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1.
Arch Esp Urol ; 73(2): 113-118, 2020 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-32124841

RESUMO

INTRODUCTION: Congenital penile curvature (PCC) is a disorder caused by an alteration in the embryonic development of the urethra and the corporacavernosa, which causes difficulty in penetration, requiring surgical correction when inter course is impossible. OBJECTIVE: To analyze the results of the surgical treatment of the IPC by means of rotation of the corpora cavernosa (RCC) described and modified by Shaeer. PATIENTS AND METHODS: Ten patients diagnosed with PCC with impossibility to inter course, were operated in a period of 36 months. Prior to the intervention,we applied the IIEF-5 questionnaire, measured the length of the penis and the angle of curvature throughself-photographs in three projections. By subcoronal approach,we perform denudation of the penis. On both sides of the urethra we incised Buck's fascia and released the neurovascular bundle from the ventral to the dorsal side. We generate an artificial erection evidencing the curvature. On the dorsal aspect of both corpora cavernosa, we made two incisions in the external longitudinal layer of the tunica albuginea. We sutured the internal and external edges of both incisions together with a 4/0 non-reabsorbable monofilament continuous suture, checking the correction of the curvature by means of an artificial erection. The patients were discharged the day after the intervention. The penile length and curvature were determined in the sixth month, and the IIEF-5 questionnaire. For the comparison of means we used the Mann-Whitney U test.  RESULTS: The mean age was 26.8 years. The average follow-up was 20.7 months (12-31) and the median was 24. Before the intervention, the average curvature was 68.5° (50-90°); the average length 14.2 cm (10-18) and the IIEF-5 of 21. After surgery, the average length was 13.7 cm, the residual curvature the IIEF-5 of 25. There were no statistically significant differences between pre and postoperative penile length,(p=0.08). Nine patients assured that they would under go the same intervention again. CONCLUSIONS: RCC is an effective therapeutic alternative to the techniques of plication or lengthening of the tunica albuginea for the treatment of PCC, main tainingits long-term results.


Assuntos
Doenças do Pênis , Ereção Peniana , Adulto , Feminino , Humanos , Masculino , Doenças do Pênis/terapia , Rotação , Uretra , Útero
2.
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
3.
Emerg Med Clin North Am ; 37(4): 583-592, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31563196

RESUMO

The penis is an organ of enormous importance and is vital for both excretory and reproductive function. The anatomy of the penis itself can lead to many of its emergent conditions and a thorough understanding of the anatomy and physiology is central to recognition of these conditions. Physicians should have a high clinical suspicion for penile emergencies and perform a thorough physical examination to make a proper diagnosis. Prompt diagnosis and proper management are essential for minimizing dysfunction of this vital organ.


Assuntos
Doenças do Pênis/diagnóstico , Emergências , Humanos , Masculino , Parafimose/diagnóstico , Parafimose/terapia , Doenças do Pênis/terapia , Pênis/lesões , Fimose/diagnóstico , Fimose/terapia , Priapismo/diagnóstico , Priapismo/terapia
4.
Pediatr Dermatol ; 36(3): 391-392, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30828865

RESUMO

Hookworm-related cutaneous larva migrans is an infestation of the skin caused by nematodes. Involvement of genitals is extremely rare. We report the case of a child with this infestation on the penis who cleared rapidly with topical ivermectin.


Assuntos
Infecções por Uncinaria/diagnóstico , Infecções por Uncinaria/terapia , Larva Migrans/diagnóstico , Larva Migrans/terapia , Doenças do Pênis/diagnóstico , Doenças do Pênis/parasitologia , Animais , Pré-Escolar , Humanos , Masculino , Doenças do Pênis/terapia
5.
Bol. pediatr ; 59(247): 15-18, 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-183163

RESUMO

La patología del pene y la vulvar en niñas es un motivo de consulta muy frecuente en urología pediátrica y suele ser origen hasta de consultas por problemas que no lo son, como las adherencias balanoprepuciales, la fimosis -fisiológica en el recién nacido y lactante- o el tamaño, que siempre preocupa por defecto. Describimos los principales procesos que solemos encontrar en consulta tanto de urología pediátrica como en atención primaria


