			Home About us Contact

Penile Surgery (penile + surgery)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

The neuronal and endothelium-dependent relaxing responses of human corpus cavernosum under physiological oxygen tension last longer than previously expected

INTERNATIONAL JOURNAL OF UROLOGY, Issue 5 2004
KAZUNORI 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]

Repeat dynamic sentinel node biopsy in locally recurrent penile carcinoma

BJU INTERNATIONAL, Issue 8 2010
Niels M. Graafland
Study Type , Diagnosis (case series) Level of Evidence 4 OBJECTIVE To explore the role of repeat dynamic sentinel-node biopsy (SNB) in clinically node-negative patients with locally recurrent penile carcinoma after previous penile surgery and SNB. PATIENTS AND METHODS Between 1994 and 2008, 12 patients (4% of the 304 in our prospectively maintained dynamic sentinel node database) with clinically node-negative groins had a repeat SNB for locally recurrent penile carcinoma after previous penile surgery and SNB. Five of these patients had previously had a unilateral inguinal node dissection for groin metastases. The median disease-free interval was 18 months. The protocol and technique of primary dynamic SNB and the repeat procedure were similar, including preoperative lymphoscintigraphy and blue-dye injection. Completion inguinal node dissection was only done if there was an involved sentinel node. RESULTS No sentinel nodes were seen on preoperative lymphoscintigraphy in the five groins that had previously been dissected. A sentinel node was visualized on lymphoscintigraphy in the remaining 19 undissected groins. In 15 of these groins (79%) the sentinel node was identified during surgery. Histopathological analysis showed involved sentinel nodes in four groins of three patients. Additional metastatic nodes were found in one completion inguinal lymph node dissection specimen. During a median follow-up of 32 months after the repeat SNB, one patient developed a groin recurrence 14 months after a tumour-negative sentinel node procedure. CONCLUSIONS Repeat dynamic SNB is feasible in clinically node-negative patients with locally recurrent penile carcinoma despite previous SNB. [source]

Circumcision is not mandatory in penile surgery

BJU INTERNATIONAL, Issue 2 2010
Giulio Garaffa
Study Type , Therapy (case series) Level of Evidence 4 OBJECTIVE To assess the outcome of not circumcising patients having surgery to correct a congenital or acquired curvature, through a subcoronal approach. PATIENTS AND METHODS In a series of 251 consecutive patients (mean age 46 years, range 17,74) that had their penis straightened by either a Lue (86), or a Nesbit procedure (162) or a combination of both (three) between 2000 and 2008, a subcoronal circumferential incision was used for the degloving in 241. Among the 183 patients who had not been previously circumcised, 22 presented with a tight foreskin and were offered a circumcision; six of them refused to be circumcised. Of the remaining 161 patients, 115, including two who had previous penile surgery, opted not to be circumcised. RESULTS After a median (range) follow-up of 5.5 (1,50) months, secondary circumcision was performed in three of the six patients with a tight foreskin, in one of the 113 (0.8%) with a normal retractable foreskin and in one of the two who had had previous penile surgery and had a normal foreskin. CONCLUSIONS Circumcision should not be considered as a routine part of penile surgery unless a significant phimosis is present or revisional surgery is contemplated. [source]

In vitro viability of human cavernosal endothelial and fibroblastic cells after exposure to papaverine/phentolamine and prostaglandin E1

BJU INTERNATIONAL, Issue 9 2005
Adrian Pilatz
OBJECTIVE To investigate the influence of commercially available vasoactive drugs on human cavernosal endothelial and fibroblastic cells in vitro, as although corporal fibrosis is a well known side-effect of intracavernosal injection therapy for erectile dysfunction, the possible detrimental effect of these agents on the endothelium lining the cavernosal vascular spaces is uncertain. MATERIALS AND METHODS Cultured primary endothelial (13) and fibroblastic cells (12), obtained from potent patients undergoing penile surgery, were exposed to different physiological dilutions of prostaglandin E1 (PGE1), papaverine/phentolamine or the respective triple-mix of these agents for 30 min. Viable cells were counted and cell metabolic activity measured in these cultures 48 h after drug exposure. RESULTS There was a significant dose-dependent decrease in the viable cell count after exposure to papaverine-containing formulations, probably because of the low pH of this substance. This cytotoxic effect was more pronounced in endothelial than in fibroblastic cells, and was not apparent in the PGE1 groups. The relative increase in cell metabolic activity in cultures affected by a moderate cytotoxic effect indicated a regenerative process. CONCLUSION These comparative results in endothelial and fibroblastic cell cultures suggest that the endothelium rather than the interstitium of the corpus cavernosum is more sensitive to side-effects produced by intracavernosal injection therapy with papaverine. Thus, unfavourable consequences on the function of the endothelial layer might be as important as the risk of interstitial fibrosis. As these effects were not detected for PGE1 this drug should be preferred to papaverine in clinical practice. [source]