standard regional lymph node dissection subsequently. Conclusions: The lymphoscintigraphy is a promising staging technique to detect early metastatic dissemination of penile cancer based on individual lymphatic drainage mapping. This technique enables to identify the patients with clinically node negative disease, who have a tumor positive SN and require regional lymph node dissection. The SN identification may lead to a more accurate staging and avoid extensive lymph node dissection in the majority of penile cancer patients with a tumor negative SN. (authors)

  17. Mechanisms of venous occlusion during canine penile erection: an anatomic demonstration.

    Science.gov (United States)

    Fournier, G R; Juenemann, K P; Lue, T F; Tanagho, E A

    1987-01-01

    Hemodynamic studies have clearly demonstrated that intracorporeal injection of papaverine causes an increase of venous outflow resistance, and we therefore undertook a study of the venous drainage of the canine penis to delineate the anatomic changes in the venular structure during papaverine-induced erection. In 11 dogs, the corpora cavernosa were examined by corrosion casting in six and serial trichrome staining and histologic sectioning in five. Low-power scanning electron microscopy of the corrosion casts demonstrated the existence of a venular plexus interposed between the tunica albuginea and the sinusoidal spaces. After papaverine injection, this subalbugineal venular plexus is compressed between the dilated sinusoids from below and the tunica albuginea from above, such that venous drainage is effectively impeded. Examination of two cadaveric human penile corrosion casts by low-power scanning electron microscopy revealed evidence of a similar subalbugineal venular plexus draining into the emissary veins along the shaft of the penis. Based on the above, a model for the anatomic basis of venous occlusion during penile erection is outlined. Along with arteriolar and sinusoidal smooth-muscle relaxation, this can account for the three basic hemodynamic changes necessary for erection: increased arterial inflow, increased intracorporeal pressure, and increased venous outflow resistance. PMID:3795360

  18. 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.

  19. Penile amputation and scrotal urethrostomy in 18 dogs.

    Science.gov (United States)

    Burrow, R D; Gregory, S P; Giejda, A A; White, R N

    2011-12-17

    The objective of this study was to report the signalment, indications for surgery, postoperative complications and outcome in dogs undergoing penile amputation and scrotal urethrostomy. Medical records of three surgical referral facilities were reviewed for dogs undergoing penile amputation and scrotal urethrostomy between January 2003 and July 2010. Data collected included signalment, presenting signs, indication for penile amputation, surgical technique, postoperative complications and long-term outcome. Eighteen dogs were included in the study. Indications for surgery were treatment of neoplasia (n=6), external or unknown penile trauma (n=4), penile trauma or necrosis associated with urethral obstruction with calculi (n=3), priapism (n=4) and balanoposthitis (n=1). All dogs suffered mild postoperative haemorrhage (posturination and/or spontaneous) from the urethrostomy stoma for up to 21 days (mean 5.5 days). Four dogs had minor complications recorded at suture removal (minor dehiscence (n=1), mild bruising and swelling around the urethrostomy site and mild haemorrhage at suture removal (n=2), and granulation at the edge of stoma (n=1)). One dog had a major complication (wound dehiscence and subsequent stricture of the stoma). Long-term outcome was excellent in all dogs with non-neoplastic disease. Local tumour recurrence and/or metastatic disease occurred within five to 12 months of surgery in two dogs undergoing penile amputation for the treatment of neoplasia. Both dogs were euthanased. PMID:21968541

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

    Science.gov (United States)

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

    2014-04-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Metz, P.; Vestergaard, A.S.; Bruenner, S.

    1982-05-01

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

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

    International Nuclear Information System (INIS)

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

  3. Penile ossification: A traumatic event or evolutionary throwback? Case report and review of the literature

    OpenAIRE

    Yilmaz, Ibrahim Edhem; Barazani, Yagil; Tareen, Basir

    2013-01-01

    Penile ossification is very rare, with only a handful of histologically confirmed reported cases. The most common condition leading to penile ossification is Peyronie’s disease. Other conditions, such as gout, end-stage renal disease, diabetes mellitus, hyperparathyroidism and local trauma, have also been associated with penile ossification. We report a unique case of near-complete penile ossification of the corporal bodies with histologic confirmation on pathologic review. Our report summa...

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

    OpenAIRE

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

    2012-01-01

    PURPOSE: Peyronie's disease is an acquired connective tissue disorder of the penile tunica albuginea with fibrosis and inflammation. The disease produces palpable plaques, penile curvature and pain during erections. Usually it results in impairment of the quality of life. Our objective is to review the long-term results of the albugineal grafting harvested from the penile crura for the treatment of severe penile curvature. MATERIALS AND METHODS: Thirty-three patients with Peyronie's disease w...

  5. [Therapeutic strategies in penile cancer: state of the art].

    Science.gov (United States)

    Gulino, Gaetano; Palermo, Giuseppe; Antonucci, Michele; Racioppi, Marco; Pinto, Francesco; Sacco, Emilio; Bassi, Pier Francesco

    2013-01-01

    A systematic review of the current treatment options and of the outcomes of penile carcinoma has been performed with special focus on controversial issues. A MedLine search using specified search terms was done during the period 1988 - January 2013. Demolitive surgery is considered as the "gold standard" treatment of invasive penile carcinoma staged higher than T2, but negative psychological outcomes were reported. On the other hand, conservative surgical techniques have been associated with higher recurrence rates. Potency-sparing technique (glansectomy and apexes sparing) preserves penile length: the reconstruction of glans anatomy and function is a key point to restore anatomy and sexual functions. Techniques such as glanduloplasty have given satisfactory anatomic, functional and sexual outcomes. Lymphadenectomy is indicated in any case of inguinal palpable nodes that persist after a course of antibiotic therapy, but also in all the cases staged T2 or higher, or in any high-grade penile cancer. It is still being debated the extension of inguinal lymphadenectomy for penile cancer: unilateral, bilateral, and extended to pelvic lymph nodes. Due to the specific radioresistance of penile cancer, radiation therapy is currently indicated in case of unresectable penile cancers with palliative intent. Chemotherapy is indicated as adjuvant therapy for stage T1-T3, N1-3, M0, or as neo-adjuvant therapy in the event of extensive pelvic and inguinal lymphadenopathies, or as palliative treatment in patients with unresectable or metastatic cancers. New chemotherapy agents such as Cis - platinum and Taxanes have shown promising results in early trials. PMID:23559129

  6. Nonmicrosurgical use of the radial forearm flap for penile reconstruction.

    Science.gov (United States)

    Mutaf, M

    2001-01-01

    Although the era of microsurgical techniques has greatly expanded the number of possible solutions for penile reconstruction, additional options are still needed for some unusual situations when microsurgery is not available or not desired. This article describes the first nonmicrosurgical use of the radial forearm flap for penile reconstruction. With this technique, an osteocutaneous radial forearm flap 15 x 20 cm in size is elevated as a reverse-flow island flap and used to create a neopenis in the classic "tube within a tube" fashion. The neopenis is then transferred to the recipient site as a distant flap, without dividing its vascular connection with the forearm. Once a complete healing is ensured after the following 2 to 3 weeks, the pedicle is cut and the penile reconstruction is completed. Since 1995, this technique was used for total penile reconstruction in four patients: two with congenital penile agenesis, one with penile amputation as a result of a high-voltage electrical injury, and one with total loss of the external genitalia as a result of a shotgun injury. The patients have been followed up for 1 to 4 years. Good results were achieved in all patients. In conclusion, non-microsurgical use of the radial forearm flap seems to be a useful alternative to create an innervated functionally and aesthetically acceptable neopenis when microsurgery is not available or not desired. Although it is a multistage procedure, it is easy to perform. Moreover, this technique provides all well-known advantages of the radial forearm flap in penile reconstruction but does not require the sophisticated equipment and expertise of microsurgery. This is a great advantage that enables surgeons without microsurgical skill to use the radial forearm flap for phallic reconstruction. The author believes that the described technique will be extremely useful in developing countries that have limited resources and where microsurgery is difficult to obtain. PMID:11176605

  7. Aspirin therapy in small-caliber arterial prostheses: long-term experimental observations.

    Science.gov (United States)

    Zammit, M; Kaplan, S; Sauvage, L R; Marcoe, K F; Wu, H D

    1984-11-01

    To study the therapeutic effects of 3 mg/kg aspirin given at the time of surgery and postoperatively, Dacron carotid grafts with an internal diameter of 4 mm and a length of 6 cm were implanted bilaterally in mongrel dogs. Sixteen control grafts in eight subjects and 20 grafts in 10 subjects treated with aspirin were followed by serial angiograms until consecutive studies showed stable patency rates in both groups. Platelet aggregations, malondialdehyde production, serum salicylate levels, and thromboxane A2 and prostacyclin secretion (measured as thromboxane B2 and 6-keto-prostaglandin F1 alpha) were monitored prior to and throughout the experiment. Surface mapping, indium-111 uptake, factor VIII-related antigen staining, and scanning and transmission electron microscopy were performed on the grafts at sacrifice. This study demonstrates a protective effect on the early patency of small-caliber prostheses in the canine model with daily oral aspirin administration. The degree and duration of this effect depends on the preoperative baseline ratio of thromboxane to prostacyclin in each subject. PMID:6238183

  8. Mechanical properties and composition of mesenteric small arteries of simulated microgravity rats with and without daily -G(x) gravitation.

    Science.gov (United States)

    Gao, Fang; Cheng, Jiu-Hua; Bai, Yun-Gang; Boscolo, Marco; Huang, Xiao-Feng; Zhang, Xiang; Zhang, Li-Fan

    2012-04-25

    The aim of the present study was to evaluate the active and passive mechanical properties and wall collagen and elastin contents of mesenteric small arteries (MSAs) isolated from rats of 28-day simulated microgravity (SUS), countermeasure [S + D: SUS plus 1 h/d -G(x) to simulate intermittent artificial gravity (IAG)] and control (CON) groups. Three mechanical parameters were calculated: the overall stiffness (?), circumferential stress (?(?))-strain (?(?)) relationship and pressure-dependent incremental elastic modulus (E(inc,p)). Vessel wall collagen and elastin percentage were quantified by electron microscopy. The results demonstrate that the active mechanical behavior of MSAs differs noticeably among the three groups: the active stress-strain curve of SUS vessels is very close to the passive curve, whereas the active ?(?)-?(?) curves of CON and S + D vessels are shifted leftward and display a parabolic shape, indicating that for MSAs isolated from S + D, but not those from SUS rats, the pressure-induced myogenic constriction can effectively stiffen the vessel wall as the CON vessels. The passive mechanical behavior of MSAs does not show significant differences among the three groups. However, the percentage of collagen is decreased in the wall of SUS and S + D compared with CON vessels in the following order: SUS gravity-based countermeasure. PMID:22513459

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

    Science.gov (United States)

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

    2015-01-01

    A 7 yr old castrated male standard poodle weighing 25 kg was presented with a 5 day history of hematuria, dysuria, and the presence of a 2.5 cm, firm swelling within the prepuce. Abdominal radiographs revealed a soft-tissue mass on the distal prepuce and lysis of the cranial margin of the os penis. The patient was sedated and an ulcerated hemorrhagic mass was identified at the tip of the penis. The mass was diagnosed as hemangiosarcoma via incisional biopsy. A penile amputation with scrotal urethrostomy was performed followed by chemotherapy with doxorubicin. PMID:25415220

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

    OpenAIRE

    Gontero, Paolo

    2002-01-01

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

  11. Endothelial epithelial sodium channel inhibition activates endothelial nitric oxide synthase via phosphoinositide 3-kinase/Akt in small-diameter mesenteric arteries.

    Science.gov (United States)

    Pérez, Francisco R; Venegas, Fabiola; González, Magdalena; Andrés, Sergio; Vallejos, Catalina; Riquelme, Gloria; Sierralta, Jimena; Michea, Luis

    2009-06-01

    Recent studies have shown that the epithelial sodium channel (ENaC) is expressed in vascular tissue. However, the role that ENaC may play in the responses to vasoconstrictors and NO production has yet to be addressed. In this study, the contractile responses of perfused pressurized small-diameter rat mesenteric arteries to phenylephrine and serotonin were reduced by ENaC blockade with amiloride (75.1+/-3.2% and 16.9+/-2.3% of control values, respectively; Pbenzamil, another ENaC blocker, had similar effects. alpha, beta, and gamma ENaC were identified in small-diameter rat mesenteric arteries using RT-PCR and Western blot with specific antibodies. In situ hybridization and immunohistochemistry localized ENaC expression to the tunica media and endothelium of small-diameter rat mesenteric arteries. Patch-clamp experiments demonstrated that primary cultures of mesenteric artery endothelial cells expressed amiloride-sensitive sodium currents. Mechanical ablation of the endothelium or inhibition of eNOS with N(omega)-nitro-L-arginine inhibited the reduction in contractility caused by ENaC blockers. ENaC inhibitors increased eNOS phosphorylation (Ser 1177) and Akt phosphorylation (Ser 473). The presence of the phosphoinositide 3-kinase inhibitor LY294002 blunted Akt phosphorylation and eNOS phosphorylation and the decrease in the response to phenylephrine caused by blockers of ENaC, indicating that the phosphoinositide 3-kinase/Akt pathway was activated after ENaC inhibition. Finally, we observed that the effects of blockers of ENaC were flow dependent and that the vasodilatory response to shear stress was enhanced by ENaC blockade. Our results identify a previously unappreciated role for ENaC as a negative modulator of eNOS and NO production in resistance arteries. PMID:19398659

  12. Imaging in primary penile cancer: current status and future directions

    International Nuclear Information System (INIS)

    Penile cancer is a rare neoplasm in the developed world. Clinical assessment often results in inaccurate staging and radiological techniques have a key role in staging and postoperative assessment. Magnetic resonance imaging (MRI) depicts penile anatomy in detail and is the most accurate technique for local staging and postoperative follow-up. MRI and ultrasound (US), although helpful for assessment of lymph nodes, are not reliable enough for accurate nodal staging. US-guided fine needle aspiration cytology (FNAC), however, remains a valuable tool to confirm metastases in suspicious inguinal nodes. Lymphoscintigraphy with dynamic sentinel node biopsy (DSNB) is a promising technique used to predict occult lymph node metastases. Novel imaging techniques such as positron emission tomography/computed tomography (PET-CT) and nanoparticle enhanced MRI have high sensitivity and specificity for lymph node metastases but their availability is limited and clinical utility is not fully established. The radiologist needs to be familiar with the normal penile anatomy, imaging appearances of pre- and post-treatment penile cancer, and the advantages and limitations of the available imaging techniques. This review highlights the above points and presents a systematic approach to make the best use of imaging in the management of patients with penile cancer. (orig.)

  13. Penile lymphoscintigraphy for sentinel node identification

    International Nuclear Information System (INIS)

    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. 57Co-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 SNuring 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.)

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

    DEFF Research Database (Denmark)

    Kroigaard, Christel; Dalsgaard, Thomas

    2012-01-01

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

  15. 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).

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

    Science.gov (United States)

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

    2014-10-01

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

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

    Science.gov (United States)

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

    2015-04-01

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

  18. An unusual surgical success with a defective penile prosthesis.

    Science.gov (United States)

    Zhao, Chen; Choi, Bo Ram; Jeong, Young Beom; Park, Jong Kwan

    2011-12-01

    A defective penile prosthesis is disconcerting for the surgeon performing an implantation in a patient with erectile dysfunction. We became aware of the defective Titan penile prosthesis just after insertion of the left cylinder, which had an abnormal rotation (180 degrees) due to abnormal rotated tubing, which occurred at the manufacturing plant. We successfully performed the implantation by cutting and re-connecting the tubing between the cylinder and pump with a spare connector. When the surgeon encounters a defective penile prosthesis with abnormal rotation of the cylinder due to abnormal rotated tubing in the operative field, disconnection and re-connection of the tubing using an extra connector are alternative cost-effective maneuvers. PMID:22154174

  19. 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.

  20. Radiation Dose-Volume Effects and the Penile Bulb

    International Nuclear Information System (INIS)

    The dose, volume, and clinical outcome data for penile bulb are reviewed for patients treated with external-beam radiotherapy. Most, but not all, studies find an association between impotence and dosimetric parameters (e.g., threshold doses) and clinical factors (e.g., age, comorbid diseases). According to the data available, it is prudent to keep the mean dose to 95% of the penile bulb volume to <50 Gy. It may also be prudent to limit the D70 and D90 to 70 Gy and 50 Gy, respectively, but coverage of the planning target volume should not be compromised. It is acknowledged that the penile bulb may not be the critical component of the erectile apparatus, but it seems to be a surrogate for yet to be determined structure(s) critical for erectile function for at least some techniques.

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

    OpenAIRE

    Tizzani, Alessandro; Gontero, Paolo

    2009-01-01

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

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

    DEFF Research Database (Denmark)

    Juul, B; Plesner, L

    2011-01-01

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

  3. 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 SciELO Brazil | Language: English Abstract in english 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

  4. Therapeutic effectiveness of the superselective arterial gelfoam embolization in post-traumatic arterial priapism

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Byung Chul [Ewha Womans Univ. College of Medicine, Seoul (Korea, Republic of); Won, Je Hwan [Ajou Univ. College of Medicine, Suwon (Korea, Republic of)

    1999-07-01

    We retrospectively evaluated superselective embolization with Gelfoam for the management of post-traumatic arterial priapism. Six male patients with post-traumatic priapism underwent pudendal angiography and embolization. We evaluated the time and incidence of detumescence after embolization and compared normal erectile function and its duration with the results of other reports. In all patients, color Doppler sonography was performed pre- and post-angiographically. On pudendal arteriography, intracavernosal arteriovenous fistulas were observed in all patients, and pseudoaneurysm of the cavernosal artery (or common penile artery) in three. Detumescence and normal erectile function were achieved in all patients after superselective embolization. Using color Doppler sonography, the location of the lesion causing priapism was found, in four patients, to be the proximal or middle one-third of the cavernosal artery. Pudendal angiography with superselective embolization with Gelfoam is a safe and effective method for the correction of post-traumatic arterial priapism.

  5. Therapeutic effectiveness of the superselective arterial gelfoam embolization in post-traumatic arterial priapism

    International Nuclear Information System (INIS)

    We retrospectively evaluated superselective embolization with Gelfoam for the management of post-traumatic arterial priapism. Six male patients with post-traumatic priapism underwent pudendal angiography and embolization. We evaluated the time and incidence of detumescence after embolization and compared normal erectile function and its duration with the results of other reports. In all patients, color Doppler sonography was performed pre- and post-angiographically. On pudendal arteriography, intracavernosal arteriovenous fistulas were observed in all patients, and pseudoaneurysm of the cavernosal artery (or common penile artery) in three. Detumescence and normal erectile function were achieved in all patients after superselective embolization. Using color Doppler sonography, the location of the lesion causing priapism was found, in four patients, to be the proximal or middle one-third of the cavernosal artery. Pudendal angiography with superselective embolization with Gelfoam is a safe and effective method for the correction of post-traumatic arterial priapism

  6. 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.

  7. 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 F-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

  8. Argon-helium cryoablation combined with bronchial artery infusion for the treatment of advanced non-small cell lung carcinoma

    International Nuclear Information System (INIS)

    Objective: To investigate the technique, efficacy and clinical significance of argon-helium cryoablation combined with bronchial artery infusion (BAI) for the treatment of advanced non-small cell lung carcinoma. Methods: Twenty patients, who met the requirements of this study, were divided into two groups. Patients in group A, were treated with argon-helium cryoablation only, whereas those in group B were treated with argon-helium cryoablation combined with BAI. Four week after the treatment, check-up CT scan or DSA were carried out. CT value of the tumor area both before and after the procedure was measured and compared.The clinical efficacy was evaluated based on the CT value, the parameters of CT perfusion imaging, RECIST criteria and the median survival time. Breslow method was used to figure out the median survival time and to draw the survival curves. Results: The coverage of spherical frozen region was over 90% in 80% patients (16/20). The difference was of no significance in the coverage between two groups (P > 0.05). The CT value of group A and group B was (16.73 ± 9.43) Hu and (15.29 ± 6.98) Hu, respectively, with no significant difference (P > 0.05). The blood flow (BF), blood volume (BV) and PS before the treatment were significantly different from that after the treatment in both group A and group B (P < 0.05). The difference in BV between two groups was statistically significant (P < 0.05). The therapeutic effect of group B was better than that of grou of group B was better than that of group A. During the follow-up period, 10 of the 20 patients died. The longest survival time was 20 months and the shortest survival time was 7 months, with the median survival time of 9 months in group A and 14 months in group B. By using Breslow method, the difference between two groups was of statistical significance (P < 0.05). The survival curves showed that the survival rate of group B was higher than that of group A. Conclusion: Argon-helium cryoablation combined with BAI is a safe and effect treatment for advanced non-small cell lung carcinoma, and its clinical efficacy is better than that of using cryoablation alone. CT perfusion imaging can reflex the changes after the operation, which is very helpful in accurately evaluating the therapeutic results. (authors)

  9. Differential actions of the prostacyclin analogues treprostinil and iloprost and the selexipag metabolite, MRE-269 (ACT-333679) in rat small pulmonary arteries and veins.

