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2.
Urologe A ; 59(2): 209-218, 2020 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-32020240

RESUMO

The incidence of penile cancer in central Europe and North America is low, and patients often present at a late stage of the disease. The diagnosis can very often be made by visual examination of the primary tumor. Its morphology, size, and location as well as the inguinal lymph nodes are of clinical interest. The removal of (micro)metastatic lymph nodes is decisive for the prognosis. These cannot be diagnosed clinically or by imaging with sufficient reliability, which makes invasive lymph node staging necessary. Penile cancer can only be cured by surgery in patients with localized cancer and early stage regional lymph node metastasis. The primary tumor, including metastatic lymph nodes, must be completely excised as early as possible. If indicated, organ preservation must be performed with strict adherence of safety margins. Optimal lymph node management is crucial for long-term survival.


Assuntos
Excisão de Linfonodo/métodos , Linfonodos/patologia , Neoplasias Penianas/diagnóstico , Neoplasias Penianas/cirurgia , Intervalo Livre de Doença , Europa (Continente) , Humanos , Metástase Linfática/patologia , Metástase Linfática/prevenção & controle , Masculino , Estadiamento de Neoplasias , Neoplasias Penianas/mortalidade , Neoplasias Penianas/patologia , Pênis/patologia , Prognóstico , Reprodutibilidade dos Testes , Análise de Sobrevida
3.
Urology ; 137: 183-189, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31926195

RESUMO

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


Assuntos
Doenças do Pênis , Pênis , Complicações Pós-Operatórias , Uretra , Estreitamento Uretral , Procedimentos Cirúrgicos Urológicos , Pesos e Medidas Corporais/métodos , Brasil , Constrição Patológica , Correlação de Dados , Técnicas de Imagem por Elasticidade/métodos , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Doenças do Pênis/diagnóstico , Doenças do Pênis/etiologia , Pênis/patologia , Pênis/cirurgia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/patologia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Uretra/irrigação sanguínea , Uretra/inervação , Uretra/patologia , Uretra/cirurgia , Estreitamento Uretral/diagnóstico , Estreitamento Uretral/epidemiologia , Estreitamento Uretral/etiologia , Estreitamento Uretral/patologia , Procedimentos Cirúrgicos Urológicos/efeitos adversos , Procedimentos Cirúrgicos Urológicos/métodos
4.
Ann R Coll Surg Engl ; 102(2): e36-e38, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31530167

RESUMO

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


Assuntos
Angioplastia/métodos , Calciofilaxia/terapia , Tratamento Conservador/métodos , Doenças do Pênis/terapia , Inibidores da Agregação de Plaquetas/uso terapêutico , Bandagens , Calciofilaxia/diagnóstico , Calciofilaxia/etiologia , Artéria Femoral/cirurgia , Humanos , Falência Renal Crônica/complicações , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Doenças do Pênis/diagnóstico , Doenças do Pênis/etiologia , Pênis/irrigação sanguínea , Pênis/patologia , Diálise Renal/efeitos adversos , Resultado do Tratamento
5.
Urology ; 135: 133-135, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31586472

RESUMO

Malignant peripheral nerve sheath tumors (MPNSTs) are soft tissue sarcomas that arise from peripheral nerve fibers and primarily occur in the setting of neurofibromatosis (NF1). MPNST arising from the penis is very rare and may require mutilating surgery to achieve surgical cure. We previously reported a case of MPNST involving the penis in a 14-month-old boy treated with neoadjuvant chemotherapy, total penectomy, and adjuvant radiation. Here we report intermediate follow-up of the same patient, describe his subsequent genitourinary reconstruction, and discuss management dilemmas that arise following treatment of penile MPNST.


