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Penis
Kinds of Penis Selected AbstractsADAPTIVE PLASTICITY OF THE PENIS IN A SIMULTANEOUS HERMAPHRODITEEVOLUTION, Issue 8 2009J. Matthew Hoch Acorn barnacles are important model organisms for the study of sex allocation. They are sessile, nonselfing hermaphrodites that copulate with penises that have been suggested to be phenotypically plastic. On wave-exposed shores, Semibalanus balanoides develop penises with relatively greater diameter whereas in wave-protected sites they are thinner. A reciprocal transplant experiment between wave-exposed and protected sites tested whether these exposure-specific morphologies have adaptive value. Mating success was compared over a range of distances to compare the ability of barnacles to reach mates. Barnacles that grew in the wave-protected site and mated in the wave-protected site fertilized more broods at increasing distances than those transplanted to the wave-exposed site. For barnacles that developed in the wave-exposed site, there was no difference in the ability to fertilize neighbors between sites of differing exposure. This study demonstrates the adaptive value of plasticity in penis morphology. The results suggest a trade-off between development of a penis adapted to wave exposure and the ability to fertilize distant mates. Barnacles in different physical environments are limited by different factors, which may limit numbers of potential mates, constrain optimal sex allocation strategies and alter reproductive behavior. [source] Myointimoma of the Glans PenisJOURNAL OF CUTANEOUS PATHOLOGY, Issue 1 2006S. Thurber A 54-year-old man presented with a 2-month history of a firm, non-tender, non-mobile 0.4 cm nodule of his coronal sulcus. An incisional biopsy was performed and histopathology revealed a multinodular proliferation of cytologically bland spindled cells embedded in a fibromyxoid matrix. The lesional cells were immunoreactive for smooth-muscle actin but not S-100 protein. A Verhoeff van Gieson stain demonstrated a meshwork of elastic fibers surrounding individual tumor nodules. The clinical and histologic findings were diagnostic of a myointimoma. The lesion has not recurred one month after the initial partial biopsy. Myointimomas are a recently described, myointimal proliferation affecting the corpus spongiosum. Clinical experience with this type of lesion is limited. Reports in the literature thus far suggest this neoplasm is benign with persistence of incompletely excised lesions but no recurrences or metastases following complete excision. Myointimomas represent a strictly intravascular proliferation of intimal cells of blood vessels. [source] New results concerning the morphology of the most ancient dragonflies (Insecta: Odonatoptera) from the Namurian of Hagen-Vorhalle (Germany)JOURNAL OF ZOOLOGICAL SYSTEMATICS AND EVOLUTIONARY RESEARCH, Issue 4 2001G. Bechly The holotype specimen of the ,protodonate'Erasipteroides valentini (Brauckmann in Brauckmann et al., 1985) and the paratype specimen K-13 of the giant ,protodonate'Namurotypus sippeliBrauckmann and Zessin, 1989 from the Upper Carboniferous (Namurian B) of Hagen-Vorhalle (Germany) are redescribed, and a new specimen of Erasipteroides cf. valentini is described. The new evidence is used to refine the groundplan reconstruction of Odonatoptera and the reconstruction of odonatoid phylogeny. Prothoracic winglets for Erasipteroides and the absence of an archaedictyon are documented. Furthermore, a very long and sclerotized ovipositor with gonangulum is described from the female holotype specimen of Erasipteroides valentini, and it is proposed that it was not used for endophytic but for endosubstratic oviposition. The record of prothoracic winglets in early odonatoids, and their presence in fossil Palaeodictyoptera and ,protorthopteres', indicates that the groundplan of Pterygota indeed included three pairs of wings. A phylogenetic analysis suggests that the Palaeozoic giant Meganisoptera and "higher" odonatoids (incl. crowngroup Odonata) together form a monophyletic group which is here named Euodonatoptera. Erasipteroides and the other ,Erasipteridae' are shown to be more closely related to Euodonatoptera than to Eugeropteridae. The description of the male primary genital structures of Namurotypus sippeli is emended and a new interpretation is proposed, including new hypotheses concerning their function. The males of Namurotypus had a paired penis with a pair of lateral parameres, and a pair of leaf-like, but still segmented, gonopods. Segmented leg-like male gonopods are considered as a groundplan character of insects, while a paired penis is regarded as a putative synapomorphy of the palaeopterous insect orders Palaeodictyopteroida, Ephemeroptera, and Odonatoptera. It is proposed that Namurotypus did not mate by direct copulation but retained the archaic deposition of external spermatophores, just like the primarily wingless insects. The sigmoidal male cerci may have been placed behind the female head and used to drag the female over the spermatophore, which is remotely similar to the mating behaviour of some extant arachnids (e.g. Amblypygi). Three hypothetical scenarios regarding the evolution of secondary copulation in modern Odonata are proposed. Neue Erkenntnisse zur Morphologie der ältesten Libellen (Insecta: Odonatoptera) aus dem Namurium von Hagen-Vorhalle (Deutschland) Das Holotypusexemplar der ,Protodonate'Erasipteroides valentini (Brauckmann