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1.
Expert Rev Cardiovasc Ther ; 18(3): 155-164, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32192361

RESUMO

Introduction: A large body of evidence has clearly documented that erectile dysfunction (ED) represents not only a complication of cardiovascular (CV) diseases (CVD) but often an early sign of forthcoming CVD.Areas covered: All the available data from meta-analyses evaluating the association between ED and CV risk were collected and discussed. Similarly, all available meta-analyses investigating the significance of ED as a possible early marker for major adverse cardiovascular events (MACE) were analyzed. In addition, data originally obtained in a Florence cohort, dealing with a large series of patients seeking medical care for sexual dysfunction, will be also reported.Expert opinion: Available evidence indicates that ED represents a risk factor of CV mortality and morbidity. Not only conventional CV risk factors but also unconventional ones, derived from a perturbation of the relational and intrapsychic domains of ED, might play a possible role in CV risk stratification of ED subjects. Finally, penile doppler ultrasound can give important information on CV risk, especially in younger and low risk subjects. The presence of ED should become an opportunity - for the patient and for the physician - to screen for the presence of comorbidities improving not only sexual health but, more importantly, men's overall health.


Assuntos
Doenças Cardiovasculares/epidemiologia , Disfunção Erétil/fisiopatologia , Pênis/irrigação sanguínea , Biomarcadores , Doenças Cardiovasculares/diagnóstico , Sistema Cardiovascular/fisiopatologia , Humanos , Masculino , Metanálise como Assunto , Pênis/diagnóstico por imagem , Fatores de Risco
2.
J Med Vasc ; 45(1): 3-12, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32057324

RESUMO

The goal of this work was to demonstrate that Doppler ultrasound (DUS) after pharmacological stimulation of erection (PSE) can be used to evaluate the presence and intensity of a cavernovenous leak (CVL) suspected in erectile dysfunction (ED) patients. The study was built around 50 DUS-PSE exams of penile arteries and veins, which were carried out 3, 5, 10 and 20minutes after pharmacological stimulation. Measured parameters were end diastolic velocity of the cavernous arteries and mean velocity of the deep penile vein and/or penile superficial veins. A score from 0 to 3 was attributed to each according to the recorded velocities. A final score from 0 to 9 was established by adding the three values: patients quoting 0 and 1 were classified as "no leak" (n=8); from 2 to 9 (n=42) as "leaking". Penile computed tomography (CT-scan) under identical pharmacological stimulation identified the cavernovenous leak to be compared with the DUS-PSE results, which were valid in 47 cases (94%), with 97.6% sensitivity and 77.7% specificity. The kappa correlation coefficient for CT-scan diagnosis of suspected CVL was 0.7875 (P<0.001). In addition, we found that end diastolic velocity in the cavernous artery, considered up until now as the gold standard in cases of suspected CVL was insufficient (negative predictive value=47%). In addition to its well-known diagnostic value regarding ED of arterial origin, DUS-PSE is an excellent screening test for CVL, especially in young patients without vascular risk factors who are resistant to medical treatments. For those with well-established CVL, confirmation by CT-scan to discuss possible surgery should be the next step. Moreover, DUS-PSE is useful in postoperative monitoring.


Assuntos
Atropina/administração & dosagem , Dipiridamol/administração & dosagem , Disfunção Erétil/diagnóstico por imagem , Papaverina/administração & dosagem , Ereção Peniana , Pênis/irrigação sanguínea , Pênis/diagnóstico por imagem , Piperidinas/administração & dosagem , Piribedil/administração & dosagem , Ultrassonografia Doppler de Pulso , Ioimbina/administração & dosagem , Adulto , Idoso , Velocidade do Fluxo Sanguíneo , Angiografia por Tomografia Computadorizada , Combinação de Medicamentos , Disfunção Erétil/fisiopatologia , Disfunção Erétil/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Pênis/cirurgia , Valor Preditivo dos Testes , Recuperação de Função Fisiológica , Fluxo Sanguíneo Regional , Reprodutibilidade dos Testes , Estudos Retrospectivos , Resultado do Tratamento
3.
Arq. bras. med. vet. zootec. (Online) ; 72(1): 40-48, Jan.-Feb. 2020. tab, ilus
Artigo em Português | LILACS, VETINDEX | ID: biblio-1088936

