Risk factors for the complications of primary hypospadias urethroplasty with the urethral plate reserved / 中华男科学杂志

Objective@#To investigate the risk factors for the complications of urethroplasty in patients with primary hypospadias by postoperative follow-up observation.@*METHODS@#We retrospectively analyzed 110 cases of primary hypospadias repair performed from November 2010 to October 2015, including 70 cases of tubularized incised plate (TIP) urethroplasty and 40 cases of inlay internal preputial graft (IIPG) urethroplasty, all with the urethral plate reserved. We followed up the patients for 15.6－36 months, (27.3 ± 0.52) mo for those with and (26.9 ± 0.22) mo for those without complications. The mean age of the two groups of patients was (7.5 ± 0.2) and (7.0 ± 0.5) yr, respectively.@*RESULTS@#The follow-up data were collected from all the patients, 17 (15.5%) with and 93 (84.5%) without complications. The success rate of surgery was 84.5%. There were no statistically significant differences in the follow-up time and age between the two groups of patients (P >0.05). Single-factor analysis of variance showed significant differences between the complication and non-complication groups in the preoperative urethral opening (P <0.01), ventral penile curvature (P <0.01), and length of urethral defect (P = 0.04), while multiple linear regression analysis exhibited that only ventral curvature was associated with the postoperative complications of the patients (OR = 1.12, 95% CI: 1.06－1.19, P<0.01).@*CONCLUSIONS@#We chose single-stage urethroplasty with the urethral plate reserved for the treatment of primary hypospadias and achieved satisfactory outcomes. Ventral penile curvature is an independent risk factor for the complications of primary hypospadias, and a higher degree of curvature is associated with a higher incidnece of complications.

The analysis of allelic deletion in 4 cases of Amelogenin loci in paternity testing / 复旦学报（医学版）

Objective To apply PowerPlex(R) 21 System Kit and AGCU 21 + 1 STR Fluorescence Detection Kit as supplementary detection kit in some samples with Amelogenin locus X deletion.Methods While with the help of Investigator Argus X-12 Kit,MicroreaderTM 19X ID System kit and the application of capillary electrophoresis,the complete X pattern of these four samples can be identified.Results From Mar,2013 to Dec,2016,4 cases of male samples with Amelogenin locus X deletion have been found.Conclusions Sometimes Amelogenin locus X deletion may happen when using PowerPlex(R)21 System Kit and AGCU 21 + 1 STR Fluorescence Detection Kit,while validating with other forensic biology detection kit can assure the accuracy of genotyping.

Microsurgical management of male infertility in china: 15-year development and prospects / 中华男科学杂志

Male infertility is a common and complex disease in urology and andrology, and for many years there has been no effective surgical treatment. With the emergence of microsurgery and assisted reproductive medicine (IVF/ICSI), rapid development has been achieved in the treatment of male infertility. The Center for Male Reproductive Medicine and Microsurgery at Weill Cornell Medical College of Cornell University has been playing an important leading role in developing microsurgical techniques for the management of male infertility. The development of microsurgical treatment of male infertility in China has experienced the 3 periods of emerging, making, and boosting ever since its systematic introduction from Weill Cornell Medical College 15 years ago. At present, many Chinese hospitals have adopted microsurgery in the management of male infertility, which has contributed to the initial establishment of a microsurgical treatment system for male infertility in China. However, some deficiencies do exist concerning microsurgical treatment of male infertility, as in normalized technical training programs for competent surgeons, unified criteria for evaluation of surgical outcomes, and detailed postoperative follow-up data. This article presents an overview on the 15-year development of microsurgical management of male infertility in China, points out the existing deficiencies, and offers some propositions for the promotion of its development.

