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1.
Med Sci Monit ; 26: e927491, 2020 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-33341820

RESUMO

BACKGROUND We explored the effect of asthma on erectile dysfunction (ED) and the effects of the expression of related proteins. MATERIAL AND METHODS We used a bioinformatics database to predict the targets and pathways associated with asthma and ED. The rat model of asthma was caused by an ovalbumin solution. The number of erections in 30 min was observed by injecting apomorphine into the neck at a dose of 100 µg/kg. Rats with no erection were regarded as the model group (group B), and the previous random 6 normal rats were regarded as the control group (group A). We used hematoxylin and eosin (HE) to compare the tissue structure of the cavernous body of the penis. Real-time quantitative polymerase chain reaction (RT-qPCR) and western blotting were used to determine the expression levels of insulin (INS), interleukin 6 (IL6), albumin (ALB), tumor necrosis factor (TNF), and vascular endothelial growth factor A (VEGFA) at both the protein and messenger ribonucleic acid (mRNA) levels. RESULTS HE staining results show that compared with group A, the blood sinus distribution of the cavernous body in group B was disordered, and the density of endothelial cells and smooth muscle cells decreased significantly. Western blotting and RT-qPCR showed that the levels of IL6, TNF, and VEGFA protein and mRNA in group B were significantly higher (P<0.05) than those in group A. The levels of INS and ALB were not significantly different between the 2 groups. CONCLUSIONS On the basis of the results, we found that asthma caused pathological changes in the penises of rats and led to reduced erectile function via changes in the expression of IL6, TNF, and VEGFA proteins.


Assuntos
Asma , Disfunção Erétil , Interleucina-6/metabolismo , Pênis , Fator de Necrose Tumoral alfa/metabolismo , Fatores de Crescimento do Endotélio Vascular/metabolismo , Animais , Asma/metabolismo , Asma/fisiopatologia , Bioensaio , Biologia Computacional/métodos , Modelos Animais de Doenças , Disfunção Erétil/etiologia , Disfunção Erétil/metabolismo , Masculino , Pênis/metabolismo , Pênis/fisiopatologia , Ratos
2.
Zootaxa ; 4894(3): zootaxa.4894.3.9, 2020 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-33311076

RESUMO

A new species of Notacanthurus Tshernova, 1974 is described based on larvae from India. Notacanthurus pange Vasanth, Selvakumar Subramanian sp. nov. can be distinguished from all known species of Notacanthurus by the following combination of characters: (i) gill lamellae 5-6 with accessory lobe; (ii) dorsal surface of femora with scattered spatulate setae (iii) male genitalia having penis lobes fused, 'V' shaped apically blunt with me-dian pair of spine-like titillators subapically and mesally; (iv) labrum with anterior portion straight and laterally curved; and (v) lingua of hypopharynx apically broad and convex. The distribution map of the new species is also provided.


Assuntos
Ephemeroptera , Distribuição Animal , Animais , Brânquias , Índia , Larva , Masculino , Pênis
3.
Urologiia ; (6): 70-74, 2020 Dec.
Artigo em Russo | MEDLINE | ID: mdl-33377682

RESUMO

INTRODUCTION: Erectile dysfunction (ED) is a condition characterized by the inability to achieve or maintain an erection sufficient for sexual intercourse. The prevalence of ED ranges from 6% to 64% depending on age. Obesity is one of the factors leading to ED, which is widespread in the world. Men with obesity are 30% more likely to develop ED compared with men with normal body weight. AIM: The aim was to identify morphological changes in the cavernous tissue of the penis of patients with obesity using the biological model of laboratory rats as an example. MATERIALS AND METHODS: In vivo modeling of diet-induced obesity was performed. A total of 22 laboratory sexually mature white rats weighing 140-160 g were included in the study. The animals were divided into two groups, the control group (n=10) and experimental group, which included rats with diet-induced obesity (n=12). After 12 weeks, the experiment was completed. All rats underwent: 1) calculation of the Lee index (body mass index in rats); 2) determination of blood glucose level; 3) determination of the level of total cholesterol and triglycerides in the blood; 4) sampling of the penis with fixation in 10% formalin; histological sections 6-8 m thick were stained with hematoxylin and eosin, and frozen sections were prepared with subsequent staining with Sudan 3 to identify adipose cells. RESULTS: In the experimental group, alimentary obesity developed. There were no differences in glucose and total cholesterol levels between two groups. However, a significant difference was found in the serum triglycerides level (1.24+/-0.05 mmol/L in the control group vs. 1.6+/-0.1 mmol/L in the experimental group). In the control group, the average number of adipocytes was 10+/-5 per sample; in the experimental group, their number increased by 3 times (p<0.01). In obese rats, there was an increase not only in the number of adipose cells, but also in their area compared with the control group (17.7+/-7.5 m and 12.9+/-5.3 m, respectively, p<0.01). CONCLUSION: In rats with alimentary obesity, deposition of adipose tissue is observed not only in the visceral and paratesticular regions, but also in the cavernous tissue of the penis, which can negatively affect erectile function.