RESUMO

A ultrassonografia é um exame complementar não invasivo ainda pouco utilizado na avaliação prepucial e sem descrições detalhadas da parte livre do pênis (PLP) de bovinos. Este estudo objetivou padronizar a ultrassonografia prepucial em bovinos hígidos da raça Nelore com um ano de idade e, para tanto, descreveu o aspecto da lâmina interna prepucial (LIP) e da PLP, determinando as principais janelas acústicas, a viabilidade da utilização de contraste no lúmen da cavidade prepucial (LCP) e o melhor posicionamento do animal para a realização do exame. O escaneamento foi realizado com os animais na posição quadrupedal e em decúbito lateral direito. Foram determinadas cinco janelas acústicas a partir do óstio até a identificação do recesso prepucial. Os escaneamentos foram realizados nos planos longitudinais, transversais e dorsais, antes e após a infiltração de solução fisiológica a 0,9% no LCP. Como conclusões, o exame ultrassonográfico permitiu identificar a LIP e a PLP em todos os planos e em todas as janelas acústicas propostas. O melhor ponto de referência é a identificação da glande. O posicionamento quadrupedal é mais adequado para a realização do exame e o uso de contraste é recomendado para delimitação topográfica das estruturas.(AU)


Ultrasonography is a noninvasive complementary exam that is still rarely used in the preputial evaluation and without detailed descriptions of the bovine free end of the penis. The purpose of this study was to standardize preputial ultrasonography in one-year-old healthy Nelore cattle, describing the main acoustic windows, the viability of using contrast in the preputial cavity and the best positioning of the animal for performing the ultrasound examination. The scanning was performed with the animals in standing and decubitus position. Five acoustic windows were determined from the preputial ostium to the preputial fornix, at the free end of the penis. The scans were performed in longitudinal, transverse and dorsal planes, before and after infiltration of 0.9% saline solution into the preputial cavity. As conclusions, the ultrasound examination is able to identify the internal layer and the free part of the penis in all proposed planes and acoustic windows. The best landmark is the identification of the glans. Furthermore, standing positioning is the most appropriate to perform the exam and the use of contrast is recommended for topographic delimitation of the structures.(AU)


Assuntos
Animais , Masculino , Bovinos , Pênis/diagnóstico por imagem , Prepúcio do Pênis/diagnóstico por imagem , Ultrassonografia/métodos
5.
AJR Am J Roentgenol ; 214(5): 1112-1121, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31990215

RESUMO

OBJECTIVE. Erectile dysfunction (ED) is a common medical condition that has a high prevalence and incidence worldwide and may have a significant impact on both physical and psychosocial health. The purpose of this article is to review the role of penile Doppler sonography in the assessment of ED. CONCLUSION. Penile Doppler sonography is an essential tool for differentiating between vascular and nonvascular causes of ED; therefore, radiologists must be familiar with the imaging protocol, the limitations of the technique, and interpretation of its findings, to warrant an accurate diagnosis and appropriate patient management.


Assuntos
Disfunção Erétil/diagnóstico por imagem , Pênis/diagnóstico por imagem , Ultrassonografia Doppler , Humanos , Masculino , Pênis/anatomia & histologia
6.
Urology ; 137: 168-172, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31794814

RESUMO

Neurofibromatosis-1 has a known increased risk of malignancy with rhabdomyosarcoma occurring in up to 6% of patients. Here we report on an 8-year-old male with a history of Neurofibromatosis-1 and previously treated stage 3, group III bladder/prostate embryonal rhabdomyosarcoma (diagnosed at 18 months old) who presented with penile swelling concerning for priapism. Imaging and subsequent biopsy confirmed embryonal rhabdomyosarcoma of the penile corporal bodies. Penile rhabdomyosarcoma is exceedingly rare, with less than 15 case reports in the literature. Our patient received chemoradiation per D9803 with organ preserving local control and is doing well 3 months after treatment.


