Introduction:We aimed to compare the oncological and functional outcomes of glansectomy and split-thickness skin graft reconstruction(GR)with those of glansectomy alone(GA)and penile amputation(PA).Materials and Metho...Introduction:We aimed to compare the oncological and functional outcomes of glansectomy and split-thickness skin graft reconstruction(GR)with those of glansectomy alone(GA)and penile amputation(PA).Materials and Methods:This retrospective study included patients with penile carcinoma or penile intraepithelial neoplasia diagnosed between 2017 and 2022.Surgical outcomes,complications,and oncological outcomes were assessed through a chart review,and functional outcomes were assessed using a questionnaire administered to patients who underwent GR(group A),GA(group B),or PA(group C).Results:Six,eight,and seven patients were enrolled in groups A,B,and C,respectively.Their complication rates were 0%,25%,and 29%,respectively;margin positivity rates were 17%,13%,and 0%,respectively;and local recurrence rates were 0%,0%,and 14%,respectively.Logistic regression analysis showed that being in group Arather than C was a significant predictor of favorable erectile function(p=0.007)and cosmetic outcomes(p=0.030).However,being in group A rather than B was not a significant predictor of favorable erectile function(p=0.127)or cosmetic outcomes(p=0.638).Conclusion:Excellent functional results were observed after GR;however,the benefits were significant only when compared with those of amputation.展开更多
Repairing glans dehiscence after failed hypospadias repair is challenging for pediatric surgeons.Here,we introduced and evaluated a newly modified Mathieu technique,Mathieu combined tunnel(MCT),which involves multiple...Repairing glans dehiscence after failed hypospadias repair is challenging for pediatric surgeons.Here,we introduced and evaluated a newly modified Mathieu technique,Mathieu combined tunnel(MCT),which involves multiple custom-designed flaps for the shortage of flap source material after repeated operations;we also constructed a tunnel to avoid the glans incision that may carry new risks of dehiscence.This retrospective study included 26 patients who were consecutively admitted to the First Affiliated Hospital of Sun Yat-Sen University(Guangzhou,China)for glans dehiscence repair after failed hypospadias repair from October 2014 to October 2020;sixteen patients underwent surgery using the MCT(MCT group)and ten patients underwent surgery using the tubularized incised plate(TIP)technique(TIP group).The operative time,blood loss,postoperative complications,normal urethral meatus rate,success rate,and Hypospadias Objective Penile Evaluation(HOPE)score were compared between the two groups.The MCT group achieved an overall satisfactory penile appearance and voiding function,with a higher rate of normal urethral meatus(15/16,93.8%)and a lower rate of glans dehiscence(1/16,6.2%),compared with the TIP group(70.0%and 30.0%,respectively).However,these differences were not statistically significant,possibly because of the limited number of patients(all P>0.05).Mean postoperative HOPE scores were similar in the MCT group(mean±standard deviation:8.83±0.89)and TIP group(8.94±0.57)(P>0.05).No significant differences were found between the two groups in terms of blood loss and success rate,nor in the rates of various complications(e.g.,fistula,urethral stricture,and glans dehiscence).In conclusion,the MCT technique appears to be feasible and reliable for repairing glans dehiscence after failed hypospadias repair.展开更多
We aim to design a new glanuloplasty procedure combined with spongiosum to reduce the incidence of glans dehiscence and coronal fistula after proximal hypospadias repair.Patients who underwent urethroplasty by dorsal ...We aim to design a new glanuloplasty procedure combined with spongiosum to reduce the incidence of glans dehiscence and coronal fistula after proximal hypospadias repair.Patients who underwent urethroplasty by dorsal preputial island flap for proximal hypospadias between January 2014 and December 2016 were reviewed in this retrospective cohort study.Those who underwent spongiosum-combined glanuloplasty comprised the new-maneuver group,whereas those who underwent conventional glanuloplasty comprised the control group.The incidence of complications was then compared.In the new-maneuver group,dysplastic corpus spongiosum alongside lateral Buck's fascia(0.3-0.4 cm wide)on both sides of the urethral plate was separated from the proximal normal spongy tissue,joining into the glans wings to increase tissue volume and covering the neourethra in the glans penis.In the control group,the neourethra was covered with superficial fascia under the coronal sulcus.As a result,the new-maneuver and control groups comprised 47 and 28 patients,respectively.In the new-maneuver group,no glans dehiscence was detected;however,two(4.3%)patients had coronal fistula,two(4.3%)had urethral stricture,and four(8.5%)had diverticulum.In the control group,two(7.1%)patients had glans dehiscence,eight(28.6%)had coronal fistula,four(14.3%)had urethral stricture,one(3.6%)had diverticulum,and one(3.6%)had penile curvature recurrence.The new-maneuver group had less incidences of coronal fistula(P<0.001),glans dehiscence(P=0.033),and urethral stricture(P=0.008)but had a higher incidence of diverticulum than the control group(P=0.040).It clearly demonstrates that spongiosum-combined glanuloplasty can significantly reduce the incidences of coronal fistula and glans dehisce.展开更多