Assuntos
Disfunção Erétil , Pênis , Tecido Adiposo , Animais , Disfunção Erétil/etiologia , Humanos , Masculino , Obesidade/complicações , Ereção Peniana , Ratos
4.
Urologiia ; (6): 122-125, 2020 Dec.
Artigo em Russo | MEDLINE | ID: mdl-33377690

RESUMO

Bladder exstrophy is a complex of urogenital malformations, varying in severity from epispadias to classical bladder exstrophy. The main aim of correcting bladder exstrophy in childhood is to achieve urine continence with the prevention of upper urinary tract disorders and to provide penile reconstruction. However, by the time of puberty, it is not always possible to achieve optimal anatomical features of the penis, and usually, by the end of puberty, the penile length is no more than 7 cm, which subsequently leads to psychosocial and sexual problems during puberty. Neither patient, nor urologist in most cases do not satisfy final result of the treatment of exstrophy and a number of epispadias forms. A clinical case of the surgical rehabilitation of a patient after undergoing multi-stage surgical treatment for a congenital malformation of the genitourinary system is presented in the article. MATERIALS AND METHODS: At the admission, the size of the penis was 3 cm (microfallia), urethral meatus was located in the area of the penoscrotal junction. From 2016 to 2019, the patient underwent neofallos formation, urethroplasty, and implantation of prostheses in the neophallos. RESULTS: According to the results, urinary and sexual function was completely restored, as well as anatomical relationships and dimensional parameters of the genitals.


Assuntos
Extrofia Vesical , Epispadia , Extrofia Vesical/cirurgia , Criança , Epispadia/cirurgia , Humanos , Masculino , Pênis/cirurgia , Uretra
5.
Hinyokika Kiyo ; 66(11): 411-414, 2020 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-33271660

RESUMO

Priapism is defined as a full or partial erection for >4 hours without sexual stimulation or orgasm. Ischemic priapism is an emergency disease that urgently requires surgery to reduce pressure in the corpora cavernosa. We encountered a case of severe ischemic priapism that required a proximal shunt. The patient was a 71-year-old man who had been diagnosed with benign prostatic hyperplasia ; hence, oral administration of tamsulosin had been initiated at a local hospital. His penis became gradually rigid and presented with prolonged erection. Then he consulted our hospital. Penile aspiration was impossible, and phenylephrine injection was not effective. He was subsequently transferred to our hospital. He did not have severe pain but had complete erection. We could not correctly evaluate blood gas from the corpora cavernosa and color Doppler ultrasonography showed little blood flow in the corpora cavernosa. We judged that the patient had ischemic priapism. The erection could not be controlled by distal shunt plastic surgery performed using the T shunt and Al-Ghorab methods. Therefore, a proximal shunt plastic surgery as described by Sacher was performed. The surgery was effective, but it caused erectile dysfunction.