in Brauckmann et al., Geol. Paläont. Westfalen 3, 1,131, 1985) und das Paratypusexemplar K-13 der riesenwüchsigen ,Protodonate'Namurotypus sippeliBrauckmann and Zessin, 1989 aus dem Oberkarbon (Namurium B) von Hagen-Vorhalle (Deutschland) werden wiederbeschrieben. Die neuen Erkenntnisse werden zu einer Präzisierung der Grundplanrekonstruktion der Odonatoptera und für die Rekonstruktion der Libellenstammesgeschichte verwendet. Für Erasipteroides werden prothorakale Flügelchen beschrieben und das Fehlen eines Archaedictyons wird belegt. Des weiteren wird ein sehr langer und sklerotisierter Ovipositor mit Gonangulum für das weibliche Holotypusexemplar von Erasipteroides valentini beschrieben, und es wird vorgeschlagen, dass dieser nicht zur endophytischen Eiablage, sondern zur endosubstratischen Eiablage diente. Der Nachweis prothorakaler Flügelchen bei frühen Libellen sowie deren Vorkommen bei fossilen Palaeodictyoptera und ,Protorthopteren', deutet darauf hin, dass zum Grundplan der Pterygota drei Flügelpaare gehörten. Eine phylogenetische Analyse legt nahe, dass die riesenwüchsigen Meganisoptera des Paläozoikums und die ,höheren' Odonaten (inkl. Kronengruppe Odonata) gemeinsam eine monophyletische Gruppe bilden, die hier als Euodonatoptera benannt wird. Es wird gezeigt, dass Erasipteroides und die übrigen ,Erasipteridae' näher mit den Euodonatoptera verwandt sind als die Eugeropteridae. Die Beschreibung der primären männlichen Geschlechtsorgane von Namurotypus sippeli wird ergänzt, und eine neue Interpretation sowie neue Hypothesen zu deren Funktion werden vorgestellt. Die Männchen von Namurotypus besaßen einen paarigen Penis mit einem Paar lateraler Parameren und einem Paar blattartiger, aber noch segmentierter Gonopoden. Segmentierte, beinartige, männliche Gonopoden werden als Grundplanmerkmale der Insekten angesehen, während ein paariger Penis als potentielle Synapomorphie der paläopteren Insektenordnungen Palaeodictyopteroida, Ephemeroptera und Odonatoptera betrachtet wird. Es wird vorgeschlagen, dass die Paarung bei Namurotypus nicht durch eine direkte Kopulation ablief, sondern durch das Absetzen freier Spermatophoren, so wie bei den primär flügellosen Insekten. Die sigmoidalen männlichen Cerci könnten hinter dem weiblichen Kopf platziert worden sein, um das Weibchen über die Spermatophore zu dirigieren, ähnlich dem Paarungsverhalten mancher rezenter Spinnentiere (z.B. Amblypygi). Drei hypothetische Szenarien zur Evolution der sekundären Kopulation bei modernen Libellen werden vorgestellt. [source] ORIGINAL RESEARCH,WOMEN'S SEXUAL HEALTH: Vaginal Orgasm Is Associated with Vaginal (Not Clitoral) Sex Education, Focusing Mental Attention on Vaginal Sensations, Intercourse Duration, and a Preference for a Longer PenisTHE JOURNAL OF SEXUAL MEDICINE, Issue 8 2010Stuart Brody PhD ABSTRACT Introduction., Evidence was recently provided for vaginal orgasm, orgasm triggered purely by penile,vaginal intercourse (PVI), being associated with better psychological functioning. Common sex education and sexual medicine approaches might undermine vaginal orgasm benefits. Aims., To examine the extent to which women's vaginal orgasm consistency is associated with (i) being told in childhood or adolescence that the vagina was the important zone for inducing female orgasm; (ii) how well they focus mentally on vaginal sensations during PVI; (iii) greater PVI duration; and (iv) preference for above-average penis length. Methods., In a representative sample of the Czech population, 1,000 women reported their vaginal orgasm consistency (from never to almost every time; only 21.9% never had a vaginal orgasm), estimates of their typical foreplay and PVI durations, what they were told in childhood and adolescence was the important zone for inducing female orgasm, their degree of focus on vaginal sensations during PVI, and whether they were more likely to orgasm with a longer than average penis. Main Outcome Measures., The association of vaginal orgasm consistency with the predictors noted above. Results., Vaginal orgasm consistency was associated with all hypothesized correlates. Multivariate analysis indicated the most important predictors were being educated that the vagina is important for female orgasm, being mentally focused on vaginal sensations during PVI, and in some analyses duration of PVI (but not foreplay) and preferring a longer than average penis. Conclusions., Focusing attention on penile,vaginal sensation supports vaginal orgasm and the myriad benefits thereof. Brody S, and Weiss P. Vaginal orgasm is associated with vaginal (not clitoral) sex education, focusing mental attention on vaginal sensations, intercourse duration, and a preference for a longer penis. J Sex Med 2010;7:2774,2781. [source] Analysis of Testosterone Effects on Sonic Hedgehog Signaling in Juvenile, Adolescent and Adult Sprague Dawley Rat PenisTHE JOURNAL OF SEXUAL MEDICINE, Issue 3 2010Christopher W. Bond MS ABSTRACT Introduction., Smooth muscle apoptosis is a major contributing factor to erectile dysfunction (ED) development in prostatectomy and diabetic patients and animal models. A critical regulator of penile smooth muscle and apoptosis is Sonic hedgehog (SHH). The SHH protein is decreased in ED models and SHH treatment of cavernous nerve (CN) injured rats prevents smooth muscle apoptosis. A close association between androgen deficiency and ED has been suggested in the literature, but few studies have examined the molecular effects on penile smooth