Assuntos
Quimiorradioterapia/métodos , Recidiva Local de Neoplasia , Neurofibromatose 1 , Neoplasias Penianas , Priapismo/diagnóstico , Neoplasias da Próstata , Rabdomiossarcoma Embrionário , Neoplasias da Bexiga Urinária , Biópsia/métodos , Criança , Diagnóstico Diferencial , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Neurofibromatose 1/patologia , Neurofibromatose 1/terapia , Neoplasias Penianas/diagnóstico , Neoplasias Penianas/tratamento farmacológico , Neoplasias Penianas/patologia , Neoplasias Penianas/radioterapia , Pênis/diagnóstico por imagem , Pênis/patologia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Neoplasias da Próstata/patologia , Neoplasias da Próstata/terapia , Rabdomiossarcoma Embrionário/patologia , Rabdomiossarcoma Embrionário/terapia , Resultado do Tratamento , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/terapia
7.
Urology ; 135: 146-153, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31626854

RESUMO

OBJECTIVE: To evaluate the magnetic resonance imaging (MRI) findings of traumatic bulbar stricture and to evaluate their ability to estimate repair complexity. METHODS: Eighty-nine men with traumatic bulbar stricture who underwent urethrography and MRI at least 3 months postinjury and subsequent excision and primary anastomosis were retrospectively analyzed. The associations of MRI findings, including continuity of the tunica albuginea of the corpus spongiosum, periurethral fistula, spongiofibrosis length (SFL), and distal and proximal bulbar urethral length from the stricture, with urethrography and operative parameters were evaluated. RESULTS: Mean SFL was significantly longer than mean stricture length on urethrography (14.9 vs 7.9 mm, P <.0001). Periurethral fistula was found in 18 (20.2%) patients on MRI but not in 10 (55.6%) of them on urethrography. The corpus spongiosum was disrupted in 40 patients (55.1%) on MRI. On multivariate linear regression, SFL (standard coefficient, 0.25; t value, 2.31; P = .02) predicted operation time, while SFL (standard coefficient, 0.22; t value, 2.04; P = .04) and proximal bulbar urethral length (standard coefficient, -0.25; t value, -2.11; P = .04) independently predicted blood loss. Corporal splitting to reduce anastomotic tension and/or increase visualization during repair was needed in 33 patients (37.1%). Stricture length on urethrography (odds ratio [OR], 1.22; 95% confidence interval, 1.04-1.42; P = .006) and corpus spongiosum disruption (odds ratio, 5.51; 95% confidence interval, 1.57-19.34, P = .005) were independent predictors for the need of corporal splitting. CONCLUSION: In contrast to urethrography findings, MRI findings help predict traumatic bulbar stricture repair complexity.


Assuntos
Planejamento de Assistência ao Paciente , Doenças do Pênis/complicações , Pênis/lesões , Procedimentos Cirúrgicos Reconstrutivos/métodos , Estreitamento Uretral/cirurgia , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Adulto , Estudos de Viabilidade , Seguimentos , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Doenças do Pênis/cirurgia , Pênis/diagnóstico por imagem , Período Pré-Operatório , Estudos Retrospectivos , Resultado do Tratamento , Uretra/diagnóstico por imagem , Estreitamento Uretral/diagnóstico por imagem , Estreitamento Uretral/etiologia
8.
Urology ; 135: 66-70, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31541647

RESUMO

OBJECTIVE: To define age-specific normal Color Doppler Duplex Ultrasound (CDDU) parameters based on a large institutional database of men referred for vascular erectile testing, but found to have normal and sustained rigidity following penile injection of alprostadil. METHODS: A retrospective review of patients who underwent CDDU from January 1, 2005 to December 31, 2014 was conducted. The indications for CDDU assessments included complaint of erectile dysfunction refractory to PDE-5 inhibitors, new-onset penile curvature, or secondary consultation for erectile dysfunction. Pearson correlation test was used to evaluate the association between ordinal age groups with peak systolic velocity (PSV) and resistive index (RI) measurements to determine the effect of age on erectile response. RESULTS: A total of 2043 patients underwent CDDU from January 1, 2005 to December 31, 2014. 259 patients (12.7%) with a mean age 53.7 and a mean BMI of 27.2 were noted to have normal erectile rigidity and normal Doppler parameters (PSV >35 cm/s, RI >0.90). Prolonged erection, defined by need to inject phenylephrine reversal agent at 1-2 hours, occurred in 93% of patients. When age was categorized by decade, a negative correlation coefficient was obtained for previsual sexual stimulation PSV (-0.09, P = .164) and postvisual sexual stimulation PSV (-0.23, P = .005). CONCLUSION: In men with normal vascular erections there appears to be a significant, age-related decline in postvisual sexual stimulation PSV without compromise to cavernous venous occlusion as measured by RI. We have used Doppler parameters in patients without vascular ED to define age-specific normalcy.