Assuntos
Disfunção Erétil , Priapismo , Idoso , Humanos , Masculino , Ereção Peniana , Pênis , Ultrassonografia Doppler em Cores
6.
Zhonghua Nan Ke Xue ; 26(2): 139-142, 2020 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-33346417

RESUMO

Objective: To investigate the impact of unilateral cryptorchidism (UC) on penile development in children. METHODS: We collected the relevant data on 491 male children aged 12-24 months from January 2017 to January 2019, including 241 normal healthy subjects (the control group) and 250 UC patients (the UC group, 123 with intra-abdominal and the other 127 with inguinal cryptorchidism). We measured the stretched penile length (SPL) in the flaccid state and analyzed its association with the height and weight of the subjects. RESULTS: The average SPL of the UC patients was significantly shorter than that of the normal controls (ï¼»3.7 ± 0.5ï¼½ vs ï¼»4.3 ± 0.8ï¼½ cm, P < 0.01), and so was that of the UC patients in the 12-18 and 19-24 months age groups than that of the normal controls in the same age groups (P < 0.01). Besides, the SPL was also markedly shorter in the intra-abdominal UC than in the inguinal UC group (ï¼»3.4 ± 0.2ï¼½ vs ï¼»3.8 ± 0.3ï¼½ cm, P < 0.05). No statistically significant differences, however, were observed in the height and weight of the subjects between the UC and normal control groups. CONCLUSIONS: The penile length of the boy with unilateral cryptorchidism is shorter than that of the normal healthy child, the higher the testis location, the shorter the penile length.


Assuntos
Criptorquidismo/fisiopatologia , Pênis/patologia , Estatura , Peso Corporal , Estudos de Casos e Controles , Humanos , Lactente , Masculino
7.
Zhonghua Nan Ke Xue ; 26(2): 167-173, 2020 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-33346422

RESUMO

Objective: To investigate the effect of Xiongcan Yishen Prescription (XYP) on the expressions of eNOS and cGMP in the penile tissue of ED rats with liver depression and kidney deficiency (LDKD). METHODS: The model of ED-LDKD was established in 30 eight-week-old SPF-class male SD rats by injecting hydrocortisone intramuscularly and binding the limbs for 14 days, and another 10 rats were taken as blank controls. Then, the model rats were randomized into six groups of equal number and treated intragastrically with distilled water (model control), tadalafil tablets at 0.52 mg/kg/d (tadalafil control), Shugan Yiyang Capsules 0.3125 g/kg/d (SYC control), and XYP at 10.4 g/kg/d (low-dose XYP), 20.8 g/kg/d (medium-dose XYP) and 41.6 g/kg/d (high-dose XYP), bid, for 28 successive days, respectively. Before and after modeling and after 28-day treatment, the animals were subjected to tail suspension and mating tests. The next day after medication, the penile tissues of the rats were harvested for determining the expression levels of eNOS and cGMP proteins by immunohistochemical analysis of the mean optical density. RESULTS: Compared with the model controls, the rats of the high-, medium- and low-dose XYP and SYC control groups all showed significant decreases in the tail suspension time (ï¼»3.17 ± 0.11ï¼½ vs ï¼»2.58 ± 0.25ï¼½, ï¼»2.52 ± 0.31ï¼½, ï¼»2.51 ± 0.3ï¼½ and ï¼»2.57 ± 0.29ï¼½ min, P < 0.05) and mount latency (ML) (ï¼»9.23 ± 0.11ï¼½ vs ï¼»1.21 ± 0.12ï¼½, ï¼»2.17 ± 0.16ï¼½, ï¼»2.26 ± 0.13ï¼½, ï¼»1.23 ± 0.15ï¼½ and ï¼»2.48 ± 0.18ï¼½ min, P < 0.05) but increases in mount frequency (MF) (ï¼»0.48 ± 0.18ï¼½ vs ï¼»3.29 ± 0.11ï¼½, ï¼»3.18 ± 0.11ï¼½, ï¼»3.05 ± 0.05ï¼½, ï¼»3.23 ± 0.12ï¼½ and ï¼»3.2 ± 0.28ï¼½ times, P < 0.05) and intromission frequency (IF) (ï¼»0.8 ± 0.84ï¼½ vs ï¼»11.8 ± 0.84ï¼½, ï¼»11.2 ± 1.48ï¼½, ï¼»9.4 ± 1.14ï¼½, ï¼»11.4 ± 1.14ï¼½ and ï¼»10 ± 1.22ï¼½ times, P < 0.05). The eNOS and cGMP proteins were mainly expressed in the nucleus and cytoplasm of the arterial and venous endothelial cells and sinusoidal endothelial cells of the cavernous, as brownish yellow particles in a scattered and focal pattern. Both the expressions of eNOS and cGMP in the penile tissue were remarkably upregulated in the high-, medium- and low-dose XYP and SYC control groups as compared with those in the model control (P < 0.05) but exhibited no statistically significant difference between the tadalafil and model control groups (P > 0.05). CONCLUSIONS: Xiongcan Yishen Prescription can relieve the depression symptoms, increase the mount frequency, activate the NO/cGMP pathway, and upregulate the expressions of eNOS and cGMP in the penile tissue of ED rats with liver depression and kidney deficiency.


