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1.
Curr Urol Rep ; 22(3): 16, 2021 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-33533997

RESUMO

PURPOSE OF REVIEW: The goal of this paper is to understand the reasons behind penile length and girth issues after penile prosthesis surgery and review the literature for current strategies employed to decrease these issues. RECENT FINDINGS: Measurement inconsistencies triggering further studies have shown there is a real loss of penile length and girth after prosthesis surgery. There have been varying hypotheses of why this happens, and numerous approaches have been proposed to help combat this in the preoperative, intraoperative, and postoperative settings. Erectile dysfunction prevalence is expected to increase; therefore it is important for urologists to understand the treatment options, including prosthesis surgery. Numerous techniques have been hypothesized and studied in smaller settings in the preoperative, intraoperative, and postoperative settings with regard to prosthetics surgery. However, larger studies are still needed to confirm these findings in order to help to counsel and educate patients preoperatively in addition to employing tactics to help minimize penile shortening.


Assuntos
Disfunção Erétil/cirurgia , Implante Peniano/efeitos adversos , Prótese de Pênis , Pênis/cirurgia , Pesos e Medidas Corporais/métodos , Disfunção Erétil/complicações , Disfunção Erétil/patologia , Humanos , Masculino , Tamanho do Órgão , Doenças do Pênis/etiologia , Doenças do Pênis/terapia , Ereção Peniana , Implante Peniano/métodos , Prótese de Pênis/efeitos adversos , Pênis/patologia , Período Pós-Operatório
2.
Curr Urol Rep ; 22(2): 9, 2021 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-33420894

RESUMO

PURPOSE OF REVIEW: The goal of this review article is to evaluate sexual dysfunction among men who have sex with men (MSM). RECENT FINDINGS: Men who have sex with men are commonly affected by sexual dysfunction. Often sexual dysfunction in MSM will significantly impact their psychological well-being perhaps even more than their heterosexual counterparts. Despite the frequency and high impact of sexual dysfunction in MSM, access to appropriate care may be limited. It is important for urologists, especially sexual medicine clinicians, to be aware of and comfortable with differences in sexual practices of MSM. Penile pathology in this patient population will negatively affect their quality of life and well-being. Therefore, it is important to properly assess and treat these patients.


Assuntos
Comportamento Sexual , Disfunções Sexuais Fisiológicas , Disfunções Sexuais Psicogênicas , Minorias Sexuais e de Gênero , Humanos , Masculino , Doenças do Pênis/diagnóstico , Doenças do Pênis/etiologia , Doenças do Pênis/psicologia , Doenças do Pênis/terapia , Pênis/anatomia & histologia , Pênis/lesões , Qualidade de Vida , Ruptura , Comportamento Sexual/psicologia , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Fisiológicas/psicologia , Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Psicogênicas/etiologia , Disfunções Sexuais Psicogênicas/psicologia , Disfunções Sexuais Psicogênicas/terapia , Minorias Sexuais e de Gênero/psicologia
3.
Pediatr Surg Int ; 36(4): 523-528, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32088740

RESUMO

PURPOSE: To perform a medical evaluation of penile necrosis causes and treatment approaches by examining patients who had penile necrosis after circumcision surgery. METHODS: A total of 24 patients with penile necrosis after circumcision surgery, who presented at various hospitals in Turkey between September 2003 and April 2013 and whose cases were being reviewed at the Institution of Forensic Medicine with regard to malpractice, were evaluated retrospectively. RESULTS: The mean age of the patients was 5 ± 3.7 years, and the mean time of the necrosis diagnosis after circumcision was 5.2 ± 6.3 days. In etiologic terms, the predictive factors were monopolar cautery use in ten (41.6%) patients, post-circumcision infection in eight (33.3%), compartment syndrome due to post-circumcision dressing in three (12.5%), local anesthetic agent used for dorsal nerve blockage in two (8.3%), and methemoglobinemia in one (4.1%) patient. The first approaches to necrosis treatment were surgical intervention in 15 (62.5%) patients, hyperbaric oxygen treatment (HBOT) in 6 (25%), the conservative approach in 2 (8.3%), and HBOT plus surgical intervention in 1 (4.1%) patient. CONCLUSION: Penile necrosis is a preventable complication that requires early intervention. The current study will be helpful in preventing penile necrosis and in guiding surgeons in approaches following its occurrence.