Single nucleotide polymorphisms of the DGKK gene and hypospadias in Chinese children / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the role of single nucleotide polymorphisms of the gene of diacylglycerol kinase κ (DGKK) in hypospadias in Chinese children.</p><p><b>METHODS</b>We performed direct sequencing on 2 hypospadias-related candidate single nucleotide polymorphisms of the DGKK gene (rs1934179 and rs7063116, never previously reported in the Chinese population) from 300 children with sporadic hypospadias and 200 healthy controls, and compared the results between the two groups.</p><p><b>RESULTS</b>The mutation frequencies of rs1934179 and rs7063116 were 5.0% (15/300) and 5.67% (17/300) respectively in the hypospadias patients, significantly higher than 1.5% (3/200) and 2.0% (4/200) in the normal controls (P <0.05). The mutation frequencies of rs1934179 and rs7063116 in the cases of distal and middle hypospadias were also remarkably higher (6.5%, [13/200] and 7.5% [15/200], P <0.05), but those in the proximal cases (both 2.0% [2/100]) showed no statistically significant difference from the control (P >0.05).</p><p><b>CONCLUSION</b>The polymorphisms of the DGKK gene may be associated with hypospadias, particularly distal and middle hypospadias, in Chinese children.</p>

A recommendable standard protocol of adult male circumcision with the Chinese Shang Ring: outcomes of 328 cases in China / 中华男科学杂志

<p><b>OBJECTIVE</b>Standardization of and training in adult male circumcision can significantly reduce its complication rate. Currently no such program exists for its standardization and training, making it difficult to guarantee the quality of male circumcision services. We therefore established a standardized surgical protocol for adult male circumcision in China using the Shang Ring, and applied it to a clinical study examining the performance of the Shang Ring in adult male circumcision.</p><p><b>METHODS</b>A total of 328 adult men aged 18-58 (mean 27.8) years, 25 with phimosis and 303 with redundant prepuce, underwent circumcision with the Shang Ring, and evaluation of the operation time, pain scores (using the visual analog scale), postoperative complications, time for wound healing, and their satisfaction with the postoperative appearance.</p><p><b>RESULTS</b>The operation time was 4.7 +/- 1.3 minutes. The pain scores were 0. 2 +/- 0.6 during the surgery, 1.6 +/- 1.0 twenty hours postoperatively, 1.7 +/- 1.1 twenty hours prior to the ring removal, and 2.7 +/- 1.4 during the ring removal. Complications included infection in 2 (0.6%), bleeding in 2 (0.6%), and wound dehiscence in 2 (0.6%) of the patients. None of the patients with wound dehiscence required postoperative suturing and all were managed conservatively instead. Sixteen of the patients (4.9%) experienced penile edema. The time for complete wound healing after circumcision was 20.3 +/- 6.7 days. The rate of the patients'satisfaction was 99.7% (327/328).</p><p><b>CONCLUSION</b>The standard protocol of adult male circumcision with the Shang Ring has the advantages of short operation time, slight pain, low rate of complications, and high satisfaction and acceptance of the patients. Strict standardization of the surgical protocol can maximize its clinical advantages for adult male circumcision.</p>

The need for high-quality training and surgical standards for adult male circumcision in China / 中华男科学杂志

Although HIV is a significant problem in Africa, HIV infection rates are rising rapidly in other regions such as Asia and South America. International health organizations have recognized the need to develop effective strategies to check the worldwide transmission of HIV. Studies have demonstrated the significant reduction of HIV, HPV, HSV-2 and other STD infection rates with male circumcision (MC). Although numerous MC techniques are available, there are no standardized protocols and surgical training programs. Studies have shown that the standardization of MC techniques coupled with training programs can significantly reduce complication rates. High complication rates have been a primary obstacle to the implementation of MC services. We recommend the establishment of surgical standards and training protocols prior to the promotion of MC services in China.

