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1.
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
3.
J Urol ; 204(6): 1290-1295, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32717158

RESUMO

PURPOSE: We evaluated the success of minimally invasive management of lichen sclerosus with topical and intraurethral clobetasol, as defined by improvement in patient reported outcome measures and nonprogression to surgery. MATERIALS AND METHODS: We conducted a review of our prospective ongoing quality improvement study to determine outcomes of our current standard practice for males with penile and urethral biopsy proven lichen sclerosus. Data were collected between 2011 and 2019, and included patient demographic information, medical and surgical histories, and location and extent of lichen sclerosus related pathology. The primary outcomes for this study were voiding function and voiding related quality of life, and were assessed using the AUASS (American Urological Association Symptom Score) and quality of life bother index, respectively. RESULTS: We identified 42 patients with biopsy proven lichen sclerosus related urethral stricture disease. Of these patients 85.7% were treated with intraurethral steroids alone and did not require surgical intervention. Median AUASS significantly improved from 12 to 8, and median quality of life bother index improved from 4 ("mostly dissatisfied") to 2 ("mostly satisfied"). Average stricture length of those with penile urethral disease and bulbar urethral disease was 4.8 cm (SD 3.0) and 16.2 cm (SD 6.5), respectively. Median followup was 8.4 months (IQR 2.6-26.4). CONCLUSIONS: Lichen sclerosus related urethral stricture disease can be effectively managed with intraurethral steroids. This minimally invasive management strategy improves patient reported voiding symptoms and voiding quality of life.


Assuntos
Clobetasol/administração & dosagem , Líquen Escleroso e Atrófico/tratamento farmacológico , Qualidade de Vida , Estreitamento Uretral/tratamento farmacológico , Micção/fisiologia , Administração Tópica , Adulto , Biópsia , Seguimentos , Humanos , Líquen Escleroso e Atrófico/complicações , Líquen Escleroso e Atrófico/patologia , Líquen Escleroso e Atrófico/fisiopatologia , Masculino , Pessoa de Meia-Idade , Medidas de Resultados Relatados pelo Paciente , Satisfação do Paciente , Pênis/efeitos dos fármacos , Pênis/patologia , Estudos Prospectivos , Estudos Retrospectivos , Creme para a Pele/administração & dosagem , Resultado do Tratamento , Uretra/efeitos dos fármacos , Uretra/patologia , Estreitamento Uretral/etiologia , Estreitamento Uretral/patologia , Estreitamento Uretral/fisiopatologia
4.
J Urol ; 204(6): 1341-1348, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32718276

RESUMO

PURPOSE: Surgery is the first line treatment for congenital concealed penis but penile retraction is inevitable in some cases. We investigate the anatomical and histological characteristics of penile fasciae and describe a new technique for the correction of concealed penis. MATERIALS AND METHODS: The anatomical structures of penile fasciae were observed in 10 adult cadaveric penises. Penile tissue samples were stained with hematoxylin-eosin, Masson's trichrome and Weigert's resorcin-fuchsin, respectively. From January 2017 to May 2019, 78 patients with congenital concealed penis were treated with the new surgical technique. Median patient age was 14 years (range 8 to 18). RESULTS: Dartos fascia had sublayers. The superficial layer was a well vascularized tissue composed of nonpolar collagen fibers intermixed with nerves and vessels. The deep layer was composed of a transverse arrangement of collagen fibers and elastic fibers, and there were fewer venules and nerve fibers. Based on this finding we performed anatomical resection of the deep layer of dartos fascia to correct concealed penis. During the operation dartos fascia was separated into 2 layers and a complete circular resection of the deep layer was made at the base of the penis. Mean followup was 14 months. All patients and their parents were satisfied with the outcomes. None of the patients underwent postoperative penile retraction. CONCLUSIONS: The anatomical resection of the deep layer of dartos fascia for correcting concealed penis is technically easy, safe and effective. It provides a good cosmetic appearance and functional outcomes.