muscle and on known signaling mechanisms that regulate morphology. Aim., Examine testosterone and SHH interaction in eugonadal adult, adolescent and juvenile rats by performing castration studies and treatment with supraphysiological testosterone. Methods., The eugonadal adult Sprague Dawley rats were either treated with testosterone for 7 or 14 days (N = 14) or were castrated for 4 or 7 days (N = 12). The juvenile rats were treated with testosterone for 8 days (N = 7). The adolescent rats were castrated and sacrificed at P88 (N = 8). The control rats had empty vehicle (N = 22) or sham surgery (N = 20). Main Outcome Measures., The active form of SHH protein and mRNA were quantified by semi-quantitative immunohistochemical analysis and real-time reverse transcriptase polymerase chain reaction (RT-PCR). Results., Testosterone treatment did not alter SHH signaling in juvenile rats. Shh mRNA increased 3.2-fold and SHH protein increased 1.2-fold in rats castrated during puberty. In adult rats, castration decreased Shh mRNA 3.2-fold but did not alter SHH protein. Testosterone supplement in adult rats increased Shh mRNA 2.3-fold and decreased SHH protein 1.3-fold. Conclusions., SHH signaling is independent of testosterone in normal juvenile rats and is sensitive to testosterone during adolescence, while testosterone supplement in the adult adversely impacts SHH signaling in a very similar manner to that observed with CN injury. Bond CW, Angeloni NL, and Podlasek CA. Analysis of testosterone effects on sonic hedgehog signaling in juvenile, adolescent and adult Sprague Dawley rat penis. J Sex Med 2010;7:1116,1125. [source] ORIGINAL RESEARCH,SURGERY: Torsion of the Penis in Adults: Prevalence and Surgical CorrectionTHE JOURNAL OF SEXUAL MEDICINE, Issue 3 2008Osama Shaeer MD ABSTRACT Introduction., Torsion of the penis is a condition where the penis rotates around its longitudinal axis, whether congenital or acquired. Extreme degrees may provoke a cosmetic complaint. Aim., We describe surgical correction of congenital torsion of the penis in adults, and its prevalence among a special patient group. Main Outcome Measures., Success and ease of surgical repair. Methods., Sixteen cases with congenital torsion were operated upon, by counter-rotation, using a dartos flap in eight cases, and skin realignment in the other eight. The prevalence of congenital torsion was examined in 12,307 patients attending two andrology clinics. Results., Full correction was achieved in all cases. Skin realignment was easier and faster than dartos flap, and was equally effective. Congenital torsion was present in 11.993% of the epidemiologic study group, mild in 80%, moderate in 15%, and severe in 5%. Only 2.2% was bothered by the condition. Conclusion., Torsion of the penis is not uncommon but rarely provokes a complaint. Surgical repair by degloving and skin realignment is effective and easy. Dartos flap technique may be utilized if the former is inadequate. Shaeer O. Torsion of the penis in adults: Prevalence and surgical correction. J Sex Med 2008;5:735,739. [source] Age-Related Changes in Phosphorylation of Endothelial Nitric Oxide Synthase in the Rat PenisTHE JOURNAL OF SEXUAL MEDICINE, Issue 3 2005Biljana Musicki PhD ABSTRACT Aim., Aging is associated with erectile dysfunction (ED) attributed to reduced nitric oxide synthase (NOS) activity and nitric oxide bioavailability. However, the mechanism for this effect has not been fully investigated. We evaluated (i) whether age-related ED involves dysregulation of endothelial NOS (eNOS) phosphorylation; and (ii) whether vascular endothelial growth factor (VEGF) exerts erectile effects and operates via eNOS phosphorylation in aged rats. Methods., Male Fischer 344 "young" (4-month-old) and "aged" (19-month-old) rats were used. Electrical stimulation of the cavernous nerve (CNS) was performed to generate penile erection. Erectile response in the presence of rhVEGF165 was evaluated by intracavernosal pressure monitoring 25 minutes after intracavernosal injection of VEGF. Penes were excised at baseline, with or without rhVEGF treatment, and after CNS for Western immunoblot of phospho-eNOS (Ser-1177 and Thr-495), phospho-Akt, and eNOS. Results., Erectile response was significantly reduced in aged rats compared with young rats. Phospho-eNOS (Ser-1177) and phospho-Akt were significantly reduced, while phospho-eNOS (Thr-495) was significantly increased, in the aged penis at baseline and after CNS. rhVEGF significantly improved erection and reversed downregulated Ser-1177, but not upregulated Thr-495 phosphorylation, on eNOS in aged penes. eNOS protein was significantly increased in aged penes. Conclusions., Age-related ED is associated with eNOS inactivation through a decrease in phosphorylation of its positive regulatory site (Ser-1177) and an increase in phosphorylation of its negative regulatory site (Thr-495) in the penis. Altered phosphorylation/constitutive activation of eNOS by fluid shear stress may be a major determinant of compromised vascular homeostasis of the aged penis. The finding that VEGF rapidly induces erection and partly corrects alterations in eNOS phosphorylation in the aged rat penis suggests impaired eNOS activation by deficient endogenous VEGF and supports the potential for growth factor therapy in the treatment of age-related ED. [source] The Alchemy of Jargon: Etymologies of urologic neologisms. number 6: The language of the urogenital systemTHE PROSTATE, Issue 15 2009Lochlan Shelfer