    Science.gov (United States)

    Orie, N N; Ledwozyw, A; Williams, D J; Whittle, B J; Clapp, L H

    2013-10-01

    The prostacyclin (IP) receptor agonists, treprostinil, iloprost and the selexipag metabolite, MRE-269 (ACT-333679) were evaluated in rat distal pulmonary blood vessels. Small pulmonary arteries and veins were pre-contracted with the thromboxane mimetic, U46619 (25 and 100nM, respectively), and relaxation determined with and without IP receptor antagonists, RO1138452 and RO3244794. In arteries, treprostinil was a more potent vasorelaxant than iloprost, while the efficacy of iloprost was greater. In pulmonary arteries, treprostinil-induced relaxation was essentially abolished by both IP antagonists (1?M), while responses to iloprost were partially inhibited. Both treprostinil and iloprost were equipotent, prominently relaxing pulmonary veins with responses being similarly and partially sensitive to IP antagonists. In contrast, RO1138452 failed to inhibit relaxations to MRE-269 in either pulmonary arteries or veins, suggesting no involvement of typical IP receptors. Thus, rat pulmonary tissues cannot be considered appropriate to assess classical IP receptors using the proposed highly selective non-prostanoid agonist MRE-269, contrasting with the IP receptor agonism profile of prostacyclin analogues, iloprost and treprostinil. PMID:23872196

  10. 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

  11. [Penile dressings of C.M.H. silicone elastomer foam].

    Science.gov (United States)

    Mollard, P

    1984-01-01

    We found silicone foam elastomer (produit by C.M.H. lab.) to be an excellent post-operative penile dressing. Although compressive the material is elastic enough to avoid ischemia and to allow slight swelling of the penis. Soft, light, it is never adherent to the wound and, thus, is removed easily without discomfort to the patient. PMID:6744501

  12. 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.

  13. Priapism secondary to penile metastasis in a dog

    OpenAIRE

    Rogers, Laura; Lo?pez, Alfonso; Gillis, Ann

    2002-01-01

    A 4-year-old, male Newfoundland cross was presented for lethargy, anorexia, and dysuria. The main clinical finding was an enlarged and painful prostate gland. While the dog was hospitalized, priapism developed. Following euthanasia, microscopic examination revealed that a carcinoma involving both bladder and prostate gland had widely metastasized to the penile vasculature.

  14. 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.

  15. 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.

  16. 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.

  17. Contrasting effects of simulated microgravity with and without daily -Gx gravitation on structure and function of cerebral and mesenteric small arteries in rats.

    Science.gov (United States)

    Lin, Le-Jian; Gao, Fang; Bai, Yun-Gang; Bao, Jun-Xiang; Huang, Xiao-Feng; Ma, Jin; Zhang, Li-Fan

    2009-12-01

    This study was designed to test the hypothesis that a 28-day tail suspension (SUS) could induce hypertrophy and enhanced myogenic and vasoconstrictor reactivity in middle cerebral arteries (MCAs), whereas atrophy and decreased myogenic and vasoconstrictor responses in mesenteric third-order arterioles (MSAs). Also, in addition to the functional enhancement in MCAs, structural changes in both kinds of arteries and functional decrement in MSAs could all be prevented by the intervention of daily 1-h dorsoventral (-G(x)) gravitation by restoring to standing posture. To test this hypothesis, vessel diameters to pressure alterations and nonreceptor- and receptor-mediated agonists were determined using a pressure arteriograph with a procedure to measure in vivo length and decrease hysteresis of vessel segments and longitudinal middlemost sections of vessels fixed at maximally dilated state were examined using electron microscopy and histomorphometry. Functional studies showed that 28-day tail-suspended, head-down tilt (SUS) resulted in enhanced and decreased myogenic tone and vasoconstrictor responses, respectively, in MCAs and MSAs. Histomorphometric data revealed that SUS-induced hypertrophic changes in MCAs characterized by increases in thickness (T) and cross-sectional area (CSA) of the media and the number of vascular smooth-muscle-cell layers (N(CL)), whereas in MSAs, it induced decreases in medial CSA and T and N(CL). Daily 1-h -G(x) over 28 days can fully prevent these differential structural changes in both kinds of small arteries and the functional decrement in MSAs, but not the augmented myogenic tone and increased vasoreactivity in the MCAs. These findings have revealed special features of small resistance arteries during adaptation to microgravity with and without gravity-based countermeasure. PMID:19815720

  18. Optimizing penile length in patients undergoing partial penectomy for penile cancer: novel application of the ventral phalloplasty oncoplastic technique.

    Science.gov (United States)

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

    2014-01-01

    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 penile 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. PMID:25498284

  19. 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.

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

    International Nuclear Information System (INIS)

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

  1. 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.

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

    OpenAIRE

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

    2014-01-01

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

  3. Radiation therapy of penile cancer: six to ten-year follow-up

    International Nuclear Information System (INIS)

    Ten patients with penile cancer were treated with radiation therapy between 1968 and 1973. Nine of ten remain free of disease though in 1 patient a new penile primary developed eight years after the radiation therapy and was treated by partial penectomy. One patient died following surgery for ''bleeding ulcer.'' He was free of penile cancer five years after radiation. The most common complication is urethral stricture and skin telangiectasia

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

    Directory of Open Access Journals (Sweden)

    Ozgu Aydogdu

    2011-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Carlos Teodósio Da Ros

    2012-04-01

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

  6. Conservative Management of Penile Trauma may be Complicated by Abscess Formation

    OpenAIRE

    Bantis, Athanasios; Sountoulides, Petros; Kalaitzis, Christos; Deftereos, Savas

    2014-01-01

    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 p...

  7. Effect of apomorphine on penile tumescence in men with psychogenic impotence.

    Science.gov (United States)

    Segraves, R T; Bari, M; Segraves, K; Spirnak, P

    1991-06-01

    In a double-blind study using physiological recording of penile tumescence, brachial subcutaneous apomorphine hydrochloride injections elicited penile erections in men with psychogenic impotence. This observation is compatible with the hypothesis of central dopaminergic involvement in human penile erection. Since apomorphine is believed to induce erections by its effect on brain monoamine pathways, apomorphine response may have diagnostic use in evaluating the etiology of erectile failure. PMID:2033687

  8. 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.

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

    Scientific Electronic Library Online (English)

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

    2012-04-01

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

  10. Complete penile amputation during ritual neonatal circumcision and successful replantation using postoperative leech therapy.

    Science.gov (United States)

    Banihani, Omaya I; Fox, Janelle A; Gander, Brian H; Grunwaldt, Lorelei J; Cannon, Glenn M

    2014-08-01

    Circumcision is the most common surgical procedure in males in the United States, and minor complications are not uncommon. Major complications like partial penile amputations have been reported with successful replantation. Complete penile amputations in adult males have been described, and successful replantation has been reported with increasing success. We report a case of complete penile amputation at the penopubic junction using a Mogen clamp in a 7-day-old neonate with replantation using postoperative leech therapy. To our knowledge this is the first time leech therapy has been used postoperatively for neonatal penile amputation. PMID:24928459

  11. Smooth muscle Ca(2+) -activated and voltage-gated K+ channels modulate conducted dilation in rat isolated small mesenteric arteries.

    OpenAIRE

    Beleznai, Tz; Yarova, Pl; Yuill, Kh; Dora, Ka

    2011-01-01

    OBJECTIVE: ? To assess the influence of blocking smooth muscle large conductance Ca(2+) -activated K+ channels and voltage-gated K+ channels on the conducted dilation to ACh and isoproterenol. MATERIALS AND METHODS: ? Rat mesenteric arteries were isolated with a bifurcation, triple-cannulated, pressurized and imaged using confocal microscopy. Phenylephrine was added to the superfusate to generate tone, and agonists perfused into a sidebranch to evoke local dilation and subsequent conducte...

  12. Penile tourniquet injury due to a coil of hair

    OpenAIRE

    Chaware Suresh; Gajbhiye Raj; Singh A.

    2006-01-01

    Penile strangulation caused by a coil of hair is frequently an unrecognized clinical entity with several potential complications, such as necrosis of glans penis, urethrocutaneous fistulae and partial or complete amputation of the glans. We report on a 7 year old boy with a tourniquet injury to the penis secondary to strands of hair being tied around the glans at the level of the corona.

  13. Penile tourniquet injury due to a coil of hair

    Directory of Open Access Journals (Sweden)

    Chaware Suresh

    2006-01-01

    Full Text Available Penile strangulation caused by a coil of hair is frequently an unrecognized clinical entity with several potential complications, such as necrosis of glans penis, urethrocutaneous fistulae and partial or complete amputation of the glans. We report on a 7 year old boy with a tourniquet injury to the penis secondary to strands of hair being tied around the glans at the level of the corona.

  14. Current approach to the treatment of penile implant infections

    OpenAIRE

    Mulcahy, John J.

    2010-01-01

    Modern penile implants, introduced to the market almost four decades ago, have provided a predictable and reliable treatment of erectile dysfunction (ED) despite the development of less-invasive therapies. Infection associated with the placement of these devices does occur, and with prophylactic measures and protocols the incidence has decreased fortunately. In the presence of an infection the implant and all foreign material should be removed. A salvage procedure, during which the wound is t...

  15. Pentoxifylline treatment and penile calcifications in men with Peyronie's disease

    OpenAIRE

    Smith, James F.; Shindel, Alan W.; Huang, Yun-ching; Clavijo, Raul I.; Flechner, Lawrence; Breyer, Benjamin N.; Eisenberg, Michael L.; Lue, Tom F.

    2010-01-01

    This retrospective cohort study from a single clinical practice enrolled patients with evidence of calcified Peyronie's disease (PD) plaques detected on penile ultrasound at the time of initial presentation. The primary objective was to describe the effect of pentoxifylline (PTX) treatment on subtunical calcifications in men with PD. A PD-specific questionnaire was administered and sonographic evaluations were performed at baseline and follow-up visits. Descriptive statistics and ?2 analysis...

  16. Ischemic Gangrene of the Glans following Penile Prosthesis Implantation

    OpenAIRE

    Alfredo Rodríguez Antolín; Eduardo García-Cruz; Estibaliz Jiménez Alcaide; Javier Romero Otero; Amp Xed Ez Sicilia, Laura D.; Amp Xf Mez, Borja Garc Amp Xed A. G.

    2013-01-01

    The development of ischemic gangrene of the penis following implantation of prosthesis is unusual, and very few cases are available in the literature. As a result, no established treatment protocol is available. We report our experience within a case of gangrene of the glans following implantation of a three-component prosthesis. We present a 53-year-old male, smoker with diabetes and hypercholesterolemia, who underwent surgery for the insertion of a penile prosthesis with 3 components to cor...

  17. Penile Fracture: Experience from a Third World Country

    OpenAIRE

    Sajad Ahmad Thakur; Rouf Ahmad Bhat; Shakeeb Nabi; Arshad Rashid; Majid Mushtaque; Rajandeep Singh Bali

    2013-01-01

    Aim. To ascertain the clinical presentation, commonest age group affected, and treatment of patients diagnosed to have penis fracture. Materials and Methods. We performed a retrospective study carried at a tertiary care hospital from January 2005 to January 2011. All the 36 patients diagnosed to have penile fracture were enrolled in the study group. The diagnosis was made based on the clinical findings in the patients. All, except two patients, were managed by a standard surgical procedure, s...

  18. Annualr elastolytic giant cell granuloma with penile involvement

    Directory of Open Access Journals (Sweden)

    Sengupta Sujata

    2006-01-01

    Full Text Available Annular elastolytic giant cell granuloma is a recently described entity of unknown origin that presents as indolently growing papules and plaques over sun-exposed skin. Histology shows a granulomatous infiltrate with loss of elastin in the center of the lesion. We came across a patient who had penile lesions and a paucity of literature about the involvement of the external genitalia in this disorder.

  19. Penile amputation and emasculation: hazards of modern agricultural machinery.

    Science.gov (United States)

    Dogra, P N; Gautam, Gagan; Ansari, M S

    2004-01-01

    We report a case of 20-year-old farmer with penile amputation and emasculation secondary to crushing injury inflicted by agricultural machinery. His entire penis, scrotum and both the testis had been avulsed after falling onto a rotating axel wheel of an electronically driven thrashing machine. After resuscitation the wound was thoroughly washed with saline, hemostasis achieved and a perineal urethrostomy was made from the remnant urethra. PMID:15783110

  20. 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

  1. Penile Prosthesis Implantation for Treatment of Postpriapism Erectile Dysfunction

    Directory of Open Access Journals (Sweden)

    Akbar A Jalal

    2008-06-01

    Full Text Available Normal 0 false false false MicrosoftInternetExplorer4 st1:*{behavior:url(#ieooui } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} 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 implanted, 11 were malleable, 4 were 2-piece, and 2 were 3-piece prostheses (AMS, Minnetonka, Minnesota, USA. Results: All the 17 patients were successfully implanted with penile prosthesis. Intra-operatively, corporeal dilation was difficult due to extensive corporeal fibrosis, which led to urethral injury in 2 patients. There were no major postoperative complications. The median hospital stay was 5 days. The follow-up period ranged from 2 to 9 years (median, 6 years. All the patients were satisfied with the prosthesis. Conclusion: Penile prosthesis implantation is the modality of treatment for patients with postpriapism erectile dysfunction at our institution. It has a high patient satisfaction rate. Although procedure-related complications are common due to corporeal fibrosis, they were mostly minor ones and did not affect the outcome of the procedure.

  2. Surgical reimplantation of penile glans amputation in children during circumcision.

    Science.gov (United States)

    Khaireddine, Bouassida; Adnen, Hidoussi; Khaled, Ben M; Adel, Slama

    2014-01-01

    Circumcision is one of the oldest and most commonly performed surgical procedures. Unfortunately, various complications may occur during circumcision, ranging from trivial to tragic such as penile amputation which is a serious complication and a challenging injury to treat. We describe two cases of non-microsurgical successful reattachment of a distal penile glans which were amputated during circumcision. In the first case, a 5-year-old child underwent circumcision by an urologist under local anesthesia. In the second one, a 3-year-old child underwent circumcision by a general practitioner who used to make circumcision. In this article, the literature is reviewed; results and potential complications of this surgery are also discussed. Glans sensation was present, early morning erection was maintained, and there was an erectile response during penile manipulation in both cases. Although circumcision is not technically difficult, it should be taken seriously. The use of microsurgical reattachment is not always possible, especially in pediatric cases; it also requires special equipment and training. PMID:24669132

  3. Ischemic Gangrene of the Glans following Penile Prosthesis Implantation

    Science.gov (United States)

    García Gómez, Borja; Romero Otero, Javier; Díez Sicilia, Laura; Jiménez Alcaide, Estibaliz; García-Cruz, Eduardo; Rodríguez Antolín, Alfredo

    2013-01-01

    The development of ischemic gangrene of the penis following implantation of prosthesis is unusual, and very few cases are available in the literature. As a result, no established treatment protocol is available. We report our experience within a case of gangrene of the glans following implantation of a three-component prosthesis. We present a 53-year-old male, smoker with diabetes and hypercholesterolemia, who underwent surgery for the insertion of a penile prosthesis with 3 components to correct his erectile dysfunction and severe Peyronie's disease. The procedure was carried out without incidents. During the postoperative period, the patient began to complain from penile and perineal pain. He developed avascular necrosis of the glans. The necrosed area was excised. Four weeks later, he developed fever and perineal pain arriving to the emergency room with the prosthesis extruding through the glans. He had emergency surgery to remove the prosthesis plus surgical lavage and was prescribed broad-spectrum antibiotic therapy. Four weeks later, the penis was completely revascularized and reepithelialized. Ischemic gangrene following penile prosthesis implantation takes place in patients with poor peripheral vascularisation. Diabetes mellitus has been the common denominator to all of the reported cases. PMID:23956919

  4. Granuloma de silicona en el pene "siliconoma" / Penile silicone granuloma

    Scientific Electronic Library Online (English)

    Fructuoso, García Díez; Francisco Miguel, Izquierdo García; Manuel Emilio, Benéitez Álvarez; Rafael, Guerreiro González; Javier, Casasola Chamorro; Victor de, Blas Gómez; Francisco Javier, Gallo Rolanía; Juan Manuel, Roa Luzuriaga.

    2005-06-01

    Full Text Available SciELO Spain | Language: Spanish Abstract in spanish OBJETIVO: Mostrar la experiencia adquirida con un caso de "siliconoma" peneano, de interés clínico por su infrecuente presentación. METODO /RESULTADOS: Presentamos el caso de un paciente con alteración de la función sexual secundaria a la inyección subcutánea de silicona líquida en el pene, dando lu [...] gar a la formación de un granuloma "siliconoma" peneano y a la migración de partículas del compuesto a raíz de pene y a rafe medio escrotal. Se procedió a la extirpación quirúrgica del "siliconoma " peneano y de las partículas migradas reparando el defecto peneano con piel escrotal. CONCLUSIONES: La inyección subcutánea de silicona líquida es una práctica no justificada que produce efectos devastadores y requiere cirugías importantes para la eliminación del material inyectado. Abstract in english OBJECTIVES: To report our experience with one case of penile silicone granuloma, that has clinical interest for its unfrequent presentation. METHODS/RESULTS: We report the case of a patient with sexual dysfunction secondary to subcutaneous injection of liquid silicone in the penis resulting in a pen [...] ile granuloma and migration of the particles to the penile root and midline scrotal raphe. We proceeded to the surgical excision of the granuloma and migrated particles, repairing the penile defect with scrotal skin. CONCLUSIONS: Subcutaneous injection of liquid silicone is a practice that does not have any justification because of its devastating effects and requires major perations for the elimination of the injected material.

  5. BLOOD FLOW RESISTANCE FOR A SMALL ARTERY WITH THE EFFECT OF MULTIPLE STENOSES AND POST STENOTIC DILATATION

    OpenAIRE

    Sanjeev Kumar; Chandrashekhar Diwakar

    2013-01-01

    An attention for the effect of a post stenotic dilatation and multiple stenoses on an arterial blood flow is made through this work. The resistance to flow ratio is investigated with the different values of yield stress, viscosity, and the flux. For this study we consider fully developed, one-dimensional non-Newtonian fluid namely Bingham plastic fluid flow through a single vessel. The radius of vessel is varying. The formula for the resistance to flow is determined and the results are found ...

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

    OpenAIRE

    Mustafa Yasar Ozdamar; Kursad Zengin; Serhat Tanik; Sebahattin Albayrak; Adnan Gucuk; Mesut Gurdal

    2014-01-01

    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.

  7. 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.

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

    Science.gov (United States)

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

    2014-01-01

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

  9. 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.

  10. 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.

  11. 99mTc penile scan: An investigative modality in priapism

    International Nuclear Information System (INIS)

    A 99mTc penile scan was performed in 9 patients with priapism. The technique of the procedure is described. Penile scan is an easily obtainable modality that can differentiate between high- and low-flow forms of priapism. We believe that these scintigraphic findings facilitate management of priapism

  12. /sup 99m/Tc penile scan: An investigative modality in priapism

    Energy Technology Data Exchange (ETDEWEB)

    Hashmat, A.I.; Raju, S.; Singh, I.; Macchia, R.J.

    1989-01-01

    A 99mTc penile scan was performed in 9 patients with priapism. The technique of the procedure is described. Penile scan is an easily obtainable modality that can differentiate between high- and low-flow forms of priapism. We believe that these scintigraphic findings facilitate management of priapism.

  13. Peripheral Artery Disease

    Science.gov (United States)

    ... an angioplasty procedure, an interventional radiologist threads a catheter through a blood vessel to the affected artery and inflates a small balloon to reopen it. In some cases, the insertion of a stent is required to ...