Assuntos
Anestesia Local/métodos , Anestésicos Locais/farmacologia , Circuncisão Masculina/efeitos adversos , Bloqueio Nervoso/métodos , Doenças do Pênis/cirurgia , Pênis/patologia , Complicações Pós-Operatórias/epidemiologia , Adolescente , Bandagens , Criança , Pré-Escolar , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Necrose/epidemiologia , Necrose/etiologia , Necrose/cirurgia , Doenças do Pênis/epidemiologia , Doenças do Pênis/etiologia , Pênis/cirurgia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Reoperação , Estudos Retrospectivos , Turquia/epidemiologia
4.
Urology ; 137: 183-189, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31926195

RESUMO

OBJECTIVE: To characterize the bulbospongiosus muscle (BSM) in patients with bulbar urethral strictures. MATERIALS AND METHODS: We studied 21 patients divided into 2 groups: Stricture Group (n = 14; mean age = 62.00 years) with bulbar stricture submitted to open urethroplasty; and Control Group (n = 7; mean age = 60.14 years) with penile strictures (hypospadias cripples, penile cancer and/or penile infection) who were submitted to perineal urethrostomy. Samples of the BSM were dissected and histologic sections were stained by histochemical and immunohistochemical techniques. Histomorphometric analyzes were performed on photomicrographs. Means were statistically compared using the unpaired Student t test and the Mann-Whitney test (P <.05). RESULTS: The etiology of bulbar urethral stricture was idiopathic in 2 cases (14.29%), post-TURP in 6 (42.86%), post open radical prostatectomy in 5 (35.71%) and post open prostatectomy in 1 case (7.14%). The average length of the stricture was 2.08 cm. The only parameter analyzed with significant difference between the groups was the vessels (significant difference between the control group: 5.11 ± 1.98% and stricture group: 3.57 ± 1.32%, P = .0460). The quantitative analysis of collagen (Control Group: 10.63 ± 5.37% and Stricture Group: 10.83 ± 4.55%, P = .9296); diameter of BSM muscle fibers (Control Group: 41.71 ± 14.63 µm and Stricture Group: 40.11 ± 8.59 µm, P = .76 and elastic system fibers (Control Group; 3.83 ± 1.54% and Stricture Group: 5.43 ± 2.90%, P = .2601) showed no significant difference. CONCLUSIONS: Histologic analysis showed a significant decrease of the BSM vessels in urethral stricture, without changes in elastic fibers, collagen, nerves, and muscle fiber diameter. These findings show that the bulbar urethral stricture causes minimal alterations in the structure of the BSM.


Assuntos
Doenças do Pênis , Pênis , Complicações Pós-Operatórias , Uretra , Estreitamento Uretral , Procedimentos Cirúrgicos Urológicos , Pesos e Medidas Corporais/métodos , Brasil , Constrição Patológica , Correlação de Dados , Técnicas de Imagem por Elasticidade/métodos , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Doenças do Pênis/diagnóstico , Doenças do Pênis/etiologia , Pênis/patologia , Pênis/cirurgia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/patologia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Uretra/irrigação sanguínea , Uretra/inervação , Uretra/patologia , Uretra/cirurgia , Estreitamento Uretral/diagnóstico , Estreitamento Uretral/epidemiologia , Estreitamento Uretral/etiologia , Estreitamento Uretral/patologia , Procedimentos Cirúrgicos Urológicos/efeitos adversos , Procedimentos Cirúrgicos Urológicos/métodos
5.
Int Braz J Urol ; 46(2): 152-157, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31961620

RESUMO

OBJECTIVE: To present the evolution and the recent data on the etiology, diagnosis, management and outcomes of penile fracture (PF) with concomitant urethral injury. MATERIALS AND METHODS: We searched the Pubmed database between 1998 and 2019 using the following key words: "penile fracture", "fracture of penis", "trauma to penis", "rupture of corpora cavernosa", "urethral injury", "urethral rupture" and "urethral reconstruction". RESULTS: The incidence of urethral lesion in patients with PF varies by geographic region and etiology. Blood in the meatus, hematuria and voiding symptoms are highly indicative of urethral rupture. The diagnosis of PF is eminently clinical and complementary exams are not necessary. The treatment consists of urethral reconstruction and the most common complications found are urethral stenosis and urethrocutaneous fistula. CONCLUSION: PF is an uncommon urological emergency, particularly in cases with urethral involvement. Urethral injury should be suspected in the presence of suggestive clinical signs, and diagnosis is usually clinical. Urgent urethral reconstruction is man-datory and produces satisfactory results with low levels of complications.