There is no safe and effective standard method for glans penis augmentation. Furthermore, there has been scant research on glans penis augmentation due to a poor understanding of glans anatomy, technical difficulty, a...There is no safe and effective standard method for glans penis augmentation. Furthermore, there has been scant research on glans penis augmentation due to a poor understanding of glans anatomy, technical difficulty, and a lack of suitable substances for augmentation. Cross-linked dextran gel is a newly developed filler for soft-tissue augmentation. We evaluated the efficacy and safety of using a novel technique to inject cross-linked dextran gel for glans penis augmentation during a 24-week follow-up study. This prospective, single-arm, multicenter study enrolled twenty healthy adult men who underwent glans penis augmentation between June and August 2013. Cross-linked dextran gel was injected into the glans penis using a simple and easy technique. The sizes of the glans penis and individual satisfaction were assessed. Any adverse event was also reported. A total of 18 individuals were analyzed; two of them were lost to follow-up. The mean procedure time and injected volume were about 30 rain and 6.6 ＋- 0.9 ml, respectively. The mean surface areas of the glans at baseline and 24 weeks were 20.0 _＋ 3.5 cm2 and 33.6 -＋ 5.4 cm2, respectively, representing a mean increase of 68.7% _＋ 14.0% （P 〈 0.001）. Sixteen individuals （88.9%） were satisfied with the outcomes, and none were dissatisfied. There were no serious adverse events during the study. Cross-linked dextran gel injection for glans penis augmentation was easy and showed a significant augmentative effect on the glans penis, good durability, and was well tolerated without serious adverse events. Therefore, cross-linked dextran gel injection may be an effective, new technique for glans penis augmentation.展开更多
Objective: To investigate chemical constituents and new antimicrobial agents among essential oils from the rhizomes of Curcuma aeruginosa(C. aeruginosa) Roxb., Curcuma glans K. Larsen & J. Mood and Curcuma cf. xan...Objective: To investigate chemical constituents and new antimicrobial agents among essential oils from the rhizomes of Curcuma aeruginosa(C. aeruginosa) Roxb., Curcuma glans K. Larsen & J. Mood and Curcuma cf. xanthorrhiza Roxb.Methods: The essential oils were obtained by hydro-distillation and analyzed by gas chromatography/mass spectroscopy. Agar-well diffusion assay was used to study the antimicrobial activity and also broth-micro dilution techniques were examined for minimum inhibitory concentration(MIC) against four bacterial strains and yeast.Results: The gas chromatography/mass spectroscopy analysis showed monoterpenes predominantly(88.53%) in the rhizome oil of Curcuma cf. xanthorrhiza. Sesquiterpenes(50.10%) was the most abundant component in the essential oil of C. glans, while monoterpenes(45.55%) and sesquiterpenes(45.81%) were found in C. aeruginosa with a significant amount. The major components of C. aeruginosa were characterized as camphor(29.39%) and germacrone(21.21%). Germacrone(15.76%), b-pinene(9.97%)and camphor(9.96%) were found as major compounds in the rhizome oils of C. glans while a-terpinolene(24.86%) and p-cymen-7-ol(12.17%) were found as major compositions in Curcuma cf. xanthorrhiza. The essential oils were tested against four bacterial strains and yeast. As a result, the rhizome oil of C. aeruginosa exhibited potent activity against Staphylococcus aureus [inhibition zone(21.94 ± 0.24) mm, MIC 125 μg/mL],Bacillus cereus [inhibition zone(20.83 ± 0.36) mm, MIC 125 μg/mL], and Candida albicans [inhibition zone(11.60 ± 0.30) mm, MIC 250 μg/mL].Conclusions: The essential oils from three Curcuma species possessed greater activity against the gram-positive bacteria(Staphylococcus aureus and Bacillus cereus) than gram-negative bacteria(Escherichia coli and Pseudomonas aeruginosa). The results suggest that the essential oils from the fresh rhizome of Curcuma spp. might be a potential source of natural antimicrobial substances.展开更多
A 33-year-old male receiving dorsal penile nerve block (DPNB) for circumcision exhibited a postoperative ischemic change over the glans penis. The event occurred nearly 24 hours after the procedure. The patient was tr...A 33-year-old male receiving dorsal penile nerve block (DPNB) for circumcision exhibited a postoperative ischemic change over the glans penis. The event occurred nearly 24 hours after the procedure. The patient was treated with intravenous pentoxifyllin and hyperbaric oxygenation. Total reverse of the ischemia was observed. The complications associated with circumcision and DPNB were reviewed and discussed.展开更多