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

    Science.gov (United States)

    Bajpai, Minu

    2013-01-01

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

  15. 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.

  16. 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 SciELO Spain | Language: Spanish Abstract in spanish 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.

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

    OpenAIRE

    Baltogiannis Dimitrios; Zotos Konstantinos; Tsambalas Stavros; Giannakis Dimitrios; Sofikitis Nikolaos

    2011-01-01

    Abstract Introduction Penile cancer is uncommon. When penile cancer is left untreated, at an advanced stage it can have tragic consequences for the patient. Case presentation Our case report does not concern a new manifestation of penile cancer, but an interesting presentation with clinical significance that emphasizes the need to diagnose and treat penile cancer early. It is an unusual case of a neglected penile cancer in a 57-year-old Greek man that led to auto-amputation of the penis and a...

  18. A case of penile squamous cell carcinoma treated with a combination of antiepidermal growth factor receptor antibody and chemotherapy.

    Science.gov (United States)

    Men, Hai-Tao; Gou, Hong-Feng; Qiu, Meng; He, Jian-Ping; Cheng, Ke; Chen, Ye; Ge, Jun; Liu, Ji-Yan

    2014-01-01

    Our previous study showed that the features of epidermal growth factor receptor (EGFR)-RAS signaling in penile squamous cell carcinoma (SCC) suggested potential benefits of anti-EGFR monoclonal antibodies (mAbs) for penile SCC. Here, we report, for the first time, a combination of nimotuzumab (an EGFR mAb) with chemotherapy that resulted in a partial response in a 44-year-old patient with penile SCC, who developed bilateral inguinal node metastasis after primary partial penile amputation. The literature of case reports of anti-EGFR mAbs in penile SCC was also reviewed. PMID:24263192

  19. The combination of penile revascularization surgery with penile corrective techniques as an alternative to prosthesis implantation in patients with Peyronie's disease having ED: preliminary results.

    Science.gov (United States)

    Kayigil, O; Okulu, E

    2013-09-01

    The aim of this study was to investigate for the first time the surgical results of combining complex corrective techniques with penile revascularization in patients with Peyronie's disease having ED and consider the technique as an alternative to penile prosthesis implantation. Between 2008 and 2011 penile revascularization surgery along with penile corrective techniques was performed in nine patients with Peyronie's disease having ED. A preoperative urological evaluation was performed with penile color doppler ultrasonography, electromyography of the corpus cavernosum and cavernosometry. The degree of penile angulation was >40° in all patients. All the patients were asked to answer a 15-item questionnaire-the 'International Index of Erectile Function' (IIEF-15)-and a 5-item version of the IIEF (IIEF-5) preoperatively and during the postoperative follow-up. The operation was deemed an improvement or a failure according to the scores on the IIEF-5. The mean age of the patients was 51.4±4.2 years. The mean follow-up period was 18 months. None of the patients reported complications after surgery. Complete penile straightening was achieved in all patients. However, two (22.2%) patients reported penile shortening but did not express any dissatisfaction in this regard. All patients were satisfied with the final surgical results. The mean IIEF-5 score was 9.8±3.1 before the operation and it was reported to be 22.03±2.4 at the end of the follow-up period (PPeyronie's disease having ED; however, further studies are needed to validate this conclusion. PMID:23514758

  20. 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

  1. 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)

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

    DEFF Research Database (Denmark)

    MØller, Kate; Aalkjær, Christian

    2009-01-01

    Previous gene deletion studies have provided insight into the critical role of L-type voltage-gated Ca2+ channels (Cav1.2) in regulation of blood pressure. Homozygous knockout is, however, lethal but this limitation can be overcome by a small RNA 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 Cav1.2 or with the control non-related siRNAs. The effect of transfection was evaluated after 3 days using qPCR and isometric myography.   In comparison to some other genes the expression of Cav1.2 is very sensitive to transfection procedure (see abstract Broegger et al.). The optimization has been made to avoid the unwanted changes in mRNA in the controls transfected with non-related siRNAs. The level of Cav1.2 mRNA correlated with the functional responses, although when Cav1.2 mRNA was above 60% of the control no changes in the contractility were seen. When mRNA was <50% it accompanied with significant reduction in the contractile responses.   We conclude that although in vivo siRNA-induced downregulation in small arteries is possible the optimization of the procedure for the specific gene is necessary. Analyses at both functional and molecular biological levels are beneficial for correct evaluation of the efficiency of downregulation. Due to its the importance for vascular reactivity, Cav1.2 can be suggested as a good candidate for this siRNA optimization procedure.

  3. Study of penile circulation before and after radiation in patients with prostate cancer and its effect on impotence

    Energy Technology Data Exchange (ETDEWEB)

    Mittal, B.

    1985-06-01

    Decrease in penile blood flow has been implicated as the cause of erectile impotence in patients receiving pelvic irradiation. To determine any changes in the penile circulation secondary to pelvic irradiation, the authors measured the penile blood flow before and 6-9 months following completion of irradiation in six patients with prostate cancer. None of these patients had hormonal manipulation. The non-invasive techniques of Penile Brachial Index (PBI) and Penile Flow Index (PFI) were used to study penile circulation. Two patients developed impotence 2 to 4 1/2 months following completion of irradiation. There was no significant change in penile blood flow following irradiation in any of the six patients studied. The etiology of post-irradiation impotence is probably multifactorial and it may be an oversimplification to attribute it to a single organic cause.

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

    DEFF Research Database (Denmark)

    Jensen, P E; Ohanian, J

    1996-01-01

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

  5. 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

  6. Ultrasound guided dorsal penile nerve block in children.

    Science.gov (United States)

    Sandeman, D J; Dilley, A V

    2007-04-01

    We describe a technique for using a portable ultrasound scanner (38 mm broadband (10-5 MHz) linear array transducer (Sonosite Titan SonoSite, Inc. 21919 30th Drive SE Bothell, WA.)) to guide dorsal penile nerve block in children under general anaesthesia. Real-time scanning is used to guide bilateral injections into the sub-pubic space, deep to Scarpa's fascia either side of the midline fundiform ligament. Scanning can confirm that the local anaesthetic has spread to contact the deep fascia on each side. A subcutaneous wheal of local anaesthetic along the penoscrotal junction completes the block. PMID:17444318

  7. Penile cancer in a man with netherton syndrome.

    Science.gov (United States)

    Isharwal, Sumit; Manivel, Juan Carlos; Konety, Badrinath

    2015-04-01

    Netherton syndrome (NS) is a rare autosomal recessive skin disease with severe skin inflammation and scaling, a specific hair shaft defect (trichorrhexis invaginata or bamboo hair), and severe atopic manifestations including atopic dermatitis and hay fever with high serum immunoglobulin E levels and hypereosinophilia. NS is caused by loss-of-function mutations in serine protease inhibitor of Kazal-type 5 (SPINK5) encoding lympho-epithelial Kazal-type-related inhibitor (LEKTI) expressed in the stratified epithelia. We report the first case of penile squamous cell carcinoma in a patient with NS. PMID:25817126

  8. 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.

  9. 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 ra 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)

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

    International Nuclear Information System (INIS)

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

  11. 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 ad 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.

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

    Directory of Open Access Journals (Sweden)

    Ignjatovi? Ivan

    2010-01-01

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

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

    Science.gov (United States)

    Liu, Sulai; Zeng, Fuhua; Qi, Lin; Jiang, Shusuan; Tan, Pingping; Zu, Xiongbing; Xie, Yu; Han, Weiqing

    2014-07-01

    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 performed, and histological examination showed metastasis UC with sarcomatoid differentiation. To our knowledge, we describe the first case of malignant priapism due to isolated penile metastasis of renal pelvic carcinoma. PMID:25210564

  14. Pollakiuria and stranguria in a Labrador retriever with penile HSA.

    Science.gov (United States)

    Fry, Joanna K; Burney, Derek; Hottinger, Heidi; Fabiani, Michelle; Feagin, Clint

    2014-01-01

    An approximately 8 yr old castrated male Labrador retriever presented for evaluation of weight loss, stranguria, and pollakiuria. Lysis of the proximal one-third of the os penis was diagnosed on abdominal radiographs, and a positive contrast urethrography revealed a smoothly marginated filling defect along the dorsal aspect of the urethra at the level of the radiographically observed osteolysis. Regional ultrasound revealed an echogenic mass at the proximal aspect of the os penis with a severely irregular and discontinuous periosteal surface. A penile hemangiosarcoma (HSA) was confirmed on histopathologic evaluation after a penile amputation and scrotal urethrostomy were performed. Although HSA is a common malignant neoplasm in dogs, lysis of the os penis has not previously been documented. Adjunctive chemotherapy, although recommended, was declined, and the patient survived 236 days postoperatively. That survival time is considerably longer than the average survival time for patients with HSA, other than cutaneous forms of HSA. Although an uncommon presentation, HSA of the penis should be considered a differential diagnosis in older canines with signs of lower urinary tract disease, especially in breeds that have been documented to be predisposed to HSA. PMID:24446403

  15. Mentor inflatable penile prosthesis: clinical experience in 52 patients.

    Science.gov (United States)

    Merrill, D C

    1984-10-01

    The Mentor inflatable penile prosthesis is manufactured from Bioflex polyurethane, a material which is less elastic and more durable than silicone. Use of this new biocompatible polymer eliminates cylinder aneurysms and wear-induced cylinder leaks. The new prosthesis also incorporates a snap-on connector system designed to eliminate connector leaks and decrease operative time. The Mentor prosthesis has been implanted in 52 patients with organic impotence. The patients have been followed up for 2 to 16 months (average 8.3), the follow-up exceeding 1 year in 15 patients. A satisfactory cosmetic and functional result was achieved in 51 cases. Infection necessitated removal of the prosthesis in one patient. There were no pump, reservoir or tubing failures. After early connector failures there were no connector failures in the subsequent 48 patients. Additional complications included an incisional hernia and a cylinder failure which resulted from a manufacturing defect. There were no failures attributable to wear or material fatigue. The inherent reliability of this new prosthesis and the excellent functional and cosmetic results it produces justify its use in any patient who is a candidate for a penile prosthesis. PMID:6534455

  16. 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.

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

    Scientific Electronic Library Online (English)

    Natalio, Cruz Navarro.

    2010-10-01

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

  18. 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)

  19. Occlusion of small arteries in the neuroendovascular and head and neck territory-initial experiences with a microvascular plug.

    Science.gov (United States)

    Kleine, Justus F; Prothmann, Sascha; Boeckh-Behrens, Tobias

    2015-03-01

    The microvascular plug (MVP, UNO; Reverse Medical Corp, Irvine, California) is designed for occlusion of small vessels that are accessible only by microcatheters. This report describes eight neuroendovascular cases, including aneurysms and acute or imminent hemorrhage, treated with 10 microvascular plug devices. Instantaneous flow arrest was observed in all but two cases, in which the device was undersized, requiring supplementary coiling or microvascular plug replacement, respectively. Persistent occlusion was confirmed on follow-up examinations. There was one adverse event, which involved inadvertent device detachment after repeated resheathing. The microvascular plug appears to be suitable for the designated purpose. Further studies need to evaluate safety and confirm long-term durability of the results. PMID:25735524

  20. The treatment of ventral penile chordee without hypospadias by dorsal midline plication in an adolescent boy

    OpenAIRE

    Soner Coban; Muhammet Guzelsoy; Ali Riza Turkoglu; Murat Aydos

    2014-01-01

    Herein we report of a case with isolated ventral penile chordee who underwent dorsal midline plication procedure. We aimed to present our experience and to review of the literature on current management.

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

    Directory of Open Access Journals (Sweden)

    Baltogiannis Dimitrios

    2011-12-01

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

  2. Penile ischemia and loss due to warfarin-induced skin necrosis.

    Science.gov (United States)

    Talbert, Melissa; Wood, Hadley

    2011-02-01

    A 30-year-old man with a history of bilateral deep vein thromboses and recurrent penile ischemic episodes presented for distal penile amputation and skin graft. Despite suspicion, serologies indicated no hypercoagulable disorder. After surgery, the patient was bridged from enoxaparin to warfarin. Nine days after initiation of warfarin therapy, he developed necrotic arm ulcers, which were subsequently proved to be secondary to warfarin-induced skin necrosis. PMID:20451980

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

    Science.gov (United States)

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

    2014-01-01

    The present study set forth the reference values for penile size and determined the prevalence of buried penis in Japanese full-term newborns. The stretched penile length was measured and the presence of buried penis was assessed at 1-7 days of age in 547 Japanese full-term newborn infants born between 2008 and 2012 in Tokyo. The stretched penile lengths were compared at 1-12 hours and 1-7 days of age in 63 infants and by two observers in 73 infants to estimate postnatal changes and interobserver variation, respectively. The mean stretched penile length was 3.06 cm (SD, 0.26; 95% confidence interval [CI], 3.04-3.08) and the mean ratio of penile length to body length was 6.24 × 100(-1) (SD, 0.55 × 100(-1)), both of which were significantly smaller than those in Caucasian newborn infants. Buried penis was identified in 20 of 547 infants (3.7%; 95% CI, 2.1-5.2%). The first measurements of penile length at 1-12 hours were significantly smaller than the next measurements at 1-7 days (95% CI of the difference, 0.22-0.34). The 95% CI for the limits of agreement in the penile lengths measured by the two observers was -0.58 to -0.40 for the lower limit and 0.33 to 0.51 for the upper limit. These findings indicate that the penile length should be assessed after 24 hours of age by the reference standard of the same ethnicity for identifying micropenis and that buried penis is not uncommon in Japanese full-term newborns. PMID:24931740

  4. The Nesbit operation for penile curvature: an easy and effective technical modification

    OpenAIRE

    Fontana, Dario; Rolle, Luigi; Destefanis, Paolo; Ceruti, Carlo

    2005-01-01

    PURPOSE: We report the results of an original technical modification to the Nesbit operation, designed to increase precision and simplify the correction of congenital or acquired penile curvature. MATERIALS AND METHODS: A total of 50 patients were considered candidates for surgical treatment of penile curvature and underwent a modified corporoplasty procedure involving plication suture on the convex aspect of the penis before tunica albuginea resection. Hospital records and followup data were...

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

    OpenAIRE

    Rees, R.; Manners, J.; Ashouri, F.

    2011-01-01

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

  6. An innovative surgical technique for treating penile incarceration injury caused by heavy metallic ring

    OpenAIRE

    Baruah, S. J.; Bagchi, P. K.; Barua, S. K.; Deka, P. M.

    2009-01-01

    Penile incarceration injury by heavy metallic ring is a rare genital injury. A man may place metal object for erotic or autoerotic purposes, for masturbation or increasing erection, and due to psychiatric disturbances are some of the reasons for a penile incarceration injury. The incarcerating injury results in reduced blood flow distal to the injury, leading to edema, ischemia, and sometimes gangrene. These injuries are divided into five grades and their treatment options are divided into fo...

  7. Detection of human papillomavirus types in balanitis xerotica obliterans and other penile conditions.

    OpenAIRE

    Lau, P. W.; Cook, N.; Andrews, H.; Bracka, A.; Myint, S. H.

    1995-01-01

    OBJECTIVES--To determine the prevalence of human papillomavirus (HPV) types 6, 11, 16 and 18 in foreskin biopsies from patients with balanitis xerotica obliterans (BXO) and other penile conditions. MATERIALS AND METHODS--Foreskin biopsy specimens from 24 patients with penile lesions and 5 control patients were analysed by type-specific polymerase chain reaction (PCR). RESULTS--HPV6 or HPV16 were not detected in patients with BXO. HPV6 was detected in 2 controls. CONCLUSIONS--Genital papilloma...

  8. 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.

  9. Gastroenterology-urology devices; classification for external penile rigidity devices. Final rule.

    Science.gov (United States)

    2004-12-28

    The Food and Drug Administration (FDA) is classifying external penile rigidity devices intended to create or maintain sufficient penile rigidity for sexual intercourse into class II (special controls). FDA also is exempting these devices from premarket notification requirements. Elsewhere in this issue of the Federal Register, FDA is announcing the availability of the guidance document that will serve as the special control for the device. PMID:15624252

  10. 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...

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

    OpenAIRE

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

    2014-01-01

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

  12. Penile gangrene with abscess formation after modified Al-ghorab shunt for idiopathic ischemic priapism.

    Science.gov (United States)

    Ford-Glanton, Beneranda S; Patel, Parth; Siddiqui, Sameer

    2014-01-01

    Penile gangrene is a rare but unfortunate complication of surgical intervention and priapism shunts. The literature regarding penile gangrene following surgical correction of priapism is sparse, the majority of which dates back to thirty to forty years. Here, we present the case of a 60-year-old man who presented with priapism that required operative management with a modified Al-Ghorab shunt and eventually suffered from complete necrosis of the penis with abscess formation in both corpora cavernosa. PMID:25276468

  13. Current and Future Strategies in the Diagnosis and Management of Penile Cancer

    OpenAIRE

    Spiess, Philippe E.; Simon Horenblas; Rodriguez, Alejandro R.; Lawindy, Samuel M.

    2011-01-01

    Penile cancer is an uncommon malignancy that has a devastating effect on the patient while also being challenging to diagnose and treat. By implementing preventive measures, we can decrease the incidence of this disease and improve the quality of life of our patients. Early detection plays an important role in disease control and proper diagnostic modalities must be used in order to accurately identify the cancer and its progression. Primary penile lesions should be initially approached wh...

  14. Human papillomavirus and penile cancers in Rio de Janeiro, Brazil: HPV typing and clinical features

    OpenAIRE

    Scheiner, Marcos A.; Campos, Mercia M.; Ornellas, Antonio A.; Chin, Eduardo W.; Ornellas, Maria H.; Andrada-serpa, Maria J.

    2008-01-01

    OBJECTIVE: To determine the prevalence of human papillomavirus (HPV) DNA in penile cancers in Rio de Janeiro, Brazil. MATERIALS AND METHODS: We studied, prospectively, 80 consecutive cases of patients with penile cancers who underwent surgical treatment at three different Hospitals in Rio de Janeiro between March 1995 and June 2000. Of these patients, 72 were diagnosed with invasive squamous cell carcinoma and 8 patients with verrucous carcinoma. The following parameters were observed: presen...

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

    OpenAIRE

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

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Safarinejad

    2007-02-01

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

  17. 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

  18. 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.

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

    OpenAIRE

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

    2008-01-01

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

  20. Penile prosthesis implantation and tunica albuginea incision without grafting in the treatment of Peyronie's disease with erectile dysfunction

    OpenAIRE

    Djordjevic, Miroslav L.; Kojovic, Vladimir

    2013-01-01

    We evaluated penile prosthesis implantation with tunica albuginea-relaxing incisions without grafting in the treatment of Peyronie's disease associated with erectile dysfunction. Between April 2005 and June 2011, 62 patients underwent surgery due to severe Peyronie's disease associated with erectile dysfunction. Malleable and inflatable penile prostheses were inserted in 49 and 13 cases, respectively. Penile prostheses were inserted into the corpora cavernosa using the standard ventral approa...

  1. Tunical plication in the management of penile curvature due La Peyronie’s disease. Our experience on 47 cases

    OpenAIRE

    Iacono Fabrizio; Prezioso Domenico; Ruffo Antonio; Illiano Ester; Romeo Giuseppe; Amato Bruno

    2012-01-01

    Abstract Background Peyronie’s disease is an acquired connective tissue disorder of the penile tunica albuginea with fibrosis and inflammation. The disease produces palpable plaques, penile curvature and pain during erections. Patients report negative effects in four major domains: physical appearance and self-image, sexual function and performance. These changes damage sexual life and compromise the quality of life. Our objective is to review the patient's sexual life after penile tunical ...

  2. Penile traction therapy and Peyronie’s disease: a state of art review of the current literature

    OpenAIRE

    Chung, Eric; Brock, Gerald

    2013-01-01

    In recent years, penile traction therapy (PTT) has gained considerable interest as a novel nonsurgical treatment option for men with Peyronie’s disease (PD) and short penises. The current published literature suggests that selected cases of PD may benefit from a conservative approach with PTT, resulting in increased penile length and reduction of penile deformity. It appears to be safe and well tolerated but requires a great deal of patient compliance and determination. This article reviews...