Assuntos
Doenças do Pênis , Pênis/lesões , Uretra/lesões , Doenças Uretrais/etiologia , Humanos , Masculino , Doenças do Pênis/diagnóstico , Doenças do Pênis/etiologia , Doenças do Pênis/cirurgia , Pênis/cirurgia , Ruptura/diagnóstico , Ruptura/etiologia , Ruptura/cirurgia , Uretra/cirurgia , Doenças Uretrais/cirurgia
6.
Urology ; 137: 146-151, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31887351

RESUMO

OBJECTIVE: To explore a series of classic bladder exstrophy (CBE) cases referred to the authors' institution where primary closure with penile disassembly epispadias repair was complicated by penile injury. The penile disassembly technique is frequently combined with bladder closure in patients with CBE undergoing the complete primary repair of exstrophy (CPRE). Penile disassembly has been posited as a risk for penile injury by ischemic mechanisms. METHODS: A prospectively-maintained institutional database of 1337 exstrophy-epispadias complex patients was reviewed for CPRE cases referred to the authors' institution, and those with injury to the penis were identified. The location, extent of injury, and subsequent management is reported. RESULTS: One hundred and thirteen male CBE patients were referred after prior CPRE. Twenty-six (20%) were identified with penile loss and reviewed. Eighty-one percent were closed in the neonatal period, and 54% had a pelvic osteotomy. Median follow-up time was 9.9 years (range 0.6-21.3). Of 26 patients with penile loss, 77% had unilateral loss and in 23% had bilateral loss involving the glans and/or one or both corpora cavernosa. Three patients were successfully managed with myocutaneous neophalloplasty. CONCLUSION: Complete penile disassembly during bladder exstrophy closure may lead to penile injury. This major complication questions the continued application of complete penile disassembly in the reconstruction of bladder exstrophy.


Assuntos
Extrofia Vesical/cirurgia , Epispadia/cirurgia , Complicações Intraoperatórias , Doenças do Pênis , Pênis , Procedimentos Cirúrgicos Urológicos , Atrofia , Criança , Humanos , Recém-Nascido , Complicações Intraoperatórias/diagnóstico , Complicações Intraoperatórias/cirurgia , Masculino , Avaliação de Processos e Resultados em Cuidados de Saúde , Doenças do Pênis/diagnóstico , Doenças do Pênis/etiologia , Doenças do Pênis/cirurgia , Pênis/irrigação sanguínea , Pênis/lesões , Pênis/patologia , Pênis/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Reoperação/métodos , Fatores de Risco , Procedimentos Cirúrgicos Urológicos/efeitos adversos , Procedimentos Cirúrgicos Urológicos/métodos , Adulto Jovem
7.
Ann R Coll Surg Engl ; 102(2): e36-e38, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31530167

RESUMO

Penile calciphylaxis or calcific uremic arteriolopathy is a rare urological condition often associated with patients undergoing renal dialysis for end-stage renal disease. The majority of cases are associated with systemic calciphylaxis. The pathophysiology, diagnosis and management of penile calciphylaxis as an individual entity has brought little attention. The rates of comorbidity and mortality of these patients are often particularly high. Early diagnosis and a multidisciplinary approach are therefore essential. We report a case of penile calciphylaxis in a 59-year-old man with end-stage renal failure on haemodialysis who was successfully managed conservatively.


Assuntos
Angioplastia/métodos , Calciofilaxia/terapia , Tratamento Conservador/métodos , Doenças do Pênis/terapia , Inibidores da Agregação de Plaquetas/uso terapêutico , Bandagens , Calciofilaxia/diagnóstico , Calciofilaxia/etiologia , Artéria Femoral/cirurgia , Humanos , Falência Renal Crônica/complicações , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Doenças do Pênis/diagnóstico , Doenças do Pênis/etiologia , Pênis/irrigação sanguínea , Pênis/patologia , Diálise Renal/efeitos adversos , Resultado do Tratamento
9.
J Sex Med ; 16(12): 2011-2017, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31668731