Assuntos
Fáscia/patologia , Fasciotomia/métodos , Doenças dos Genitais Masculinos/cirurgia , Pênis/anormalidades , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Adolescente , Adulto , Cadáver , Criança , Fasciotomia/efeitos adversos , Estudos de Viabilidade , Seguimentos , Doenças dos Genitais Masculinos/congênito , Doenças dos Genitais Masculinos/patologia , Humanos , Masculino , Pênis/patologia , Pênis/cirurgia , Resultado do Tratamento , Procedimentos Cirúrgicos Urológicos Masculinos/efeitos adversos
6.
Acta Cir Bras ; 35(3): e202000305, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32520081

RESUMO

PURPOSE: To evaluate the effect of chronic alcoholism on morphometry and apoptosis mechanism and correlate with miRNA-21 expression in the corpus cavernosum of rats. METHODS: Twenty-four rats were divided into two experimental groups: Control (C) and Alcoholic group (A). After two weeks of an adaptive phase, rats from group A received only ethanol solution (20%) during 7 weeks. The morphometric and caspase-3 immunohistochemistry analysis were performed in the corpus cavernosum. The miRNA-21 expression was analyzed in blood and cavernous tissue. RESULTS: Chronic ethanol consumption decreased cavernosal smooth muscle area of alcoholic rats. The protein expression of caspase 3 in the corpus cavernosum was higher in A compared to the C group. There was no difference in the expression of miRNA-21 in serum and cavernous tissue between the groups. CONCLUSION: Chronic ethanol consumption reduced smooth muscle area and increased caspase 3 in the corpus cavernosum of rats, without altered serum and cavernosal miR-21 gene expression.


Assuntos
Alcoolismo/complicações , Apoptose/efeitos dos fármacos , Pênis/efeitos dos fármacos , Pênis/patologia , Animais , Caspase 3/análise , Modelos Animais de Doenças , Disfunção Erétil/induzido quimicamente , Disfunção Erétil/patologia , Expressão Gênica , Imuno-Histoquímica , Masculino , MicroRNAs/análise , Músculo Liso/efeitos dos fármacos , Ratos Wistar , Valores de Referência
7.
J Pathol ; 251(4): 411-419, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32488868

RESUMO

Penile cancer is an under-studied disease that occurs more commonly in developing countries and 30-50% of cases show high-risk human papillomavirus (HPV) infection. Therapeutic advances are slow, largely due to the absence of animal models for translational research. Here, we report the first mouse model for HPV-related penile cancer. Ten-week-old mice expressing all the HPV16 early genes under control of the cytokeratin 14 (Krt14) gene promoter and matched wild-type controls were exposed topically to dimethylbenz(a)anthracene (DMBA) or vehicle for 16 weeks. At 30 weeks of age, mice were sacrificed for histological analysis. Expression of Ki67, cytokeratin 14, and of the HPV16 oncogenes E6 and E7 was confirmed using immunohistochemistry and quantitative PCR, respectively. HPV16-transgenic mice developed intraepithelial lesions including condylomas and penile intraepithelial neoplasia (PeIN). Lesions expressed cytokeratin 14 and the HPV16 oncogenes E6 and E7 and showed deregulated cell proliferation, demonstrated by Ki67-positive supra-basal cells. HPV16-transgenic mice exposed to DMBA showed increased PeIN incidence and squamous cell carcinoma. Malignant lesions showed varied histological features closely resembling those of HPV-associated human penile cancers. Wild-type mice showed no malignant or pre-malignant lesions even when exposed to DMBA. These observations provide the first experimental evidence to support the etiological role of HPV16 in penile carcinogenesis. Importantly, this is the first mouse model to recapitulate key steps of HPV-related penile carcinogenesis and to reproduce morphological and molecular features of human penile cancer, providing a unique in vivo tool for studying its biology and advancing basic and translational research. © 2020 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.


Assuntos
Carcinoma in Situ/virologia , Carcinoma de Células Escamosas/virologia , Papillomavirus Humano 16/fisiologia , Infecções por Papillomavirus/virologia , Neoplasias Penianas/virologia , Animais , Carcinogênese , Carcinoma in Situ/patologia , Carcinoma de Células Escamosas/patologia , Proliferação de Células , Modelos Animais de Doenças , Papillomavirus Humano 16/genética , Humanos , Imuno-Histoquímica , Masculino , Camundongos , Camundongos Transgênicos , Proteínas Oncogênicas Virais/genética , Proteínas Oncogênicas Virais/metabolismo , Proteínas E7 de Papillomavirus/genética , Proteínas E7 de Papillomavirus/metabolismo , Infecções por Papillomavirus/patologia , Neoplasias Penianas/patologia , Pênis/patologia , Pênis/virologia , Distribuição Aleatória , Proteínas Repressoras/genética , Proteínas Repressoras/metabolismo
8.
Medicine (Baltimore) ; 99(21): e20217, 2020 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-32481291