  3. Influence of a small field-of-view size on the detection of coronary artery calcifications with MSCT: in vitro and in vivo study

    International Nuclear Information System (INIS)

    The purpose of this study is to asses the impact of small field-of-view (FOV) sizes on the detection of coronary artery calcifications using multislice-spiral computed tomography (MSCT). First, a static chest phantom containing calcium inserts was scanned 10 times using a standardized scan protocol. Secondly, 50 patients (28 male, 63.6±10.6 years) underwent cardiac MSCT using the same protocol. Images were reconstructed with three different FOV sizes (180 x 180, 220 x 220, 380 x 380 mm2). Coronary calcium scoring and risk stratification were performed for each image series. In the phantom study, the Agatston score calculated with a FOV size of 180 x 180 mm2 was 657.80±20.05. At a FOV of 220 x 220 mm2 and 380 x 380 mm2, the corresponding values were 657.04±21.36 and 655.04±20.74, respectively. The corresponding values in the patient study were 541.65±869.87, 541.91±872.57 and 536.61±867.81. No statistically significant differences in the calcium score were found comparing different FOV sizes. Significantly more lesions (p=0.00149) were detected in the patient study. Comparing the different FOV sizes of 180 x 180 mm2 and 220 x 220 mm2 (380 x 380 mm2), four (six) patients had to be assigned to different risk groups. The use of small FOV sizes resulted in an improved detection of coronary calcifications influencing the risk stratification for further cardiac events in MSCT coronary calciumiac events in MSCT coronary calcium scoring. (orig.)

  4. Influence of a small field-of-view size on the detection of coronary artery calcifications with MSCT: in vitro and in vivo study

    Energy Technology Data Exchange (ETDEWEB)

    Mahnken, Andreas H.; Muehlenbruch, Georg; Das, Marco; Pohl, Saskia; Guenther, Rolf W.; Wildberger, Joachim E. [Aachen University of Technology, Department of Diagnostic Radiology, Aachen (Germany); Koos, Ralf [Aachen University of Technology, Medical Clinic I, Aachen (Germany); Stanzel, Sven [Aachen University of Technology, Institute of Medical Statistics, Aachen (Germany)

    2006-02-01

    The purpose of this study is to asses the impact of small field-of-view (FOV) sizes on the detection of coronary artery calcifications using multislice-spiral computed tomography (MSCT). First, a static chest phantom containing calcium inserts was scanned 10 times using a standardized scan protocol. Secondly, 50 patients (28 male, 63.6{+-}10.6 years) underwent cardiac MSCT using the same protocol. Images were reconstructed with three different FOV sizes (180 x 180, 220 x 220, 380 x 380 mm{sup 2}). Coronary calcium scoring and risk stratification were performed for each image series. In the phantom study, the Agatston score calculated with a FOV size of 180 x 180 mm{sup 2} was 657.80{+-}20.05. At a FOV of 220 x 220 mm{sup 2} and 380 x 380 mm{sup 2}, the corresponding values were 657.04{+-}21.36 and 655.04{+-}20.74, respectively. The corresponding values in the patient study were 541.65{+-}869.87, 541.91{+-}872.57 and 536.61{+-}867.81. No statistically significant differences in the calcium score were found comparing different FOV sizes. Significantly more lesions (p=0.00149) were detected in the patient study. Comparing the different FOV sizes of 180 x 180 mm{sup 2} and 220 x 220 mm{sup 2} (380 x 380 mm{sup 2}), four (six) patients had to be assigned to different risk groups. The use of small FOV sizes resulted in an improved detection of coronary calcifications influencing the risk stratification for further cardiac events in MSCT coronary calcium scoring. (orig.)

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

    Scientific Electronic Library Online (English)

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

    1065-10-01

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

  6. Apomorphine-induced penile erections in Parkinson's disease.

    Science.gov (United States)

    O'Sullivan, J D; Hughes, A J

    1998-05-01

    Penile erections were regularly induced by intermittent subcutaneous injections of apomorphine in five patients with Parkinson's disease (PD) complicated by motor fluctuations. Four of the patients reported erectile dysfunction before beginning apomorphine and two of these report a significant improvement in their sexual function resulting from apomorphine use. Animal studies suggest central D2-type dopamine receptor stimulation and oxytocin release from the paraventricular nucleus of the hypothalamus mediate the effect. Erections reported with other dopamine agonists and levodopa are probably mediated by the same mechanism. Apomorphine-induced erections in PD are probably more common than previously thought. The benefit of apomorphine on sexual function in some patients suggests a possible role in the treatment of impotence in PD. PMID:9613749

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

    Directory of Open Access Journals (Sweden)

    Ekrem Akta?

    2008-12-01

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

  8. Is there a rationale for penile rehabilitation following radical prostatectomy?

    Science.gov (United States)

    Barazani, Yagil; Stahl, Peter J; Nagler, Harris M; Stember, Doron S

    2015-01-01

    Erectile function recovery after radical prostatectomy (RP) is an increasingly prominent quality-of-life outcome following surgery. Following RP many men, despite the advent of cavernous nerve-sparing surgical technique, have moderately or significantly impaired erectile function (EF). The term penile rehabilitation (PR) is used to define interventions that maintain the health of erectile tissue in the context of nervous, vascular, and structural tissue injury. The goal of PR is to regain, as closely re-approximate, preoperative erectile function. PR is based on an increasing volume of preclinical and clinical data, but conclusive evidence of efficacy has not been established, and therefore the concept of PR remains controversial. The optimal PR regimen has not been established, but all strategies rely on one or more erectile dysfunction treatments to be administered on a regular basis regardless of actual use for sexual activity. This review highlights recent studies and evidence related to PR. PMID:24692247

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

    Directory of Open Access Journals (Sweden)

    Mario Paranhos

    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 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 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.

  10. 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 SciELO Brazil | Language: English Abstract in english 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.

  11. 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.

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

    International Nuclear Information System (INIS)

    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.)

  13. OUR EXPERIENCE WITH TUBULARIZED INCISED PLATE URETHROPLASTY FOR DISTAL AND MID-PENILE HYPOSPADIAS

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    Danijela ?eri?

    2003-10-01

    Full Text Available Hypospadias does not present an isolated genital anomaly but a complex urological, sex-ual, psychological and psychiatric, reproductive and aesthetic problem. Although there are over 200 operative techniques, this great surgical challenge presently does not have ideal operative solution. Nowadays, the use of urethral plate for urethroplasty, through various surgical tech-niques, presents a revolutionary concept in hypospadias surgery and it is being accepted by an ever-increasing number of hypospadiologists.Tubularized incised plate urethroplasty (TIP -Snodgrass procedure was performed on a total of 22 boys; 16 distal (72.7%, 5 mid-penile (22.7% and 1 proximal hypospadias in period from 1.1.2000 to 30.08.2003, by the same surgical team. The average patient age was 4.5 years (6 mon. to 12 years. All reconstructions have been done as primary urethroplasty while one distal hypospadias had one previous, unsuccessful MAGPI procedure. Complication included small urethrocutaneous fistulas in 4 (18% and meatal stenosis in 1 (4.5% child. Snodgrass pro-cedure is a successful method for reparation of distal hypospadias for it provides an excellent aesthetic result with acceptable complications. In order to evaluate the success of this method in reparation of mid- and proximal hypospadias, as well as the possibility of its application on previously unsuccessful or circumcised patients, it is necessary to gain additional experience al-though the first results are encouraging.

  14. A New, Innovative, Lengthening Surgical Procedure for Peyronie's Disease by Penile Prosthesis Implantation with Double Dorsal-Ventral Patch Graft: The "Sliding Technique"

    OpenAIRE

    Fontana, Dario; Destefanis, Paolo; Rolle, Luigi; Ceruti, Carlo

    2012-01-01

    Introduction.? Peyronie's disease is the result of the formation of fibrous plaques in the tunica albuginea of the penis; typical presentations of the disease are represented by pain during erection, erectile dysfunction, and penile deformities, such as curvature, narrowing, and penile shortening. The most complex treatment is related to penile shortening. Aim.? To find a safe procedure in penile shortening due to Peyronie's disease providing a satisfactory lengthening, allowing an early ...

  15. 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.

  16. 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.

  17. The potential of Cystatin C and small dense LDL as biomarkers of coronary artery disease risk in a young Indian population.

    Science.gov (United States)

    Manocha, Anjali; Gupta, Flora; Jain, Rajneesh; Bhargava, Seema; Kankra, Mamta; Das, Sabari; Srivastava, L M

    2014-04-01

    Coronary artery disease (CAD) affects Indians 5-6 years earlier than in the west, is diffuse and malignant, and poses a heavy burden on India's developing economy. Traditional risk factors have failed to explain this high incidence of premature CAD and hence this study investigated the association of two novel risk biomarkers, cystatin C and small dense LDL (sdLDL) with the presence and severity of CAD. Cystatin C and sdLDL were estimated in 204 CAD patients ?45 years of age and compared with 161 age-matched healthy controls. The traditional lipid profile parameters, i.e., cholesterol, LDL, HDL, triglycerides, apolipoproteins A1 and B, and Lp(a) were also measured in both groups. Cystatin C was significantly raised and mean LDL particle size significantly reduced in CAD patients as compared to controls. 62.7 % of CAD patients showed pattern B while 37.3 % patients showed pattern A. Of the traditional lipid tests, only HDL and apolipoprotein A1 showed a significant decrease in the CAD group. sdLDL was significantly associated with the severity of CAD, while cystatin C was not. Both cystatin C and sdLDL emerged as independent risk factors, however, of the two, sdLDL was a more sensitive predictor of CAD events. Cystatin C and mean LDL particle size are significantly and independently associated with the presence of CAD events in patients ?45 years with normal kidney function. Hence, these novel risk biomarkers can be useful tools in reducing the morbidity and mortality associated with CAD in the productive Indian workforce. PMID:24357117

  18. Cellular basis of endothelial dysfunction in small mesenteric arteries from spontaneously diabetic (db/db ?/?) mice: role of decreased tetrahydrobiopterin bioavailability

    Science.gov (United States)

    Pannirselvam, Malarvannan; Verma, Subodh; Anderson, Todd J; Triggle, Chris R

    2002-01-01

    Endothelium-dependent and -independent regulation of vascular tone in small mesenteric arteries (SMA) from control (db/db +/?) and diabetic (db/db ?/?) mice was compared.Phenylephrine-induced maximum contraction, but not sensitivity, of SMA in db/db ?/? compared to db/db +/? was enhanced.Acetylcholine (ACh), but not sodium nitroprusside (SNP), -induced relaxation was reduced in SMA from db/db ?/? compared to db/db +/?.ACh-induced relaxation of SMA was inhibited by a combination of N?-nitro-L-arginine and indomethacin in db/db +/?, but not in db/db ?/?.Acute incubation of SMA with tetrahydrobiopterin (BH4, 10??M) and sepiapterin (100??M) enhanced ACh-induced relaxation in SMA from db/db ?/?, but not from db/db +/? 2,4-diamino-6-hydroxypyrimidine, an inhibitor of GTP cyclohydrolase I, (10?mM), impaired the sensitivity of SMA from db/db +/? to ACh, which was restored by co-incubation with BH4 (10??M).BH4 and superoxide dismutase (SOD, 150?u?ml?1), either alone or in combination, had no effect on either ACh or SNP-induced relaxation in SMA from eNOS ?/? mice.Incubation of SMA with SOD (150?iu?ml?1), catalase (200?iu?ml?1) and L-arginine (1?mM) had no effect on ACh-induced relaxation of SMA. However, the combination of polyethylene glycol-SOD (200?iu?ml?1) and catalase (80?u?ml?1) improved the sensitivity of ACh-induced relaxation in db/db ?/?, but not in db/db +/?.These data suggest that increased production of superoxide anions and decreased availability of BH4 result in an ‘uncoupling' of nitric oxide synthase and endothelial dysfunction in SMA from db/db ?/? mice. PMID:12010774

  19. Cellular basis of endothelial dysfunction in small mesenteric arteries from spontaneously diabetic (db/db -/-) mice: role of decreased tetrahydrobiopterin bioavailability.

    Science.gov (United States)

    Pannirselvam, Malarvannan; Verma, Subodh; Anderson, Todd J; Triggle, Chris R

    2002-05-01

    1. Endothelium-dependent and -independent regulation of vascular tone in small mesenteric arteries (SMA) from control (db/db +/?) and diabetic (db/db -/-) mice was compared. 2. Phenylephrine-induced maximum contraction, but not sensitivity, of SMA in db/db -/- compared to db/db +/? was enhanced. 3. Acetylcholine (ACh), but not sodium nitroprusside (SNP), -induced relaxation was reduced in SMA from db/db -/- compared to db/db +/?. 4. ACh-induced relaxation of SMA was inhibited by a combination of N(omega)-nitro-L-arginine and indomethacin in db/db +/?, but not in db/db -/-. 5. Acute incubation of SMA with tetrahydrobiopterin (BH(4), 10 microM) and sepiapterin (100 microM) enhanced ACh-induced relaxation in SMA from db/db -/-, but not from db/db +/? 2,4-diamino-6-hydroxypyrimidine, an inhibitor of GTP cyclohydrolase I, (10 mM), impaired the sensitivity of SMA from db/db +/? to ACh, which was restored by co-incubation with BH(4) (10 microM). 6. BH(4) and superoxide dismutase (SOD, 150 u ml(-1)), either alone or in combination, had no effect on either ACh or SNP-induced relaxation in SMA from eNOS -/- mice. 7. Incubation of SMA with SOD (150 iu ml(-1)), catalase (200 iu ml(-1)) and L-arginine (1 mM) had no effect on ACh-induced relaxation of SMA. However, the combination of polyethylene glycol-SOD (200 iu ml(-1)) and catalase (80 u ml(-1)) improved the sensitivity of ACh-induced relaxation in db/db -/-, but not in db/db +/?. 8. These data suggest that increased production of superoxide anions and decreased availability of BH(4) result in an 'uncoupling' of nitric oxide synthase and endothelial dysfunction in SMA from db/db -/- mice. PMID:12010774

  20. Occlusive Peripheral Arterial Disease

    Science.gov (United States)

    ... Disease Peripheral Arterial Disease Aneurysms and Aortic Dissection Venous Disorders Lymphatic Disorders Topics in Peripheral Arterial Disease Overview of Peripheral Arterial Disease Occlusive Peripheral Arterial ...

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

    Directory of Open Access Journals (Sweden)

    Ali Reza Babaei

    2009-02-01

    Full Text Available

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

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

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

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

  2. Urethral reconstruction in severe hypospadias using buccal mucosa graft and penile skin flap

    Directory of Open Access Journals (Sweden)

    Majstorovi? Marko

    2011-01-01

    Full Text Available Introduction. Hypospadias represents the most frequent penile anomaly. The most challenging part of hypospadias surgery is urethral reconstruction. Many various tissues are used (local skin flaps, bladder mucosa grafts, buccal mucosa grafts etc. for the reconstruction of the neourethra. Objective. Our aim was to evaluate advantages and disadvantages of combined buccal mucosa graft and penile skin flap in urethral reconstruction in severe hypospadias repair. Methods. Between December 2005 and August 2009, 48 patients with severe hypospadias, aged from nine months to 12 years (mean age 23 months underwent surgery. Thirty-four (71% had penoscrotal and 14 (29% scrotal hypospadias. Ventral penile curvature was present in all cases, and was corrected by incision of the short urethral plate. Urethroplasty was performed using a buccal mucosa graft combined with dorsal penile skin flap. Results. Mean follow-up was 22 months (range from 9 months to 3 years. Satisfactory functional and aesthetic results were achieved in 40 (83% patients. Fistula was noted in six cases and was solved by minor revision. Urethral stenosis in two cases was resolved by simple dilatation. Conclusion. Urethral reconstruction using the buccal mucosa graft and dorsal penile skin flap in severe hypospadias repair could be the method of choice. Using this technique, single stage urethral reconstruction is possible with satisfactory esthetical and functional results.

  3. Mechanisms predisposing penile fracture and long-term outcomes on erectile and voiding functions.

    Science.gov (United States)

    Reis, Leonardo O; Cartapatti, Marcelo; Marmiroli, Rafael; de Oliveira Júnior, Eduardo Jeronimo; Saade, Ricardo Destro; Fregonesi, Adriano

    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-question self-report of erectile and voiding functions. Results. Among the 44 suspicious cases, 42 (95.4%) were confirmed, mean age was 34.5 years (range: 18-60), mean follow-up 59.3 months (range 9-155). Half presented the classical triad of audible crack, detumescence, and pain. Heterosexual intercourse was the most common cause (28 patients, 66.7%), followed by penile manipulation (6 patients, 14.3%), and homosexual intercourse (4 patients, 9.5%). "Woman on top" was the most common heterosexual position (n = 14, 50%), followed by "doggy style" (n = 8, 28.6%). Four patients (9.5%) maintained the cause unclear. Six (14.3%) patients had urethral injury and two (4.8%) had erectile dysfunction, treated by penile prosthesis and PDE-5i. No patient showed urethral fistula, voiding deterioration, penile nodule/curve or pain. Conclusions. "Woman on top" was the potentially riskiest sexual position (50%). Immediate surgical treatment warrants long-term very low morbidity. PMID:24822062

  4. Coronary artery grafting in infants

    Science.gov (United States)

    Gopal, MR; Maskari, S; Zacharias, S; Valliathu, J

    2009-01-01

    Background Coronary artery bypass grafting (CABG) with cardiac vale repair is an uncommon surgery in infants. CABG is technically demanding in infants due to the small size not only of the coronary arteries but also the potential graft arteries. The short and long-term outcome of surgery is not known and thus has largely been avoided. Results We report the case histories of two infants in whom CABG was undertaken successfully as a life-saving measure. Case 1: This infant needed an arterial switch operation after which the right coronary artery (RCA) was stenosed resulting in low cardiac output. After the right internal mammary artery (RIMA) was used to anastamose the RCA, the hemodynamic status improved drastically. Case 2: This infant underwent surgical correction for Anomalous Left Coronary Artery from Pulmonary Artery (ALCAPA). Postoperatively, she was in low cardiac output. She was found to have an occluded left coronary artery and mitral regurgitation (MR). After she underwent left internal mammary artery (LIMA) to Left Anterior Descending (LAD) anastamosis and mitral valve repair, the clinical condition improved dramatically. Conclusion CABG is an uncommon operation in infants. This surgery is technically difficult. The long term results are not known and there are very few reports for the same. Though such an operation is best avoided, it can be used as a desperate life saving measure. PMID:22368554

  5. Rarefaction and blood pressure in systemic and pulmonary arteries

    OpenAIRE

    Olufsen, Mette S.; Hill, N. A.; Vaughan, Gareth D. A.; Sainsbury, Christopher; Johnson, Martin

    2012-01-01

    The effects of vascular rarefaction (the loss of small arteries) on the circulation of blood are studied using a multiscale mathematical model that can predict blood flow and pressure in the systemic and pulmonary arteries. We augmented a model originally developed for the systemic arteries (Olufsen et al. 1998, 1999, 2000, 2004) to (a) predict flow and pressure in the pulmonary arteries, and (b) predict pressure propagation along the small arteries in the vascular beds. The systemic and pulm...

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

    Directory of Open Access Journals (Sweden)

    Igor Piacentini

    2008-12-01

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

  7. BILATERAL ANATOMICAL VARIATION IN THE ARTERIAL SUPPLY OF FACE INVOLVING THE FACIAL AND TRANSVERSE FACIAL ARTERY

    Directory of Open Access Journals (Sweden)

    Vrushali S. Kolte

    2014-03-01

    Full Text Available We present a case-report whereby a bilateral variation in the arterial supply of face was seen. The facial artery which is the main artery of face was seen terminating in the lower part of the face, as the inferior labial artery and few other branches; the transverse facial artery, which supplements the facial artery normally, was seen to enlarge and take over the course of facial artery, giving the superior labial and lateral nasal branches. The small pre-masseteric branch arising from facial artery was seen only on right side of face. It was absent on left side. Accurate knowledge of the normal and variant arterial anatomy of the facial artery is important for vascular radiology and will provide an anatomical basis to assist surgeons in performing maxillo-facial surgeries successfully. The details of this variation and its clinical significance are discussed herein.

