[Reconstruction of extended skin defect after the radical resection procedure for penile scrotum skin cancer].

OBJECTIVES: To investigate the reconstruction of skin defect after extended resection of malignant skin tumor in or adjacent to the genitals, and to investigate the recovery of the function of urinary system and sexual intercourse after the operation. METHODS: From February 1998 to August 2006, 17 patients with carcinoma of sweat gland or Paget's disease in or adjacent to the genitals were given standard radical resections including groin lymph node dissections. The deformation of penis were corrected with the split-thickness skin grafts. RESULTS: A large split-thickness skin to cover the wound gave a good result. More than 95% of the skin survived, and the shape and function were perfect. CONCLUSIONS: It is a simple and easy way to repair the skin defect. And the patients have a normal shape and function of genitals. The erectile function and the ability of sexual intercourse is good.

[Severe hypospadias repair: reconstructing penis, scrotum and urethra].

OBJECTIVE: To investigate the surgical technic of re-shape penis and scrotum, as well as construct urethra in severe hypospadias patients. METHODS: Twenty-two cases of perineal hypospadias with abnormal penis and scrotum were involved in operative repair. All the patients underwent two-stage of repair technic. The penis sponge were completely stretched out and uprighted in the first-stage. Foreskin and partial penis back skin was transferred into the ventral of penis and scrotum crack. At second-stage, urethroplasty was performed using bladder mucosa folded into half tube that sutured with urothra plate to reconstruct the urothra. The scrotum were re-shaped using foreskin and skinflap. RESULTS: The operation's successful rate was 68% (15/22). There were 7 cases (32%) suffered from urethrocutaneous fistula and recovered after repair. Five cases (23%) occurred stricture of urethra and were treated by urethra dilatation. The appearance of penis and scrotum in 22 cases were satisfied. CONCLUSIONS: The operative methods should be made according to the type of hypospadias and of scrotum. The technic were effective on severe hypospadias with abnormal scrotum, even for the patients who need more than 10 cm urethra construct. The appearance of penis and scrotum were satisfied after following up.

[One case report of primary penile malignant lymphoma (with a review of 24 case reports)].

OBJECTIVE: To investigate the early diagnosis and early treatment of primary penile malignant lymphoma. METHODS: One case of rare primary penile malignant lymphoma was studied with regard to its primary clinical process and characteristics, differential diagnosis and therapeutic method. The application value of the immunohistochemical features, in clinical diagnosis was analyzed. RESULTS: Surgical treatment of removing the penis, testes and scrotum was carried out, followed by chemotherapy went. The immunohistochemical tests showed CD56, granzyme B, perforin and cytoplasmic CD3epsilon to be positive, and surface CD3 negative. CONCLUSION: Primary malignant lymphoma of the penis, though rare clinically, may be treated effectively if diagnosed early. Wedge biopsy with histological examination and immunohistochemical tests is the most common method for definite diagnosis.

[Prevention and treatment of erectile dysfunction during peri-operation period of radical retropubic prostatectomy].

The incidence of prostatic cancer rises with increasing age and early diagnosis rate of the disease keeps increasing at the same time. Early diagnosis provides opportunities for radical prostatectomy to cure prostatic cancer. However, the problem of erectile dysfunction (ED) post operation puzzles urologists and exerts negative impacts on the patients life quality. Study on the prevention and treatment of peri-operational ED is of great importance to dwindle the occurrence rate of ED and is the key to improve the life quality of such patients.

[Duplex ultrasonography and internal pudendal arteriogram in the diagnosis of trauma-associated arteriogenic erectile dysfunction (a report of 7 cases)].

OBJECTIVE: To make a comparative study of duplex ultrasonography (DU) and internal pudendal arteriogram (IPA) in the diagnosis of trauma-associated arteriogenic erectile dysfunction (ED). METHODS: Seven patients suffering from arteriogenic erectile dysfunction caused by pelvic fracture trauma underwent comprehensive history inquiries and physical examinations by duplex ultrasonography and internal pudendal arteriogram, which ruled out neurogenic erectile dysfunction. RESULTS: DU suggested penile artery blood flow injury, and IPA indicated artery injury in all the cases, including left internal pudendal artery injury, right or left common penile artery injury and bilateral common penile artery injury. CONCLUSION: Trauma-associated arteriogenic erectile dysfunction may result from common penile artery injury and internal pudendal artery injury. DU is proved valuable for evaluating hemodynamic abnormalities of cavernous artery flow, and IPA useful in locating common penile artery and internal pudendal artery injury. DU can be used as the first line diagnostic means to define trauma-associated arteriogenic ED.