Penile reconstruction following cancer resection has long been a challenge due to demand for both aesthetic and functional preservation. Although various methods have attempted to achieve both goals, none have succeed...Penile reconstruction following cancer resection has long been a challenge due to demand for both aesthetic and functional preservation. Although various methods have attempted to achieve both goals, none have succeeded entirely. In this report, we introduce a novel reconstructive technique on a 64-year-old patient with squamous cell carcinoma of the glans penis. The technique consisted of two staged procedures. First, a dermal substitute, consisting of bovine collagen, was sutured onto the defect after partial glansectomy and three weeks later, the integrated dermis was covered with autologous non-meshed partial thickness skin graft. Use of this dermal substitute in a staged fashion allowed for ability to await final pathologic margins prior to definitive reconstruction and increased dermal thickness. After 9-month follow-up, sexual function returned within 3 months and the patient remained healed. We found this technique to be useful in concurrently preserving penile function and cosmesis. Future studies should include more patients and longer follow-up.展开更多
Circumcision refers to the removal of the skin covering the tip of the penis and is one of the most common surgical procedures performed in childhood.Even though circumcision is a well-standardized operation,several m...Circumcision refers to the removal of the skin covering the tip of the penis and is one of the most common surgical procedures performed in childhood.Even though circumcision is a well-standardized operation,several minor and major complications may be experienced by paediatric surgeons.Glans ischemia(GI)has been widely reported in the paediatric literature as a complication following circumcision.Nonetheless,etiopathogenesis of GI is not well defined and management guidelines are lacking.CASE SUMMARY We describe our experience with this rare and scary complication using subcutaneous enoxaparin alone or in association with a topical vasodilator.CONCLUSION Hypothetical causes and different management strategies are discussed.展开更多
This study aimed to introduce a modified Byars staged procedure and investigate its application value in patients with severe hypospadias.We retrospectively analyzed the clinical data of patients with severe hypospadi...This study aimed to introduce a modified Byars staged procedure and investigate its application value in patients with severe hypospadias.We retrospectively analyzed the clinical data of patients with severe hypospadias admitted to the First Affiliated Hospital of Sun Yat-sen University(Guangzhou,China)between October 2012 and October 2022.In total,31 patients underwent the conventional Byars procedure(conventional group),and 45 patients underwent the modified Byars staged procedure(modified group).Our modified strategy was built upon the standard Byars procedure by incorporating glansplasty during the first stage and employing a Y-shaped flap in conjunction with a glandular tunnel for urethroplasty during the second stage.Notably,there were no statistically significant differences in the preoperative baseline characteristics,duration of surgery,amount of blood loss,or occurrence of postoperative complications,including urethral fistula,stricture and diverticulum,or penile curvature,between the conventional and modified groups.However,there was a significantly lower incidence of coronal sulcus fistula(0 vs 16.1%,P=0.02)and glans dehiscence(0 vs 12.9%,P=0.02)in the surgical group than that in the conventional group.In addition,the modified group exhibited a notably greater rate of normotopic urethral opening(100.0%vs 83.9%,P=0.01)and a higher mean score on the Hypospadias Objective Penile Evaluation(HOPE;mean±standard error of mean:8.6±0.2 vs 7.9±0.3,P=0.02)than did the conventional group.In conclusion,the modified Byars staged procedure significantly reduced the risks of glans dehiscence and coronal sulcus fistula.Consequently,it offers a promising approach for achieving favorable penile esthetics,thereby providing a reliable therapeutic option for severe hypospadias.展开更多
Penile glans amputation is a tragic complication of circumcision. Beyond the psychological trauma parents go through, they have to deal with the lower urinary tract symptoms including acute urine retention their baby ...Penile glans amputation is a tragic complication of circumcision. Beyond the psychological trauma parents go through, they have to deal with the lower urinary tract symptoms including acute urine retention their baby boys suffer due to meatal stenosis from the scaring process that ensues. We report on the cosmetic and functional outcomes in two patients ten years after neo-glans reconstruction following total glans amputation as a complication of circumcision and discuss the lessons learned over the period.展开更多