  8. Conservative Management of Penile Trauma may be Complicated by Abscess Formation.

    Science.gov (United States)

    Bantis, Athanasios; Sountoulides, Petros; Kalaitzis, Christos; Deftereos, Savas

    2014-10-30

    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. PMID:25568766

  9. Anatomical stages of penile erection in the agouti (Dasyprocta leporina) induced by electro-ejaculation.

    Science.gov (United States)

    Mollineau, W M; Sampson, T; Adogwa, A O; Garcia, G W

    2012-10-01

    The reproductive system of the male agouti is not well documented. This study describes the specific anatomical features of the free part of the penis occurring during penile erection in the agouti. Electro-ejaculation was used to induce erection in three male agoutis that had previously produced offspring. Results proved that there were four stages in the erection process. Stage 1 involved protrusion of the penis from the preputial orifice. The lateral penile cartilages were then spread (stage 2). During stage 3, there was the blooming of the head of the glans penis (penile flower) and eversion of the intromittent sac. The protrusion of the keratinaceous styles and ejaculation occurred during stage 4. This information could assist in semen collection for use in reproductive techniques for the agouti such as artificial insemination. PMID:22352811

  10. Prepuce and partial penile amputation for treatment of preputial gland neoplasia in two ferrets.

    Science.gov (United States)

    van Zeeland, Y R A; Lennox, A; Quinton, J F; Schoemaker, N J

    2014-11-01

    Preputial tumours in ferrets are frequently malignant and therefore warrant prompt investigation. As many cases do not respond favourably to surgery, even in combination with radiation therapy, wide surgical resection has been recommended. Such a procedure may necessitate partial or total penile resection but outcomes have thus far not been well described. The current case series describes two ferrets in which surgical resection, including penile amputation, was performed using 10 and 5 mm margins, respectively. In the first case, no recurrence of preputial gland adenocarcinoma was noted for 32 months postsurgery, whereas multiple attempts at surgery and radiation therapy were unsuccessful in the second. These cases suggest that margins of at least 1 cm may help achieve a better outcome. Penile amputation for the treatment of preputial tumours appears to be well tolerated by ferrets, as demonstrated by these cases. PMID:24962052

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

    Directory of Open Access Journals (Sweden)

    Athanasios Bantis

    2014-10-01

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

  12. Penile replantation: report of two cases and review of the literature.

    Science.gov (United States)

    Li, Gui-zhong; He, Feng; Huang, Guang-ling; Man, Li-bo; Liu, Kun; Shen, Yu-ming

    2013-01-01

    Penile amputation and successful replantation is very uncommon, and there is no routine standardized procedures for dealing with this medical condition. Here we report two cases of penile amputation and replantation involving different degrees of vascular insult leading to different pathogenesis, clinical presentation, surgical approach and prognosis. This report described the microsurgical procedure and postoperative care using bipedicled scrotal flap to achieve successful engraftment and function. A review of the published data and future methods to increase success of such surgical procedures is provided. PMID:23384873

  13. 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...

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

    International Nuclear Information System (INIS)

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

  15. Partial penile reconstruction following fat augmentation with anterolateral thigh perforator flap.

    Science.gov (United States)

    Spyriounis, Petros K; Karmiris, N I

    2012-01-01

    Augmentation phalloplasty of the normal penis although is gaining popularity among a subgroup of men, is not free of complications. A 27 years old healthy man with normal functioning penis underwent a lipofilling penile augmentation. The procedure was complicated by a post-operative haematoma and infection resulting in a full thickness dorsal penile skin necrosis and a pedicled anterolateral thigh (ALT) perforator flap was required for reconstruction. His presentation, operation and final outcome are reported and the possible options for reconstruction are discussed. PMID:21875822

  16. Prevention of erection after penile surgery. A double-blind trial of intracavernous noradrenaline versus placebo.

    Science.gov (United States)

    Johansen, L V; Kirkeby, H J; Kiil, J

    1989-01-01

    To prevent nocturnal erections after penile surgery a randomized, double blind trial of nocturnal intracavernous infusion of noradrenaline (10 micrograms per hour) versus placebo in 20 patients was carried out. During infusion the corpus cavernosum pressure was continuously registered. The patients made a record of nocturnal erections and associated pain. The pressure registration confirmed total absence of erections in the noradrenaline group. In the placebo group half of the patients were devoid of nocturnal erections. No signs of ischaemia was seen, but in four patients receiving noradrenaline infusion was stopped due to pain. This treatment seems effective in preventing nocturnal erections after penile surgery. PMID:2696196

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

    Directory of Open Access Journals (Sweden)

    Soufiane Mellas

    2010-07-01

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

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

    OpenAIRE

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

    2004-01-01

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

  19. 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

  20. Severe, disabling, and/or chronic penile pain associated with Peyronie disease: management with subcutaneous steroid injection.

    Science.gov (United States)

    Dickstein, Rian; Uberoi, Jayant; Munarriz, Ricardo

    2010-01-01

    Penile pain is one of the most distressing, limiting, and difficult to treat manifestations of Peyronie disease. The use of steroid injections for penile deformities associated with Peyronie disease has been ineffective. However, use of steroid injections in managing penile pain has been poorly investigated. The aim of this study was to examine the efficacy and safety of subcutaneous, nonintralesional steroid injections in patients with severe, disabling, and/or chronic penile pain associated with Peyronie disease. This was a single-institution retrospective study of 16 patients with severe, disabling, and/or chronic penile pain associated with Peyronie disease who underwent subcutaneous, nonintralesional injection of triamcinolone (50 mg) between 2004 and 2006. Preinjection and postinjection analog pain scales were used to assess treatment efficacy. All 16 patients (mean age, 47.6 ± 11.1 years) had penile pain associated with erections for an average of 13.9 months (range, 3-36 months) prior to injections. Mean preinjection and postinjection penile pain scores were 6.6 ± 2.1 and 0.5 ± 0.5, respectively. On average, patients were pain free at follow-up visits within 10.6 ± 7.6 weeks. The mean pain-free duration was 23.8 months (range, 3-52 months). The mean cumulative dose of triamcinolone was 75.0 mg (range, 50-200 mg), with a mean of 1.5 injections (range, 1-4 injections). All 16 patients had overall improvement in pain scores. There were no adverse events or geometric penile changes after injections. Subcutaneous, nonintralesional injections of triamcinolone is an effective, safe, and durable means of managing severe, disabling, and/or chronic penile pain in patients with Peyronie disease. Future studies are needed to validate these findings. PMID:19684339

  1. Arterial embolism

    Science.gov (United States)

    ... or leg (pallor) Weakness of an arm or leg Later symptoms: Blisters of the skin fed by the affected artery Shedding (sloughing) of skin Skin erosion ( ulcer ) Tissue death (necrosis; skin is dark and damaged) ...

  2. Arterial stick

    Science.gov (United States)

    ... injected or applied before the needle is inserted. Blood flows into a special collecting syringe. The needle is ... to breathing problems or problems with the body's metabolism. Sometimes arterial sticks are done to get blood culture or blood chemistry samples.

  3. 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 SciELO Brazil | Language: English Abstract in portuguese 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.

  4. Penile traction therapy and Peyronie’s disease: a state of art review of the current literature

    Science.gov (United States)

    Brock, Gerald

    2013-01-01

    In recent years, penile traction therapy (PTT) has gained considerable interest as a novel nonsurgical treatment option for men with Peyronie’s disease (PD) and short penises. The current published literature suggests that selected cases of PD may benefit from a conservative approach with PTT, resulting in increased penile length and reduction of penile deformity. It appears to be safe and well tolerated but requires a great deal of patient compliance and determination. This article reviews the current literature pertaining to the use of PTT in men with PD, short penises and in the setting of pre- and postprosthesis corporal fibrosis. PMID:23372611

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

    Directory of Open Access Journals (Sweden)

    James J. Elist

    2014-11-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  7. Sarcoma de pene: un tumor raro y agresivo / Penile sarcoma: a rare tumor

    Scientific Electronic Library Online (English)

    Jesús Ignacio, Tornero Ruíz; José A., Nicolás Torralba; Félix, Escudero Bregante; Mariano, Pérez Albacete.

    2007-09-01

    Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Objetivo: Presentamos el caso de un tumor de pene que debutó con metástasis pulmonares y ganglionares con evolución fatal sin respuesta a cirugía y terapia adyuvante. Métodos: Varón que se presenta con masa peneana de aparición progresiva con metástasis. Resultados: Se practica penectomía parcial y [...] quimioterapia adyuvante, apareciendo recidiva local de crecimiento rápido provocando la muerte del paciente en pocos meses. El tumor resultó ser un sarcoma de pene con diferenciación osteosarcomatosa. Conclusiones: El sarcoma de pene es un tumor infrecuente pero de comportamiento muy agresivo que requiere un diagnóstico precoz y una actitud agresiva en su manejo. Tiene tendencia a la recurrencia local y cuando debuta con metastasis a distancia es letal en pocos meses. Abstract in english Objective: We report the case of a penile tumor presenting with lung and lymph node metastasis, with fatal evolution after the absence of response to surgery and adjuvant treatment. Methods: Male patient presenting with a penile mass appearing progressively, with metastases. Results: Partial penecto [...] my and adjuvant chemotherapy were performed, with the appearance of a rapidly growing local recurrence which led to death of the patient in a few months. The tumor was a penile sarcoma with osteosarcomatous differentiation. Conclusions: Penile sarcoma is an unfrequent tumor that has a very aggressive behavior, requiring early diagnosis and aggressive management. It has tendency to local recurrence, and when it presents with distant metastases is lethal within a few months.

  8. 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.

  9. 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

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

    Science.gov (United States)

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

    2012-01-01

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

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

    International Nuclear Information System (INIS)

    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 18F fluorodeoxyglucose (FDG) positron emission tomography/computed tomography(PET/CT)showed diffuse hypermetabolic activity along the penis shaft, which was confirmed as a penile metastasis

  12. 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.

  13. 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.)

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

    DEFF Research Database (Denmark)

    Jensen, Lars JØrn; Björling, K.

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

  15. Left Common Carotid Artery Cannulation for Type A Aortic Dissections

    OpenAIRE

    Mochizuki, Yoshihiko; Iida, Hiroshi; Mori, Hideaki; Yamada, Yasuyuki; Miyoshi, Shinichiro

    2003-01-01

    We used left common carotid artery cannulation for repair of type A aortic dissection in 2 patients for whom both femoral artery and axillary artery cannulation were thought to be more dangerous, due to dissection of the brachiocephalic trunk and left subclavian artery in association with abdominal stenosis. Before performing end-to-side anastomosis, we attached a small partial clamp to the left common carotid artery, thereby maintaining adequate cerebral blood flow during perfusion. To date,...

  16. Modern utilization of penile prosthesis surgery: a national claim registry analysis.

    Science.gov (United States)

    Segal, R L; Camper, S B; Burnett, A L

    2014-01-01

    The objective of this study was to evaluate the modern utilization of penile prosthesis surgery based on data derived from national claim databases and contrast to an analysis of patients similarly treated at an academic center during a contemporaneous period. A retrospective claim analysis utilizing a national database (MarketScan, Thomson Reuters) was performed for Commercial insurer and Medicare databases between January 2000 and March 2011. A retrospective analysis of contemporaneous penile prosthesis implantation at the Johns Hopkins Hospital (JHH) was done. Population demographics, comorbidities, previous (ED) therapies and time from ED diagnosis to surgery were assessed. Median ages for patients undergoing penile prosthesis implantation were 58, 70 and 63 years for the Commercial, Medicare and JHH cohorts, respectively. For the claim databases (Commercial, Medicare, respectively), hypertension (72%, 78%), dyslipidemia (71%, 56%) and diabetes mellitus (45%, 40%) were predominant comorbidities, whereas for the JHH database prostate cancer (51%) and its management by prostatectomy (45%) or radiation (12%) were predominant. Previous use of PDE5 inhibitors was similar across databases (60, 58 and 69% for Commercial, Medicare and JHH cohorts, respectively), although previous use of non-oral ED therapies was greater in the JHH database. Median time to surgery from initial ED diagnosis was 2, 2 and 4 years for the Commercial, Medicare and JHH patients, respectively. Demographic variables and ED risk factors associated with penile prosthesis surgery at a national population-based level over a contemporary period were defined. Some differences in utilization trends of penile prosthesis surgery exist at a single institutional level. PMID:24830674

  17. Genetics of Pulmonary Arterial Hypertension

    OpenAIRE

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

    2009-01-01

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

  18. 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

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

    Science.gov (United States)

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

    2015-01-01

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

  20. Effects of fenfluramine, m-chlorophenylpiperazine, and other serotonin-related agonists and antagonists on penile erections in nonhuman primates.

    OpenAIRE

    Szele, Fg; Murphy, Dl; Garrick, Na

    1988-01-01

    Fenfluramine, m-chlorophenylpiperazine (m-CPP), 1-phenylpiperazine, and the buspirone metabolite, 1-(2-pyrimidyl)piperazine given intravenously to adult rhesus monkeys regularly elicited penile erections. In contrast, serotonin (5-HT) agonists with 5-HT1A site specificity (8-OH-DPAT, buspirone) as well as trazodone, ritanserin, and metergoline were no different from saline in producing penile erections. Fenfluramine's effects were blocked by the 5-HT2 antagonists, ritanserin and metergoline, ...

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

    Directory of Open Access Journals (Sweden)

    Abhyankar Suhas

    2010-01-01

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

  2. Unusual trivial trauma may end with extrusion of a well-functioning penile prosthesis: a case report

    OpenAIRE

    Salama Nader; Kishimoto Tomoteru; Kanayama Hiro-Omi; Kagawa Susumu

    2007-01-01

    Abstract Background Diabetes mellitus (DM) is the most common indication for insertion of a penile prosthesis and is a risk factor for infection of such prostheses. Case presentation Two patients presented with infected prostheses following unusual trivial penile trauma. Both patients underwent exploration and removal of the prostheses with uneventful recovery. Conclusion Appropriate sizing of the prosthesis should be taken into account to ensure good concealment and avoid easy exposure of th...

  3. 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...

  4. 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.

  5. Arterial Catheterization

    Science.gov (United States)

    ... to better monitor blood pressure and/or blood gases. ? Blood clots— If blood clots form on the tips of arterial catheters, the clots can block blood flow. If another blood vessel does not carry blood to the area beyond the clot, this can cause the loss ...

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

    International Nuclear Information System (INIS)

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

  7. The lateral genicular artery flap.

    Science.gov (United States)

    Hayashi, A; Maruyama, Y

    1990-04-01

    A method for reconstruction of skin defects around the knee using the lateral genicular artery flap is presented. This flap is supplied mainly by the cutaneous perforator of the superior lateral genicular artery. On the basis of ten cadaver dissections, we found that the nutrient artery is reliable, penetrates the deep fascia at a small triangular area surrounded by the lateral femoral condyle, the vastus lateralis, and the short head of the biceps femoris, and anastomoses predominantly with the lateral perforators of the profunda femoris artery in the midlayer of the subcutaneous fatty tissue. This flap can be safely extended to the midpoint between the lateral femoral condyle and the greater trochanter. PMID:2353779

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

    Science.gov (United States)

    Takabayashi, Shuji; Suzuki, Yuiko; Katoh, Hideki

    2015-05-01

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

  9. Current management of penile implant infections, device reliability, and optimizing cosmetic outcome.

    Science.gov (United States)

    Mulcahy, John J; Kramer, Andrew; Brant, William O; Parker, Justin L; Perito, Paul E; Myers, Jeremy B; Bryson, Richard; Dunne, Meagan

    2014-06-01

    Penile implants hold a major position in the treatment algorithm for patients with erectile dysfunction who find medications and vacuum erection devices ineffective or unsatisfactory. As with any surgical procedure, adverse events may occur. The infection rate associated with implant placement has been lowered to the range of 1 % or less due to multifactorial improvements including no-touch techniques, the use of antibiotic-coated devices, and improved quality measures in the operating room. Urologists have been proactive in employing techniques and procedures which minimize loss of erectile length, hence enhancing patient satisfaction. Flat reservoirs have been developed and techniques of placing these to avoid problems in the space of Retzius have reduced complication rates as well. Device reliability has improved to the point that penile implants are among the most durable mechanical surgical products that contribute to patient and partner satisfaction, which is by far the greatest among all the treatments of erectile dysfunction. PMID:24740273

  10. [Urethral injuries secondary to implantation of penile prosthesis. Analysis of the causes, prevention and treatment.

    Science.gov (United States)

    Vitarelli, Antonio; Divenuto, Lucia; Palminteri, Enzo; Lorusso, Giovanni; Pagliarulo, Arcangelo

    2014-03-21

    Urethral injuries due to penile prosthesis implant represent a rare complication of the intervention to position penile prosthesis, but unfortunately scientific literature about this is poor. This rare complication may occur during surgery and in the postoperative period, both early and late. It recognizes a variety of causes that may include anatomical or functional conditions, for example cavernosal fibrosis or outcomes of inflammations or previous urethral lesions and pathological sensibility due to diabetic neuropathy or other forms of neuropathy including those from spinal cord injury or myelopathy. This review evaluates the possible predisposing conditions, the clinical presentations, and the devices in the surgical procedures to use to minimize the risk of onset of this lesions and the measures to take if they occur. PMID:24665026

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

    Science.gov (United States)

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

    2015-04-01

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

  12. 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

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

    Science.gov (United States)

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

    2008-04-01

    The genital localized myiasis is a rare zooparasitic dermatosis. This case reported to a penile myiasis by Dermatobia hominis larvae in a 62 year-old man, who is a retired military official from São Gonçalo city, Rio de Janeiro state, Brazil. This patient was guided to the sexually transmitted diseases (STD) clinic from Universidade Federal Fluminense (UFF) by professionals from a urology outpatient clinic of a public hospital from Rio de Janeiro state. The exam showed a 2 cm diameter nodular lesion with a hyperemic area in the glands penis that had arisen 20 days before the exam. It evolved in a favorable way after larvae removal, through previous local anesthesia and slight pressure in lesion's base with the extraction of the larvae. Penile myiasis is not a very frequent situation, although it must be considered as an option in differential diagnosis of genital infectious diseases, even among people of low economical level, as in the case presented. PMID:18641855

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

    Directory of Open Access Journals (Sweden)

    Mauro R.L. Passos

    2008-04-01

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

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

    International Nuclear Information System (INIS)

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

  16. Epidemiological aspects of penile cancer in Rio de Janeiro: evaluation of 230 cases

    OpenAIRE

    Leandro Koifman; Vides, Antonio J.; Nelson Koifman; Carvalho, Joa?o P.; Ornellas, Antonio A.

    2011-01-01

    PURPOSE: To determine epidemiological characteristics of penile cancer in Rio de Janeiro, its associated risk factors and clinical manifestations. PATIENTS AND METHODS: Between 2002 and 2008 we evaluated 230 patients at three public institutions, considering age, ethnicity, birthplace, marital status, educational level, religion, tobacco smoking, presence of phimosis and practice of circumcision. RESULTS: The ages ranged from 25 to 98 years, with an average of 58.35 years. Of the 230 patients...

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

    OpenAIRE

    Bustamante-montes, L. P.; Herna?ndez-valero, M. A.; Flores-pimentel, D.; Garci?a-fa?bila, M.; Amaya-cha?vez, A.; Barr, D. B.; Borja-aburto, V. H.

    2013-01-01

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

  18. Tourniquet application and epinephrine injection to penile skin: is it safe?

    Science.gov (United States)

    Cakmak, M; Caglayan, F; Kisa, U; Bozdogan, O; Saray, A; Caglayan, O

    2002-09-01

    Although a tourniquet is frequently used in penile surgery there is still no consensus on safe application time. The aim of the present study is to investigate the effect of malondialdehyde (MDA) levels and histological changes in skin flaps after penile tourniquet application and epinephrine injection. A total of 36 male white New Zealand rabbits were randomly divided into six groups each containing six animals. A Mathieu-like flap was raised in all of the groups and a tourniquet was applied and the penis was subjected to ischemia for 10, 20 and 40 min in groups 1, 2 and 3, respectively. The flaps were then allowed to reperfuse for 5 min. Biopsies for MDA measurement were harvested in these groups. Subcutaneous 1/200,000 epinephrine was injected into penile skin in group 4 and 5 rabbits and biopsies for MDA measurement were harvested 10 and 40 min after injection. The control group was anesthetized without tourniquet usage or epinephrine injection. Specimens taken from the harvested flaps of all groups were submitted for histological evaluation. The mean MDA levels in all experimental groups were higher than in the control group and the difference was statistically significant. Edema, congestion and extravasation were observed in groups 1, 2 and 3. Minimal congestion and edema were observed in group 4 and severe edema and extravasation in group 5. Tourniquet usage for a duration of less than 10 min is clearly safer than prolonged usage. Epinephrine injection to penile skin may show a deleterious effect on wound healing. PMID:12202946

  19. 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...