RESUMO

INTRODUCTION: Acellular dermal matrix (ADM) is a common filler used widely in clinical practice to increase penile girth for cosmetic reasons, but there are few studies on its complications. AIM: The aim of this study was to investigate and analyze the complications of penile girth enhancement (PGE) with ADM. METHODS: The medical records of 78 patients who underwent PGE with ADM between June 2016 and January 2019 were retrospectively reviewed. MAIN OUTCOME MEASURE: Related complications and their subsequent management were summarized and analyzed. RESULTS: 78 patients (mean age 31.14 years [21-66 years]) received PGE with ADM. At the 3-month follow-up, the penile circumference was increased by 1.1 (0.5-2.1) cm on average. There were 47 patients with erectile discomfort, 12 with delayed healing, 10 with unobvious augmentation effect, 8 with wound hematoma, 7 with prepuce edema, 4 with wound infection, and 3 patients with skin necrosis of the dorsal side. 7 patients eventually underwent ADM removal. CLINICAL IMPLICATIONS: These adverse complications indicate that ADM should be used with caution for PGE. STRENGTH & LIMITATIONS: This study adds important data, as there are few published reports on the complications of PGE with ADM. However, this study did not compare postoperative complications with ADM to those seen with other filler material. CONCLUSION: Even with standardized surgical methods and rigorous postoperative care, complications of PGE using ADM are severe, which indicates that it is not an ideal or safe method for PGE. Xu T, Zhang G, Bai W, et al. Complications and Management of Penile Girth Enhancement with Acellular Dermal Matrix. J Sex Med 2019;16:2011-2017.


Assuntos
Derme Acelular/efeitos adversos , Doenças do Pênis/etiologia , Pênis/cirurgia , Adulto , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Ereção Peniana , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Adulto Jovem
10.
Urology ; 133: 229-233, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31369750

RESUMO

OBJECTIVE: To determine the prevalence of penile cancer in patients with adult acquired buried penis (AABP). Penile cancer is a rare but aggressive cancer. Several case reports have recently been published that indicate that AABP may increase the risk of penile cancer. MATERIALS AND METHODS: A retrospective review was conducted of adults diagnosed with AABP and penile cancer between January, 2008 and December, 2018 seen at a tertiary referral center. Demographics including age, BMI, comorbidities, etiology of AABP, smoking history, circumcision status, and premalignant lesions (condyloma, lichen sclerosus [LS] carcinoma in situ [CIS]) were recorded. For patients with penile cancer, AJCC staging, grade, TNM staging and treatments were recorded. Basic descriptive statistics were performed for the overall cohort. We used Chi-square tests and Fisher exact tests to compare differences between patients with benign pathology and patients with malignant or pre-malignant pathology. RESULTS: We identified 150 patients with the diagnosis of AABP. The prevalence of penile squamous cell carcinoma was 7%. There was a 35% rate of premalignant lesions. This study is limited by its retrospective and single-institution nature. CONCLUSION: AABP is a condition that incorporates multiple risk factors for penile cancer. The prevalence of penile cancer appears to be higher in patients with AABP; however, more data are needed to confirm these initial findings. Patients with AABP should be counseled on these risks and should be considered for buried penis repair if a physical examination cannot be performed.


Assuntos
Doenças do Pênis/complicações , Neoplasias Penianas/complicações , Neoplasias Penianas/epidemiologia , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Doenças do Pênis/etiologia , Prevalência , Estudos Retrospectivos
11.
Andrologia ; 51(9): e13351, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31264245

RESUMO

Until now, no reliable method is recognised in treating buried penis. This study explored a new method of penile length augmentation using acellular dermal matrix filler in infrapubic space combined with liposuction and penile suspensory release. Patients with "small-sized penis" received penile length augmentation procedure including suprapubic liposuction, penile suspensory ligament release and insertion of folded acellular dermal matrix between corpora cavernosa and pubis symphysis. Their penile length from tip to skin was measured pre-operatively and post-operatively. The post-operative complications and patients' satisfaction were also recorded. Fifteen adult male patients were included with the mean age of 33.2 ± 4.6 years old and BMI of 28.9 ± 5.3 kg/m2 . The average amount of liposuction was 430 ± 90.0 ml. The average penile length measured pre-operatively and post-operatively (on table and 3 months afterwards) was 3.0 ± 1.3 cm, 7.3 ± 2.1 cm and 5.4 ± 1.8 cm. The penile length has significantly increased by 4.3 ± 1.6 cm (on table) and 2.4 ± 0.8 cm (3 months post-operatively; p < 0.05). The post-operative complications included oedema of penis, ecchymosis of lower abdomen and poor wound healing. No patient was dissatisfied with the appearance and function. The new method using acellular dermal matrix combined with liposuction and penile suspensory ligament release is safe and effective. The method could be applied to selected patients with buried penis.