Assuntos
Envelhecimento/fisiologia , Disfunção Erétil/diagnóstico , Ereção Peniana/fisiologia , Pênis/diagnóstico por imagem , Ultrassonografia Doppler em Cores , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Disfunção Erétil/tratamento farmacológico , Disfunção Erétil/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Ereção Peniana/efeitos dos fármacos , Pênis/irrigação sanguínea , Pênis/fisiologia , Fenilefrina/administração & dosagem , Fenilefrina/antagonistas & inibidores , Inibidores da Fosfodiesterase 5/farmacologia , Inibidores da Fosfodiesterase 5/uso terapêutico , Estudos Retrospectivos , Falha de Tratamento , Agentes Urológicos/uso terapêutico , Adulto Jovem
9.
Curr Probl Diagn Radiol ; 49(1): 54-63, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30704768

RESUMO

The purpose of this review is to discuss the role of magnetic resonance imaging (MRI) in the evaluation of penile pathology. Normal penile anatomy as well as the appearance of neoplastic and non-neoplastic entities on MRI will be reviewed. While ultrasound remains the first line imaging modality in evaluating most penile pathology, MR imaging has specific advantages owing to improved soft tissue resolution, ability to evaluate less accessible or complex anatomy (such as at the base of the penis), and the ability to detect subtle enhancement. Therefore, MRI is useful for when ultrasound and/or clinical findings are equivocal or incongruent. In addition, MR imaging is essential for preoperative surgical planning and is the imaging modality of choice in evaluating penile prostheses. The added value of MRI in these settings makes it an integral component to the management of many pathological entities affecting the penis.


Assuntos
Imagem por Ressonância Magnética/métodos , Doenças do Pênis/diagnóstico por imagem , Doenças do Pênis/patologia , Pênis/diagnóstico por imagem , Pênis/patologia , Humanos , Masculino , Pênis/anatomia & histologia
10.
Eur Radiol ; 30(1): 11-25, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31332561

RESUMO

Varicoceles are relatively common particularly in asymptomatic men and are even more prevalent in subfertile men, representing the most common potentially correctable cause of male infertility. Ultrasound (US) is the imaging modality of choice for varicocele evaluation, but there is no widely accepted consensus on examination technique, diagnostic criteria, or classification. In view of this uncertainty, the guideline writing group (WG) of the European Society of Urogenital Radiology (ESUR) Scrotal and Penile Imaging Working Group (ESUR-SPIWG) undertook a literature review and assessment of the quality of relevant evidence. The group then produced evidence-based recommendations for varicocele US examination, interpretation, and classification by consensus agreement. The results are presented in the form of 15 clinical questions with a brief summary of the relevant evidence and the authorised recommendations from the SPIWG. This paper provides a short summary of the evidence evaluation and the complete recommendations.Key Points• Varicocele is a common clinical problem; it is highly prevalent amongst subfertile men and the most common potentially correctable cause of male infertility. • Ultrasound is the imaging modality of choice for varicocele assessment, but there is no generally agreed consensus on the US examination technique or the criteria that should be used for diagnosis, grading, and classification. • This paper summarises the recommendations of the ESUR-SPIWG for standardising the US assessment of varicoceles. This includes examination technique, image interpretation, classification, and reporting.


Assuntos
Infertilidade Masculina/diagnóstico por imagem , Escroto/diagnóstico por imagem , Varicocele/diagnóstico por imagem , Consenso , Medicina Baseada em Evidências , Humanos , Infertilidade Masculina/etiologia , Masculino , Pênis/diagnóstico por imagem , Espermatogênese/fisiologia , Ultrassonografia , Varicocele/complicações
11.
Urologiia ; (5): 119-123, 2019 Dec.
Artigo em Russo | MEDLINE | ID: mdl-31808645

RESUMO

A clinical observation of the distal segmental thrombosis of the left corpus cavernosum is presented in the article. Efficient treatment was based on the results of contrast MRI, and timely application of long-term doses of antithrombotic drugs was done. It is allowed to avoid short-term formation of such a complication as cavernous fibrosis.