Assuntos
GMP Cíclico/metabolismo , Medicamentos de Ervas Chinesas/uso terapêutico , Disfunção Erétil/tratamento farmacológico , Óxido Nítrico Sintase Tipo III/metabolismo , Pênis/metabolismo , Animais , Células Endoteliais , Rim/fisiopatologia , Fígado/fisiopatologia , Masculino , Ereção Peniana , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley
8.
Zhonghua Nan Ke Xue ; 26(3): 223-227, 2020 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-33346961

RESUMO

Objective: To investigate the expression of the kallistatin gene in the corpus cavernosum and search for some new molecular targets for the regulation of penile erectile function and treatment of ED. METHODS: Using reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR), Western blot and immunofluorescence staining, we detected the expression of kallistatin in the rat corpus cavernosum and compared it with that in the aorta. RESULTS: The results of RT-qPCR and Western blot revealed both mRNA and protein expressions of kallistatin in the rat corpus cavernosal tissue, with no statistically significant difference from those in the aorta (P > 0.05). Immunofluorescence staining showed that kallistatin was expressed in both endothelial and smooth muscle cells in the corpus cavernosum and localized in the cytoplasm, with no statistically significant difference from its expression in the aorta (P > 0.05) either. CONCLUSIONS: The kallistatin gene is highly expressed in the corpus cavernosum and localized in cavernosal endothelial and smooth muscle cells, suggestive of its involvement in the cellular function of cavernosal endothelial and smooth muscle cells and its participation in the regulation of penile erectile function.


Assuntos
Ereção Peniana/genética , Pênis/metabolismo , Serpinas/genética , Animais , Aorta , Western Blotting , Células Endoteliais/metabolismo , Disfunção Erétil/genética , Masculino , Miócitos de Músculo Liso/metabolismo , Ratos
10.
J Pediatr Urol ; 16(6): 864-865, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33176975
11.
Urologiia ; (5): 73-77, 2020 11.
Artigo em Russo | MEDLINE | ID: mdl-33185351

RESUMO

AIM: Urethral stenosis is one of the serious complications after proximal hypospadias repair. A variety of techniques has been suggested for its correction, such as urethral dilation using bougies, endoscopic incisions and one- or two-staged urethroplasty with buccal mucosa. The aim of our study was to improve results of urethral stenosis correction in children after multiple proximal hypospadias repairs. MATERIALS AND METHODS: A total of 24 patients with urethral stenosis after proximal hypospadias repairs underwent treatment in the Department of Uroandrology of the Russian Childrens Clinical Hospital from 2015 to 2019. The age of the patients was from 3-17 years (average - 4.2) with penoscrotal form of hypospadias in 12, scrotal in 8, and perineal in 4 patients. All children previously underwent 2-8 hypospadias repairs. Patients were divided into 2 groups. In group I, 16 patients had urethral stenosis from the glans of the penis to the penoscrotal area, urethral diameter of 3-4 Ch and ventral penile curvature of 45-60o. These patients were treated with a two-staged urethroplasty, similar to Brackas technique. In group II, 8 patients with urethral stenosis in the penile shaft area, urethral diameter of 6 Ch, without penile curvature were included. They underwent to a one-stage urethroplasty with buccal mucosa graft, which was sutured on the dorsolateral aspect of the urethra, with a formation of the age-appropriate urethra (Dorsolateral Inlay). RESULTS: All patients in both groups had successful results with flow rate of 8-12 ml/sec. CONCLUSIONS: The correction of urethral stenosis in children after proximal hypospadias repairs can be performed using buccal mucosa. In cases of long urethral stenosis, urethral diameter of 3-4 Ch, penile curvature, and scarring of the penile skin, a two-staged urethroplasty is recommended. In patients with stenosis of the penile shaft, urethral diameter of 6 Ch and lack of penile curvature, a one-stage urethroplasty with buccal mucosa fixation on the dorsolateral aspect of the urethra (Dorsolateral Inlay) allows to achieve successful results.