RESUMO

RATIONALE: Hemangiomas of the glans penis are very rare. Treatment options include surgical excision, laser therapy, intralesional sclerotherapy, electrofulguration, and cryotherapy. However, there have been no definitive treatment guidelines established to date. PATIENT CONCERNS: A 19-year-old man presented with a mass on the glans penis, incidentally found during a circumcision performed at a local urology clinic 3 months before visiting our department. DIAGNOSES: Histopathological examination identified the specimen as a cavernous hemangioma. INTERVENTIONS: The mass was completely excised and the resulting wound was closed layer by layer. OUTCOMES: The patient was discharged without complications, such as wound dehiscence or infection. Follow-up 14 months after surgery showed that the wound was well healed without recurrence and the patient was satisfied with the aesthetic result. LESSONS: Although there are many options to treat hemangiomas occurring on the glans penis, surgical excision can be considered when they are small in size.


Assuntos
Circuncisão Masculina/normas , Hemangioma Cavernoso/cirurgia , Pênis/patologia , Humanos , Achados Incidentais , Masculino , Neoplasias Penianas/irrigação sanguínea , Neoplasias Penianas/patologia , Pênis/irrigação sanguínea , Resultado do Tratamento , Adulto Jovem
9.
J Sex Med ; 17(7): 1400-1404, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32444341

RESUMO

BACKGROUND: Men concerned about their penis size often consult professionals working in urology, andrology, surgery, and sexual medicine. AIM: To inform professionals in the sexual medicine field about small penis syndrome as a clinical syndrome and to provide recommendations for treatment. METHODS: This was an overview of the existing literature combined with our extensive clinical experience. RESULTS: Small penis syndrome is a syndrome with psychiatric comorbidities and social consequences that impair life. Men with these concerns tend to be susceptible for treatment that is not evidence based and potentially harmful. CLINICAL IMPLICATIONS: Treatment of men with concerns about penis size should start with a thorough biopsychosocial assessment, followed by extensive psychoeducation, counselling, and psychological interventions, even if surgery is being considered. STRENGTHS & LIMITATIONS: The strength of this study is the concise overview of the existing literature combined with clinical experience which leads to important recommendations. Limitation is that this is not a systematic review. CONCLUSION: Complaints about penis size should be taken seriously, and a thorough biopsychosocial and multidisciplinary assessment is required.


Assuntos
Satisfação do Paciente , Pênis/anatomia & histologia , Pênis/patologia , Emoções , Doenças dos Genitais Masculinos , Humanos , Masculino , Tamanho do Órgão , Doenças do Pênis/cirurgia , Comportamento Sexual
10.
Int J STD AIDS ; 31(7): 699-701, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32362198

RESUMO

Annular syphilis may range from mildly raised lesions with scaly borders to verrucous plaques. Localized annular syphilis on the genitalia has been rarely reported in HIV-negative cases. This paper reports a case of annular secondary syphilis on the penis. Dermoscopy showed peripheral dotted and short linear vessels and white scaling with a relatively clear central area in an erythematous annular plaque. Histopathology revealed mild hyperkeratosis, parakeratosis, psoriasiform acanthosis, and focal basal vacuolar degeneration with lichenoid, perivascular, and periadnexal infiltrate of lymphohistiocytes and plasma cells in the superficial dermis. Silver stain showed several spirochetes in the lower epidermis and superficial dermis. Electron microscopy revealed a few intercellular and intracytoplasmic spirochetes in the basal epidermis and free spirochetes in the papillary dermis. Rapid plasma reagin and Treponema pallidum particle agglutination assays were positive. The lesions disappeared after intramuscular benzathine penicillin, with no relapse at six-month follow-up.