Assuntos
Assistência ao Convalescente/métodos , Neoplasias da Bainha Neural/terapia , Neoplasias Penianas/terapia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Criança , Humanos , Masculino , Terapia Neoadjuvante , Neoplasias da Bainha Neural/patologia , Neoplasias Penianas/patologia , Pênis/patologia , Pênis/cirurgia , Escroto/cirurgia , Resultado do Tratamento , Uretra/cirurgia
6.
Urology ; 135: 11-19, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31605681

RESUMO

OBJECTIVE: To elucidate current understanding on the pathophysiological mechanism of genital lichen sclerosus (LS), urologic manifestations, and treatment options. MATERIALS AND METHODS: The Medline/PubMed and Embase databases were systematically reviewed for publications pertaining to LS. After applying inclusion and exclusion criteria, references were assessed for relevance to the pathophysiology, presentation, and treatment of LS by title and abstract review by 2 independent reviewers, yielding 186 articles for assessment. RESULTS: The contemporary understanding of the epidemiology and histology of LS is reviewed herein. Additionally, we explore in detail the 3 hypotheses regarding the pathophysiological mechanism contributing to disease presentation: infectious etiology, primary immune dysregulation, and the isotraumatopic response. We summarize the available biological evidence supporting each hypothesis. This discussion provides context for understanding LS morbidity and may spur new avenues of research. For the clinician, we review the clinical presentation of disease, including the risk of progression to squamous cell carcinoma. The current medical and surgical treatment options are also detailed. CONCLUSION: LS remains a potentially insidious disease which may lead to debilitating urinary and sexual dysfunction. Cross disciplinary research should aim for earlier detection, as well as more effective and durable treatment. The exact cause of LS remains unknown.


Assuntos
Balanite Xerótica Obliterante/diagnóstico , Líquen Escleroso e Atrófico/diagnóstico , Líquen Escleroso Vulvar/diagnóstico , Administração Tópica , Balanite Xerótica Obliterante/epidemiologia , Balanite Xerótica Obliterante/terapia , Biópsia , Circuncisão Masculina , Diagnóstico Diferencial , Progressão da Doença , Feminino , Glucocorticoides/uso terapêutico , Humanos , Líquen Escleroso e Atrófico/epidemiologia , Líquen Escleroso e Atrófico/terapia , Masculino , Pênis/patologia , Pênis/cirurgia , Prevalência , Resultado do Tratamento , Vulva/patologia , Líquen Escleroso Vulvar/tratamento farmacológico , Líquen Escleroso Vulvar/epidemiologia
7.
Urology ; 137: 146-151, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31887351

RESUMO

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


Assuntos
Extrofia Vesical/cirurgia , Epispadia/cirurgia , Complicações Intraoperatórias , Doenças do Pênis , Pênis , Procedimentos Cirúrgicos Urológicos , Atrofia , Criança , Humanos , Recém-Nascido , Complicações Intraoperatórias/diagnóstico , Complicações Intraoperatórias/cirurgia , Masculino , Doenças do Pênis/diagnóstico , Doenças do Pênis/etiologia , Doenças do Pênis/cirurgia , Pênis/irrigação sanguínea , Pênis/lesões , Pênis/patologia , Pênis/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Reoperação/métodos , Fatores de Risco , Procedimentos Cirúrgicos Urológicos/efeitos adversos , Procedimentos Cirúrgicos Urológicos/métodos , Adulto Jovem
8.
Acta Cir Bras ; 34(9): e201900901, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31800678

RESUMO

PURPOSE: To evaluate the effects of tadalafil (TD) in preventing histological alterations of the corpus cavernosum caused by isolated lesions of cavernous nerve (ILCN) and artery (ILCA) in rats. METHODS: Fifty male Wistar rats were randomly assigned in five groups: G1: control; G2: bilateral ILCN; G3: bilateral ILCA; G4: ILCN+TD; G5: ILCA+TD. The cavernous bodies were submitted to histomorphometry, immunohistochemistry and biochemical analysis. RESULTS: Nerve density was significantly higher in G2 and G4 compared to control (22.62±2.84 and 19.53±3.47 vs. 15.72±1.82; respectively, p<0.05). Smooth muscle density was significantly lower in G2 and G3 in comparison to G1 (12.87±1.90 and 18.93±1.51 vs. 21.78±1.81, respectively; p<0.05). A significant decrease in the sinusoidal lumen area was observed in G2 compared to controls (5.01±1.62 vs. 9.88±3.66, respectively; p<0.05) and the blood vessel density was increased in G2 and G3 (29.32±4.13 e 20.80±2.47 vs. 10.13±2.71, p<0.05). Collagen density was higher in G3 compared to G1 (93.76±15.81 vs. 64.59±19.25; p<0.05). CONCLUSIONS: Histomorphometric alterations caused by ILCN were more intense than those produced by vascular injury, but the collagen analyses showed more fibrosis in animals with ILCA. TD was effective in preventing the majority of the alterations induced by the periprostatic bundle injury.