During the most recent years, a variety of new techniques of penile reconstruction have been described in the literature. This paper focuses on the most recent advances in male genital reconstruction after trauma, exc...During the most recent years, a variety of new techniques of penile reconstruction have been described in the literature. This paper focuses on the most recent advances in male genital reconstruction after trauma, excision of benign and malignant disease, in gender reassignment surgery and aphallia with emphasis on surgical technique, cosmetic and functional outcome.展开更多
Objective:Penile cancer(PeCa)is a rare disease with a global incidence of 36068 new cases in 2020.This accounts for 0.4%of all male malignancies.The surgical management of PeCa depends on the location of the tumour an...Objective:Penile cancer(PeCa)is a rare disease with a global incidence of 36068 new cases in 2020.This accounts for 0.4%of all male malignancies.The surgical management of PeCa depends on the location of the tumour and depth of invasion.Here,we review the oncological and functional outcomes of penile-preserving surgery(PPS).Methods:A PubMed search until July 2021 on PPS for PeCa was conducted;a narrative review on different penile-sparing approaches and outcomes was performed.Results:PPS is now the standard of care in specialist centres for distal tumours not involving the corpus cavernosa.Laser therapy,glans resurfacing,and wide local excision are options for superficial lesions,whilst glansectomy is required for lesions invading into the corpus spongiosum.Conclusion:PPS aims to preserve urinary and sexual function without compromising oncological outcomes.展开更多
We reviewed our experience in reconstructing forked corpus spongiosum(FCS)in distal/midshaft hypospadias repair and analyzed the efficacy of this surgical technique.From August 2013 to December 2018,137 consecutive ca...We reviewed our experience in reconstructing forked corpus spongiosum(FCS)in distal/midshaft hypospadias repair and analyzed the efficacy of this surgical technique.From August 2013 to December 2018,137 consecutive cases of distal/midshaft hypospadias operated by the same surgeon in Urology Department,Children’s Hospital of Fudan University(Shanghai,China),were retrospectively analyzed.Sixty-four patients who underwent routine tubularized incised plate(TIP)or onlay island flap(ONLAY)surgery were included in the nonreconstructing group,and 73 patients who underwent reconstructing FCS during TIP or ONLAY surgery were included as the reconstructing group.Thirty-eight cases underwent TIP,and 26 underwent ONLAY in the nonreconstructing group,with a median follow-up of 44(range:30-70)months.Twenty-seven cases underwent TIP,and 46 underwent ONLAY in the reconstructing group,with a median follow-up of 15(range:6-27)months.In the nonreconstructing/reconstructing groups,the mean age at the time of surgery was 37.55(standard deviation[s.d.]:29.65)/35.23(s.d.:31.27)months,the mean operation duration was 91.95(s.d.:12.17)/93.84(s.d.:14.91)min,the mean neourethral length was 1.88(s.d.:0.53)/1.94(s.d.:0.53)cm,and the mean glans width was 11.83(s.d.:1.32)/11.56(s.d.:1.83)mm.Twelve(18.8%)/5(6.8%)postoperative complications occurred in the nonreconstructing/reconstructing groups.These included fistula(5/2),glans dehiscence(3/0),diverticulum(1/2),residual chordee(3/0),and meatus stenosis(0/1)in each group.There was a significant difference in the overall rate of complications(P=0.035).These results indicate that the technique of reconstructing FCS provides excellent outcomes with fewer complications in distal/midshaft hypospadias repair.展开更多
Erythroplasia of Queyrat (EQ) is Squamous cell carcinoma in situ of penis usually involving glans and prepuce, commonly found in uncircumcised men with progression into invasive carcinoma in about 30% of cases. We pre...Erythroplasia of Queyrat (EQ) is Squamous cell carcinoma in situ of penis usually involving glans and prepuce, commonly found in uncircumcised men with progression into invasive carcinoma in about 30% of cases. We present a case of 50 yrs, male with reddish, Irritative rash on glans penis;HPE confirms the case of EQ with acanthosis, derangement of stratum spinosum and basement membrane integrity. It successfully treated with two cycle of Photo Dynamic Therapy (PDT). If conservative approach with immquimod, fluorouracil fails then invasive approach should be adopted.展开更多