The pathology of the penis as well as the vaginal pathology in girls are a very frequent presentation in pediatric Urology and usually comes from consultations for problems that are not, such as balanopreputial adhesions, phimosis, or the size of the penis that always worries about. We will describe the main processes that we find in consultation urology and primary care


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Doenças do Pênis/terapia , Doenças do Pênis/classificação , Doenças da Vulva/classificação , Doenças da Vulva/terapia , Fimose/cirurgia , Balanite (Inflamação)/terapia , Pênis/anormalidades , Hímen/anormalidades
6.
Zhonghua Nan Ke Xue ; 24(8): 740-743, 2018 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-30173436

RESUMO

Prepuce diseases are very common conditions in urology and andrology, and quite a few cases need to be treated by surgery. Preputial edema is a common complication after prepuce surgery, with a higher incidence rate in children than in adults. Although preputial edema is just moderate symptom and does not affect urination, it worries or even distresses the patient both physically and psychologically. In recent years, rapid achievements have been made in prepuce surgery, as in prepuce circumcision, preputial neoplasm excision, and penile degloving repair, which can now be accomplished with shorter time and higher efficiency. Despite constant improvement in the methods and techniques for prepuce surgery, postoperative edema remains difficult to be totally prevented. Pathogenic factors for postoperative preputial edema vary from disturbance of blood circulation to inflammatory factor-induced change in capillary permeability, lymphatic circulation disorders, and neurogenic edema. Elimination of the pathogenic factors and precautionary measures after surgery count significantly to the prevention and management of postoperative preputial edema. This review focuses on the pathogenesis, prevention and treatment of edema after prepuce surgery.


Assuntos
Edema/etiologia , Edema/terapia , Prepúcio do Pênis/cirurgia , Doenças do Pênis/etiologia , Doenças do Pênis/terapia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/terapia , Adulto , Andrologia , Criança , Circuncisão Masculina , Edema/prevenção & controle , Humanos , Masculino , Doenças do Pênis/prevenção & controle , Complicações Pós-Operatórias/prevenção & controle , Urologia
8.
J Pediatr Urol ; 14(5): 471-475, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29980391

RESUMO

Cicatrix formation, which can form after neonatal circumcision to entrap the glans penis, presents a therapeutic challenge. Previous studies in the literature have described either using a topical steroid cream or stretching of the scar tissue with an instrument but not a combination of both modalities. In our experience, monotherapy has resulted in significant recurrence and/or need for further treatment. We present our successful experience that combines cicatrix stretching with a hemostat using local anesthesia in the office followed by several weeks of topical steroids with a minority of patients needing any additional therapy.


Assuntos
Betametasona/administração & dosagem , Cicatriz/etiologia , Cicatriz/terapia , Circuncisão Masculina/efeitos adversos , Glucocorticoides/administração & dosagem , Doenças do Pênis/etiologia , Doenças do Pênis/terapia , Modalidades de Fisioterapia , Pré-Escolar , Terapia Combinada , Humanos , Lactente , Recém-Nascido , Masculino , Visita a Consultório Médico , Estudos Retrospectivos
9.
Obes Surg ; 28(10): 3348-3351, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30030726

RESUMO

BACKGROUND: Urethral catheterization is a common procedure in daily medical practice and most medical staff are trained for the procedure. Buried penis in morbid obese patients with scrotal edema makes urethral catheterization challenging and sometimes fails. Different methods have been published to overcome the urethral catheterization difficulties in buried penis of obese patients. METHODS: A 51-year-old morbidly obese male patient presented with urine retention. On inspection of his external genitalia, there was no penile shaft seen and the penis was buried within the cavity between pubic fat and severely edematous scrotum. To overcome the urethral catheterization difficulties, we used a laryngoscope which helps in visualization of the glans and external urethral meatus. The figures demonstrate the technique used. RESULTS: Successful urethral catheterization under direct visualization was achieved. CONCLUSIONS: The technique is well tolerated by patients and increases the overall likelihood of successful urethral catheterization.