Assuntos
Hipospadia , Procedimentos Cirúrgicos Reconstrutivos , Estreitamento Uretral , Criança , Humanos , Hipospadia/cirurgia , Lactente , Masculino , Pênis/cirurgia , Federação Russa , Resultado do Tratamento , Uretra/cirurgia , Estreitamento Uretral/etiologia , Estreitamento Uretral/cirurgia , Procedimentos Cirúrgicos Urológicos Masculinos/efeitos adversos
12.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 34(11): 1423-1428, 2020 Nov 15.
Artigo em Chinês | MEDLINE | ID: mdl-33191701

RESUMO

Objective: To evaluate the effectiveness of pedicled skin flap of foreskin for phalloplasty and Sugita surgical method in the treatment of complete concealed penis. Methods: The clinical data of 46 children with complete concealed penis between January 2016 and January 2018 were analyzed retrospectively. Among which, 25 cases were treated with pedicled skin flap of foreskin for phalloplasty (group A) and 21 cases were treated with Sugita surgical method (group B) with an average age of 4.7 years (range, 2 years and 8 months to 11 years). At 3 months after operation, the concealed penis recovery was scored from three aspects of postoperative penis length (the difference of the penis length between at 3 months after operation and before operation), penis appearance, and skin appearance (the total score was 10). And the parents evaluation of satisfaction degree of penis exposure, penis appearance, and foreskin appearance after surgical correction was collected. Results: Eighteen cases (72.0%) in group A and 15 cases (71.4%) in group B were followed up with an average of 13 months (range, 3-36 months). The incisions healed well in both groups, and there was no flap dehiscence, infection, necrosis, and penile erectile dysfunction. The penile length of the two groups increased significantly at 3 months after operation ( P<0.05); there was no significant difference between the two groups in terms of penis length and increased length at 3 months after operation and score of increase penis length after operation ( P>0.05). No penile retraction occurred in the two groups. And there was no significant difference between the two groups in penis appearance score, but the penis appearance score, skin appearance score, and total score of group A were significantly better than those of group B ( P<0.05). At 3 months after operation, the satisfaction rate of penis exposure in group A and group B was 88.9% and 80.0%, respectively, with no significant difference ( χ 2=0.50, P=0.48); the satisfaction rate of penis appearance was 72.2% and 53.3%, and the satisfaction rate of foreskin appearance was 94.4% and 53.3%, respectively, and the differences were significant ( χ 2=5.13, P=0.03; χ 2=7.53, P=0.01). Conclusion: Both surgical methods are suitable for correction of complete concealed penis, and the penile length gets a satisfactory recovery. However, the lymphedema of the prepuce after Sugita surgical method is serious, which can easily lead to poor appearance of the penis after operation. In general, the effectiveness of pedicled skin flap of foreskin for phalloplasty is better than that of the Sugita surgical method.


Assuntos
Prepúcio do Pênis , Procedimentos Cirúrgicos Reconstrutivos , Criança , Prepúcio do Pênis/cirurgia , Humanos , Lactente , Masculino , Pênis/cirurgia , Estudos Retrospectivos , Procedimentos Cirúrgicos Urológicos Masculinos
13.
BMC Infect Dis ; 20(1): 834, 2020 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-33176727