  20. Engaging men with penile cancer in qualitative research: reflections from an interview-based study.

    OpenAIRE

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

    2014-01-01

    AIM: To explore the challenges of engaging men with penile cancer in qualitative interview research. BACKGROUND: Qualitative interviewing offers an ideal tool for exploring men's experiences of illness, complementing and providing context to gendered health inequalities identified in epidemiological research on men. But conducting interviews with men can be challenging and embarking on a qualitative interview study with males can feel like a daunting task, given the limited amount of practica...

  1. Chronic Idiopathic Penile Edema: Three Cases and a Review of the Literature

    OpenAIRE

    Raty, Laurent; Failla, Vale?rie; Andrianne, Robert; Fillet, Marc; Waltregny, David; Nikkels, Arjen

    2011-01-01

    Abstract: Chronic idiopathic penile edema (CIPE) is an exceptional entity with disabling persistent lymphedema of the penis, affecting accessorily the scrotum and the pubis. The onset presents with recurrent swelling of the external genitalia, regressing spontaneously. After 2-3 years the swelling becomes progressively persistent. Mictional and erectile dysfunctions are not uncommon. A thorough work-up including RX, ultrasound examination, CT scanning, MRI imaging, serology and extens...

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

    OpenAIRE

    Gennaro Selvaggi; Cecilia Dhejne; Mikael Landen; Anna Elander

    2012-01-01

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

  3. 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...

  4. 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...

  5. Surgical reconstruction of penile stump in a patient with Klingsor syndrome.

    Science.gov (United States)

    Jindal, T; Ghosh, N; Kamal, M; Sharma, R K; Mukherjee, S; Mandal, S N; Karmakar, D

    2012-12-01

    Self-mutilation of genitalia is an extremely rare entity, usually found in psychotic patients. Klingsor syndrome is a condition in which such an act is based upon religious delusions. The extent of genital mutilation can vary from superficial cuts to partial or total amputation of penis to total emasculation. The management of these patients is challenging. The aim of the treatment is restoration of the genital functionality. Microvascular reanastomosis of the phallus is ideal but it is often not possible due to the delay in seeking medical attention, non viability of the excised phallus or lack of surgical expertise. Hence, it is not unusual for these patients to end up with complete loss of the phallus and a perineal urethrostomy. We describe a patient with Klingsor syndrome who presented to us with near total penile amputation. The excised phallus was not viable and could not be used. The patient was managed with surgical reconstruction of the penile stump which was covered with loco-regional flaps. The case highlights that a functional penile reconstruction is possible in such patients even when microvascular reanastomosis is not feasible. This technique should be attempted before embarking upon perineal urethrostomy. PMID:23661844

  6. The epidermal growth factor receptors as biological targets in penile cancer.

    Science.gov (United States)

    Di Lorenzo, Giuseppe; Buonerba, Carlo; Ferro, Matteo; Calderoni, Giuseppe; Bozza, Giovanni; Federico, Piera; Tedesco, Beatrice; Ruggieri, Vitalba; Aieta, Michele

    2015-04-01

    Penile cancer is a rare disease, with an incidence that is higher in less developed countries and is in the range of 1 - 10 per 100000 men worldwide. Early diagnosis is essential for cure, as 5 year cancer-specific survival is 90 - 100 % in patients with intraepithelial neoplasms and in those with low-grade superficial tumors without lymphovascular invasion, but it drops to 30% in men with multiple mobile or bilateral inguinal lymph nodes. The EGFR family plays a major role in penile cancer biology, with distinct receptors being involved in HPV-positive and -negative tumors. A number of anti-EGFR agents were used in penile cancer patients outside the context of a clinical trial, mainly as a salvage treatment after failure of first-line chemotherapy. A total of 28 patients received anti-EGFR monoclonal antibodies, with 50% of them showing a response to treatment, and a median PFS of ? 3 months. The rarity of the disease poses great challenge in terms of education and awareness of the general population, planning of preventive measures on a large scale, as well as conduction of prospective trials and approval of high-cost biological therapy. PMID:25496291

  7. Pulmonary arterial hypertension: the clinical syndrome.

    Science.gov (United States)

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

    2014-06-20

    Pulmonary arterial hypertension 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 pulmonary arterial hypertension pertaining to the disease, and aim to provide an explanation in terms of classification, diagnosis, pathophysiology, genetic causes, demographics, and prognostic factors. Furthermore, important molecular pathways that are central to the pathogenesis of pulmonary arterial hypertension are reviewed, including nitric oxide, prostacyclin, endothelin-1, reactive oxygen species, and endothelial and smooth muscle proliferation. PMID:24951762

  8. 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.

  9. 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.

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

    Scientific Electronic Library Online (English)

    Celso, Suárez Lescay.

    1361-13-01

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

  11. Patent arterial duct

    OpenAIRE

    Martin Robin P; Elmasry Ola A; Forsey Jonathan T

    2009-01-01

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

  12. Kugel's artery: an anatomical and angiographic study using a new technique.

    Science.gov (United States)

    Nerantzis, Christos E; Marianou, Soultana K; Koulouris, Spyridon N; Agapitos, Emmanouil B; Papaioannou, John A; Vlahos, Lampros J

    2004-01-01

    In this study, we tried to resolve the confusion in the literature regarding the existence and course of Kugel's artery. With the aid of a new technique, we studied 100 human hearts ex vivo by radiography and by direct observation through dissection, to demonstrate anatomical and postmortem angiographic findings of Kugel's artery. Kugel's artery was found in only 6 hearts out of 100 (6%). It originated from the proximal left circumflex artery and ended in the right coronary artery in 2 cases; from the right coronary artery and ended in the same artery in 2 cases; from the left circumflex artery and ended in the same artery in 1 case; and from the right coronary artery through the sinus node artery, ending in the left circumflex artery, in 1 case. In all 100 hearts, an anastomotic network of small atrial branches was found in the same area (lower portion of the interatrial septum), connecting the large vessels indirectly. Branches of the sinus node artery in all hearts, and of the atrioventricular node artery in 66 hearts, participated in this network. Our procedure showed the detailed course of Kugel's artery and its course independent from the atrioventricular node artery and from the anastomotic network. In conclusion, in all cases an anastomotic network of small atrial branches courses through the lower interatrial septum and connects indirectly the proximal and distal ends of the larger coronary arteries. Kugel's artery provides an additional direct arterial anastomosis in the same area in 6% of the hearts. PMID:15562847

  13. 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 ...

  14. Hardening of the arteries

    Science.gov (United States)

    Hardening of the arteries, also called atherosclerosis, occurs when fat, cholesterol, and other substances build up in ... the arteries and cause problems throughout the body. Hardening of the arteries is a common disorder.

  15. Increased cerebral arterial pulsatility in patients with leukoaraiosis: arterial stiffness enhances transmission of aortic pulsatility.

    OpenAIRE

    Webb, Ajs; Simoni, M.; Mazzucco, S.; Kuker, W.; Schulz, U.; Rothwell, Pm

    2012-01-01

    BACKGROUND AND PURPOSE-: Arterial stiffening reduces damping of the arterial waveform and hence increases pulsatility of cerebral blood flow, potentially damaging small vessels. In the absence of previous studies in patients with recent transient ischemic attack or stroke, we determined the associations between leukoaraiosis and aortic and middle cerebral artery stiffness and pulsatility. METHODS-: Patients were recruited from the Oxford Vascular Study within 6 weeks of a transient ischemic a...

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

    DEFF Research Database (Denmark)

    Jensen, P E; Hughes, A

    1993-01-01

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

  17. Intra-arterial digital subtraction angiography of the carotid arteries

    International Nuclear Information System (INIS)

    A cross-over test in intra-arterial digital subtraction angiography (IADSA) of the carotid arteries was performed in 50 patients to evaluate image quality and side-effects with iohexol and metrizoate injected at concentrations of 100 mg I/ml by hand. The image quality was excellent or good in all cases. Although the severity and the frequency of side-effects were higher with metrizoate, both contrast media were suitable for IADSA at this low concentration. No complications were seen. It was assumed that the risk with IADSA was less than that of conventional-selectivity and with small amounts of contrast media, as in this study. (orig.)

  18. [Arterial stenosis after radiotherapy].

    Science.gov (United States)

    Piedbois, P; Becquemin, J P; Pierquin, B; Blanc, I; Mazeron, J J; Pavlovitch, J M; Otmezguine, Y; Calitchi, E; Brun, B; Feuilhade, F

    1990-01-01

    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. PMID:8703540

  19. 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

  20. How curved is too curved? The severity of penile deformity may predict sexual disability among men with Peyronie's disease.

    Science.gov (United States)

    Walsh, T J; Hotaling, J M; Lue, T F; Smith, J F

    2013-05-01

    Peyronie's disease (PD) is caused by progressive fibrotic scarring of the tunica albuginea resulting in curvature or other deformities of the erect penis. The severity of penile curvature or other deformity may contribute to a man's inability to have intercourse (sexual disability), due to difficulty with penetration, partner pain or emotional stress. To determine whether the degree of curvature or type of penile deformity predicts sexual disability among men with PD. This cross-sectional analysis of consecutive men evaluated for PD at a single tertiary referral center used a PD-specific questionnaire to evaluate risk factors for sexual disability in men with PD, who did not have erectile dysfunction (ED). Multivariate logistic regression was used to determine the clinical predictors of sexual disability. Sexual disability as defined by the inability to have penetrative intercourse. A total of 202 men were evaluated and 88 men with ED were excluded. Sexual disability was associated with relationship problems, penile curvature and penile length loss in bivariate, but not multivariate analysis. We found that although many of the demographic, medical and sexual function domains were significant predictors of inability to have sex, the only significant predictor of sexual disability in multivariate analysis was curvature>60° (odds ratio 3.23 95%CI 1.08-9.67). PD can be sexually disabling in many men without ED. Severe penile curvature is a robust independent predictor of the ability to have intercourse. Other penile deformities fail to predict sexual disability. This is important for counseling patients with newly diagnosed PD and those who are considering medical or surgical intervention. PMID:23344164

  1. Positive lymphoscintigraphy (ILS) and negative computed tomography for metastatic penile cancer.

    Science.gov (United States)

    Bantis, Athanasios; Sountoulides, Petros; Kalaitzis, Christos; Boussios, Nikolaos; Giannakopoulos, Stelios; Zissimopoulos, Athanasios

    2011-01-01

    Penile carcinoma usually occurs in older than 40 years men with an incidence in western communities of 0.5 to 1.6 per 100,000 men per year while in developing countries the rate is much higher in men. Extensive lymph node dissection of lymphatic inguinal metastases evident by inguinal lymphoscintigraphy (ILS) induces improved overall survival. A 75 years old male with penile squamous cell carcinoma stage pT2N0M0 of less than 2cm diameter, with tumor invasion of the penis corpora underwent partial penectomy with a 2-cm disease-free margin. Three months postoperation, computed tomography (CT) was negative for local recurrence or distant metastases. A dynamic ILS was performed after local anaesthesia and intradermal injection of 80MBq of (99m)Tc-nanocolloid at the lower edge of the left and right inguinal ducts. The lymphatic chain and a hot spot suggestive of a first draining lymph node appeared after 15min on the right inguinal region in the second zone according to Daseler mapping. The left inguinal area was negative for sentinel node (SN). In view of this finding an exploratory laparotomy was performed and pathology showed that this lymph node that was probably a SN was infiltrated by the squamous cell carcinoma. The patient was upstaged to T2N1M0 and scheduled to receive adjuvant chemotherapy with two courses of cisplatin and 5-fluorouracil. While T1 and T2 tumours of diameters penile-preserving methods such as circumciand/or local excision. Tumours of T2 >2cm, T3 tumours, and T4 tumours are treated with glans amputation and/or partial or total penile amputation. Imaging with magnetic resonance imaging (MRI) or computed tomography (CT) scan do not always give accurate staging information, because positive findings are usually found only in patients with clinically palpable, enlarged inguinal lymph nodes. Computed tomography and MRI have low sensitivity to identify occult metastases, because they present criteria for malignant involvement mainly based on the size of the lesions. The main pitfall of these diagnostic modalities is due to occult metastatic disease occurring within normal sized nodes. Approximatively 20% of the patients with non palpable lymph nodes harbour occult inguinal metastases, and there is evidence that this group of patients may benefit from early surgical dissection of the inguinal nodes, compared to a wait-and-see policy. It is understood that current imaging techniques cannot accurately detect occult metastases, while ILS is more reliable. In 80% of patients with penile cancer, after ILS, drainage to both groins is observed. Bilateral nodes are often visualized early, sometimes asynchronously with one of the lymph nodes filling late. This is why delayed images are recommended. Pitfalls of ILS are: a) Contamination of the skin with the tracer and b) radiopharmaceutical entering the blood. There are also several reasons that may account for absent or faint SN uptake: low dose of the tracer or low tracer quality, patient's age (better in young patients), tumor involvement of the sentinel node, and finally too short or too long interval between tracer injection and ILS. The ILS can be mapped according to Daseler's inguinal zones. Penile cancer drains directly to the nodes in the superior and central Daseler zones. According to others, the majority (73%) of SN was located in the medial superior, 8.7% in the lateral superior, and 18.3% in the central zone. No drainage was seen on the two inferior quadrants. The majority (62.1%) of higher-tier nodes was found in the external iliac zone. Inguinal LS can save us from watchful waiting in cases of otherwise occult metastases. In conclusion, ILS has shown lymph node metastases while clinical and CT examinations were negative. The false positive and false negative results of ILS are mentioned. PMID:22087456

  2. Rarefaction and blood pressure in systemic and pulmonary arteries.

    Science.gov (United States)

    Olufsen, Mette S; Hill, N A; Vaughan, Gareth D A; Sainsbury, Christopher; Johnson, Martin

    2012-08-01

    The effects of vascular rarefaction (the loss of small arteries) on the circulation of blood are studied using a multiscale mathematical model that can predict blood flow and pressure in the systemic and pulmonary arteries. We augmented a model originally developed for the systemic arteries (Olufsen et al. 1998, 1999, 2000, 2004) to (a) predict flow and pressure in the pulmonary arteries, and (b) predict pressure propagation along the small arteries in the vascular beds. The systemic and pulmonary arteries are modelled as separate, bifurcating trees of compliant and tapering vessels. Each tree is divided into two parts representing the `large' and `small' arteries. Blood flow and pressure in the large arteries are predicted using a nonlinear cross-sectional area-averaged model for a Newtonian fluid in an elastic tube with inflow obtained from magnetic resonance measurements. Each terminal vessel within the network of the large arteries is coupled to a vascular bed of small `resistance' arteries, which are modelled as asymmetric structured trees with specified area and asymmetry ratios between the parent and daughter arteries. For the systemic circulation, each structured tree represents a specific vascular bed corresponding to major organs and limbs. For the pulmonary circulation, there are four vascular beds supplied by the interlobar arteries. This manuscript presents the first theoretical calculations of the propagation of the pressure and flow waves along systemic and pulmonary large and small arteries. Results for all networks were in agreement with published observations. Two studies were done with this model. First, we showed how rarefaction can be modelled by pruning the tree of arteries in the microvascular system. This was done by modulating parameters used for designing the structured trees. Results showed that rarefaction leads to increased mean and decreased pulse pressure in the large arteries. Second, we investigated the impact of decreasing vessel compliance in both large and small arteries. Results showed, that the effects of decreased compliance in the large arteries far outweigh the effects observed when decreasing the compliance of the small arteries. We further showed that a decrease of compliance in the large arteries results in pressure increases consistent with observations of isolated systolic hypertension, as occurs in ageing. PMID:22962497

  3. 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

  4. Suprapubic Cystostomy for the Management of Urethral Injuries During Penile Prosthesis Implantation

    Science.gov (United States)

    Anele, Uzoma A; Le, Brian V; Burnett, Arthur L

    2014-01-01

    Introduction Urethral injury is an uncommon surgical complication of penile prosthesis (PP) surgery. Conventional dogma requires abortion of the procedure if the adjacent corporal body is involved or delayed implantation to avert device infection associated with urinary extravasation. Besides the setback of the aborted surgery, this management approach also presents the possible difficulty of encountering corporal fibrosis at the time of reoperation. Aim We report an approach using primary urethral repair and temporary suprapubic cystostomy for the management of incidental urethral injuries in a cohort of patients allowing for successful completion of unaborted PP implantation. Materials and Methods We performed a retrospective analysis of all patients receiving PPs from 1990 to 2014 in which incidental urethral injuries were repaired and PP implantation was completed with suprapubic cystostomy (suprapubic tube [SPT] insertion). After allowing for urethral healing and urinary diversion via SPT for 4–8 weeks, the PP was activated. Main Outcome Measures Successful management was determined by the absence of perioperative complications within 6 months of implantation. Results We identified four cases, all receiving inflatable PPs, managed with temporary suprapubic cystostomy. These patients sustained urethral injuries during corporal dissection (one patient), corporal dilation (one patient), and penile straightening (two patients). All patients were managed safely and successfully. Conclusion Primary urethral repair followed by temporary suprapubic cystostomy offers a surgical approach to complete PP implantation successfully in patients who sustain urethral injury complications, particularly for complex PP surgeries. Anele UA, Le BV, and Burnett AL. Suprapubic cystostomy for the management of urethral injuries during penile prosthesis implantation. PMID:25548649

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

    International Nuclear Information System (INIS)

    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 192Ir 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 rgery. 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.)

  6. 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.

  7. 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

  8. The evolution of the inflatable penile prosthetic device and surgical innovations with anatomical considerations.

    Science.gov (United States)

    Hakky, Tariq S; Wang, Run; Henry, Gerard D

    2014-06-01

    Historically, early surgical treatment for erectile dysfunction involved the placement of rigid devices outside of the corpora cavernosa. This practice resulted in high rates of erosion and infection. Today, most urologists in the United States place an inflatable penile prosthesis (IPP) with an infection-retardant coating inside the corpora cavernosa. In addition to changes in the type of implant used, surgical techniques have evolved greatly in recent years, resulting in reduced operating times, lower infection rates, and improved outcomes. However, anatomical considerations have directed the prosthetic surgeon to improve patient outcomes and satisfaction rates by employing both new surgical techniques and postoperative maneuvers. PMID:24756452

  9. Penile measurements in normal adult Jordanians and in patients with erectile dysfunction.

    Science.gov (United States)

    Awwad, Z; Abu-Hijleh, M; Basri, S; Shegam, N; Murshidi, M; Ajlouni, K

    2005-01-01

    The purpose of this work was to determine penile size in adult normal (group one, 271) and impotent (group two, 109) Jordanian patients. Heights of the patients, the flaccid and fully stretched penile lengths were measured in centimeters in both groups. Midshaft circumference in the flaccid state was recorded in group one. Penile length in the fully erect penis was measured in group two. In group one mean midshaft circumference was 8.98+/-1.4, mean flaccid length was mean 9.3+/-1.9, and mean stretched length was 13.5+/-2.3. In group two, mean flaccid length was 7.7+/-1.3, and mean stretched length was 11.6+/-1.4. The mean of fully erect penile length after trimex injection was 11.8+/-1.5. In group 1 there was no correlation between height and flaccid length or stretched length, but there was a significant correlation between height and midpoint circumference, flaccid and stretched lengths, and between stretched lengths and midpoint circumference. In group 2 there was no correlation between height and flaccid, stretched, or fully erect lengths. On the other hand, there was a significant correlation between the flaccid, stretched and fully erect lengths. Comparing group 1 and group 2, the patients in group 1 were slightly older than in group 2 (P=0.035), but there was no significant difference in their height. However, there was a significant difference regarding the mean flaccid length 9.3 vs 7.7 (P=0.001), and the mean stretched length 13.5 vs 11.6 (P=0.000). We divided both groups into those who are less than 40 y of age, and over 40 y old. There was no statistical difference in the stretched and flaccid lengths between the younger and older individuals in each group. However, when we compared the stretched and flaccid lengths in those of less than 40 y old in group 1 and 2, a significant difference was noticed. Similarly, a significant difference in the stretched and flaccid lengths in those patients over 40 y of age was also present. PMID:15510185

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

    International Nuclear Information System (INIS)

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

  11. Bilateral pericallosal arterial ectasia

    Energy Technology Data Exchange (ETDEWEB)

    Tsukamoto, Y.; Nakata, H.; Soejima, T.; Yamamoto, H.; Araki, R.

