Application value of ultrasonography in penile diseases / 中华男科学杂志

Penile disease is one of the male urological diseases. Although the penis is a small organ, once the problem occurs, it often brings great trouble to the patient. Therefore, the accurate diagnosis of penile disease is particularly important. High-frequency ultrasonography, with its advantages of noninvasiveness, safety, low cost, easy operation and reproducibility, can clearly show the structure and blood flow of the penis and has a significant value in the diagnosis and follow-up of penile diseases such as vascular erectile dysfunction, priapism, penile injury, penile neoplastic and non neoplastic nodules. Meanwhile, the development of new technologies such as shear wave elastography (SWE) and contrast enhanced ultrasound (CEUS) has made up for the shortcomings of traditional ultrasound imaging, expanded the application of ultrasound in penile diseases, and improved the efficiency of ultrasound diagnosis of the diseases. This article focuses on the application value of ultrasound in erectile dysfunction, priapism, penile cavernous injury and penile tubercle, as well as the latest progress in such new technologies as SWE and CEUS applied to penile diseases.

Ladder step strategy for surgical repair of congenital concealed penis in children / 中华男科学杂志

<p><b>Objective</b>To assess the feasibility of the ladder step strategy in surgical repair of congenital concealed penis in children.</p><p><b>METHODS</b>This study included 52 children with congenital concealed penis treated in the past two years by surgical repair using the ladder step strategy, which consists of five main steps: cutting the narrow ring of the foreskin, degloving the penile skin, fixing the penile skin at the base, covering the penile shaft, and reshaping the prepuce. The perioperative data of the patients were prospectively collected and statistically described.</p><p><b>RESULTS</b>Of the 52 patients, 20 needed remodeling of the frenulum and 27 received longitudinal incision in the penoscrotal junction to expose and deglove the penile shaft. The advanced scrotal flap technique was applied in 8 children to cover the penile shaft without tension, the pedicled foreskin flap technique employed in 11 to repair the penile skin defect, and excision of the webbed skin of the ventral penis performed in another 44 to remodel the penoscrotal angle. The operation time, blood loss, and postoperative hospital stay were 40－100 minutes, 5－30 ml, and 3－6 days, respectively. Wound bleeding and infection occurred in 1 and 5 cases, respectively. Follow-up examinations at 3 and 6 months after surgery showed that all the children had a satisfactory penile appearance except for some minor complications (2 cases of penile retraction, 2 cases of redundant ventral skin, and 1 case of iatrogenic penile curvature).</p><p><b>CONCLUSIONS</b>The ladder step strategy for surgical repair of congenital concealed penis in children is a simple procedure with minor injury and satisfactory appearance of the penis.</p>

Transient Distal Penile Corporoglanular Shunt as an Adjunct to Aspiration and Irrigation Procedures in the Treatment of Early Ischemic Priapism

PURPOSE: Ischemic priapism, a compartment syndrome, requires urgent treatment in order to nourish the corpora cavernosa. As the first step, aspiration of blood and irrigation of the cavernosal bodies is performed to prevent fibrotic activity and secure erectile capability. During aspiration, there are risks of cardiovascular side effects of adrenergic agonists. We aimed to evaluate a transient distal penile corporoglanular shunt technique in place of aspiration and irrigation techniques for treatment of early ischemic priapism. MATERIALS AND METHODS: A transient distal penile shunt was applied to 15 patients with early ischemic priapism between January 2011 and May 2012. Priapism duration, history, causes, pain, and any prior management of priapism were assessed in all patients. A complete blood count and penile Doppler ultrasonography were performed, which showed attenuated blood flow in the cavernosal artery. A sterile closed system blood collection set, which has two needles and tubing, was used for the transient distal penile shunt. RESULTS: Ten of 15 patients with early ischemic priapism were successfully treated with this transient shunt technique. No additional procedures were needed after the resolution of rigidity in the 10 successfully treated patients. CONCLUSIONS: The transient nature of this technique is an advantage over aspiration and irrigation in the treatment of early ischemic priapism. Our results indicate that the technique can be offered for patients with an ischemic priapism episode of no more than 7 hours.

Penile Squamous Cell Carcinoma Diagnosed following Treatment of Urethrocutaneous Fistula after CO2 Laser Therapy for Misdiagnosed Penile Lesion: Report of a Case / 대한남성과학회지

The complications of the treatment of penile lesion are wide ranging, urethrocutaneous fistula being one of the less common. This complication affects the ventral aspect of the penis. We present a rare case of urethrocutaneous fistula after vaporization of penile lesion by CO2 Laser. One fistula was at ventral aspect of the penis. A 43-year-old male presented with passage of urine from one opening. He had undergone a vaporization by CO2 laser, 2 times. Urethrocutaneous fistula repairs was performed with biopsy of the edge of fistula site. Squamous cell carcinoma was confirmed. He subsequently underwent a partial penectomy. It is very important that biopsy was performed before vaporization of even small size skin lesion. This case is reported along with a brief review of the literature.

Glans necrosis / Necrose de glande

Ischemic necrosis of the glans penis is a rare entity. To this day, roughly fifteen cases have been described. Certain physiological abnormalities are commonly found in association with this condition, including diabetes, chronic renal failure and peripheral vascular disease. Usually the penile lesion suffers black-mummy-shaped necrosis or liquefaction and progresses from dry to wet gangrene. Correct diagnosis and early treatment are essential for a successful treatment.

Necrose isquêmica do pênis é uma situação rara. Atualmente há cerca de 15 casos relatados na literatura. Distúrbios fisiológicos estão comumente associados aos episódios de necrose de glande, como diabetes, insuficiência renal crônica e doença vascular periférica. Freqüentemente a lesão peniana se mumifica, porém ela pode evoluir com liquefação tecidual, progredindo para lesão peniana úmida. O diagnóstico correto e intervenção precoce são essenciais para o sucesso do tratamento

Superficial Thrombophlebitis of the Dorsal Vein of the Penis (Penile Mondor's Disease) / 대한비뇨기과학회지

Herein, two cases of penile Mondor's disease are described. The first was a 45-year-old man who complained of a small subcutaneous induration, with localized discomfort at the distal rim of the coronal sulcus of the penis. The other was a 46-year-old man who complained of similar symptoms of penile induration. The lesions were surgically removed under local anesthesia, and found to be thromboses of the penile superficial dorsal vein. As a result, the diagnoses of Mondor's disease of the penis were confirmed.