Abstract BACKGROUND As the scientific community is increasingly severed from the study of linguistics, the underlying significance of their common technical words is becoming blurred. This article will focus on the genesis of terminology of the urogenital system. METHODS These notes will give a detailed background of the history of technical terms, including how they came into being, whence they were derived, and how they impacted the scientific community through the ages. RESULTS In this installment, following terms are analyzed: Penis, Ampulla, Vas Deferens, Epididymis, Gonad, and Bladder. CONCLUSIONS This analysis of the history and significance of scientific terms common to the urological community works towards a fortification of their power by offering a reminder of their origins. Prostate 69: 1611,1612, 2009. © 2009 Wiley-Liss, Inc. [source] Arterial Supply of the Penis in the New Zealand Rabbit (Oryctolagus cuniculus L.)ANATOMIA, HISTOLOGIA, EMBRYOLOGIA, Issue 1 2003O. Ozgel Summary In the present study, the distributional pattern of the penile artery and the vessels joining the blood supply of the penis were investigated in the New Zealand rabbit. Eight adult rabbits were used in the study. In order to exhibit the vascular network by dissection, latex was injected via the abdominal aorta. The main vessel which supplies blood to the penis, the penile artery, is a branch of the internal pudendal artery. It divides into two branches which form the deep and dorsal penile arteries at the level of the ischiadic arch. The deep penile artery penetrates the tunica albuginea, and forms the arterial network of corpus cavernosum penis. On the other hand, the dorsal penile artery gives off three small branches for the subischiocavernosus muscle and at the level of the attachment of this muscle sends two small branches for the preputium. The course of both arteries follows the dorsolateral surface of the penis to the glans and ends in an anastomosis. Hence, a caudal branch of the prostatic artery which originates from the umbilical artery joins the blood supply of the penis in the rabbit. After vascularizing the prostate complex, it ends by entering the corpus spongiosus penis at the dorsolateral surface at the level of the ischiadic arch. [source] Clinical Implications of a Close Vicinity of Nervus Dorsalis Penis/Clitoridis and Os PubisTHE JOURNAL OF SEXUAL MEDICINE, Issue 7 2008ABSTRACT Introduction., Close relation of nervus dorsalis penis/clitoris and os pubis has a major impact in surgical disciplines. Aim., To summarize a current knowledge about this region, represented by the course of sulcus nervi dorsalis penis/clitoridis. Methods., Literature search of years 1970,2007. Main Outcome Measures., In male, it accommodates nervus dorsalis penis whereas in female nervus et arteria dorsalis clitoridis. Lateral border of sulcus nervi dorsalis penis corresponds to vertical ridge and lateral border of sulcus nervi dorsalis clitoridis to ventral arc,two parameters, which are parts of the Phenice's method for sexing of isolated os pubis. Results., Exact preparation of nervus dorsalis penis is crucial in correct performance of conversion of genitalia in patients with transsexualism, in reconstruction of posterior urethra, in hypospadia, during performance of penile blockade during circumcision and in revascularization surgery of erectile dysfunction. Possible role of the sulcus nervi dorsalis penis in the Alcock's syndrome is discussed. Similarly, it is advisable to take care of nervus dorsalis clitoridis during reduction clitoridoplasty in patients with adrenogenital syndrome and during the insertion of transobturator vaginal tape. Injury of nervus dorsalis penis/clitoridis leads to hypestesia or anestesia of glans penis/clitoridis. The injury to arteria dorsalis clitoridis leads to bleeding and/or hematoma. Conclusions., Clinical anatomy of sulci is important in several situations in urologic surgery. It is possible to use sulcus nervi dorsalis penis/clitoridis for sexing of isolated pubis for antropological or forensic purposes.,edý J, Na,ka O, ,pa,ková J, and Jarolím L. Clinical implications of a close vicinity of nervus dorsalis penis/clitoridis and os pubis. J Sex Med 2008;5:1572,1581. [source] Gene expression analyses on embryonic external genitalia: identification of regulatory genes possibly involved in masculinization processesCONGENITAL ANOMALIES, Issue 2 2008Hisayo Nishida ABSTRACT Androgen plays a crucial role in initiating and maintaining the expression of male sexual characteristics in mammals. In humans and mice, any defects along the pathway of androgen functions result in congenital urogenital abnormalities. The genital tubercle (GT), an anlage of the external genitalia, differentiates into a penis in males and a clitoris in females. Although masculinization of the external genitalia is androgen-dependent, the molecular pathway of its potential downstream genes is largely unclear. To identify the genes involved in mouse GT masculinization, we performed gene expression analyses, such as real-time quantitative polymerase chain reaction and section in situ hybridization analysis. From our studies we have identified candidate genes, Cyp1b1, Fkbp51 and MafB as potential androgen targets during mouse GT masculinization. [source] Comparison of pressure within the corpus spongiosum penis during urination between geldings and stallionsEQUINE VETERINARY JOURNAL, Issue 4 2004J. TAINTOR No abstract is available