Assuntos
Fibrinolíticos/uso terapêutico , Pênis/diagnóstico por imagem , Priapismo , Trombose/tratamento farmacológico , Humanos , Imagem por Ressonância Magnética , Masculino , Pênis/irrigação sanguínea , Priapismo/etiologia , Trombose/diagnóstico por imagem , Resultado do Tratamento
12.
Ann Ital Chir ; 90: 330-334, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31657357

RESUMO

INTRODUCTION: Fracture of the penis is a urological casualty resulting from a tear in the tunica albuginea of the penis. The diagnosis of suspicion is based fundamentally on the data obtained by means of clinical presentation and physical examination. Penile ultrasound is a useful, quick and innocuous test for suspected cavernous body ruptures. MATERIALS AND METHODS: We observed 22 patients with suspected asymptomatic penile trauma. All of them underwent a Colour Doppler US examination, 5 of them an MRI scan. A functional US with stimulation was not carried out immediately, neither was a retrograde urethrography performed. RESULTS: No lesions were found in six patients and only one patient underwent partial penectomy. The other patients received conservative treatments, such as cold compressive bandaging of the penis and the administration of fibrinolysis. CONCLUSION: Penile fracture is underestimated because the traumas are often kept silent. Early diagnostic imaging management permits evaluation of the best procedure to adopt and whether surgery is necessary or not. KEY WORDS: Colour Doppler US, Penectomy, Penile fracture.


Assuntos
Imagem por Ressonância Magnética , Pênis/diagnóstico por imagem , Pênis/lesões , Ultrassonografia Doppler em Cores , Humanos , Masculino , Ruptura/diagnóstico por imagem
13.
Med Ultrason ; 21(3): 353-355, 2019 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-31476217

RESUMO

High flow priapism caused by perineal trauma is a relatively rare disorder. Early diagnosis represents a mandatory condition for the therapeutic resolution. Ultrasound examination is affordable and a within reach method for diagnosis also in an emergency context. We present the case of a 56-year-old male patient with traumatic priapism which was subsequently investigated by contrast-enhanced ultrasound and shear wave elastography. This may be one of the first cases presented in the literature.


Assuntos
Meios de Contraste , Aumento da Imagem/métodos , Pênis/diagnóstico por imagem , Pênis/lesões , Priapismo/diagnóstico por imagem , Ultrassonografia/métodos , Humanos , Masculino , Pessoa de Meia-Idade
14.
Urology ; 134: 217-220, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31542463

RESUMO

A case of accessory scrotum with duplicated penis (diphallia) in a male fetus is reported because of its rarity. This case is presented with proved negative androgen receptors in the accessory genitalia. The results of excisional surgery as well as immunostaining for androgen receptors in the resected specimens are presented as well. The outcomes of prenatal ultrasonography, clinical examination of the infant, and pathologic findings of the resected accessory genitalia are also discussed.


Assuntos
Pênis/anormalidades , Escroto/anormalidades , Ultrassonografia Pré-Natal , Adulto , Feminino , Humanos , Masculino , Pênis/diagnóstico por imagem , Pênis/cirurgia , Gravidez , Diagnóstico Pré-Natal , Escroto/diagnóstico por imagem , Escroto/cirurgia
15.
Andrologia ; 51(9): e13365, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31273827

RESUMO

The aim of this study was to evaluate the relationship between penile colour doppler ultrasonography (PCDUS) and complete blood count parameters in patients with erectile dysfunction (ED). The data of the patients who applied to our outpatient clinic with ED (IIEF-5 score <22 or IIEF-EF score <26) between January 2007 and May 2017 were retrospectively analysed. The patients who had available PCDUS results and complete blood count (CBC) values were included in the study. Patients were divided into two groups having normal (n = 530 [68.9%]) or abnormal (n = 240 [31.1%]) PCDUS findings (group 1 versus group 2 respectively). Subsequently, group 2 was divided into three subgroups according to presence of arterial insufficiency (group 2a; n = 85 [11%]), venous insufficiency (group 2b; n = 140 [18.2%]) and both of arterial and venous insufficiency (group 2c; n = 15 [1.9%]), and the four groups were compared in terms of CBC parameters. There was no statistically significant difference between the 4 groups, and between the patients with normal and abnormal PCDUS findings in terms of CBC values. CBC values were not associated with PCDUS findings in patients with ED.