Assuntos
Obesidade Mórbida/complicações , Obesidade Mórbida/terapia , Doenças do Pênis/terapia , Pênis/patologia , Cateterismo Urinário/métodos , Retenção Urinária/terapia , Doenças dos Genitais Masculinos/complicações , Doenças dos Genitais Masculinos/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/patologia , Doenças do Pênis/complicações , Pênis/anormalidades , Retenção Urinária/complicações
10.
BMC Endocr Disord ; 18(1): 49, 2018 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-30053902

RESUMO

BACKGROUND: Glycaemic control is one of the most effective strategies for the treatment of diabetes-related erectile dysfunction (DMED). Compared to conventional anti-diabetic drugs and insulin, islet transplantation is more effective in the treatment of diabetic complications. The aim of this study was to investigate the efficacy of islet transplantation for reversing advanced-stage DMED in rats and to observe its influence on corpus cavernosum fibrosis. METHODS: Wistar rats were intraperitoneally injected with streptozotocin to establish a diabetes model. After 12 weeks, the rats were divided into 4 groups: diabetic, insulin, islet transplantation, and normal control. Following supplementation, the changes in blood glucose and weight were determined sequentially. Penile erectile function was evaluated by apomorphine experiments in the fourth week, and the penile corpus cavernosum was also collected for assessment by Masson staining, immunohistochemistry and Western blot to observe the spongy tissue and the related cellular changes at the molecular level. RESULTS: Islet transplantation significantly ameliorated penile erectile function in advanced-stage diabetic rats. The ratio of corpus cavernosum smooth muscle cells to fibroblasts and the expression level of α-SMA in the islet transplantation group were significantly higher than those in the diabetic and insulin groups. In addition, the expression levels of TGF-ß1, p-Samd2, and connective tissue growth factor (CTGF) in the islet transplantation and insulin groups were much lower than those in the diabetic group, while those in the islet transplantation group were significantly lower than those in the insulin group. CONCLUSIONS: Our findings strongly suggest that islet transplantation can promote the regeneration of smooth muscle cells and ameliorate corpus cavernosum fibrosis to restore its normal structure in advanced-stage diabetic rats. The possible mechanism of ameliorating corpus cavernosum fibrosis by islet transplantation may be associated with improvement of the hyperglycaemic status in diabetic rats, thereby inhibiting the TGF-ß1/Samd2/CTGF pathway.


Assuntos
Diabetes Mellitus Experimental/terapia , Diabetes Mellitus Tipo 1/terapia , Transplante das Ilhotas Pancreáticas , Doenças do Pênis/terapia , Pênis/patologia , Animais , Complicações do Diabetes/terapia , Diabetes Mellitus Experimental/induzido quimicamente , Diabetes Mellitus Experimental/complicações , Diabetes Mellitus Tipo 1/induzido quimicamente , Diabetes Mellitus Tipo 1/complicações , Disfunção Erétil/etiologia , Disfunção Erétil/terapia , Fibrose/etiologia , Fibrose/terapia , Masculino , Doenças do Pênis/etiologia , Ratos , Ratos Wistar , Estreptozocina
11.
Am Fam Physician ; 97(2): 102-110, 2018 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-29365226

RESUMO

Noninfectious penile lesions are classified by clinical presentation as papulosquamous (e.g., psoriasis), inflammatory (e.g., lichen sclerosus, lichen nitidus, lichen planus), vascular (e.g., angiokeratomas), or neoplastic (e.g., carcinoma in situ, invasive squamous cell carcinoma). Psoriasis presents as red or salmon-colored plaques with overlying silvery scales, often with extragenital cutaneous lesions. Lichen sclerosus presents as a phimotic, hypopigmented prepuce or glans penis with a cellophane-like texture. Lichen nitidus usually produces asymptomatic pinhead-sized, hypopigmented papules. The lesions of lichen planus are pruritic, violaceous, polygonal papules that are typically systemic. Angiokeratomas are typically asymptomatic, well-circumscribed, red or blue papules, often with annular or figurate configurations. Carcinoma in situ should be suspected if there are velvety red or keratotic plaques on the glans penis or prepuce, whereas invasive squamous cell carcinoma presents as a painless lump, ulcer, or fungating mass. Some benign lesions, such as psoriasis and lichen planus, may mimic carcinoma in situ or invasive squamous cell carcinoma. Biopsy is indicated if the diagnosis is in doubt or neoplasm cannot be excluded. The management of benign noninfectious penile lesions usually involves observation, topical corticosteroids, or topical calcineurin inhibitors. Neoplastic lesions generally warrant organ-sparing surgery.