Assuntos
Pênis/patologia , Sífilis Cutânea/patologia , Sífilis/diagnóstico , Treponema pallidum/isolamento & purificação , Adulto , Humanos , Masculino , Microscopia Eletrônica , Penicilina G Benzatina/uso terapêutico , Sífilis/tratamento farmacológico , Sorodiagnóstico da Sífilis , Resultado do Tratamento
11.
PLoS One ; 15(4): e0231795, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32302375

RESUMO

During the necropsies of Iberian hares obtained in 2018/2019, along with signs of the nodular form of myxomatosis, other unexpected external lesions were also observed. Histopathology revealed nuclear inclusion bodies in stromal cells suggesting the additional presence of a nuclear replicating virus. Transmission electron microscopy further demonstrated the presence of herpesvirus particles in the tissues of affected hares. We confirmed the presence of herpesvirus in 13 MYXV-positive hares by PCR and sequencing analysis. Herpesvirus-DNA was also detected in seven healthy hares, suggesting its asymptomatic circulation. Phylogenetic analysis based on concatenated partial sequences of DNA polymerase gene and glycoprotein B gene enabled greater resolution than analysing the sequences individually. The hare' virus was classified close to herpesviruses from rodents within the Rhadinovirus genus of the gammaherpesvirus subfamily. We propose to name this new virus Leporid gammaherpesvirus 5 (LeHV-5), according to the International Committee on Taxonomy of Viruses standards. The impact of herpesvirus infection on the reproduction and mortality of the Iberian hare is yet unknown but may aggravate the decline of wild populations caused by the recently emerged natural recombinant myxoma virus.


Assuntos
Lebres/virologia , Infecções por Herpesviridae/veterinária , Animais , Células Cultivadas , Feminino , Geografia , Herpesviridae/isolamento & purificação , Infecções por Herpesviridae/patologia , Infecções por Herpesviridae/virologia , Masculino , Pênis/patologia , Pênis/virologia , Filogenia , Portugal
12.
Oxid Med Cell Longev ; 2020: 6834236, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32190176

RESUMO

Objective: To investigate the protective effects and mechanisms of human tissue kallikrein 1 (hKLK1) on type 1 diabetes mellitus- (DM-) induced erectile dysfunction in rats. Materials and Methods. The homozygous transgenic rats (TGR) harboring the hKLK1 gene and age-matched wild-type Sprague Dawley rats (WTR) were involved, and intraperitoneal injection of streptozotocin was utilized to induce diabetes in rats. Forty-eight-week-old male rats were randomly divided into a WTR group, TGR group, diabetic WTR group (WTDM), diabetic TGR group (TGDM), and TGDM with HOE140 group (TGDMH), with eight rats in each group. Twelve weeks later, the erectile response of all rats was detected by cavernous nerve electric stimulation, and corpus cavernosums were harvested to evaluate the levels of cavernous oxidative stress (OS), apoptosis, fibrosis, and involved pathways. Moreover, cavernous smooth muscle cells (CSMC) and endothelial cells (EC) were primarily isolated to build a coculture system for a series of in vitro verification. Results: The hKLK1 gene and age-matched wild-type Sprague Dawley rats (WTR) were involved, and intraperitoneal injection of streptozotocin was utilized to induce diabetes in rats. Forty-eight-week-old male rats were randomly divided into a WTR group, TGR group, diabetic WTR group (WTDM), diabetic TGR group (TGDM), and TGDM with HOE140 group (TGDMH), with eight rats in each group. Twelve weeks later, the erectile response of all rats was detected by cavernous nerve electric stimulation, and corpus cavernosums were harvested to evaluate the levels of cavernous oxidative stress (OS), apoptosis, fibrosis, and involved pathways. Moreover, cavernous smooth muscle cells (CSMC) and endothelial cells (EC) were primarily isolated to build a coculture system for a series of. Conclusions: hKLK1 preserves erectile function of DM rats through its antitissue excessive OS, apoptosis, and fibrosis effects, as well as activation of the PI3K/AKT/eNOS/cGMP pathway in the penis. Moreover, hKLK1 promotes relaxation and prevents high glucose-induced injuries of CSMC mediated by EC-CSMC crosstalk.


Assuntos
Diabetes Mellitus Experimental/complicações , Disfunção Erétil/tratamento farmacológico , Óxido Nítrico Sintase Tipo III/metabolismo , Estresse Oxidativo , Fosfatidilinositol 3-Quinases/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Calicreínas Teciduais/uso terapêutico , Animais , Apoptose/efeitos dos fármacos , Glicemia/metabolismo , Peso Corporal , Cálcio/metabolismo , GMP Cíclico/metabolismo , Diabetes Mellitus Experimental/patologia , Estimulação Elétrica , Disfunção Erétil/complicações , Disfunção Erétil/patologia , Jejum/sangue , Fibrose , Glucose/toxicidade , Masculino , Miócitos de Músculo Liso/efeitos dos fármacos , Miócitos de Músculo Liso/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Pênis/efeitos dos fármacos , Pênis/patologia , Ratos Sprague-Dawley , Ratos Transgênicos , Transdução de Sinais/efeitos dos fármacos , Estreptozocina , Calicreínas Teciduais/farmacologia
13.
Panminerva Med ; 62(1): 13-18, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32199407