[Correlation of age and sex hormones to the transition zone volume of the prostate].

OBJECTIVE: To investigate the correlation of age and sex hormones to the total volume (TV) and transition zone volume METHODS: Eighty-two men were divided into two groups with the age of 60 as the dividing line. Prostatic TV (TZV and TZV were measured with transrectal ultrasound (TRUS) and the concentrations of total testosterone (T), free testosterone (fT) and estradiol (E2) were measured with radioimmunoassay. Exponential curve regression and one-factor analysis of variance (ANOVA) were used for statistical analysis. RESULTS: Age was significantly correlated with TV, TZV and the TZV/TV ratio, P < 0.01. There was a significant positive correlation between the concentrations of fT and TZV, a negative correlation between those of E2 and TZV (P < 0.01), but no correlation between those of T and TZV (P > 0.05). CONCLUSION: The significant acceleration of the TZV of the prostate after the age of 60 is related to sex hormones.

[Pre- and post-prostatectomy variation and supplement of sexual hormones in patients with benign prostatic hyperplasia].

OBJECTIVE: To explore the variation of sexual hormones (T and fT) before and after prostatectomy and their post-operative supplement in patients with benign prostatic hyperplasia (BPH). METHODS: Sixty-four cases of BPH were randomly divided into a treatment group (Group I, n = 25) and a control group (Group II, n = 39). Plasma LH, FSH, T and fT were measured by radioimmunoassay a week before and two weeks after prostatectomy. After operation, Group I received supplement of testosterone undecanoate, while Group II received none. RESULTS: The variations of plasma LH, FSH, T and fT were not statistically significant in the two groups before prostatectomy (P > 0.05), but obviously less in Group I than in Group II after operation (P < 0.01). CONCLUSION: Testosterone supplement is a useful therapy for post-prostatectomy patients with androgen deficiency.

[Prospect of tissue engineering study in andrology].

The concept of cell transplantation by tissue engineering has provided numerous possibilities for tissue reconstruction in andrology. Application studies of tissue engineering have been made in such aspects as Leydig cells, testicular prosthesis, penile corporal and penile prosthesis in order to improve, restore or replace the existing tissue function. Although most reconstructive efforts still remain at the experimental stage, several techniques have been applied to clinical practice with satisfactory results. This article briefly reviewed the applications of tissue engineering to andrology.

[Study of sexual hormone changes in prostate cancer patients before and after androgen deprivation therapy].

OBJECTIVES: To investigate and observe serum sexual hormone (testosterone, T; free testosterone, FT; dihydrotestosterone, DHT) changes in patients with prostate cancer (PCa) before and after androgen deprivation. METHODS: Serum T, FT, DHT were measured with radioimmunoassay in 16 cases with PCa respectively one week before and the fifth day after androgen deprivation. The changes of T, FT, DHT were analyzed. RESULTS: Serum T, FT, DHT declined 92.27%, 92.26%, 58.36% respectively. They were statistically significant before and after androgen deprivation (P < 0.001). CONCLUSIONS: After androgen deprivation, most T and FT were deprived while DHT declined 58.36% only. Androgen receptor competitor shall be applied continually to prohibit the action of remnant androgen.

[Comparison of PSAD and PSAD-TZ value in prostatic hyperplasia and prostatic cancer].

OBJECTIVES: To compare PSAD, PSAD-TZ, PSA, FPSA/TPSA detection used in diagnosis of prostatic hyperplasia(BPH) and prostatic cancer(PCa). METHODS: Fourty-three cases of BPH and twenty cases of PCa with PSA < 20 micrograms/L were chosen, then compared PSA, PSAD, FPSA/TPSA, PSAD-TZ between BPH and PCa. RESULTS: The mean PSA in BPH and PCa is (10.47 +/- 6.25) microgram/L and (13.92 +/- 3.20) microgram/L respectively with no statistic difference (P > 0.05). The mean PSAD in BPH and PCa is (0.15 +/- 0.12) microgram/L and (0.24 +/- 0.13) microgram/L respectively with statistic difference (P < 0.05). The mean FPSA/TPSA in BPH and PCa is (0.58 +/- 0.42) microgram/L and (0.26 +/- 0.17) microgram/L respectively with statistic difference (P < 0.05). The mean PSA-TZ in BPH and PCa is (0.26 +/- 0.22) and (0.51 +/- 0.28) respectively with obviously statistic difference (P < 0.01). CONCLUSIONS: The results suggest PSAD, FPSA/TPSA, especially PSAD-TZ could be used to distinguish BPH and PCa.