<strong>Introduction:</strong> Penile cancer is a rare primary malignancy that occurs in patients in their 60s and 70s. The aim of the study was to describe the anatomical aspects of penile cancer and to r...<strong>Introduction:</strong> Penile cancer is a rare primary malignancy that occurs in patients in their 60s and 70s. The aim of the study was to describe the anatomical aspects of penile cancer and to report the difficulties of its management. <strong>Materials and Methods:</strong> This was a retrospective descriptive study of patients with penile tumors from January 2007 to December 2019. Patients of sexual age with an ulcerated lesion of the penis, who came to our department and whose clinical and paraclinical workup led to the diagnosis of penile cancer, were included. The variables studied were clinical, paraclinical and therapeutic. <strong>Results:</strong> In 12 years, we diagnosed and managed 8 patients with penile cancer, an incidence of 0.7 per year. The reason for consultation was the chronic ulcerating wound of the penis with a “cauliflower” aspect. The first medical consultation was late (n = 8) after a long latency period lost to traditional healers. The lesion was located in the glans penis (n = 6) and/or in the corpus cavernosum (n = 2). Histological analysis of the cores concluded to a squamous cell carcinoma. Patients were classified as T2N+M+ (n = 3) and T2N0M0 (n = 5). One patient had accepted partial amputation of the penis. <strong>Conclusion:</strong> Penile cancer is a rare tumor. Partial amputation of the penis is the only alternative in our practice context, an alternative often refuted.展开更多
文摘Introduction:We aimed to compare the oncological and functional outcomes of glansectomy and split-thickness skin graft reconstruction(GR)with those of glansectomy alone(GA)and penile amputation(PA).Materials and Methods:This retrospective study included patients with penile carcinoma or penile intraepithelial neoplasia diagnosed between 2017 and 2022.Surgical outcomes,complications,and oncological outcomes were assessed through a chart review,and functional outcomes were assessed using a questionnaire administered to patients who underwent GR(group A),GA(group B),or PA(group C).Results:Six,eight,and seven patients were enrolled in groups A,B,and C,respectively.Their complication rates were 0%,25%,and 29%,respectively;margin positivity rates were 17%,13%,and 0%,respectively;and local recurrence rates were 0%,0%,and 14%,respectively.Logistic regression analysis showed that being in group Arather than C was a significant predictor of favorable erectile function(p=0.007)and cosmetic outcomes(p=0.030).However,being in group A rather than B was not a significant predictor of favorable erectile function(p=0.127)or cosmetic outcomes(p=0.638).Conclusion:Excellent functional results were observed after GR;however,the benefits were significant only when compared with those of amputation.
基金supported by grants from the National Natural Science Foundation of China(No.81971314)。
文摘Repairing glans dehiscence after failed hypospadias repair is challenging for pediatric surgeons.Here,we introduced and evaluated a newly modified Mathieu technique,Mathieu combined tunnel(MCT),which involves multiple custom-designed flaps for the shortage of flap source material after repeated operations;we also constructed a tunnel to avoid the glans incision that may carry new risks of dehiscence.This retrospective study included 26 patients who were consecutively admitted to the First Affiliated Hospital of Sun Yat-Sen University(Guangzhou,China)for glans dehiscence repair after failed hypospadias repair from October 2014 to October 2020;sixteen patients underwent surgery using the MCT(MCT group)and ten patients underwent surgery using the tubularized incised plate(TIP)technique(TIP group).The operative time,blood loss,postoperative complications,normal urethral meatus rate,success rate,and Hypospadias Objective Penile Evaluation(HOPE)score were compared between the two groups.The MCT group achieved an overall satisfactory penile appearance and voiding function,with a higher rate of normal urethral meatus(15/16,93.8%)and a lower rate of glans dehiscence(1/16,6.2%),compared with the TIP group(70.0%and 30.0%,respectively).However,these differences were not statistically significant,possibly because of the limited number of patients(all P>0.05).Mean postoperative HOPE scores were similar in the MCT group(mean±standard deviation:8.83±0.89)and TIP group(8.94±0.57)(P>0.05).No significant differences were found between the two groups in terms of blood loss and success rate,nor in the rates of various complications(e.g.,fistula,urethral stricture,and glans dehiscence).In conclusion,the MCT technique appears to be feasible and reliable for repairing glans dehiscence after failed hypospadias repair.
基金the Program on"Reconstruction of glans with dysplastic urethral cavernosum and Bucks fascia to reduce the complication rate of fistula at coronal sulcus and dehiscence after hypospadias repair"funded under the Science and Technology Commission of Shanghai Municipality(grant number 15411966900)the Program on"Reconstruct the urethra plate by dorsal inner prepuce island flap in proximal hypospadias repair"funded under the Clinical Research Project of Shanghai Municipal Health Commission(grant number 201940223).