RESUMO

BACKGROUND: The aim of this pilot study was to evaluate the effects of Pycnogenol® and CA (Centellicum®) on penile fibrosis and on associated signs and symptoms. METHODS: A group of 82 subjects with penile nodules and plaques was included in this registry study and followed up for 3 months; 32 were managed with standard management (SM) only. Twenty-four were managed with CA (Centellicum®: 3 capsules/day: 675 mg/day) in association with SM, and 26 subjects were managed with Pycnogenol® (150 mg/day) + CA (Centellicum® at the same dosage as in group 2) and SM. RESULTS: Subjects in the 3 groups were comparable, including the distribution of plaques. The occurrence of any previous catheterizations was also comparable. Safety and tolerability were optimal, no subjects had to stop supplementation. The percentage of subjects with improved symptoms evaluated with a Visual Analogue Scale line was significantly higher with both supplements in comparison with SM (P<0.05). The combined management with Pycnogenol® and Centellicum® was superior to the other 2 managements (P<0.05). Erectile function assessed by the Index of Erectile Fuction questionnaire (IIEF) was significantly higher with the combination Pycnogenol®+Centellicum (P<0.05). The number of plaques and microplaques, the average total sectional area of the plaques in each subject and the grey scale median were all better improved with the combination. Both supplementations were superior to SM at 12 weeks (P<0.05). Oxidative stress resulted significantly better (P<0.05) with the combination. All blood tests were normal at inclusion and at 12 weeks. The minimal, penile curvature at baseline was reduced in both the supplement groups at 12 weeks more than in the SM group (P<0.05). CONCLUSIONS: In conclusion Centellicum and Pycnogenol® appear to improve penile fibrosis reducing the keloidal aspects of penile plaques.


Assuntos
Centella/química , Suplementos Nutricionais , Flavonoides/uso terapêutico , Doenças do Pênis/tratamento farmacológico , Extratos Vegetais/uso terapêutico , Cateterismo , Técnicas de Imagem por Elasticidade , Disfunção Erétil , Fibrose , Humanos , Masculino , Pessoa de Meia-Idade , Segurança do Paciente , Pênis/diagnóstico por imagem , Pênis/patologia , Projetos Piloto , Plantas Medicinais/química , Estudos Prospectivos , Sistema de Registros , Inquéritos e Questionários , Escala Visual Analógica
15.
Rev. int. androl. (Internet) ; 18(1): 14-20, ene.-mar. 2020. ilus, tab, graf
Artigo em Inglês | IBECS | ID: ibc-193833

RESUMO

INTRODUCTION AND OBJECTIVES: The aim of this study is to evaluate the effects of castration and subsequent losartan administration on the fibrosis-related parameters in the corpora cavernosa of castrated rats. MATERIAL AND METHODS: Twenty-four male rats were divided into four equal groups. Group 1:sham surgery plus vehicle (0.9% NaCl) (control:con), group 2:sham surgery plus losartan (con+los), group 3: castration plus vehicle (castration:cast) and group 4:castration plus losartan (cast+los). After four weeks of oral losartan treatment, corporal levels of transforming growth factor-beta (TGF-beta), thrombospondin-1 (TSP-1), alpha-actin, beta-actin and fibronectin were investigated by ELISA kits. Changes in the collagen and smooth muscle content were evaluated by histological analysis with Masson trichrome staining. RESULTS: Initial and post-treatment body weights of rats were similar among groups. Castration significantly increased the expression of TGF-beta, TSP-1 and fibronectin and resulted in a significant decrease in alpha-actin levels in the corpora cavernosa. Administration of losartan reduced the levels of TGF-beta, TSP-1 and fibronectin in castrated rats. Alpha actin levels also increased after losartan treatment. Beta-actin levels were not significantly different among 4 groups. The levels of all markers were similar in group 1 and 2. Rate of fibrosis was significantly higher in castrated rats and treatment with losartan reduced this rate. CONCLUSION: Castration increased the expression of fibrosis-related markers in the corpora cavernosa of rats. Administration of losartan significantly attenuated those changes and exerted an antifibrotic effect


