Protective effect of annexin-A1 against irreversible damage to cavernous tissue after cavernous nerve injury in the rat.

UNLABELLED: Study Type - Aetiology (case control) Level of Evidence 3b. What's known on the subject? and What does the study add? Penile rehabilitation is still controversial regarding good results. Our study shows a non-invasive treatment option to recovery after cavernous nervous damage. The assessment of changes in the intracavernous pressure and karyometry demonstrates the protective effect of annexin-A1 in an animal model of cavernous nerve injury. We found that annexin-A1 effectively preserved erectile function, evidently through significantly protecting the corpus cavernosum tissue against fibrosis. OBJECTIVE: • To evaluate the protective effect of annexin-A1 against irreversible damage to cavernous tissue after cavernous nerve injury. PATIENTS AND METHODS: • Thirty Sprague-Dawley male rats were divided into 3 groups; sham-operated rats (n= 10), bilateral cavernous nerve injury treated intravenously with 100 µg/kg annexin-A1 (n= 10), and a crush group of rats submitted to bilateral cavernous nerve injury and vehicle (n= 10). Groups were compared in respect to intracavernous pressure and karyometric parameters. RESULTS: • After annexin-A1 treatment, the maximum changes in intracavernous pressure responses were significantly higher in the annexin-A1 group compared to the vehicle-only group on the 7(th) postoperative day (p-value <0.05). Hematoxylin-eosin staining showed that the percentage of cavernosal smooth muscle was higher in the annexin-A1 group. Karyometry showed that the nuclear volume was greater in the annexin-A1 group, as was the major/minor smooth muscle cell diameter ratio compared to the vehicle-only group on the 7(th) postoperative day (p-value <0.05). CONCLUSION: • This is the first report that, by assessing changes in the intracavernous pressure and karyometry, demonstrates the protective effect of annexin-A1 in an animal model of cavernous nerve injury. We found that annexin-A1 effectively preserved erectile function, evidently through significantly protecting the corpus cavernosum tissue against fibrosis.

Treatment of male genital lymphedema with non-elastic fabric.

Lymphedema is a specific type of edema stemming from a failure in the formation or drainage of lymph. This condition can be congenital or acquired. The clinical treatment of genital lymphedema involves compression mechanisms of the penis. In acquired cases, the individual is born with the lymphatic system intact, but this system is damaged at some point in life, which can lead to lymphatic insufficiency and the development of edema. The non-elastic material for the penis is grosgrain that enable the adjustment to the proper pressure. This report describes a case series of penile lymphedema treated with compression mechanism. Thirteen consecutive patients with penoscrotal lymphedema aged 22 to 56 years (mean: 42.3 years) were treated. Inclusion criteria were patients with primary and secondary penoscrotal lymphedema. Volume larger than three times the normal size of the scrotum was excluded. Reductions in edema occurred in the penis in all patients. Such reductions varied in accordance with the adherence of the patients to the use and duration of compression. The patients used the compression device at times that best fit their schedules. An interesting aspect was the fact that the patients reported the possibility of leaving the penis the size they wished-neither very small nor very large-for sexual activity. All were able to control the size of the edema within the standards they considered acceptable.

Xanthogranulomatous orchitis: case report of a rare condition.

Xanthogranulomatous orchitis is a rare, non-neoplastic inflammatory condition. We present a case of a 55-year-old diabetic male with an increase in volume, pain and edema in right testicle with a one-year history. The examination involved the investigation of inflammatory markers and ultrasound. Exploration of the scrotum revealed important destruction of the tissue architecture. This case underscores the importance of including xanthogranulomatous orchitis in the differential diagnosis of a testicular lump.

Is hypogonadism the cause of penile self-amputation in a patient with prior testes self-mutilation?

INTRODUCTION: This paper presents a rare event of genital self-mutilation and few cases are reported in the literature. CASE DESCRIPTION: We report on a patient who performed partial self-penectomy 18 months after bilateral testicular amputation, as a form of self-mutilation. CONCLUSIONS: The main hypotheses to explain the recurrence of self-mutilation would be hypogonadism.

Primary Mixed Glandular-endocrine Tumor of the Male Proximal Urethra: A Case Report.

Primary urethral carcinoma is much more common in women than in men due to its association with urethritis. A 65-year-old man presented with a 10-month history of penile induration, obstructive voiding symptoms and hematuria. Urethrocystoscopy showed a solitary mass in the proximal urethra and no bladder involvement. It was performed penectomy without bladder neck excision and regional staging lymphadenectomy of the obturator lymph nodes. Pathological diagnosis revealed adenosquamous cell carcinoma with squamous and glandular components. We described a case of primary mixed glandular-endocrine tumor of the male proximal urethra consisting of adenosquamous cell carcinoma with squamous and neuroendocrine components.

Penile Replantation After Five Hours of Warm Ischemia.

Although a rare occurrence, this event may occur as a result of self-mutilation among individuals with psychiatric disturbances or due to work-related accidents, iatrogenic injuries or the actions of individuals motivated by jealously, rage and feelings of betrayal. In western societies, most penile amputations are the result of self-aggression during a psychotic episode, the treatment of victims involves resuscitation, stabilization and immediate psychiatric support. The amputated tissue must be preserved under hypothermic conditions. Micro-surgery is currently the most widely employed method for penile replantation. This paper describes a successful case of penile replantation following 5 hours of warm ischemia.

Annexin 1 mimetic peptide protects against renal ischemia/reperfusion injury in rats.

Inflammation is currently recognized as a key mechanism in the pathogenesis of renal ischemia-reperfusion (I/R) injury. The importance of infiltrating neutrophil, lymphocytes, and macrophage in this kind of injury has been assessed with conflicting results. Annexin 1 is a protein with potent neutrophil anti-migratory activity. In order to evaluate the effects of annexin A1 on renal I/R injury, uninephrectomized rats received annexin A1 mimetic peptide Ac2-26 (100 µg) or vehicle before 30 min of renal artery clamping and were compared to sham surgery animals. Annexin A1 mimetic peptide granted a remarkable protection against I/R injury, preventing glomerular filtration rate and urinary osmolality decreases and acute tubular necrosis development. Annexin A1 infusion aborted neutrophil extravasation and attenuated macrophage infiltration but did not prevent tissue lymphocyte traffic. I/R increased annexin A1 expression (assessed by transmission electron microscopy) in renal epithelial cells, which was attenuated by exogenous annexin A1 infusion. Additionally, annexin A1 reduced I/R injury in isolated proximal tubules suspension. Annexin A1 protein afforded striking functional and structural protection against renal I/R. These results point to an important role of annexin A1 in the epithelial cells defense against I/R injury and indicate that neutrophils are key mediators for the development of tissue injury after renal I/R. If these results were confirmed in clinical studies, annexin A1 might emerge as an important tool to protect against I/R injury in renal transplantation and in vascular surgery.