for this article. [source] ADAPTIVE PLASTICITY OF THE PENIS IN A SIMULTANEOUS HERMAPHRODITEEVOLUTION, Issue 8 2009J. Matthew Hoch Acorn barnacles are important model organisms for the study of sex allocation. They are sessile, nonselfing hermaphrodites that copulate with penises that have been suggested to be phenotypically plastic. On wave-exposed shores, Semibalanus balanoides develop penises with relatively greater diameter whereas in wave-protected sites they are thinner. A reciprocal transplant experiment between wave-exposed and protected sites tested whether these exposure-specific morphologies have adaptive value. Mating success was compared over a range of distances to compare the ability of barnacles to reach mates. Barnacles that grew in the wave-protected site and mated in the wave-protected site fertilized more broods at increasing distances than those transplanted to the wave-exposed site. For barnacles that developed in the wave-exposed site, there was no difference in the ability to fertilize neighbors between sites of differing exposure. This study demonstrates the adaptive value of plasticity in penis morphology. The results suggest a trade-off between development of a penis adapted to wave exposure and the ability to fertilize distant mates. Barnacles in different physical environments are limited by different factors, which may limit numbers of potential mates, constrain optimal sex allocation strategies and alter reproductive behavior. [source] Mucinous metaplasia of the glans penisHISTOPATHOLOGY, Issue 1 2004D P Ruiz-Genao No abstract is available for this article. [source] Fixed drug eruption in NigeriaINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 9 2006Edith N. Nnoruka MBBS Fixed drug eruption (FDE) causes cosmetic embarrassment in Nigerian patients, particularly when the characteristic hyperpigmented patches affect the face and lips. Drugs that have been implicated in the etiology of FDE, and the sites of lesions, may vary from country to country. Antimalarials, such as Fansidar, Fancimef, Maloxine, Amalar, and Metakelfin, were the most common offending agents, accounting for 38% of FDEs, followed by trimethoprim + sulfamethoxazole (co-trimoxazole) (28%), dipyrones (10%), Butazolidin (6%), thiacetazone (6%), metronidazole (4%), paracetamol (3%), and naproxen (3%). Lesions induced by the combination of sulfadoxine and pyrimethamine (in antimalarials) mainly involved the face and lips. In most cases, patients took these sulfa-containing antimalarials in combination with numerous other drugs, particularly analgesics. Unlike chloroquine-induced pruritus, which affects most Africans, the association between antimalarials and FDE has not been well documented in our region. Co-trimoxazole was associated more often than antimalarials with FDEs involving the mucocutaneous junctions of the genitalia and lips. Males with genital lesions on the glans penis represented 11 (48%) of those with co-trimoxazole hypersensitivity. The trunk and limbs were affected mainly by pyrazoles and Butazolidin, respectively; however, solitary lesions on the trunk were usually due to co-trimoxazole, whereas solitary lesions on the limbs were associated with Butazolidin. [source] Leprosy in type I reaction and diabetes mellitus in a patient with HIV infectionINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 10 2002Alamengada D. Belliappa MBBS A 24-year-old man was referred to our department with history of a pale red raised lesion over the right side of the face with impaired sensation of 3 months' duration. He also had generalized weakness and increased thirst for the past 1 month. He had been treated with multidrug therapy for leprosy for 3 months and oral prednisolone for 1 month by his general practitioner. He also presented with a history of multiple sexual exposures with commercial sex workers and an ulcer over the penis 2 years ago, which healed spontaneously. [source] Histological characteristics of human papilloma-virus-positive and -negative invasive and in situ squamous cell tumours of the penisINTERNATIONAL JOURNAL OF EXPERIMENTAL PATHOLOGY, Issue 2 2009Dorrit Krustrup Summary A high prevalence of cervical cancer associated high-risk types of human papillomavirus (hrHPV) has been demonstrated in premalignant and invasive squamous cell lesions of the penis, but large studies correlating histological characteristics with HPV status are few in number. Tumour tissues from 145 patients with invasive (n = 116) or in situ (n = 29) penile squamous cell carcinoma were subjected to systematic histological evaluation and were PCR-tested for 14 hrHPV types and 23 low-risk HPV types. Around half (52%) of invasive and nine-tenths (90%) of in situ lesions were positive for an hrHPV type, of which HPV 16 was by far the predominant type (91% of hrHPV-positive lesions). In relation to histological characteristics, hrHPV positivity was statistically significantly more common in high-grade tumours, lesions dominated by small tumour cells, lesions with a high number of multinucleated cells and mitoses, and lesions with a small amount of parakeratosis. In conclusion, about half of invasive penile squamous carcinomas in this study were hrHPV-positive, most notably to HPV 16, and probably arose through in situ lesions whereas the other half of invasive penile lesions appeared to be unrelated to hrHPV. A number of histological characteristics differed significantly between hrHPV-positive and -negative invasive penile