INTRODUCCIÓN Y OBJETIVOS: El objetivo de este estudio es evaluar los efectos de la castración y la posterior administración de losartán en los parámetros relacionados con la fibrosis en los cuerpos cavernosos de ratas castradas. MATERIAL Y MÉTODOS: Veinticuatro ratas macho se dividieron en 4 grupos iguales. Grupo 1: cirugía simulada más vehículo (0,9% NaCl) (control:con); grupo 2: cirugía simulada más losartán (con+los); grupo 3: castración más vehículo (castración:cast) y grupo 4: castración más losartán (cast+los). Después de 4 semanas de tratamiento oral con losartán se analizaron los niveles de factor de crecimiento transformante beta (TGF-beta), trombospondina-1 (TSP-1), alfa-actina, beta-actina y fibronectina mediante kits de ELISA. Cambios en el colágeno y el contenido de músculo liso se evaluaron mediante análisis histológico con tinción con tricrómico de Masson. RESULTADOS: Los pesos corporales iniciales y posteriores al tratamiento de las ratas fueron similares entre los grupos. La castración aumentó considerablemente la expresión de TGF-beta, TSP-1 y fibronectina, y dio como resultado una disminución importante de los niveles de alfa-actina en los cuerpos cavernosos. La administración de losartán redujo los niveles de TGF-beta, TSP-1 y fibronectina en ratas castradas. Los niveles de alfa-actina también aumentaron después del tratamiento con losartán. Los niveles de beta-actina no fueron muy diferentes entre los 4 grupos. Los niveles de todos los marcadores fueron similares en los grupos 1 y 2. La tasa de fibrosis fue mucho mayor en las ratas castradas y el tratamiento con losartán redujo esta tasa. CONCLUSIÓN: La castración aumentó la expresión de marcadores relacionados con la fibrosis en los cuerpos cavernosos de las ratas. La administración de losartán atenuó considerablemente esos cambios y ejerció un efecto antifibrótico


Assuntos
Animais , Masculino , Ratos , Disfunção Erétil/tratamento farmacológico , Bloqueadores do Receptor Tipo 1 de Angiotensina II/administração & dosagem , Losartan/administração & dosagem , Fibrose/prevenção & controle , Disfunção Erétil/sangue , Pênis/lesões , Pênis/inervação , Pênis/patologia , Ratos Wistar
16.
Oxid Med Cell Longev ; 2020: 7286958, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32215177

RESUMO

Hyperlipidemia is considered one of the most important risk factors for erectile dysfunction (ED). To determine the effect of sodium tanshinone IIA sulfonate (STS) as an antioxidant agent on ED in high-fat diet- (HFD-) induced hyperlipidemia in rats and to investigate if STS administration could improve erectile function via hydrogen sulfide (H2S) production by inhibition of oxidative stress. Hyperlipidemia was induced in Sprague-Dawley rats by feeding HFD for 16 weeks. The rats were randomly divided into 3 groups: control, HFD, and HFD treated with STS (10 mg/kg/day for 12 weeks, intraperitoneal injection). Erectile function including intracavernosal pressure (ICP), H2S production, and antioxidant capacity was assessed. In addition, cavernosal smooth muscle cells (CSMC) isolated from SD rats were pretreated with STS in vitro and exposed to H2O2. Expressions of nuclear factor erythroid 2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1), activity of antioxidant enzymes, and H2S-generating enzymes within CSMC were examined. ICP was significantly decreased in HFD rats compared with control. In addition, decreased H2S production and expression of cystathionine É£-lyase (CSE) and cystathionine ß-synthase (CBS) associated with increased oxidative stress were observed in the penile tissue of HFD rats. However, all these changes were reversed by 16 weeks after STS administration. STS also increased antioxidant defense as evidenced by increased expression of Nrf2/HO-1 in the penile tissue of HFD rats. In CSMC, pretreatment with STS attenuated the decreased expression of CSE and CBS and H2S production by H2O2. STS exerted similar protective antioxidative effect as shown in the in vivo hyperlipidemia model. The present study demonstrated the redox effect of STS treatment on ED via increased H2S production in HFD-induced hyperlipidemia rat model by increased antioxidant capacity via activation of the Nrf2/HO-1 pathway, which provides STS potential clinical application in the treatment of hyperlipidemia-related ED.