    1985-05-01

    We report a rare case of ectasia of both pericallosal arteries in a non-hypertensive 37-year-old female, whose internal carotid arteries and vertebrobasilar arteries were normal. The computed tomography (CT) showed irregular calcifications in the midline in the frontal region extending to the corpus callosum, which became partially enhanced along the course of the pericallosal artery following intravenous contrast administration. The diagnosis of arterial ectasia was established by angiography.

  12. Basilar artery dissection.

    OpenAIRE

    Berkovic, S. F.; Spokes, R. L.; Anderson, R. M.; Bladin, P. F.

    1983-01-01

    Dissection of the basilar artery caused sudden coma and death in a 40-year-old man. Atypical clinical features were explained at necropsy. A ventral dissection of the artery within its outer layers resulted in destruction of the pontine tegmentum with sparing of the basis pontis. An unsuspected defect in the internal elastic lamina in the left internal carotid artery was also found suggesting a more generalised disorder of arterial walls. Basilar artery dissection should be considered in the ...

  13. Coronary artery to pulmonary artery fistula

    Science.gov (United States)

    Dadkhah-Tirani, Heidar; Salari, Arsalan; Shafighnia, Shora; Hosseini, Seyed Fazel; Naghdipoor, Misa

    2013-01-01

    Patient: Male, 69 Final Diagnosis: Coronary artery to pulmonary artery fistula Symptoms: Chest pain Medication: — Clinical Procedure: Echocardiography • angiography • surgical intervention Specialty: Cardiology • Cardiac Surgery Objective: Rare disease Background: A coronary artery fistula is an abnormal communication between a coronary artery and one of the cardiac chambers or a great vessel, so bypassing the myocardial capillary network. They are usually discovered incidentally upon coronary angiography. Clinical manifestations are variable depending on the type of fistula, the severity of shunt, site of shunt, and presence of other cardiac condition. Case Report: We report a 69-year-old man without any previous medical history, who was admitted to our hospital with chest pain. The electrocardiogram (ECG) showed a sinus rhythm with ST depression in V2 to V6 precordial leads. Coronary angiography revealed a coronary artery fistula from left anterior descending coronary artery (LAD) to the main pulmonary artery, right coronary artery blockage and significant stenoses on the LAD and left circumflex artery (LCX). Conclusions: Surgical treatment was chosen because of the total occlusion of the right coronary artery and to relieve of pain to improve quality of life. PMID:24298301

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

    Scientific Electronic Library Online (English)

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

    2010-10-01

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

  15. Penile prosthesis implantation and tunica albuginea incision without grafting in the treatment of Peyronie's disease with erectile dysfunction.

    Science.gov (United States)

    Djordjevic, Miroslav L; Kojovic, Vladimir

    2013-05-01

    We evaluated penile prosthesis implantation with tunica albuginea-relaxing incisions without grafting in the treatment of Peyronie's disease associated with erectile dysfunction. Between April 2005 and June 2011, 62 patients underwent surgery due to severe Peyronie's disease associated with erectile dysfunction. Malleable and inflatable penile prostheses were inserted in 49 and 13 cases, respectively. Penile prostheses were inserted into the corpora cavernosa using the standard ventral approach. After lifting the neurovascular bundle, the tunica albuginea was incised and opened at the plaque region to correct the deformities and to lengthen the penis. Subsequently, the wide neurovascular bundle was replaced, and all incisions of the tunica albuginea were covered to prevent corporal grafting. In the median follow-up of 35 months (range 14-82 months), the penis was completely straightened in 59 (95%) patients. Numbness of the glans, which the patients found initially upsetting, decreased or disappeared spontaneously 3-6 months later. Penile prosthesis implantation with tunica albuginea incisions is a viable alternative in the treatment of Peyronie's disease because the extensive dissection of the neurovascular bundle allows a good approach to the plaque and provides excellent covering of the incised tunica albuginea without additional grafting. PMID:23435473

  16. Prevention by morphine of apomorphine- and oxytocin-induced penile erection and yawning: site of action in the brain.

    Science.gov (United States)

    Melis, M R; Stancampiano, R; Gessa, G L; Argiolas, A

    1992-01-01

    The effect of morphine administered systemically or into the paraventricular nucleus of the hypothalamus (PVN) on penile erection and yawning induced either by oxytocin or by the dopaminergic agonist apomorphine was studied in male rats. Systemic morphine (0.5 to 5 mg/kg intraperitoneally [IP]) prevented in a dose-dependent manner penile erection and yawning induced by the intracerebroventricular injection (ICV) of oxytocin (30 ng) or by the subcutaneous (SC) administration of apomorphine (80 micrograms/kg). Morphine (0.1 to 5 micrograms), but not U-69,593 (5 micrograms), injected into the PVN 10 minutes before oxytocin or apomorphine, was found to be able to prevent penile erection and yawning induced by the unilateral PVN microinjection of oxytocin (10 ng) or apomorphine (50 ng). The morphine-induced prevention of these behavioral responses was abolished by pretreatment with naloxone (3 mg/kg IP) 15 minutes before morphine. The present results suggest that morphine prevents apomorphine- and oxytocin-induced penile erection and yawning by inhibiting the activity of oxytocinergic neurons through mu-type receptors in this hypothalamic nucleus. PMID:1315136

  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. Does the etiology affect the outcome and satisfaction rates of penile prosthesis implantation surgery?

    Science.gov (United States)

    Bozkurt, Ibrahim Halil; Arslan, Burak; Kozacioglu, Zafer; Yonguc, Tarik; Degirmenci, Tansu; Gunlusoy, Bulent; Minareci, Suleyman

    2014-11-01

    Our aim was to compare the outcomes and satisfaction rates of men undergoing penile prostheses implantation (PPI) secondary to radical prostatectomy (RP) and other causes of vasculogenic erectile dysfunction (ED). A total of 142 patients, of whom 60 underwent PPI due to ED following RP (Group 1) and 82 underwent PPI due to ED with other vasculogenic causes (Group 2) were included in this study. The preoperative erectile status was evaluated with the International Index of Erectile Function (IIEF). The satisfaction of patients and partners were evaluated by a telephone interview using Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire and Erectile Dysfunction Inventory of Treatment Satisfaction Partner Survey. Preoperative mean IIEF scores were significantly lower in Group 1 (17.5 ± 6.4 vs. 24.2 ± 5.1, p = 0.01). For Groups 1 and 2, the mean EDITS scores of the patients were 58 ± 10 and 71 ± 8, respectively, and that for the partners were 46 ± 8 and 65 ± 7, respectively. Group 1 had significantly lower scores both for the EDITS and the EDITS Partner Survey (p = 0.03, p = 0.01, respectively). Patients who had undergone RP and their partners were found to have lower satisfaction rates compared to patients with other causes of vasculogenic ED who had penile implant surgery. From this point of view, it is important to know the patient's expectations about the treatment outcomes and a preoperative psychological and sexual counseling should be managed for possible treatment alternatives after RP. PMID:25458047

  19. 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

  20. Identification of a novel herpesvirus associated with a penile proliferative lesion in a beluga (Delphinapterus leucas).

    Science.gov (United States)

    Bellehumeur, Christian; Lair, Stéphane; Romero, Carlos H; Provost, Chantale; Nielsen, Ole; Gagnon, Carl A

    2015-01-01

    The carcass of an adult male beluga (Delphinapterus leucas) was found beach cast in 2008 on the shore of the St. Lawrence Estuary at Rivière-Ouelle, Quebec, Canada. The carcass was transported to the Faculté de médecine vétérinaire of the Université de Montréal for postmortem examination. Aspiration pneumonia was the probable cause of death. Necropsy revealed a focal papilloma-like penile lesion, characterized by focal mucosal thickening with disorganization of the epithelial layers and lymphoplasmacytic infiltration. A pan-herpesvirus nested PCR assay on frozen tissue from the penile lesion was positive. The PCR product sequencing revealed a partial herpesvirus DNA polymerase (DPOL) gene sequence of 600 nucleotides. Its nearest nucleotide identity was with the partial DPOL gene of an alphaherpesvirus, bovine herpesvirus 5 (79.5% identity). It also shared high identity with several other marine mammal herpesviruses (50.2 to 77.3% identity). This new herpesvirus was tentatively named beluga whale herpesvirus (BWHV). Virus isolation was unsuccessful. The pathogenic potential of BWHV is unknown, but the evaluation of archived tissues suggests that the virus is endemic in the St. Lawrence Estuary beluga population. PMID:25375944

  1. [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

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

    Science.gov (United States)

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

    2013-08-01

    Reproductive effects from phthalate exposure have been documented mostly in animal studies. This study explored the association between prenatal exposure to phthalate metabolites, anogenital distance and penile measurements in male newborns in Toluca, State of Mexico. A total of 174 pregnant women provided urine samples for phthalate analysis during their last prenatal visit, and the 73 who gave birth to male infants were included in the study. The 73 male newborns were weighed and measured using standardized methods after delivery. After adjusting for creatinine and supine length at birth, significant inverse associations were observed between an index of prenatal exposure to total phthalate exposure and the distance from the anus to anterior base of the penis (? = -0.191 mm per 1 ?g/l, P = 0.037), penile width (? = -0.0414, P = 0.050) and stretched length (? = -0.2137, P = 0.034); prenatal exposure to mono-2-ethylhexyl phthalate exposure was associated with a reduction in the stretched length of the penis (? = -0.2604, P = 0.050). Human exposure to phthalates is a public health concern, and the system most vulnerable to its potential effects seems to be the immature male reproductive tract. PMID:24349678

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

    Science.gov (United States)

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

    2013-01-01

    Reproductive effects from phthalate exposure have been documented mostly in animal studies. This study explored the association between prenatal exposure to phthalate metabolites, anogenital distance and penile measurements in male newborns in Toluca, State of Mexico. A total of 174 pregnant women provided urine samples for phthalate analysis during their last prenatal visit, and the 73 who gave birth to male infants were included in the study. The 73 male newborns were weighed and measured using standardized methods after delivery. After adjusting for creatinine and supine length at birth, significant inverse associations were observed between an index of prenatal exposure to total phthalate exposure and the distance from the anus to anterior base of the penis (? = ?0.191 mm per 1 µg/l, P = 0.037), penile width (? = ?0.0414, P = 0.050) and stretched length (? = ?0.2137, P = 0.034); prenatal exposure to mono-2-ethylhexyl phthalate exposure was associated with a reduction in the stretched length of the penis (? = ?0.2604, P = 0.050). Human exposure to phthalates is a public health concern, and the system most vulnerable to its potential effects seems to be the immature male reproductive tract. PMID:24349678

  4. 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.

  5. 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 SciELO Brazil | Language: English Abstract in english 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Nseyo, U.O.; Wilbur, H.J.; Kang, S.A.; Flesh, L.; Bennett, A.H.

    1984-01-01

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

  7. Fractura de pene: Estudio de 10 años / Penile fracture: Study of 10 years

    Scientific Electronic Library Online (English)

    Ariel, Núñez Roca; Tomás Lázaro, Rodríguez Collar; José Antonio, García Monzón; Santiago, Carrillo González; Gilberto, Martínez Ramos.

    2010-12-01

    Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish INTRODUCCIÓN: La fractura de pene ocurre la mayoría de las veces durante el coito, cuando el órgano, al estar erecto, se flexiona bruscamente. OBJETIVOS: Describir aspectos de la presentación y características de esta entidad, así como su diagnóstico y tratamiento. MÉTODOS: Se realizó un estudio des [...] criptivo, a partir de las historias clínicas de 25 pacientes ingresados en el servicio de urología del Hospital Militar Central "Dr. Carlos J. Finlay", de enero de 1997 a diciembre de 2006, con el diagnóstico de fractura de pene. Las variables descritas fueron: edad, síntomas y signos, agentes causales, medios diagnósticos utilizados, tratamiento aplicado y complicaciones presentadas. RESULTADOS: Predominó el grupo de edades de 26 a 44 años con el 56 %. El síntoma principal fue el hematoma del pene en el 100 % de los casos y la causa más frecuente fue el traumatismo durante el coito en el 68_%. En el 24 % de los pacientes fue necesario el auxilio de la ecografía peneana, simple o Doppler, para confirmar el diagnóstico; se aplicó el tratamiento quirúrgico en el 72 % de los pacientes. Las complicaciones se presentaron en los casos no operados y consistieron en fibrosis de los cuerpos cavernosos y la disfunción sexual eréctil. CONCLUSIONES: La fractura de pene ocurre fundamentalmente durante el coito. La sintomatología clínica tiene gran valor para el diagnóstico. En caso de dudas, la ecografía simple o Doppler resulta muy útil. El tratamiento quirúrgico es el indicado para evitar secuelas en estos pacientes. Abstract in english INTRODUCTION: The penile fracture is very frequent during the coitus when the organ is in erection undergoes a sudden flexion. OBJECTIVES: To describe the features of presentation and its entity characteristics, as well as its diagnostic and treatment. METHODS: A descriptive study was conducted from [...] the medical records of 25 patients admitted in the Urology Service of the "Dr. Carlos J. Finlay" Military Hospital from January, 1997 to December, 2006 diagnosed with penile fracture. The variables described were: age, symptoms and signs, causal agents, diagnostic means used, applied treatment and present complications. RESULTS: There was predominance of ages from 26 to 44 years with the 565. The major symptom was a penile hematoma in the 100 % of cases and the more frequent cause was the trauma during coitus in the 68 %. In the 24% of patients it was necessary the penile single echography or Doppler to verify the diagnosis; surgical treatment was applied in the 72 % of patients. The complications were present in the non-operated on cases including fibrosis of cavernous bodies and an erectile sexual dysfunction. CONCLUSIONS: The penile fracture occurs mainly during the coitus. The clinical symptomatology is very important for diagnosis. If there are doubts the single echography or Doppler is very useful. The surgical treatment is the more appropriate to avoid sequelae in these patients.

  8. Effect of angiotensin II blockade on central blood pressure and arterial stiffness in subjects with hypertension

    OpenAIRE

    Safar, Michel E.

    2010-01-01

    In hypertension, the blood pressure curve may be divided into two sets of components. The first set is mean arterial pressure, steady flow, and vascular resistance, thus acting on small arteries; the second set refers to large arteries, hence to pulse pressure, arterial stiffness, and wave reflections. The angiotensin-converting enzyme (ACE) inhibitor perindopril not only reduces mean arterial pressure but also acts specifically on pulse pressure. The effect on pulse pressure predominates on ...

  9. HERITABLE FORMS OF PULMONARY ARTERIAL HYPERTENSION

    OpenAIRE

    Austin, Eric D.; Loyd, James E.

    2013-01-01

    Tremendous progress has been made in understanding the genetics of heritable pulmonary arterial hypertension (HPAH) since its description in the 1950s. Germline mutations in the gene coding bone morphogenetic receptor type 2 (BMPR2) are detectable in the majority of cases of HPAH, and in a small proportion of cases of idiopathic pulmonary arterial hypertension (IPAH). Recent advancements in gene sequencing methods have facilitated the discovery of additional genes with mutations among those w...

  10. Penile primary melanoma: analysis of 6 patients treated at Brazilian national cancer institute in the last eight years

    Scientific Electronic Library Online (English)

    Gustavo Ruschi, Bechara; Aline Barros de Santos, Schwindt; Antonio Augusto, Ornellas; Diogo Eugenio Abreu da, Silva; Felipe Monnerat, Lott; Franz Santos de, Campos.

    2013-12-01

    Full Text Available SciELO Brazil | Language: English Abstract in english Purpose To describe our experience in treating penile melanoma in 06 patients followed at our institution. Materials and Methods Between 2004 and 2012 six consecutive patients with penile melanoma were treated at our Institution. Stage of the disease was classified according to the 2002 AJCC patho [...] logic system. Melanoma in situ (TIS) was diagnosed in one patient. One patient was staged as T1b, two patients as T2b and two patients as T4b. The clinical and pathological findings were evaluated. Immunohistochemical tests were performed for Melan-A, HNB-45, S-100 and C-KIT. All histological specimens were examined by the same pathologist (ABSS). The patients with Cis, stages T1b and one patient T2b underwent only local excision. One patient T2b underwent local excision and sentinel lymph node dissection. Two patients with melanoma stage T4b underwent partial penile amputation. One of these last patients had palpable inguinal lymph nodes at diagnosis and underwent bilateral inguinal lymphadenectomy and received systemic chemotherapy (dacarbazine, 30 cycles). Results Mean follow-up was 36.3 months. One patient, with stage T2b, died after 12 months due to disease recurrence with bilateral inguinal involvement. The patient who underwent chemotherapy progressed with lung metastases and died after 14 months of follow up. The disease-free survival at five years was 33.3%. Conclusion: Penile melanoma is a disease with poor prognosis in most cases. Local excision or partial penile amputation may have effective control for stages T1 and T2 lesions. Patients who have clinically proven metastases died despite surgical and adjuvant chemotherapy.

  11. Laser irradiation of penile blood as treatment of sexual dysfunctions

    Science.gov (United States)

    Koultchavenia, Ekaterina V.; Khomyakov, Victor T.

    2001-05-01

    40-60% of the men of average age suffer from the violations of sexual functions. Impotence doesn't make direct threat to life; nevertheless this disease essentially reduces quality of life, and consequently deserves the most steadfast attention. There are many methods of treatment of erectile dysfunction. However they are connected with a reception of medicines, which is expensive and has a number of contraindications, or with invasive procedures, or with surgical intervention, that also not always is desirable. We have developed the original device permitting to cause passive erection by creation of a local decompression. The second stage is the effect by an infrared laser radiation (denseness of a potency 4.2 mWt/sm2, continuous radiation with length of a wave 0.89 microns, exposition 5 minutes) on erection glans penis. We observed 24 patients with the complaints on insufficient erection (18), premature ejaculation (6); 2 patients in addition presented the complaint on small sizes of the penis. Age of the patients was 24-46 years, on the average 34.3 years. All have received treatment from 15 sessions in day.

  12. Penile vibratory stimulation in the recovery of urinary continence and erectile function after nerve-sparing radical prostatectomy : a randomized, controlled trial

    DEFF Research Database (Denmark)

    Fode, Mikkel; Borre, Michael

    2013-01-01

    To examine the effect of penile vibratory stimulation (PVS) in the preservation and restoration of erectile function and urinary continence in conjunction with nerve-sparing radical prostatectomy (RP).

  13. Spiral CT angiography (SCTA) study of celiac artery and superior mesenteric artery

    International Nuclear Information System (INIS)

    Objective: To study the visualization capability and scanning technique of SCTA in celiac artery, superior mesenteric artery (SMA) and other branches. Methods: Thirty patients, with normal abdominal SCTA results, were given small injection test dose after plain scan. The abdominal aorta parallel to the body of pancreas was chosen as target vessel, the peak-time plus 2 seconds as the best delay scan time. Iodine contrast medium 90?110 ml was injected into antecubital vein at the speed of 3.5 ml/s, then scan from cranial to caudal was performed. Pitch 1.0 and slice thickness 3.2 mm were selected as the scan parameters. Maximum intensity projection (MaxIP) was employed in all patients and shaded surface display (SSD) in 23 cases. Results: The display rate using MaxIP and SSD of celiac artery, splenic artery, common hepatic artery, proper hepatic artery and SMA were all 100%, the gastroduodenal artery 100% and 91%, the left gastric artery 83% and 87%, respectively. Conclusions: SCTA as a minimally invasive examination is a valuable method to detect and diagnose disease or variations of celiac artery, its branches and SMA. Spiral scanning technique and image processing have a decisive effect on the image quality

  14. Coronary Artery Bypass Grafting

    Science.gov (United States)

    ... Coronary Artery Bypass Grafting? Coronary artery bypass grafting (CABG) is a type of surgery that improves blood flow to the heart. Surgeons use CABG to treat people who have severe coronary heart ...

  15. 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.

  16. Human penile ossification: case report / Ossificação no pênis humano: relato de caso

    Scientific Electronic Library Online (English)

    Homero Oliveira de, Arruda; Hudson de, Lima; Valdemar, Ortiz.