文摘We aim to design a new glanuloplasty procedure combined with spongiosum to reduce the incidence of glans dehiscence and coronal fistula after proximal hypospadias repair.Patients who underwent urethroplasty by dorsal preputial island flap for proximal hypospadias between January 2014 and December 2016 were reviewed in this retrospective cohort study.Those who underwent spongiosum-combined glanuloplasty comprised the new-maneuver group,whereas those who underwent conventional glanuloplasty comprised the control group.The incidence of complications was then compared.In the new-maneuver group,dysplastic corpus spongiosum alongside lateral Buck's fascia(0.3-0.4 cm wide)on both sides of the urethral plate was separated from the proximal normal spongy tissue,joining into the glans wings to increase tissue volume and covering the neourethra in the glans penis.In the control group,the neourethra was covered with superficial fascia under the coronal sulcus.As a result,the new-maneuver and control groups comprised 47 and 28 patients,respectively.In the new-maneuver group,no glans dehiscence was detected;however,two(4.3%)patients had coronal fistula,two(4.3%)had urethral stricture,and four(8.5%)had diverticulum.In the control group,two(7.1%)patients had glans dehiscence,eight(28.6%)had coronal fistula,four(14.3%)had urethral stricture,one(3.6%)had diverticulum,and one(3.6%)had penile curvature recurrence.The new-maneuver group had less incidences of coronal fistula(P<0.001),glans dehiscence(P=0.033),and urethral stricture(P=0.008)but had a higher incidence of diverticulum than the control group(P=0.040).It clearly demonstrates that spongiosum-combined glanuloplasty can significantly reduce the incidences of coronal fistula and glans dehisce.
文摘There is no safe and effective standard method for glans penis augmentation. Furthermore, there has been scant research on glans penis augmentation due to a poor understanding of glans anatomy, technical difficulty, and a lack of suitable substances for augmentation. Cross-linked dextran gel is a newly developed filler for soft-tissue augmentation. We evaluated the efficacy and safety of using a novel technique to inject cross-linked dextran gel for glans penis augmentation during a 24-week follow-up study. This prospective, single-arm, multicenter study enrolled twenty healthy adult men who underwent glans penis augmentation between June and August 2013. Cross-linked dextran gel was injected into the glans penis using a simple and easy technique. The sizes of the glans penis and individual satisfaction were assessed. Any adverse event was also reported. A total of 18 individuals were analyzed; two of them were lost to follow-up. The mean procedure time and injected volume were about 30 rain and 6.6 ＋- 0.9 ml, respectively. The mean surface areas of the glans at baseline and 24 weeks were 20.0 _＋ 3.5 cm2 and 33.6 -＋ 5.4 cm2, respectively, representing a mean increase of 68.7% _＋ 14.0% （P 〈 0.001）. Sixteen individuals （88.9%） were satisfied with the outcomes, and none were dissatisfied. There were no serious adverse events during the study. Cross-linked dextran gel injection for glans penis augmentation was easy and showed a significant augmentative effect on the glans penis, good durability, and was well tolerated without serious adverse events. Therefore, cross-linked dextran gel injection may be an effective, new technique for glans penis augmentation.
基金supported by the grants from the Biodiversity-Based Economy Development Office Public Organization -National Research Council of Thailand(Grant number.R000012298)Department of Pharmaceutical Sciences,the Faculty of Pharmacy and the Graduate School,Chiang Mai University,Chiang Mai,Thailand
文摘Objective: To investigate chemical constituents and new antimicrobial agents among essential oils from the rhizomes of Curcuma aeruginosa(C. aeruginosa) Roxb., Curcuma glans K. Larsen & J. Mood and Curcuma cf. xanthorrhiza Roxb.Methods: The essential oils were obtained by hydro-distillation and analyzed by gas chromatography/mass spectroscopy. Agar-well diffusion assay was used to study the antimicrobial activity and also broth-micro dilution techniques were examined for minimum inhibitory concentration(MIC) against four bacterial strains and yeast.Results: The gas chromatography/mass spectroscopy analysis showed monoterpenes predominantly(88.53%) in the rhizome oil of Curcuma cf. xanthorrhiza. Sesquiterpenes(50.10%) was the most abundant component in the essential oil of C. glans, while monoterpenes(45.55%) and sesquiterpenes(45.81%) were found in C. aeruginosa with a significant amount. The major components of C. aeruginosa were characterized as camphor(29.39%) and germacrone(21.21%). Germacrone(15.76%), b-pinene(9.97%)and camphor(9.96%) were found as major compounds in the rhizome oils of C. glans while a-terpinolene(24.86%) and p-cymen-7-ol(12.17%) were found as major compositions in Curcuma cf. xanthorrhiza. The essential oils were tested against four bacterial strains and yeast. As a result, the rhizome oil of C. aeruginosa exhibited potent activity against Staphylococcus aureus [inhibition zone(21.94 ± 0.24) mm, MIC 125 μg/mL],Bacillus cereus [inhibition zone(20.83 ± 0.36) mm, MIC 125 μg/mL], and Candida albicans [inhibition zone(11.60 ± 0.30) mm, MIC 250 μg/mL].Conclusions: The essential oils from three Curcuma species possessed greater activity against the gram-positive bacteria(Staphylococcus aureus and Bacillus cereus) than gram-negative bacteria(Escherichia coli and Pseudomonas aeruginosa). The results suggest that the essential oils from the fresh rhizome of Curcuma spp. might be a potential source of natural antimicrobial substances.