Assuntos
Antioxidantes/administração & dosagem , Disfunção Erétil/tratamento farmacológico , Hiperlipidemias/tratamento farmacológico , Fenantrenos/administração & dosagem , Animais , Antioxidantes/metabolismo , Células Cultivadas , Dieta Hiperlipídica/efeitos adversos , Disfunção Erétil/etiologia , Peróxido de Hidrogênio/toxicidade , Sulfeto de Hidrogênio/metabolismo , Hiperlipidemias/etiologia , Injeções Intraperitoneais , Masculino , Oxirredução , Estresse Oxidativo/efeitos dos fármacos , Pênis/efeitos dos fármacos , Pênis/metabolismo , Pênis/patologia , Pênis/fisiopatologia , Ratos , Ratos Sprague-Dawley
17.
Urologe A ; 59(4): 426-431, 2020 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-32140745

RESUMO

The surgical treatment of Peyronie's disease involves a multistage procedure with increasing invasiveness. In addition to precise knowledge about the existing surgical treatment procedures, the indication and the informed consent process of the patient is extremely important. The dissatisfaction with the surgical results for many patients is due to false expectations and positivistic representations. If we can avoid this and make the right decisions during surgery, even these difficult-to-treat patients can be treated successfully.


Assuntos
Induração Peniana/cirurgia , Pênis/patologia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Humanos , Masculino , Induração Peniana/diagnóstico
18.
Sci Rep ; 10(1): 2965, 2020 02 19.
Artigo em Inglês | MEDLINE | ID: mdl-32076037

RESUMO

To determine the epidemiological, histopathological, and clinical characteristics of patients diagnosed with penile cancer in the Brazilian state of Maranhão, the region with the highest incidence worldwide. One hundred and sixteen penile cancer patients were interviewed from July 2016 to October 2018. The majority of patients lived in a rural area (57%), worked in farming (58%), had a low level of schooling or no schooling (90%), and were married or in a stable relationship (74%). The mean age was 60.4 ± 16.51 years (range, 23-93 years). Phimosis (66%), poor/moderate genital hygiene (73%), history of sexually transmitted infections (55%), and zoophilia (60%) were found in the majority of patients. Most patients had their first sexual encounter at 16.2 ± 2.8 years (range, 10-25 years), and 75% had >6 sexual partners. The most common initial symptom was pruritus (37%), and most patients waited to seek treatment (average time to treatment, 18.9 months; range, 2-84 months). Human papillomavirus (HPV)-related histologies were observed in 62% of patients. Most patients had histological grades II or III (87%), stage ≥T2 disease (84%), and lymphadenopathy at admission (42%). Penectomy was performed in 96% of patients. The population with penile cancer in the region of highest incidence in the world is marked by low socioeconomic status, high prevalence of HPV infection, and phimosis. The delay in seeking treatment is related to a very high rate of advanced cancer and aggressive surgical treatment. The high prevalence of young patients was also a striking feature.


Assuntos
Infecções por Papillomavirus/epidemiologia , Transtornos Parafílicos/epidemiologia , Neoplasias Penianas/epidemiologia , Fimose/epidemiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Animais , Brasil/epidemiologia , Estudos Transversais , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/virologia , Neoplasias Penianas/patologia , Neoplasias Penianas/cirurgia , Neoplasias Penianas/virologia , Pênis/patologia , Pênis/cirurgia , Pênis/virologia , Prevalência , Estudos Prospectivos , Fatores de Risco , População Rural/estatística & dados numéricos , Classe Social , Fatores de Tempo , Tempo para o Tratamento , Adulto Jovem
19.
Pediatr Surg Int ; 36(4): 523-528, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32088740

RESUMO

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


Assuntos
Anestesia Local/métodos , Anestésicos Locais/farmacologia , Circuncisão Masculina/efeitos adversos , Bloqueio Nervoso/métodos , Doenças do Pênis/cirurgia , Pênis/patologia , Complicações Pós-Operatórias/epidemiologia , Adolescente , Bandagens , Criança , Pré-Escolar , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Necrose/epidemiologia , Necrose/etiologia , Necrose/cirurgia , Doenças do Pênis/epidemiologia , Doenças do Pênis/etiologia , Pênis/cirurgia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Reoperação , Estudos Retrospectivos , Turquia/epidemiologia
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