RESUMO

BACKGROUND: Bacterial vaginosis (BV) is estimated to affect 1 in 3 women globally and is associated with obstetric and gynaecological sequelae. Current recommended therapies have good short-term efficacy but 1 in 2 women experience BV recurrence within 6 months of treatment. Evidence of male carriage of BV-organisms suggests that male partners may be reinfecting women with BV-associated bacteria (henceforth referred to as BV-organisms) and impacting on the efficacy of treatment approaches solely directed to women. This trial aims to determine the effect of concurrent male partner treatment for preventing BV recurrence compared to current standard of care. METHODS: StepUp is an open-label, multicentre, parallel group randomised controlled trial for women diagnosed with BV and their male partner. Women with clinical-BV defined using current gold standard diagnosis methods (≥3 Amsel criteria and Nugent score (NS) = 4-10) and with a regular male partner will be assessed for eligibility, and couples will then be consented. All women will be prescribed oral metronidazole 400 mg twice daily (BID) for 7 days, or if contraindicated, a 7-day regimen of topical vaginal 2% clindamycin. Couples will be randomised 1:1 to either current standard of care (female treatment only), or female treatment and concurrent male partner treatment (7 days of combined antibiotics - oral metronidazole tablets 400 mg BID and 2% clindamycin cream applied topically to the glans penis and upper shaft [under the foreskin if uncircumcised] BID). Couples will be followed for up to 12 weeks to assess BV status in women, and assess the adherence, tolerability and acceptability of male partner treatment. The primary outcome is BV recurrence defined as ≥3 Amsel criteria and NS = 4-10 within 12 weeks of enrolment. The estimated sample size is 342 couples, to detect a 40% reduction in BV recurrence rates from 40% in the control group to 24% in the intervention group within 12 weeks. DISCUSSION: Current treatments directed solely to women result in unacceptably high rates of BV recurrence. If proven to be effective the findings from this trial will directly inform the development of new treatment strategies to impact on BV recurrence. TRIAL REGISTRATION: The trial was prospectively registered on 12 February 2019 on the Australian and New Zealand Clinical Trial Registry (ACTRN12619000196145, Universal Trial Number: U1111-1228-0106, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376883&isReview=true ).


Assuntos
Antibacterianos/uso terapêutico , Clindamicina/uso terapêutico , Metronidazol/uso terapêutico , Parceiros Sexuais , Vaginose Bacteriana/tratamento farmacológico , Administração Intravaginal , Administração Oral , Antibacterianos/administração & dosagem , Austrália , Clindamicina/administração & dosagem , Feminino , Seguimentos , Humanos , Masculino , Metronidazol/administração & dosagem , Nova Zelândia , Pênis/microbiologia , Estudos Prospectivos , Recidiva , Resultado do Tratamento , Vaginose Bacteriana/microbiologia
14.
Wiad Lek ; 73(9 cz. 2): 2049-2055, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33148858

RESUMO

OBJECTIVE: 75% of men with coronary artery disease confirmed by coronarography have erectile dysfunction in history, while 75% of patients with a vascular etiology of ED have significant stenoses in penile arterial vascularization. Patients with coronary artery disease have shown a relationship between the range of the lesions in the coronary vessels and erectile dysfunction intensity. This paper aims at attempting to systematize the knowledge of the benefits and drawbacks of nonsurgical endovascular treatment methods for erectile dysfunction with confirmed vascular causes. It analyzes seven studies which assess the results of erectile dysfunction treatment with percutaneous angioplasty. It also mentions the limitations of the cited works and formulates relevant conclusions. CONCLUSION: Conclusions: The analysis shows that endovascular procedures in erection-related arteries are safe in a specially selected group of men. It is necessary to conduct further studies to define an appropriate group of patients who have a chance of benefiting optimally from the endovascular treatment of erectile dysfunction in a long-term follow-up.


Assuntos
Procedimentos Endovasculares , Disfunção Erétil , Impotência Vasculogênica , Disfunção Erétil/etiologia , Disfunção Erétil/terapia , Humanos , Impotência Vasculogênica/etiologia , Impotência Vasculogênica/terapia , Masculino , Ereção Peniana , Pênis
15.
Plast Reconstr Surg ; 146(5): 995-1006, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33136942