文摘A 33-year-old male receiving dorsal penile nerve block (DPNB) for circumcision exhibited a postoperative ischemic change over the glans penis. The event occurred nearly 24 hours after the procedure. The patient was treated with intravenous pentoxifyllin and hyperbaric oxygenation. Total reverse of the ischemia was observed. The complications associated with circumcision and DPNB were reviewed and discussed.
文摘Penile reconstruction following cancer resection has long been a challenge due to demand for both aesthetic and functional preservation. Although various methods have attempted to achieve both goals, none have succeeded entirely. In this report, we introduce a novel reconstructive technique on a 64-year-old patient with squamous cell carcinoma of the glans penis. The technique consisted of two staged procedures. First, a dermal substitute, consisting of bovine collagen, was sutured onto the defect after partial glansectomy and three weeks later, the integrated dermis was covered with autologous non-meshed partial thickness skin graft. Use of this dermal substitute in a staged fashion allowed for ability to await final pathologic margins prior to definitive reconstruction and increased dermal thickness. After 9-month follow-up, sexual function returned within 3 months and the patient remained healed. We found this technique to be useful in concurrently preserving penile function and cosmesis. Future studies should include more patients and longer follow-up.
文摘Circumcision refers to the removal of the skin covering the tip of the penis and is one of the most common surgical procedures performed in childhood.Even though circumcision is a well-standardized operation,several minor and major complications may be experienced by paediatric surgeons.Glans ischemia(GI)has been widely reported in the paediatric literature as a complication following circumcision.Nonetheless,etiopathogenesis of GI is not well defined and management guidelines are lacking.CASE SUMMARY We describe our experience with this rare and scary complication using subcutaneous enoxaparin alone or in association with a topical vasodilator.CONCLUSION Hypothetical causes and different management strategies are discussed.
基金supported by funding from the Medical Research Funding of Guangdong(No.A2022499 to QGX)the National Natural Science Foundation of China(No.82301796 to PL)the Guangdong Province Regional Joint Fund-Youth Fund Project of China(No.2022A1515111201 to PL).
文摘This study aimed to introduce a modified Byars staged procedure and investigate its application value in patients with severe hypospadias.We retrospectively analyzed the clinical data of patients with severe hypospadias admitted to the First Affiliated Hospital of Sun Yat-sen University(Guangzhou,China)between October 2012 and October 2022.In total,31 patients underwent the conventional Byars procedure(conventional group),and 45 patients underwent the modified Byars staged procedure(modified group).Our modified strategy was built upon the standard Byars procedure by incorporating glansplasty during the first stage and employing a Y-shaped flap in conjunction with a glandular tunnel for urethroplasty during the second stage.Notably,there were no statistically significant differences in the preoperative baseline characteristics,duration of surgery,amount of blood loss,or occurrence of postoperative complications,including urethral fistula,stricture and diverticulum,or penile curvature,between the conventional and modified groups.However,there was a significantly lower incidence of coronal sulcus fistula(0 vs 16.1%,P=0.02)and glans dehiscence(0 vs 12.9%,P=0.02)in the surgical group than that in the conventional group.In addition,the modified group exhibited a notably greater rate of normotopic urethral opening(100.0%vs 83.9%,P=0.01)and a higher mean score on the Hypospadias Objective Penile Evaluation(HOPE;mean±standard error of mean:8.6±0.2 vs 7.9±0.3,P=0.02)than did the conventional group.In conclusion,the modified Byars staged procedure significantly reduced the risks of glans dehiscence and coronal sulcus fistula.Consequently,it offers a promising approach for achieving favorable penile esthetics,thereby providing a reliable therapeutic option for severe hypospadias.
文摘Penile glans amputation is a tragic complication of circumcision. Beyond the psychological trauma parents go through, they have to deal with the lower urinary tract symptoms including acute urine retention their baby boys suffer due to meatal stenosis from the scaring process that ensues. We report on the cosmetic and functional outcomes in two patients ten years after neo-glans reconstruction following total glans amputation as a complication of circumcision and discuss the lessons learned over the period.