Comparative analysis of three different surgical approaches to varicocelectomy / 中华男科学杂志

<p><b>OBJECTIVE</b>To compare three different surgical approaches to varicocelectomy.</p><p><b>METHODS</b>Eighty-eight cases of varicocelectomy performed in our hospital between January 2006 and January 2008 were divided into an retroperitoneal high ligation group (n = 44), a laparoscopy group (n = 12) and a microsurgery group (n = 32), and retrospectively analyzed for postoperative semen quality, recurrence, early complications, hospital stay, and medical cost.</p><p><b>RESULTS</b>The rates of semen quality improvement were 56.52% (13/23), 66.67% (4/6) and 78.26% (18/23) , the rates of recurrence were 25% (8/32), 22.22% (2/9) and 7.41% (2/27), and the medical costs were RMB yen (1984 +/- 126), (8576 +/- 547) and (2159 +/- 298), respectively, in the retroperitoneal high ligation, laparoscopy and microsurgery groups (P < 0.05). None experienced serious early complications.</p><p><b>CONCLUSION</b>Microsurgery is obviously superior to retroperitoneal high ligation and laparoscopic approaches in improving semen quality and preventing postoperative recurrence, and, with its advantages of minor invasiveness and quick recovery, is preferred by most patients. Laparoscopy, however, ranks highest in medical cost.</p>

Single stage dorsal inlay buccal mucosal graft with tubularized incised urethral plate technique for hypospadias reoperations / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To report the experience with single stage dorsal inlay buccal mucosal grafts using the Snodgrass technique for complex redo cases.</p><p><b>METHODS</b>From May 2004 to December 2005, a total of 53 patients aged from 3 to 34 years old (average 11.62 +/- 7.18 years) with failed previous hypospadias surgery were included in the present study. Indications included urethral strictures and repair breakdown. The unhealthy urethra was unroofed from the meatus in the ventral midline, a buccal mucosal graft was inlayed between the incised urethral plate and fixed to the corpora cavernosa. The neourethra was tubularized, and covered with subcutaneous (dartos) tissue and penile skin. Glanuloplasty was also performed in all cases. Outcome analysis included clinical follow-up, and endoscopy in 2 selected cases.</p><p><b>RESULTS</b>The buccal mucosal graft was 3.0-7.5 cm in length and 0.7-2.0 cm in width. All patients required glanuloplasty, with buccal mucosal grafts extended to the tip of the glans. After a follow-up of 14-30 months (mean 22.6 months), the total complication rate was 15.1%, with five cases of fistula and three cases of stricture.</p><p><b>CONCLUSION</b>Inlaying dorsal buccal mucosal grafts applying the Snodgrass technique is a reliable method for creating a substitute urethral plate for tubularization. The recurrent rate of urethral stricture and fistula is at an acceptable level for redo cases. This approach represents an effective, simple and safe option for reoperations.</p>

Foreskin-deglove and shaft-fix procedure combined with Z-plasty of penis and scrotum skin in treatment of concealed penis / 上海第二医科大学学报

Objective To explore the efficacy of foreskin-deglove and shaft-fix procedure combined with Z-plasty of penis and scrotum skin in the treatment of concealed penis. Methods Fifty-eight patients diagnosed as concealed penis were included in the study.All of them underwent the foreskin-deglove and shaft-fix procedure.Foreskin was degloved from 5 mm to 10 mm proximal to corona deep to the root,and bilateral tunica albuginea at this level was sutured to suprapubic scarpas' fascia.Z plasty of penis and scrotum skin was applied to cover penile shaft. Results After follow-up for 6 to 12 months,there was no recurrent retraction of the penile shaft,and all the patients were satisfied with the appearance of penis after plastic surgery.Edema of prepuce occurred in 2 patients,and completely regressed in 2 to 3 months.There was no incision scar hyperplasy,and the function of urination and erection were normal. Conclusion Foreskin-deglove and shaft-fix procedure combined with Z-plasty of penis and scrotum skin can resolve pathologic problems of concealed penis and has favourable aesthetic results with less complications.It is easy to perform and is an ideal procedure in the treatment of concealed penis.

The inflatable penile prosthesis made in China for treatment of erectile dysfunction / 中国医疗器械杂志

Erectile dysfunction (ED) is a common male sexual dysfunction. Some ED patients who do not respond to any nonsurgical therapy will eventually be candidate for penile prostheses. This paper introduces the characteristics and application of inflatable penile prosthesis made in China.