Assuntos
Doenças do Pênis/diagnóstico , Pênis/patologia , Diagnóstico Diferencial , Humanos , Masculino , Doenças do Pênis/terapia
12.
Am J Mens Health ; 12(3): 624-627, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-27316776

RESUMO

Pearly penile papules (PPP) are common, benign lesions that appear on the corona of the glans penis during adolescence or early adulthood. Despite their benign nature, PPP are known to cause significant distress because of their resemblance to sexually transmitted infections such as condyloma acuminata. PPP can be clinically distinguished based on their uniform, dome-shaped papules that orient in one to two rows around the glans penis. There is no association between PPP and sexually transmitted infections, and treatment is generally reserved for patients with excessive concern. Physicians should be aware of this distinction in order to adequately reassure anxious patients. For patients who still desire treatment after counseling, cryotherapy and laser therapy represent two reliable treatment options with low rates of recurrence.


Assuntos
Doenças do Pênis/diagnóstico , Doenças do Pênis/terapia , Pênis/fisiopatologia , Adolescente , Humanos , Masculino , Doenças Sexualmente Transmissíveis/diagnóstico , Doenças Sexualmente Transmissíveis/terapia , Adulto Jovem
14.
Urology ; 104: 102-109, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-28347795

RESUMO

OBJECTIVE: To evaluate the outcomes in men undergoing collagenase Clostridium histolyticum (CCH) with concurrent penile traction therapy (PTT) for the treatment of Peyronie disease (PD). MATERIALS AND METHODS: We identified patients treated with CCH between March 2014 and July 2016. Patients were recommended to perform modeling and PTT between injection series. A final curve assessment was performed after patients completed CCH. A prospective database was maintained, including patient-reported frequency and duration of PTT. Statistical analysis was performed to evaluate outcomes based on use and duration of PTT. RESULTS: A total of 51 patients completed CCH and had complete objective data available for analysis. Mean (standard deviation [SD]) baseline curvature was 66.7 (25.0) degrees, and mean (SD) improvement post CCH was 20.9 (17.3) degrees (P < .0001). Thirty-five (69%) men reported daily PTT for a mean (SD) of 9.8 (6.3) hours per week. No significant difference was identified in the degree of curve improvement based on frequency or duration of PTT (P = .40). Similarly, no associations between PTT and functional outcomes including intercourse restoration and surgery prevention were identified. Stretched penile length increased nonsignificantly by a mean (SD) of +0.4 (1.5) cm in the PTT group, compared with -0.35 (1.5) in the non-PTT group (P = .21). CONCLUSION: The current series represents a "true-to-life" experience, wherein utilization patterns, attrition, and compliance issues are relevant factors impacting efficacy. PTT use with the Andropenis declined in both frequency and duration with subsequent injection series, and there was no significant difference in curve improvement or stretched penile length with a mean 10 hours of weekly concurrent PTT.


Assuntos
Clostridium histolyticum , Colagenase Microbiana/uso terapêutico , Doenças do Pênis/terapia , Induração Peniana/terapia , Tração/métodos , Idoso , Estudos de Coortes , Terapia Combinada , Bases de Dados Factuais , Humanos , Injeções Intralesionais , Masculino , Colagenase Microbiana/efeitos adversos , Pessoa de Meia-Idade , Satisfação do Paciente , Doenças do Pênis/induzido quimicamente , Pênis/fisiopatologia , Estudos Prospectivos , Resultado do Tratamento
15.
Int Urol Nephrol ; 49(4): 573-580, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28161837