RESUMO

BACKGROUND: Aesthetic augmentation phalloplasty is a set of procedures aimed at increasing penile length and/or girth; many of these procedures are investigational. This systematic review set out to summarize available literature on these procedures in patients with normal penile anatomy. METHODS: A systematic review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The MEDLINE/PubMed, Scopus, and Cochrane Databases were used to identify articles on aesthetic augmentation phalloplasty in cis-gender men without penile deformity from 1990 to 2018. Data on outcomes, complications, and patient-reported satisfaction were collected. RESULTS: Sixteen articles, involving 1192 patients, met our inclusion criteria. Mean age ranged from 23 to 44 years, and follow-up time ranged from 6 to 48 months. The quality of the studies was poor regarding methodology for patient selection and outcomes reporting. Surgical interventions included suspensory ligament incision, grafting, flaps, and penile disassembly. Augmentation was performed for length only in 16 percent of patients, girth only in 70.6 percent, and combined in 13.4 percent. Length gain ranged from 8 to 83 percent in the flaccid state and 12 to 53 percent in the erect state. Girth gain ranged from 16 to 56 percent in the flaccid state and 19 to 30 percent in the erect state. The pooled complication rate was 14.6 percent, with those undergoing combined augmentation having the highest complication rate. Patients were generally satisfied; reported satisfaction rates ranged from 50 to 100 percent. CONCLUSIONS: Enhancement procedures are controversial and investigational. Data point to inconsistent methodology when reporting penile dimensions, outcomes, and patient satisfaction. Despite the reportedly high satisfaction rates, patients should be counseled regarding high complication rates. Best-practice guidelines will be critical to achieve safe and reliable outcomes.


Assuntos
Pênis/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Humanos , Masculino , Resultado do Tratamento
17.
Pan Afr Med J ; 37: 61, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33244324

RESUMO

Introduction: the reference values of stretched penile length vary with different ethnic group. There is paucity of data on the reference range of total serum testosterone in neonates especially in Africa. This study therefore was to determine the normal stretched penile length, total serum testosterone levels in term male newborns and to correlate them with anthropometric parameters. Methods: this was a prospective cross-sectional study. One hundred and twenty-four consecutive healthy term male neonates were recruited in the first 72 hours of postnatal life. The stretched penile length (SPL) was measured with a rigid metric ruler. Weight, length and occipitofrontal circumference were also measured. Total serum testosterone level was determined using Enzyme Linked Immunoassay. Data were analysed using the Statistical Package for Social Sciences for Windows version 20. Results: a total of 124 term male neonates were recruited. The postnatal age of recruited neonates was one to 70 hours with a mean of 22.8 ± 17.6 hours and the mean of estimated gestation age was 38.5 ± 1.3 weeks. The range of stretched penile length was from 2.1 to 3.9 cm with a mean of 3.2 ± 0.4 cm and SPL less than 2.2 cm was considered as micropenis. The mean total serum testosterone level was 357.4 ± 241.7 ng/dl. The SPL had a positive correlation with the birth weight, length and total serum testosterone. The total serum testosterone and birth length were predictors of stretched penile length. Conclusion: among the studied population the mean stretched penile length was 3.2 cm and mean total serum testosterone was 357.4 ng/dL.


Assuntos
Doenças dos Genitais Masculinos/epidemiologia , Pênis/anormalidades , Pênis/anatomia & histologia , Testosterona/sangue , Antropometria , Peso ao Nascer , Estudos Transversais , Humanos , Recém-Nascido , Masculino , Estudos Prospectivos , Valores de Referência
18.
Proc Biol Sci ; 287(1936): 20201883, 2020 10 14.
Artigo em Inglês | MEDLINE | ID: mdl-33049172

RESUMO

The baculum is an enigmatic bone within the mammalian glans penis, and the driving forces behind its often bizarre shape have captivated evolutionary biologists for over a century. Hypotheses for the function of the baculum include aiding in intromission, stimulating females and assisting with prolonged mating. Previous attempts to test these hypotheses have focused on the gross size of the baculum and have failed to reach a consensus. We conducted three-dimensional imaging and apply a new method to quantify three-dimensional shape complexity in the carnivoran baculum. We show that socially monogamous species are evolving towards complex-shaped bacula, whereas group-living species are evolving towards simple bacula. Overall three-dimensional baculum shape complexity is not related to relative testes mass, but tip complexity is higher in induced ovulators and species engaging in prolonged copulation. Our study provides evidence of postcopulatory sexual selection pressures driving three-dimensional shape complexity in the carnivore baculum.