Assuntos
Disfunção Erétil/diagnóstico , Ereção Peniana/fisiologia , Pênis/diagnóstico por imagem , Ultrassonografia Doppler em Cores , Adulto , Idoso , Contagem de Células Sanguíneas , Disfunção Erétil/sangue , Disfunção Erétil/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Pênis/irrigação sanguínea , Pênis/fisiopatologia , Estudos Retrospectivos , Fatores de Risco
17.
Andrologia ; 51(6): e13289, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30983030

RESUMO

Lipomas are the most common benign tumours that originate from adipose tissue and can develop in any anatomical location where the adipose tissue layer is present in the body. Penile lipoma cases are very rare in the literature. Our case is a 21-year-old male patient who underwent TIPU operation 8 years ago due to distal hypospadias. One year after the operation, a palpable swelling at the midline of the ventral portion of the penis occurred and this lesion grew over time. In this case report, we present a patient with lipoma that was developed in the surgical area 1 year after hypospadias surgery. To the best of our knowledge, this is one of the first cases of penil lipoma related to hypospadias procedure.


Assuntos
Hipospadia/cirurgia , Lipoma/etiologia , Neoplasias Penianas/etiologia , Complicações Pós-Operatórias/etiologia , Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos , Humanos , Lipoma/diagnóstico , Masculino , Neoplasias Penianas/diagnóstico , Pênis/anormalidades , Pênis/diagnóstico por imagem , Pênis/cirurgia , Complicações Pós-Operatórias/diagnóstico , Resultado do Tratamento , Ultrassonografia , Adulto Jovem
18.
Prenat Diagn ; 39(7): 527-535, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30980419

RESUMO

OBJECTIVE: This study measured anogenital distance (AGD) during late second/early third trimester of pregnancy to confirm previous findings that AGD can be measured noninvasively in the fetus using ultrasound and further showed differences in reference ranges between populations. METHOD: Two hundred ten singleton pregnancies were recruited at the Rosie Hospital, Cambridge, UK. A 2D ultrasound was performed between 26 and 30 weeks of pregnancy. AGD was measured from the centre of the anus to the base of the scrotum in males and to the posterior convergence of the fourchette in females. RESULTS: A significant difference in AGD between males and females (P < .0001) was found, replicating previous results with a significant correlation between estimated fetal weight (EFW) and AGD in males only (P = .006). A comparison of AGD using reference data from an Israeli sample (n = 118) and our UK sample (n = 208) showed a significant difference (P < .0001) in both males and females, after controlling for gestational age (GA). CONCLUSION: Our results confirm that AGD measurement in utero using ultrasound is feasible. In addition, there are strong sex differences, consistent with previous suggestions that AGD is influenced by prenatal androgen exposure. AGD lengths differ between the UK and Israel; therefore, population-specific normative values may be required for accurate clinical assessments.


Assuntos
Feto/anatomia & histologia , Períneo/anatomia & histologia , Ultrassonografia Pré-Natal , Adulto , Canal Anal/anatomia & histologia , Canal Anal/diagnóstico por imagem , Canal Anal/embriologia , Pesos e Medidas Corporais/métodos , Feminino , Retardo do Crescimento Fetal/diagnóstico , Retardo do Crescimento Fetal/patologia , Feto/diagnóstico por imagem , Genitália/anatomia & histologia , Genitália/diagnóstico por imagem , Genitália/embriologia , Idade Gestacional , Humanos , Israel , Masculino , Pênis/anatomia & histologia , Pênis/diagnóstico por imagem , Pênis/embriologia , Períneo/diagnóstico por imagem , Gravidez , Escroto/anatomia & histologia , Escroto/diagnóstico por imagem , Escroto/embriologia , Caracteres Sexuais , Análise para Determinação do Sexo/métodos
19.
Andrologia ; 51(8): e13297, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31033009