RESUMO

PURPOSE: Lichen sclerosus (LS) is a chronic inflammatory skin condition that frequently involves the anogenital region. Ongoing research is focused on finding more effective treatments for tissue repair and reducing symptoms. The aim of this study is to evaluate the effectiveness of platelet-rich plasma (PRP) local injections in penile LS. METHODS: Forty-five male patients affected by penile LS underwent injections of autologous PRP in the affected skin areas. Age at diagnosis and at first treatment, number of treatments, clinical conditions (phimosis, splitting, inflammation, synechiae, meatus stenosis), symptoms (pain, burning, itching), and functional impairment were considered. Treatment efficacy was also evaluated through the Investigator's Global Assessment (IGA) on a six-point Likert scale and the Dermatology Life Quality Index (DLQI). RESULTS: The patient age at LS diagnosis was 36.20 ± 9.19 years, while the mean age at the first PRP treatment was 42.96 ± 11.32 years (p < 0.001). The number of treatments/patient ranged from 2 to 10. The follow-up was 17.60 ± 5.63 months. After PRP injections, it was observed in all patients a significant improvement in clinical conditions, with reduction/disappearance of symptoms. Topical steroid therapy, interrupted before PRP treatment, was not restarted by any patient. Only one patient underwent a later circumcision procedure. Both IGA scale and DLQI score showed a significant difference (p < 0.001) before and after PRP treatment. CONCLUSIONS: PRP treatment in penile LS seems to be helpful to regenerate scarring, reduce symptoms, and improve patient quality of life. Further studies are necessary to evaluate long-term results.


Assuntos
Líquen Escleroso e Atrófico/terapia , Doenças do Pênis/terapia , Plasma Rico em Plaquetas , Qualidade de Vida , Cicatrização , Adolescente , Adulto , Dermatite/complicações , Seguimentos , Humanos , Injeções Intralesionais , Líquen Escleroso e Atrófico/complicações , Masculino , Pessoa de Meia-Idade , Fimose/complicações , Estudos Retrospectivos , Índice de Gravidade de Doença , Avaliação de Sintomas , Transplante Autólogo , Adulto Jovem
17.
Sex Med Rev ; 5(2): 222-235, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28041853

RESUMO

INTRODUCTION: Stem cells for sexual disorders are steadily being introduced into clinical trials. Two conditions of importance are the main target for this line of treatment, especially when regarding the wide array of translational and basic science highlighting the potential advantages of regenerative therapy: erectile dysfunction (ED) and more recently Peyronie disease (PD). Cellular therapy offers a treatment modality that might reverse disease progression. It would be used in a curative setting, in contrast to other pharmaceutical agents that are currently available. AIM: To review basic preclinical studies and recent clinical trials of stem cells on ED and PD. METHODS: A search of the medical literature for the following terms was performed using PubMed: stem cells, cellular therapy, erectile dysfunction, Peyronie's disease, and clinical trial. MAIN OUTCOME MEASURES: A non-systematic narrative review and critical reflection on preclinical and clinical studies administering stem cells for ED and PD in animal models and human subjects. RESULTS: Numerous studies have confirmed the beneficial functional effects of stem cell injection in established animal models on ED and PD. Various stem cell types have been adopted, from embryonic to adult mesenchymal cell types. Each cell type offers distinctive advantages and disadvantages. Diverse administrations of stem cells were investigated, with insignificant variability in the ultimate results. Stem cells appear to have a pronounced paracrine effect, rather than the classic engraftment and differentiation hypothesis. Phase 1 clinical trials using stem cells have not reported any severe adverse events in animals. However, these results cannot be extrapolated to draw any conclusions about efficacy in human patients. CONCLUSION: Stem cells have an established efficacy in preclinical studies and early clinical trials. Studies are currently being published demonstrating the safety of intrapenile injection of autologous bone marrow- and adipose tissue-derived stem cells. Soebadi MA, Milenkovic U, Weyne E, et al. Stem Cells in Male Sexual Dysfunction: Are We Getting Somewhere? Sex Med Rev 2017;5:222-235.