Assuntos
Osso e Ossos , Carnívoros , Preferência de Acasalamento Animal , Pênis/anatomia & histologia , Animais , Evolução Biológica , Copulação , Masculino
19.
Rev Assoc Med Bras (1992) ; 66(9): 1180-1186, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33027442

RESUMO

INTRODUCTION: The vascular evaluation of the erectile function through Color Duplex-Doppler Ultrasound (CDDU) of the penis can benefit the therapeutic decision-making process. Unfortunately, there is no standard procedure for CDDU conduction, a fact that results in high result-interpretation variability. OBJECTIVE: The aims of this review are to promote greater standardization during CDDU of the penis and discuss the fundamental principles for its accurate conduction. METHODS: CDDU is initially conducted with the penis in the flaccid state; the whole penis must be assessed (images at B mode) with a high-frequency linear transducer (7.5-18 MHz). Intracavernous injection of vasodilating agents (prostaglandin E1, papaverine, phentolamine) is performed to induce a rigid erection. Serial measurements at different times should be taken during the CDDU session and penile rigidity must be assessed in each evaluation. RESULTS: It is important to monitor the erection response after the vasoactive agent (hardness scale), and scanning during the best-quality erection should be contemplated. Manual self-stimulation, audiovisual sexual stimulation (AVSS), and vasoactive agent re-dosing protocols must be taken into account to reduce the influence of psychogenic factors and to help the patient to get the hardest erection possible. Such measurements contribute to the maximal relaxation of the erectile tissue, so the hemodynamic parameters are not underestimated. CONCLUSIONS: CDDU is a relevant specialized tool to assess patients with erectile dysfunction; therefore, this guideline will help to standardize and establish uniformity in its conduction and interpretation, taking into consideration the complexity and heterogeneity of CDDU evaluations of the penis.


Assuntos
Pênis , Disfunção Erétil , Hemodinâmica , Humanos , Masculino , Ereção Peniana , Ultrassonografia Doppler em Cores
20.
Pediatrics ; 146(5)2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33106340

RESUMO

OBJECTIVES: Puberty suppression (PS) is a cornerstone of treatment in youth experiencing gender dysphoria. In this study, we aim to inform prescribing professionals on the long-term effects of PS treatment on the development of sex characteristics and surgical implications. METHODS: Participants received PS according to the Endocrine Society guideline at Tanner 2 or higher. Data were collected from adolescents who received PS between 2006 and 2013 and from untreated transgender controls. Data collection pre- and post-PS and before surgery included physical examination and surgical information. RESULTS: In total, 300 individuals (184 transgender men and 116 transgender women) were included. Of these, 43 individuals started PS treatment at Tanner 2/3, 157 at Tanner 4/5, and 100 used no PS (controls). Breast development was significantly less in transgender men who started PS at Tanner 2/3 compared with those who started at Tanner 4/5 and controls. Mastectomy was more frequently omitted or less invasive after PS. In transgender women, the mean penile length was significantly shorter in the PS groups compared with controls (by 4.8 cm [Tanner 2/3] and 2.1 cm [Tanner 4/5]). As a result, the likelihood of undergoing intestinal vaginoplasty was increased (odds ratio = 84 [Tanner 2/3]; odds ratio = 9.8 [Tanner 4/5]). CONCLUSIONS: PS reduces the development of sex characteristics in transgender adolescents. As a result, transgender men may not need to undergo mastectomy, whereas transgender women may require an alternative to penile inversion vaginoplasty. These surgical implications should inform decision-making when initiating PS.


Assuntos
Puberdade/efeitos dos fármacos , Caracteres Sexuais , Pessoas Transgênero , Adolescente , Mama/efeitos dos fármacos , Mama/crescimento & desenvolvimento , Estudos de Casos e Controles , Feminino , Disforia de Gênero , Identidade de Gênero , Procedimentos Cirúrgicos em Ginecologia , Humanos , Masculino , Mastectomia/métodos , Pênis/anatomia & histologia , Pênis/efeitos dos fármacos , Pênis/cirurgia , Exame Físico , Fatores Sexuais , Cirurgia de Readequação Sexual , Vagina/efeitos dos fármacos , Vagina/cirurgia , Adulto Jovem
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