Assuntos
Derme Acelular , Preenchedores Dérmicos/uso terapêutico , Lipectomia/métodos , Doenças do Pênis/cirurgia , Pênis/cirurgia , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Adulto , Estudos de Viabilidade , Humanos , Ligamentos/cirurgia , Lipectomia/efeitos adversos , Masculino , Obesidade/complicações , Obesidade/terapia , Tamanho do Órgão , Satisfação do Paciente , Seleção de Pacientes , Doenças do Pênis/etiologia , Doenças do Pênis/patologia , Pênis/patologia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Resultado do Tratamento , Procedimentos Cirúrgicos Urológicos Masculinos/efeitos adversos
13.
Urology ; 131: e7-e8, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31132425

RESUMO

OBJECTIVE: To define clinical features and surgical management of urethro-cavernosal fistulas (UCF). METHODS: A literature search was performed using PubMed to identify publications with the key word urethro-cavernosal fistula. RESULTS: We herein describe surgical techniques and long-term outcomes for UCF repair. CONCLUSION: UCFs is a rare urological condition with only 9 cases reported to date. UCFs can be diagnosed with careful history, physical examination, and retrograde urethrography. Surgical management includes basic tenets of fistula repair, including adequate mobilization, tension-free but watertight approximation, multilayered closure with nonoverlapping suture lines, and maximal bladder drainage.


Assuntos
Fístula/etiologia , Fístula/cirurgia , Doenças do Pênis/etiologia , Doenças do Pênis/cirurgia , Uretra/lesões , Doenças Uretrais/etiologia , Doenças Uretrais/cirurgia , Fístula Urinária/etiologia , Fístula Urinária/cirurgia , Adulto , Humanos , Masculino , Fatores de Tempo , Procedimentos Cirúrgicos Urológicos Masculinos/métodos
14.
Cir Cir ; 86(1): 77-80, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30951036

RESUMO

Lymphedema is the result of an alteration of the lymphatic drainage, and its most common worldwide cause is filariasis. In our practice usually is associated to neoplasic, inflammatory and granulomatous processes, radiotherapy, hydroelectrolytic disbalances, and idiopathic. It can affect any part of the body, including the penis and scrotum. The genital lymphedema is a rare presentation, it corresponds to 0.6% of lymphedema. However, causes serious functional, social and emotional limitations for the patient. Too often have pain, recurrent infections, sexual dysfunction, cosmetic deformity, sometimes it limits mobility and ambulation. Although there are several treatment options, both medical and surgical, it has not been found ideal for this disease. We present a 43 years old patient with penoscrotal lymphedema due to hidradenitis suppurativa, it limits his normal activity. The patient was referred to our center after unsuccessful medical treatment (doxycycline and clindamycin cycles). Surgical treatment consisted of total excision of the skin and subcutaneous tissue to Buck's fascia. Split thickness skin grafts were used to cover the defect. The result was satisfactory both functionally and aesthetically.


Assuntos
Hidradenite Supurativa/complicações , Linfedema/etiologia , Doenças do Pênis/etiologia , Escroto , Adulto , Doenças dos Genitais Masculinos/etiologia , Doenças dos Genitais Masculinos/cirurgia , Humanos , Linfedema/cirurgia , Masculino , Doenças do Pênis/cirurgia
15.
Urology ; 129: e1, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31009741

RESUMO

Penetrating perineal trauma is an unusual urologic injury. Even less common is a delayed presentation. Herein we present the case of a patient with delayed development of a corporal cutaneous fistula 3 months following perineal trauma.


Assuntos
Fístula Cutânea/etiologia , Fístula/etiologia , Doenças do Pênis/etiologia , Períneo/lesões , Humanos , Masculino , Fatores de Tempo , Adulto Jovem
16.
Urology ; 129: 223-227, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31005654