Assuntos
Disfunção Erétil/terapia , Doenças do Pênis/terapia , Transplante de Células-Tronco , Envelhecimento , Animais , Ensaios Clínicos como Assunto , Complicações do Diabetes/fisiopatologia , Disfunção Erétil/fisiopatologia , Humanos , Masculino , Síndrome Metabólica/fisiopatologia , Doenças do Pênis/fisiopatologia , Prostatectomia
18.
Sex Med Rev ; 5(2): 211-221, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-27544298

RESUMO

INTRODUCTION: Peyronie's disease (PD) is a wound-healing disorder of the tunica albuginea often associated with penile deformity. Less commonly, patients with PD might display atypical presentations such as ventral curvature, hourglass deformity, significantly shortened penis, and/or multiplanar curvature. AIM: To review the available literature on the prevalence of and management options for atypical PD. METHODS: A literature review was performed through PubMed from 1982 through 2016 regarding atypical PD. Keywords used for the search were Peyronie's disease, atypical Peyronie's disease, ventral Peyronie's disease, ventral plaque, hourglass deformity, penile indentation, penile notching, short penis, shortened penis, shrunken penis, biplanar curvature, and multiplanar curvature. MAIN OUTCOME MEASURES: To assess the various surgical and non-surgical techniques used for the management of atypical PD. RESULTS: Collagenase Clostridium histolyticum is contraindicated for patients with ventral plaques and/or hourglass deformities. Patients with maintained erectile function and ventral PD plaques are best treated with intralesional injections of interferon alpha-2b or tunica plication. Patients with maintained erectile function with PD associated with hourglass deformity and/or multiplanar curvature are best treated with plaque incision or partial excision and grafting. Patients with a shortened penis could attempt conservative measures such as penile traction therapy and medical management. When erectile function is compromised, insertion of an inflatable penile prosthesis with or without ancillary straightening procedures should be recommended. Lengthening procedures can be attempted in very special circumstances by expert surgeons. CONCLUSION: There is a paucity of data regarding atypical PD. Ventral plaques can be treated with intralesional injections or surgery, hourglass deformity and multiplanar curvatures are best managed surgically, and a shortened penis should be treated with non-invasive approaches. When concomitant erectile dysfunction is present, insertion of an inflatable penile prosthesis is recommended. Caution should be advised before undergoing ancillary penile lengthening maneuvers owing to the potential for serious complications. Yafi FA, Hatzichristodoulou G, DeLay KJ, Hellstrom WJG. Review of Management Options for Patients With Atypical Peyronie's Disease. Sex Med Rev 2017;5:211-221.


Assuntos
Doenças do Pênis/terapia , Cicatrização , Humanos , Masculino , Doenças do Pênis/fisiopatologia
20.
Urology ; 101: 99-103, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27789304

RESUMO

OBJECTIVE: To clarify the long-term outcome of median raphe cysts (MRCs) and parameatal urethral cysts (PUCs) in males, the clinical, anatomical, and histological findings of these cysts are described, along with treatment and follow-up. MATERIALS AND METHODS: Forty-six children diagnosed with PUCs and 23 children with MRCs at our institute during the past 14 years were retrospectively reviewed. The indications for surgery were symptoms or family preference. Telephone interviews of the parents or patients were conducted to ascertain the current condition of the cyst at a median age of 12.2 years. Fifty-nine children (85.5%) agreed to the telephone interview. RESULTS: Median age at first presentation was 41 months; 81% of children were asymptomatic. The main symptoms were voiding symptoms with PUCs and pain of the ruptured cyst in MRCs. A total of 41 (59%) children underwent complete excision at a median age of 58 months. No recurrences were encountered with surgery in all children. Of 28 children managed nonoperatively, 22 agreed to an interview. All children (95.5%), except for 1, remained free of symptoms. Six cysts showed spontaneous resolution at a median age of 24 months, and 15 improved or stabilized. No one was concerned about the genital appearance and opted for surgical intervention. CONCLUSION: Complete excision of the cyst is a durable procedure without recurrences in childhood. In the nonoperative management, several cysts may continue to be free of symptoms during childhood, and some cysts may resolve spontaneously during the first 2 years.


Assuntos
Anormalidades Múltiplas , Tratamento Conservador/métodos , Cistos/congênito , Previsões , Doenças do Pênis/congênito , Doenças Uretrais/congênito , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Pré-Escolar , Cistos/epidemiologia , Cistos/terapia , Gerenciamento Clínico , Seguimentos , Humanos , Incidência , Lactente , Recém-Nascido , Japão/epidemiologia , Masculino , Doenças do Pênis/epidemiologia , Doenças do Pênis/terapia , Estudos Retrospectivos , Resultado do Tratamento , Doenças Uretrais/epidemiologia , Doenças Uretrais/terapia
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