文摘During the most recent years, a variety of new techniques of penile reconstruction have been described in the literature. This paper focuses on the most recent advances in male genital reconstruction after trauma, excision of benign and malignant disease, in gender reassignment surgery and aphallia with emphasis on surgical technique, cosmetic and functional outcome.
文摘Objective:Penile cancer(PeCa)is a rare disease with a global incidence of 36068 new cases in 2020.This accounts for 0.4%of all male malignancies.The surgical management of PeCa depends on the location of the tumour and depth of invasion.Here,we review the oncological and functional outcomes of penile-preserving surgery(PPS).Methods:A PubMed search until July 2021 on PPS for PeCa was conducted;a narrative review on different penile-sparing approaches and outcomes was performed.Results:PPS is now the standard of care in specialist centres for distal tumours not involving the corpus cavernosa.Laser therapy,glans resurfacing,and wide local excision are options for superficial lesions,whilst glansectomy is required for lesions invading into the corpus spongiosum.Conclusion:PPS aims to preserve urinary and sexual function without compromising oncological outcomes.
文摘We reviewed our experience in reconstructing forked corpus spongiosum(FCS)in distal/midshaft hypospadias repair and analyzed the efficacy of this surgical technique.From August 2013 to December 2018,137 consecutive cases of distal/midshaft hypospadias operated by the same surgeon in Urology Department,Children’s Hospital of Fudan University(Shanghai,China),were retrospectively analyzed.Sixty-four patients who underwent routine tubularized incised plate(TIP)or onlay island flap(ONLAY)surgery were included in the nonreconstructing group,and 73 patients who underwent reconstructing FCS during TIP or ONLAY surgery were included as the reconstructing group.Thirty-eight cases underwent TIP,and 26 underwent ONLAY in the nonreconstructing group,with a median follow-up of 44(range:30-70)months.Twenty-seven cases underwent TIP,and 46 underwent ONLAY in the reconstructing group,with a median follow-up of 15(range:6-27)months.In the nonreconstructing/reconstructing groups,the mean age at the time of surgery was 37.55(standard deviation[s.d.]:29.65)/35.23(s.d.:31.27)months,the mean operation duration was 91.95(s.d.:12.17)/93.84(s.d.:14.91)min,the mean neourethral length was 1.88(s.d.:0.53)/1.94(s.d.:0.53)cm,and the mean glans width was 11.83(s.d.:1.32)/11.56(s.d.:1.83)mm.Twelve(18.8%)/5(6.8%)postoperative complications occurred in the nonreconstructing/reconstructing groups.These included fistula(5/2),glans dehiscence(3/0),diverticulum(1/2),residual chordee(3/0),and meatus stenosis(0/1)in each group.There was a significant difference in the overall rate of complications(P=0.035).These results indicate that the technique of reconstructing FCS provides excellent outcomes with fewer complications in distal/midshaft hypospadias repair.
文摘Erythroplasia of Queyrat (EQ) is Squamous cell carcinoma in situ of penis usually involving glans and prepuce, commonly found in uncircumcised men with progression into invasive carcinoma in about 30% of cases. We present a case of 50 yrs, male with reddish, Irritative rash on glans penis;HPE confirms the case of EQ with acanthosis, derangement of stratum spinosum and basement membrane integrity. It successfully treated with two cycle of Photo Dynamic Therapy (PDT). If conservative approach with immquimod, fluorouracil fails then invasive approach should be adopted.
文摘<strong>Introduction:</strong> Penile cancer is a rare primary malignancy that occurs in patients in their 60s and 70s. The aim of the study was to describe the anatomical aspects of penile cancer and to report the difficulties of its management. <strong>Materials and Methods:</strong> This was a retrospective descriptive study of patients with penile tumors from January 2007 to December 2019. Patients of sexual age with an ulcerated lesion of the penis, who came to our department and whose clinical and paraclinical workup led to the diagnosis of penile cancer, were included. The variables studied were clinical, paraclinical and therapeutic. <strong>Results:</strong> In 12 years, we diagnosed and managed 8 patients with penile cancer, an incidence of 0.7 per year. The reason for consultation was the chronic ulcerating wound of the penis with a “cauliflower” aspect. The first medical consultation was late (n = 8) after a long latency period lost to traditional healers. The lesion was located in the glans penis (n = 6) and/or in the corpus cavernosum (n = 2). Histological analysis of the cores concluded to a squamous cell carcinoma. Patients were classified as T2N+M+ (n = 3) and T2N0M0 (n = 5). One patient had accepted partial amputation of the penis. <strong>Conclusion:</strong> Penile cancer is a rare tumor. Partial amputation of the penis is the only alternative in our practice context, an alternative often refuted.