RESUMO

The penile duplex ultrasound (PDU) has been used as a diagnostic tool in erectile dysfunction (ED) management. It is currently recommended that peak systolic velocity (PSV) and end-diastolic flow (EDF) should be recorded on both the right and left cavernosal arteries. However, the clinical utility of bilateral recordings is unknown. Our primary objective is to assess the clinical utility of bilateral recordings in ED treatment with sildenafil. A total of 77 patients were included. All patients had a standardised PDU and also completed the IIEF-5 and started on-demand treatment with sildenafil at 100 mg at baseline. The IIEF-5 and EDITS were completed at the 6-month follow-up. The Spearman test was used to assess correlation. Receiver operating characteristic (ROC) curves were drawn, and the area under the curve (AUC) was calculated. Improvement, cure and satisfaction were high (77.9%, 64.9% and 67.5%, respectively), and the median IIEF-5 and EDITS were 25(22; 25) and 81.81(63.63; 88.63) respectively. The lowest PSV had the highest positive correlation with IIEF-5 and EDITS (p = 0.436 and 0.379, respectively), and it could predict improvement, cure and satisfaction with a fair-to-good accuracy (AUC = 0.837, 0.750 and 0.749 respectively). The present study shows bilateral penile blood-flow assessment is important, and attention should be focused on the lowest bilateral PSV.


Assuntos
Disfunção Erétil/diagnóstico por imagem , Pênis/irrigação sanguínea , Citrato de Sildenafila/administração & dosagem , Ultrassonografia Doppler Dupla , Agentes Urológicos/administração & dosagem , Idoso , Artérias/diagnóstico por imagem , Artérias/efeitos dos fármacos , Artérias/fisiopatologia , Velocidade do Fluxo Sanguíneo/efeitos dos fármacos , Velocidade do Fluxo Sanguíneo/fisiologia , Relação Dose-Resposta a Droga , Disfunção Erétil/tratamento farmacológico , Disfunção Erétil/fisiopatologia , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Pênis/diagnóstico por imagem , Pênis/fisiopatologia , Fluxo Sanguíneo Regional/efeitos dos fármacos , Fluxo Sanguíneo Regional/fisiologia , Resultado do Tratamento
20.
Urology ; 129: 106-112, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30954611

RESUMO

OBJECTIVE: To compare the patient's satisfaction and long-term results of 2 penile plication procedures in patients with penile curvature. METHODS: This retrospective study included 387 patients with congenital penile curvature (n = 260) and Peyronie's disease (n = 127) who underwent surgical correction of penile curvature with penile plication procedures. Of the patients, 202 underwent plication of tunica albuginea with the Lue's 16-dot technique, while 185 underwent highly superficial excision of tunica albuginea with the modified Nesbit corporoplasty. Surgical outcomes and patient's satisfaction were compared between the 2 techniques in all patients. RESULTS: The mean duration of surgery was significantly shorter in the 16-dot plication technique (48.1 ±â€¯7.5 minutes), compared with the modified Nesbit corporoplasty (63 ±â€¯16.9 minutes) (P = .001). Complete penile straightening was achieved in 87.6% of the patients who underwent 16-dot plication technique and in 89.7% of the patients who underwent modified Nesbit plication, revealing no difference (P = .514). The rates of penile sensory loss (P = .001) and de-novo erectile dysfunction (P = .016) were significantly higher in the modified Nesbit corporoplasty than in the 16-dot plication technique, but rate of suture related complications was significantly higher in the 16-dot plication technique than in the modified Nesbit corporoplasty (P = .001). The patients with congenital penile curvature had significantly less ratio of postoperative penile length loss and de-novo erectile dysfunction than Peyronie's disease patients. CONCLUSION: Overall, both surgical techniques have very high success and satisfaction rates with very low complication rates. However, the types of complications are significantly different between the 2 surgical procedures. Therefore, patients with penile curvature should be informed about outcomes of penile plication procedures, and surgical method should be preferred based on patient's preference and surgeon's experience.


Assuntos
Satisfação do Paciente , Ereção Peniana/fisiologia , Pênis/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Técnicas de Sutura , Suturas , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Induração Peniana/diagnóstico , Induração Peniana/fisiopatologia , Induração Peniana/cirurgia , Pênis/diagnóstico por imagem , Pênis/fisiopatologia , Estudos Retrospectivos , Fatores de Tempo , Ultrassonografia Doppler , Adulto Jovem
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