RESUMO

OBJECTIVE: To evaluate the feasibility and outcomes of full thickness penile skin grafting (FTSG) for phalloplasty during acquired buried penis repair. MATERIALS AND METHODS: A retrospective cohort study of patients undergoing complex genital reconstruction for buried penis between January 2013 and April 2018 was performed. Patients undergoing FTSG were identified. All patients underwent escutcheonectomy, scrotoplasty, and penile skin grafting by a single Urologist (MM) and Plastic surgeon (JS). Escutcheon tissue was used for the FTSG. The primary outcome was graft take and the secondary outcome was recurrence requiring surgical revision. RESULTS: Thirteen patients were identified for inclusion in the study with average age of 43.4 and average BMI of 42. Median (range) follow-up for the cohort was 8 (3-44) months. Surgical indication was lymphedema in 6 (46.2%), morbid obesity in 6 (46.2%), and hidradenitis suppurativa in one (7.7%). Seven required concurrent urethromeatoplasty for meatal stenosis and fossa navicularis strictures. All grafts were successful. Two patients developed postoperative wound infections requiring antibiotics. One patient redeveloped lymphedema of the scrotum and required complete revision surgery although the FTSG remained intact. No patients had reburying of the penis. Minor outpatient surgical revision was performed for 2 patients for scarring and edema of the glans. CONCLUSION: Full thickness skin grafts provide a useful option for penile reconstruction during surgical management of buried penis. Patients had excellent graft acceptance and minimal wound complications. Further research and comparative cohorts are warranted to fully determine the role of FTSG in genital reconstruction.


Assuntos
Obesidade Mórbida/complicações , Doenças do Pênis/cirurgia , Pênis/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Transplante de Pele/métodos , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Adulto , Seguimentos , Humanos , Masculino , Doenças do Pênis/etiologia , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
19.
Dermatol Online J ; 25(2)2019 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-30865408

RESUMO

Calcific uremic arteriolopathy (CUA) or calciphylaxis is a syndrome characterized by calcification of vessels located in the dermis and adipose tissue. It commonly occurs in patients with diabetes mellitus, hypertension, and end-stage renal disease. Clinical presentation generally begins with severe pain, followed by the presence of liveloid or purpuric plaques. Later the formation necrotic ulcers occur. This condition is associated with a poor prognosis, with a high rate of mortality within months of the diagnosis. Penile involvement is an uncommon but severe manifestation. We present an 81-year-old man with a history of diabetes mellitus, hypertension, and end-stage renal disease with a one-month evolution of painful necrotic ulcers on his glans penis. He was diagnosed with CUA. Owing to infection complicated by sepsis; penectomy was performed. Unfortunately, the patient died of myocardial infarction during his hospitalization.


Assuntos
Calciofilaxia/complicações , Calciofilaxia/diagnóstico , Doenças do Pênis/etiologia , Dermatopatias Vasculares/complicações , Úlcera Cutânea/etiologia , Pele/patologia , Idoso de 80 Anos ou mais , Humanos , Falência Renal Crônica/complicações , Masculino , Necrose/etiologia , Doenças do Pênis/patologia , Dermatopatias Vasculares/diagnóstico , Uremia/complicações
20.
Int Braz J Urol ; 45(2): 384-391, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30785705

RESUMO

PURPOSE: To study the effect of penile constriction devices used on a large series of patients who presented at our emergency facility. We explored treatment options to prevent a wide range of vascular and mechanical injuries occurring due to penile entrapment. MATERIALS AND METHODS: Between January 2001 and March 2016, 26 patients with penile entrapment were admitted to our facility and prospectively evaluated. RESULTS: The time that elapsed from penile constrictor application to hospital admission varied from 10 hours to 6 weeks (mean: 22.8 hours). Non-metallic devices were used by 18 patients (66.6%) while the other nine (33.4%) had used metallic objects. Acute urinary retention was present in six (23%) patients, of whom four (66.6%) underwent percutaneous surgical cystotomy and two (33.4%) underwent simple bladder catheterization. The main reason for penile constrictor placement was erectile dysfunction, accounting for 15 (55.5%) cases. Autoerotic intention, psychiatric disorders, and sexual violence were responsible in five (18.5%), five (18.5%), and two (7.4%) cases, respectively. The mean hospital stay was 18 hours (range, 6 hours to 3 weeks). CONCLUSION: Penile strangulation treatment must be immediate through the extraction of the foreign body, avoiding vascular impairments that can lead to serious complications. Most patients present with low-grade injuries and use penile constrictors due to erectile dysfunction. Removal of constrictor device can be challenging. The use of specific tools for achieving penile release from constrictors is a fast, safe and effective method. Patients with urinary retention may require urinary diversion.


Assuntos
Corpos Estranhos/terapia , Doenças do Pênis/etiologia , Pênis/lesões , Comportamento Autodestrutivo/terapia , Adolescente , Adulto , Idoso , Amputação , Constrição Patológica , Corpos Estranhos/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Doenças do Pênis/patologia , Pênis/patologia , Pênis/cirurgia , Comportamento Autodestrutivo/complicações , Comportamento Autodestrutivo/cirurgia , Comportamento Sexual , Adulto Jovem
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