carcinomas. [source] Hypospadias repair: an overviewINTERNATIONAL JOURNAL OF UROLOGICAL NURSING, Issue 1 2010Michael Pfeil Hypospadias is a birth defect in boys where the meatus is not placed at the tip of the glans of the penis. This article reviews the rapidly developing international literature surrounding hypospadias and hypospadias repairs paying specific attention to important aspects of nursing care, including preparing for surgery, use of dressings, stents and catheters as well as medication. It concludes by considering the long-term impact of hypospadias and its surgical correction on the patient's life. Hypospadias is treated surgically, normally during the second 6 months of the boy's life. Hospitalization periods vary from day case surgery to several days. The success of the hypospadias repair can be measured according to functional results and cosmetic appearance of the penis. The post-operative use of dressings as well as urinary catheters or stents is common but not uniform. Complication rates for hypospadias surgery vary from below 10% in boys with distal hypospadias to above 50% in children with a proximal meatus. The most common complications are urethral fistulas, strictures and stenoses. The continuing efforts by paediatric urologists focus on further optimizing the cosmetic and functional results. [source] A case report: Primary extragonadal yolk sac tumor of penile shaft in a 2-year-old childINTERNATIONAL JOURNAL OF UROLOGY, Issue 4 2009Ryuto Nakazawa Abstract: A 2-year-old boy, who had the chief complaints of penile swelling and pain, was brought to the hospital by his mother. Penile contusion/trauma was suspected and he was admitted the same day to undergo emergency surgery to eliminate hematoma. The surgery revealed that the origin of the bleeding was not trauma but a tumor lesion of the penile shaft. It was histopathologically identified as a yolk sac tumor and no tumorous lesions were found except that in the penis. Therefore the patient was diagnosed as definitely having a yolk sac tumor originating in the penis. The patient received four cycles of cisplatin, etoposide and bleomycin treatment as adjuvant chemotherapy. Although it was impossible to completely resect the tumor, cisplatin, etoposide and bleomycin chemotherapy was effective and a complete response was achieved. We plan to carefully monitor the patient in the future. [source] Current concepts in hypospadias surgeryINTERNATIONAL JOURNAL OF UROLOGY, Issue 8 2008Yutaro Hayashi Abstract: Anatomical anomalies in hypospadias are an abnormal ventral opening of the urethral meatus, abnormal ventral curvature of the penis and abnormal distribution of the foreskin around the glans with a ventrally deficient hooded foreskin. The techniques of hypospadias surgery continue to evolve. The current standard of care for hypospadias repair includes not only a functional penis adequate for sexual intercourse and urethral reconstruction offering the ability to stand to urinate, but also a satisfactory cosmetic result. Tubularized incised plate repair has been the mainstay for distal hypospadias. In cases of proximal hypospadias, one-stage repairs such as the Duckett repair or the Koyanagi repair have been well established, while two-stage repairs remain important alternatives. Whether dorsal plication or ventral lengthening should be used to correct penile curvature is still controversial, and long-term results are required. Efforts have been made in this decade to improve cosmetic appearance, constructing a slit-like meatus or performing foreskin reconstruction, and to prevent onerous complications. [source] Granulomatous balanoposthitis after intravesical Bacillus-Calmette-Guerin instillation therapyINTERNATIONAL JOURNAL OF UROLOGY, Issue 10 2006HATTORI YUSUKE Abstract, We report a rare case of granulomatous balanoposthitis after intravesical Bacillus-Calmette-Guerin (BCG) instillation therapy in a 58-year-old man, which followed transurethral resection (TUR) for recurrent bladder cancer, when his anterior urethra was slightly narrow and his foreskin was with phimosis. Intravesical BCG instillation therapy was started for prophylaxis of recurrent bladder cancer after TUR. Multiple painless firm papules on glans penis, edema in the foreskin and low-grade fever appeared after the seventh instillation, for which the single antituberculous agent isoniazid (300 mg/day) was administered. Biopsy of the papules on glans penis and foreskin revealed granulomatous balanoposthitis. Low-grade fever normalized and the papules disappeared within 1 week. The patient continued chemotherapy with isoniazid for the next 12 months. There was no recurrence of bladder cancer or balanoposthitis for 15 months and to date. [source] Fournier's gangrene: Report of thirty-three cases and a review of the literatureINTERNATIONAL JOURNAL OF UROLOGY, Issue 7 2006LUTFI TAHMAZ Background:, Fournier's gangrene (FG) is an extensive fulminant infection of the genitals, perineum or the abdominal wall. The aim of this study is to share our experience with the management of this difficult infectious disease. Methods:, Thirty-three male patients were admitted to our clinic with the diagnosis of FG between February 1988 and December 2003. The patient's age, etiology and predisposing factors, microbiological findings, duration of hospital stay, treatment, and outcome were analyzed. The patients were divided into two groups. The first 21 patients (Group I) were treated with broad-spectrum