    2007-03-01

    Full Text Available SciELO Brazil | Language: English Abstract in portuguese CONTEXTO: Ossificação do pênis humano é uma condição rara e apenas 34 casos histologicamente evidentes foram relatados. Várias condições foram relacionadas com o problema e o mais freqüente foi a Doença de Peyronie. Em todas, as ossificações parecem ser resultado de um processo de metaplasia com for [...] mação óssea. RELATO DO CASO: Um homem de 59 anos branco apresentou-se com história de leve dor no pênis durante as ereções há um ano. Ele também referia a presença de uma placa dura na base do pênis, que começou a crescer após um trauma na relação sexual. O exame do pênis revelou tratar-se de uma massa fixa, firme, no terço proximal do pênis de aproximadamente 3.0 x 3.0 x 2.0 cm, sem extensão para a superfície. Não havia impotência ou outra alteração clínica relevante. A radiografia do pênis identificou extensa área calcificada no corpo esponjoso e região do septo, em correspondência à massa palpada. A importância deste relato é a extensão da ossificação de acordo com a radiologia e confirmação histológica. Abstract in english CONTEXT: Ossification in the human penis is such a rare condition that only 34 histologically evident cases have previously been reported. Among several conditions that have been correlated with this problem the most frequent is Peyronie disease. In all these conditions, human penile ossification ap [...] pears to be a metaplastic bone formation process. CASE REPORT: A 59-year-old white man presented with a one-year history of slight pain upon erection and during intercourse. He also complained of hard plaque near the base of the penis. One year earlier, he had sustained blunt trauma during intercourse. Examination of the penis revealed a fixed firm mass extending over the proximal third of the penile shaft, measuring 3.0 x 3.0 x 2.0 cm and involving the corporal sponge, without surface extension. There was no impotence or other relevant clinical finding. Radiography on the penis revealed irregular calcification in the same position as the palpable mass and in the septum of the proximal inner third of the penis. The importance of this report lies in the extent of the human penile ossification, as demonstrated by the radiological and histological confirmation.

  17. 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.

  18. 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

  19. Gastroepiploic artery aneurysm

    International Nuclear Information System (INIS)

    Full text: 61-year-old man was referred to our radiology department for abdominal Multi detector computed tomography (MDCT) evaluation because of undefined abdominal discomfort. MIP and curved MPR scans revealed that, the mass is a true sacculary aneurysm at the midportion of the right gastroepiploic artery. Gastroduodenal artery aneurysms are the least common of all the splanchnic artery aneurysms. We appreciated the case as a right gastroepiploic artery aneurysm. We couldn't find any similar case in the literature

  20. [A Technic of re-using a thrombosed hepatic artery in hepatic intra-arterial chemotherapy].

    Science.gov (United States)

    Chazelet, C; Baumel, H; Deixonne, B; Ould-Said, H

    1988-11-01

    Nowadays the palliative treatment of hepatic metastasis very often uses the hepatic arterial chemotherapy in subcutaneous injection cavity. Unfortunately in about ten per cent of the cases, the thrombosis of hepatic artery limits the lasting quality of use of the catheters which last about twelve months (more or less four). As mentioned in our observation, if the patient "answers" the chemotherapy, we propose reusing this thrombosized artery by means of an original technical artifice. In this observation, in fact, we grafted a small segment of submesenteric vein on the hepatic disobstructed artery. We think that this artifice could also be used in case of anatomic variations of the hepatic artery like trifurcation. PMID:3225279

  1. [Ruptured pseudoaneurysm of the renal artery associated with segmental arterial mediolysis].

    Science.gov (United States)

    Mizutani, Kosuke; Kikuchii, Mina; Kondo, Hiroshi; Moriyama, Yoji; Tsuchiya, Tomohiro; Masahiro, Nakano; Hidetoshi, Ehara; Deguchii, Takashi; Shinoda, Ikuo

    2008-07-01

    We present a 71-year-old woman with spontaneous perinephric hematoma due to a rupture of pseudoaneurysm of the right renal artery on the fourth day after radical cystectomy and bilateral ureterocutaneostomy for bladder cancer. This patient received steroid therapy for chronic rheumatoid arthritis for several years. The digital subtraction angiography of the right renal artery showed two pseudoaneurysms in the anterior inferior segmental branch and the posterior inferior segmental branch. Transarterial coil embolization of the right renal artery proximally and distally to the two aneurysms was performed without complications. Moreover, the additional angiography showed typical string-of-beads appearance and small aneurysms in abdominal visceral arteries, suggesting segmental arterial mediolysis (SAM) as a possible etiology. Differential diagnoses of SAM are discussed. PMID:18697494

  2. Fibromuscular dysplasia of the brachial artery associated with unilateral clubbing

    OpenAIRE

    Waele, Miche?le; Lauwers, Patrick; Hendriks, Jeroen; Schil, Paul

    2012-01-01

    A 46-year old male patient was admitted with a history of an extremely painful right upper arm, associated with unilateral clubbing. Duplex scanning and magnetic resonance imaging were suggestive of a pseudo-aneurysm of the brachial artery. Digital angiography showed an irregular brachial artery, associated with a small pseudo-aneurysm. The brachial artery was partially resected and reconstructed with a venous interposition graft. Pathological examination provided the final diagnosis of fibro...

  3. Prótesis de pene: Resultados de calidad y morbilidad / Penile prosthesis: Quality outcomes and morbidity

    Scientific Electronic Library Online (English)

    Vicente, Chiva Robles; Luis, Llanes González; Carlos, Pascual Mateo; Gino, Espinales Castro; Ignacio, Romero Cajigal; Antonio, Berenguer Sánchez.

    2005-11-01

    Full Text Available OBJETIVO: Conocer la satisfacción y complicaciones presentadas en una serie de pacientes con disfunción eréctil sometidos a la implantación de una prótesis peneana. MÉTODOS: Estudio retrospectivo de los pacientes intervenidos quirúrgicamente por D.E. mediante la colocación de una prótesis de pene en [...] el periodo comprendido entre 1993 y 2003. Se recogieron datos como la edad del paciente en el momento de la intervención, el tratamiento previo y los diferentes antecedentes patológicos. Se revisaron los distintos modelos de prótesis, el tipo de incisión empleada y las distintas complicaciones que surgieron. Por último se elaboró un cuestionario para determinar el nivel de satisfacción del paciente. RESULTADOS: En el periodo comprendido entre los años 1993 y 2003 se implantaron 24 prótesis. La edad media de los pacientes fue 56,6 +/- 7,56 (36- 63) años mediana de 59,5. La incisión peno-escrotal se empleó en 13 (54,16%) pacientes, suprapúbica en 6 (25%) y subcoronal en 1 (4,16%). En cuanto a los modelos empleados, en 9 (37,5%) se utilizó la prótesis semirrígida AMS 600, y en 10 (41,66%) el modelo AMS 650, también semirrígida. Unicamente en una ocasión se empleó una prótesis hidráulica de dos componentes AMS Ambicor. Se presentaron complicaciones en 6 (25%) pacientes, de las cuales el 12,5% fueron menores como cavernositis, dolor o hematoma. En 3 (12,5%) ocasiones fue necesaria la retirada de la misma. Respondieron a la encuesta telefónica 13 (54,16%) pacientes, de los cuales un 85 % emplea la prótesis. Un 54% presentan una satisfacción propia y en la pareja adecuada (buena o mucha), un 23 % regular y el resto, otro 23 % mala o muy mala. CONCLUSIÓN: A pesar de la elevada tasa de complicaciones postoperatorias, la prótesis de pene es aceptada adecuadamente, incluso en los modelos maleables, por los enfermos con disfunción eréctil. La satisfacción por parte del paciente es alta, siendo mayor en la pareja. La mayor parte de los enfermos desearía volver a ser intervenido en el caso de encontrarse en una situación similar anterior al implante. Abstract in english OBJECTIVES: To study patient satisfaction and complications appeared in a series of patients with erectile dysfunction undergoing implant of penile prosthesis. METHODS: Retrospective study of all patients undergoing surgical treatment for erectile dysfunction by penile prosthesis implant between 199 [...] 3 and 2003. Collected data included patient age at the time of surgery, previous treatment, and significant medical history. We reviewed the models of prosthesis employed, incisions, and complications appeared. Finally, a questionnaire was elaborated to establish the level of patient satisfaction. RESULTS: 24 prostheses were implanted between 1993 and 2003. Mean patient age was 56.6 ± 7.56 years (36-63), median 59.5 yr. Penile-scrotal incision was employed in 13 (54.16%) patients, suprapubic incision in 6 (25%) and subcoronal incision in 1 (4.16%). Type of prosthesis: semirrigid AMS 600 9 (37.5%), semirrigid AMS 650 10 (41.66%); the two component hydraulic prosthesis AMS Ambicor was used only in one case. Six (25%) patients presented complications. 16.66% were minor, cavernositis, pain, hematoma or prosthesis extrusion. Prosthesis extraction was necessary in 2 (8.33%) cases. 13 (54.16%) patients responded to the telephone survey. 85% of them use their prosthesis. 54% percent refer adequate self-satisfaction and partner satisfaction (well satisfied/much satisfaction).23% not too bad, and the remainder 23% bad or very bad. CONCLUSIONS: Despite the highest rate of postoperative complications, penile prosthesis is adequately accepted by patients with erectile dysfunction, even malleable models. Patient satisfaction is high, being higher in partners. Most patients would desire to undergo surgery again if they were in the same situation.

  4. Assessment of problematic sexual interests with the penile plethysmograph: an overview of assessment laboratories.

    Science.gov (United States)

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

    2015-05-01

    Phallometric testing, or penile plethysmography (PPG), is an objective measure of sexual arousal for males. While extensive research on the reliability and validity of PPG has promoted its reputation as the "gold standard" of objective measurement of sexual arousal, there is a lack of standardization of stimulus sets and interpretation of results between sites. This article describes the laboratory protocol employed for PPG at the Royal Ottawa Mental Health Centre's Sexual Behaviours Clinic (SBC) in Ottawa, Ontario, as well as those used by the Sexual Behaviors Clinic and Lab (SBCL) in the Community and Public Safety Psychiatry Division (CPSPD) of the Department of Psychiatry and Behavioral Sciences at Medical University of South Carolina (MUSC) in Charleston, South Carolina. The need for standardization in both testing protocol and stimuli use across sites are highlighted. PMID:25773223

  5. Penile lesion with inguinal adenopathy after intravesical Bacillus Calmette-Guerin instillation therapy.

    Science.gov (United States)

    Aslan, Guven; Sevinc, Can; Tuna, Burcin; Ozkal, Sermin; Yorukoglu, Kutsal

    2013-01-01

    Intravesical Bacillus Calmette-Guérin (BCG) is widely used as an adjuvant therapy in the treatment of non-muscle-invasive bladder cancer. BCG is generally well tolerated, though localized and systemic infectious complications may occur. Infection of the glans and inguinal adenopathy are rare local complications of intravesical BCG therapy. Traumatic urethral catheterization is one of the main causes. We report the case of a 75-year-old male who developed granulomatous balanitis and enlarged inguinal lymph nodes after five cycles of intravesical BCG treatment for transitional cell carcinoma of the bladder. Histology revealed giant cell granuloma. Oral antituberculous treatment was initiated with subsequent full recovery of penile lesions and adenopathy. Physicians who administer BCG must be familiar with the possible complications and their adequate management and should inform patients about the side-effects accordingly. PMID:23671372

  6. 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

  7. 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)

  8. Penile lesion with inguinal adenopathy after intravesical Bacillus Calmette-Guerin instillation therapy

    Science.gov (United States)

    Aslan, Guven; Sevinc, Can; Tuna, Burcin; Ozkal, Sermin; Yorukoglu, Kutsal

    2013-01-01

    Intravesical Bacillus Calmette-Guérin (BCG) is widely used as an adjuvant therapy in the treatment of non-muscle-invasive bladder cancer. BCG is generally well tolerated, though localized and systemic infectious complications may occur. Infection of the glans and inguinal adenopathy are rare local complications of intravesical BCG therapy. Traumatic urethral catheterization is one of the main causes. We report the case of a 75-year-old male who developed granulomatous balanitis and enlarged inguinal lymph nodes after five cycles of intravesical BCG treatment for transitional cell carcinoma of the bladder. Histology revealed giant cell granuloma. Oral antituberculous treatment was initiated with subsequent full recovery of penile lesions and adenopathy. Physicians who administer BCG must be familiar with the possible complications and their adequate management and should inform patients about the side-effects accordingly. PMID:23671372

  9. Popliteal artery entrapment syndrome

    International Nuclear Information System (INIS)

    Popliteal artery entrapment syndrome is an uncommon cause of intermittent claudication in young athletic persons. A 32 years old soldier presented with 14 months history of intermittent claudication. On the basis of history, physical examination and angiographic findings a diagnosis of popliteal artery entrapment was made. Exploration revealed a fibrous band tightly compressing popliteal artery and irreversibly damaged popliteal artery. Short saphenous vein graft was used to bypass the occluded segment of popliteal artery. This led to complete resolution of symptoms and continuation of active service. (author)

  10. 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.

  11. Prognostic significance of the degree of extranodal extension in patients with penile carcinoma

    Directory of Open Access Journals (Sweden)

    Jin-You Wang

    2014-06-01

    Full Text Available This study sought to assess the prognostic significance of the degree of extranodal extension (ENE and several other risk factors in pathological ENE penile carcinoma. We analyzed prospectively collected data on a consecutive series of 31 chemotherapy-naive patients with proven ENE who underwent therapeutic regional lymphadenectomy. Postoperative external radiotherapy was then performed. We studied the extent of ENE utilizing a novel grading system and correlated patient grades with their outcome measures. ENE was graded as 1 - if the capsule of the lymph node (LN was ruptured less than one-third of its circumference or 2 - if the capsule was disrupted more than one-third of its circumference or the entire LN was disrupted. We estimated overall survival (OS using the Kaplan-Meier method. Multivariate analysis was performed according to the Cox proportional hazards model using factors that were identified as statistically significant in univariate analysis. The incidence rate of ENE was 51.8% in patients with pathological node-positive carcinoma of the penis. The median OS and 5-year survival were 18 months (95% confidence interval (CI, 14.4-21.6 and 23%, respectively. Prognostic variables on univariate analysis were ENE grade 2, ?3 LNs with ENE, maximal LN ? 35 mm, ?5 positive LNs and pelvic LN involvement. On multivariate analysis, only ENE grade 2 remained associated with decreased OS (hazard ratio (HR: 6.50. In conclusion, patients with ENE have a poor outcome, and ENE grade 2 is an independent predictive factor of poor OS in patients with pathological ENE penile carcinoma.

  12. Inflatable penile prosthesis technique and outcomes after radial forearm free flap neophalloplasty.

    Science.gov (United States)

    Segal, R L; Massanyi, E Z; Gupta, A D; Gearhart, J P; Redett, R J; Bivalacqua, T J; Burnett, A L

    2015-03-01

    The aim of this study was to describe the technical aspects and short-term outcomes of inflatable penile prosthesis (IPP) implantation after neophallus reconstruction at a single institution. Nine men with previously constructed radial forearm neophalli underwent IPP implantation. The etiologies of their penile anomaly were bladder exstrophy complex in five, disorder of sexual differentiation in two and genital obliteration secondary to ballistic trauma in two. Median follow-up was 9.6 months (range 1.5-139.7). The records for these patients were retrospectively reviewed and outcomes recorded. Mean age was 23.6 (range 18-31) years, and mean time interval from neophalloplasty to IPP implantation was 22.1 months (range 3-48). In all cases, 3-piece IPPs were employed, with eight of patients having one cylinder implanted in the native corporal body and extending into the neophallus. Mean surgical time was 222?min (range 142-409). Median length of implanted device was 22?cm. No intraoperative complications were observed. At the most recent follow-up, six patients (66.7%) had functional devices, with acceptable surgical outcomes. Three patients (33.3%) sustained device infections, and three (33.3%) sustained cylinder erosion. In three patients in whom neo-tunica albuginea were fashioned by ensheathing the cylinder with allograft human dermal tissue matrix, no erosions occurred. One patient underwent two revisions, the first for the associated erosion and infection and the second for genital pain, and was left with a semi-rigid prosthesis. IPP implantation affords the best opportunity for functionality for patients with a radial forearm free flap neophallus. Caution must be taken to ensure viability of the neophallus intraoperatively, and protocols to minimize the risk of infection should be followed. Fashioning neo-tunica albuginea using graft material may reduce risk of erosion. PMID:25099636

  13. Prognostic significance of the degree of extranodal extension in patients with penile carcinoma.

    Science.gov (United States)

    Wang, Jin-You; Zhu, Yao; Tang, Shao-Xian; Zhang, Hai-Liang; Qin, Xiao-Jian; Zhang, Shi-Lin; Dai, Bo; Ye, Ding-Wei

    2014-01-01

    This study sought to assess the prognostic significance of the degree of extranodal extension (ENE) and several other risk factors in pathological ENE penile carcinoma. We analyzed prospectively collected data on a consecutive series of 31 chemotherapy-naive patients with proven ENE who underwent therapeutic regional lymphadenectomy. Postoperative external radiotherapy was then performed. We studied the extent of ENE utilizing a novel grading system and correlated patient grades with their outcome measures. ENE was graded as 1 - if the capsule of the lymph node (LN) was ruptured less than one-third of its circumference or 2 - if the capsule was disrupted more than one-third of its circumference or the entire LN was disrupted. We estimated overall survival (OS) using the Kaplan-Meier method. Multivariate analysis was performed according to the Cox proportional hazards model using factors that were identified as statistically significant in univariate analysis. The incidence rate of ENE was 51.8% in patients with pathological node-positive carcinoma of the penis. The median OS and 5-year survival were 18 months (95% confidence interval (CI), 14.4-21.6) and 23%, respectively. Prognostic variables on univariate analysis were ENE grade 2, ? 3 LNs with ENE, maximal LN ? 35 mm, ? 5 positive LNs and pelvic LN involvement. On multivariate analysis, only ENE grade 2 remained associated with decreased OS (hazard ratio (HR): 6.50). In conclusion, patients with ENE have a poor outcome, and ENE grade 2 is an independent predictive factor of poor OS in patients with pathological ENE penile carcinoma. PMID:24480925

  14. Bilateral Ductal Stenting for Discontinuity of the Pulmonary Artery via the Femoral and Carotid Arteries in an Infant

    Science.gov (United States)

    Sahin, Derya Aydin

    2015-01-01

    Bilateral ductal stenting should be performed in cases of discontinuity of the pulmonary branches and pulmonary atresia. Performing this procedure via the carotid artery in small infants can be very difficult and challenging. We present a case of bilateral ductal stenting via both the femoral and carotid arteries in a little child with tetralogy of Fallot with pulmonary atresia and a nonconfluent pulmonary artery and bilateral ductus arteriosus.

  15. Surgical repair of Shone's complex with anomalous origin of the left coronary artery arising from the right pulmonary artery.

    Science.gov (United States)

    Bobylev, Dmitry; Meschenmoser, Luitgard; Boethig, Dietmar; Horke, Alexander

    2015-03-01

    Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly. ALCAPA from the right pulmonary artery (RPA) is a small subset of this anomaly, with only a few reported cases to date. We describe an extremely uncommon association of Shone's complex with ALCAPA from the RPA in a case where simultaneous surgery for both anomalies was successfully carried out in a neonate. PMID:25535179

  16. Ischemic stroke: carotid and vertebral artery disease.

    Science.gov (United States)

    Vilela, P; Goulão, A

    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. PMID:15657789

  17. 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.)

  18. 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)

  19. 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.)

  20. Genetics of Pulmonary Arterial Hypertension

    Science.gov (United States)

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

    2013-01-01

    Tremendous progress has been made in understanding the genetics of hereditable pulmonary arterial hypertension (HPAH) since its description in the 1950s. Germline mutations in the gene coding bone morphogenetic receptor type 2 (BMPR2) are detectable in the majority of cases of HPAH, and in a small proportion of cases of idiopathic pulmonary arterial hypertension (IPAH). HPAH is an autosomal dominant disease characterized by reduced penetrance, variable expressivity, female predominance, and genetic anticipation. These characteristics suggest that endogenous and exogenous factors modify disease expression and areas of emphasis for future investigation. The variable clinical expression makes genetic counseling complex because the majority of carriers of a BMPR2 mutation will not be diagnosed with the disease. This issue will become increasingly important, as clinical testing for BMPR2 mutations is now available for the evaluation of patients and family members with HPAH and IPAH. PMID:19634078