triple antimicrobial therapy, broad debridement, exhaustive cleaning, and then they underwent split-thickness skin grafts or delayed closure as needed. The other 12 patients (Group II) were treated with unprocessed honey (20,50 mL daily) and broad-spectrum triple antimicrobial therapy without debridement. Their wounds were cleaned with saline and then dressed with topical unprocessed honey. The wounds were inspected daily and the honey was reapplied after cleaning with normal saline. Then, the patients' scrotum and penis were covered with their own new scrotal skin. Results:, The mean age of the patients was 53.9 ± 9.56 years (range = 23,71). The source of the gangrene was urinary in 23 patients, cutaneous in seven patients, and perirectal in three patients. The predisposing factors included diabetes mellitus for 11 patients, alcoholism for 10 patients, malnutrition for nine patients, and medical immunosuppression (chemotherapy, steroids, malignancy) for three patients. The mean duration of hospital stay was 41 ± 10.459 (range = 14,54) days. Two patients in Group I died from severe sepsis. The clinical and cosmetic results were better in Group II than Group I. Conclusions:, Necrotizing fasciitis of the perineum and genitalia is a severe condition with a high morbidity and mortality. Traditionally, good management is based on aggressive debridement, broad-spectrum antibiotics, and intensive supportive care but unprocessed honey might revolutionize the treatment of this dreadful disease by reducing its cost, morbidity, and mortality. [source] Severe penile edema: An unusual presentation of metastatic Crohn diseaseINTERNATIONAL JOURNAL OF UROLOGY, Issue 2 2006BASHAR ZELHOF Abstract, A case of Crohn disease involving the penis is described. Diagnosis of a metastatic Crohn disease was suggested by penile biopsy. The patient was treated with prednisolone and azathioprine. [source] Tuberculid of the penis with a scab on the noduleINTERNATIONAL JOURNAL OF UROLOGY, Issue 10 2004SHIGENORI YONEMURA Abstract, Tuberculids of the penis are extremely rare. The clinical features of tuberculids of the penis have been reported as ulceration or scars. We have experienced a case of tuberculid of the penis that appeared as a scab on nodule. A 56-year-old man presented with a 4-month history of a painless subcutaneous nodule at the glans penis. Pathological findings of the nodule showed granulomatous inflammation. Tuberculin tests were strongly positive, but tubercle bacilli could not be detected. The diagnosis was tuberculid of the penis and the patient received antituberculosis chemotherapy. The present paper reports an interesting and rare case of tuberculid of the penis with a scab on nodule. [source] The neuronal and endothelium-dependent relaxing responses of human corpus cavernosum under physiological oxygen tension last longer than previously expectedINTERNATIONAL JOURNAL OF UROLOGY, Issue 5 2004KAZUNORI KIMURA Abstract Background: Intracavernosal oxygen tension varies greatly in the process of erection. Blood extracted from the human penis demonstrates an increase from approximately 30 mmHg Po2 in the flaccid state to 100 mmHg in the erect state of the penis. In the present study, using these levels as a guide, we investigate how the NO-dependent relaxation of human corpus cavernosum changed under physiological oxygen tensions ranging from approximately 30 to 100 mmHg. Methods: Human penile tissue specimens were obtained at penile surgery with informed consent from the patients. The preparations were mounted in Krebs solution in an organ bath and the isometric tension was recorded. Krebs solutions of various oxygen tensions were prepared by bubbling 5% CO2 in N2 and O2. The NO-dependent relaxation caused by electrical field stimulation (EFS) and acetylcholine (ACh) was studied, and the amplitude and duration of relaxation evaluated. Results: The amplitude of relaxation induced by EFS was significantly decreased under physiological oxygen tension conditions (P < 0.01). The duration of the relaxant response induced by EFS and ACh was significantly prolonged in physiological oxygen tension conditions than in high oxygen tension (P < 0.01). However, there was no correlation between the duration of relaxation induced by EFS and each physiological oxygen tension level. The duration of relaxation induced by ACh was most prolonged at 60,69 mmHg oxygen tension. Conclusion: Physiologically, the effect of NO may last longer than was previously thought. In addition, it would seem that there is an optimal physiological oxygen tension for maximum ACh-induced relaxation. [source] Epidermoid cyst of the penis: A case report and review of the literatureINTERNATIONAL JOURNAL OF UROLOGY, Issue 11 2000Michihiro Suwa Abstract Penile cysts are uncommon. A case of a 7-year-old boy with an epidermoid cyst of the penis is reported. He had an asymptomatic, slowly growing soft mass in the frenulum of the penis. Excision of the mass was performed, and the diagnosis was epidermoid cyst of the penis. No recurrence has been noted within the year since excision. To our knowledge, there have been no previous reports of malignancy developing in cystic disease of the penis. In such cases, clinicians should attempt more appropriate management, involving either watchful observation or complete excision of the cyst, by considering the embryogenesis and nature of the disease. [source] Penis swelling due to foreign body reaction after injection of siliconeJOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT, Issue 9 2010Tobias Plaza Summary A 19-year-old man presented with phimosis and painful swelling of the penis four weeks after augmentation with silicone in Thailand. Histology revealed a foreign body reaction to silicone. Infectious causes were ruled out. Granulomatous foreign body reactions to silicone are common, but there are few case reports on reactions following silicone injection for penis enlargement. Foreign body reactions should be included in the differential diagnosis of penis swelling. [source] ,Lues maligna" bei insulinpflichtigem Diabetes mellitusJOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT, Issue 10 2005"Lues maligna" in a female patient with diabetes Zusammenfassung Bei einer 40-jährige Patientin mit insulinpflichtigem Diabetes mellitus traten innerhalb weniger Wochen vor allem am Stamm multiple bis 2,5,cm große, lividrote Knoten und Plaques auf, die rasch ulzerierten. Einige Monate zuvor habe beim Partner ein kleines Ulkus am Penis bestanden. Die HIV-negative Patientin hatte eine hochtitrig positive Syphilisserologie (TPPA-Titer >,1 : 20.480, VDRL-Titer 1 : 128). Die nüchtern Blutglukosewerte lagen über 275,mg/dl. Nach Ausschluss einer Neurolues stellten wir die Diagnose einer ,Lues maligna" bei schlecht eingestelltem Diabetes mellitus. Unter einer Therapie mit 3,Injektionen Benzylpenicillin-Benzathin (2,4,Mio.,IE) i. m. in wöchentlichen Abständen und Einstellung des Diabetes heilten die Hautveränderungen komplett ab. Im Verlauf war der VDRL-Titer negativ. Die ,Lues maligna" tritt seit einigen Jahren wieder gehäuft auf und wird vor allem bei HIV-positiven Männern beobachtet. Das Auftreten dieser Erkrankung bei durch Diabetes mellitus bedingter Immunsuppression ist ausgesprochen selten. Summary A 40-year-old female patient with diabetes mellitus presented with multiple erythematous ulcerated nodules and plaques predominantly on the trunk. A few months ago her partner had a small ulcer on the penis. She was HIV negative but showed markedly elevated syphilis serology titers (TPPA titer >,1 : 20.480, VDRL titer 1 : 128). The serum glucose levels exceeded 275,mg/dl. After exclusion of neurological involvement, we made the diagnosis of ,lues maligna" arising in the setting of diabetes mellitus. The patient was treated with 2.4 million units benzathine penicillin intramuscularly weekly for three weeks. Simultaneously, diabetes therapy was improved with insulin injections. The syphilitic lesions cleared rapidly. In the follow-up VDRL titer was negative. ,Lues maligna" is an unusual ulcerative variant of secondary syphilis which has been observed more frequently in HIV-infected patients in the last years. The occurrence of this aggressive variant in the clinical setting of diabetes mellitus is extremely rare. [source] Doppler sonography of the penile cavernosal artery: Comparison of intraurethral instillation and intracorporeal injection of prostaglandin E1JOURNAL OF CLINICAL ULTRASOUND, Issue 5 2001Jong Min Kim MD Abstract Purpose We compared the Doppler sonographic findings in the penile cavernosal artery (arteria profunda penis) after intraurethral instillation and intracorporeal injection of prostaglandin E1 (PGE1) to evaluate the hemodynamic changes during drug-induced erection. Methods Twenty healthy male volunteers were enrolled in the study. Ten subjects (intraurethral group) were examined with Doppler sonography of the penile cavernosal artery after intraurethral administration of 1 mg of PGE1. The remaining 10 subjects (intracorporeal group) underwent Doppler sonography of the cavernosal artery after intracorporeal injection of 5 ,g of PGE1. The peak systolic velocity, minimal diastolic velocity, and resistance index were determined at 5-minute intervals for 30 minutes following administration of PGE1 in both groups. The results were compared between the 2 groups. Results The peak systolic velocity in the intraurethral group increased progressively from a mean of 31.1 cm/second at 5 minutes to 65.6 cm/second at 30 minutes after intraurethral administration of PGE1. In the intracorporeal group, the mean peak systolic velocity ranged from 44.1 to 83.2 cm/second, reached a maximum at 10 minutes, and then decreased continuously through 30 minutes after intracorporeal injection of PGE1. The mean peak systolic velocities were significantly higher in the intracorporeal group at 10 and 15 minutes (p , 0.05); the mean minimal diastolic velocities were significantly lower in the intracorporeal group at 15, 20, and 25 minutes (p , 0.05); and the mean resistance indices were significantly higher in the intracorporeal group at all time points except 5 minutes (p , 0.05). Conclusions The intracorporeal injection of PGE1 produced a greater vasoactive response in the cavernosal artery than did intraurethral instillation. © 2001 John Wiley & Sons, Inc. J Clin Ultrasound 29:273,278, 2001. [source] Leiomyosarcoma of the Penis Presenting as a Cutaneous LesionJOURNAL OF CUTANEOUS PATHOLOGY, Issue 6 2008Thomas L. Cibull We report a case of a 68-year-old man with cutaneous leiomyosarcoma of the penis. Leiomyosarcoma of the penis is an extremely rare neoplasm that usually presents in middle to old age, and to our knowledge only approximately 30 cases have been reported in the literature to date. This is an important diagnosis in the differential diagnosis of cutaneous spindle cell neoplasms of the male genital tract. [source] | ||||||||||||||||||||||||||||||||||