Assuntos
Pênis/irrigação sanguínea , Pênis/inervação , Traumatismos dos Nervos Periféricos/prevenção & controle , Inibidores da Fosfodiesterase 5/farmacologia , Substâncias Protetoras/farmacologia , Tadalafila/farmacologia , Animais , Colágeno/análise , Colágeno/efeitos dos fármacos , Tecido Elástico/anatomia & histologia , Tecido Elástico/efeitos dos fármacos , Disfunção Erétil/prevenção & controle , Imuno-Histoquímica , Masculino , Pênis/efeitos dos fármacos , Pênis/patologia , Prostatectomia/efeitos adversos , Distribuição Aleatória , Ratos Wistar , Reprodutibilidade dos Testes
9.
Undersea Hyperb Med ; 46(5): 695-699, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31683369

RESUMO

Successful penile replantations are rarely reported in the literature and are associated with significant complications. We present a case of a patient who auto-amputated his penis. Delayed microvascular replantation was performed approximately 14 hours following injury. He was treated with a phosphodiesterase inhibitor postoperatively, and adjuvant hyperbaric oxygen (HBO2) therapy was started 58 hours after replantation; 20 treatments at 2.4 atmospheres absolute (ATA), twice daily for eight days, followed by once daily for four days. Perfusion of the replanted penis was serially assessed using fluorescent angiography. With some additional surgical procedures including a split- thickness skin graft to the shaft due to skin necrosis he has made a complete recovery with return of normal urinary and sexual function. This unusual case illustrates the potential benefit of HBO2 therapy in preserving viability of a severed body part. Fluorescent angiography may have potential utility in monitoring efficacy of HBO2.


Assuntos
Oxigenação Hiperbárica , Pênis/cirurgia , Complicações Pós-Operatórias/terapia , Reimplante/métodos , Automutilação/cirurgia , Terapia Combinada , Desbridamento , Humanos , Masculino , Necrose , Pênis/irrigação sanguínea , Pênis/patologia , Fotografação , Adulto Jovem
10.
BMC Vet Res ; 15(1): 356, 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31640696

RESUMO

BACKGROUND: There is growing evidence that equine papillomavirus type 2 (EcPV2) infection is causally associated with the development of equine genital squamous cell carcinomas (SCCs). Early stages of disease present clinically as plaques or wart-like lesions which can gradually progress to tumoural lesions. Histologically these lesions are inconsistently described as benign hyperplasia, papilloma, penile intraepithelial neoplasia (PIN), carcinoma in situ (CIS) or SCC. Guidelines for histological classification of early SCC precursor lesions are not precisely defined, leading to potential misdiagnosis. The aim of this study was to identify histologic criteria and diagnostic markers allowing for a more accurate diagnosis of EcPV2-associated equine penile lesions. RESULTS: A total of 61 archived equine penile lesions were histologically re-assessed and classified as benign hyperplasia, papilloma, CIS or SCC. From these, 19 representative lesions and adjacent normal skin were comparatively analysed for the presence of EcPV2 DNA and transcripts using PCR and RNA in situ hybridisation (RISH). All lesional samples were positive by EcPV2 PCR and RISH, while adjacent normal skin was negative. RISH analysis yielded signal distribution patterns that allowed distinction of early (hyperplasia, papilloma) from late stage lesions (CIS, SCC). Subsequently, the 19 lesions were further assessed for expression of p53, Ki67, MCM7 and MMP1 by immunohistochemistry (IHC). All four proteins were expressed in both normal and lesional tissue. However, p53 expression was up-regulated in basal keratinocyte layers of papillomas, CIS and SCCs, as well as in upper keratinocyte layers of CIS and SCCs. MCM7 expression was only up-regulated in upper proliferating keratinocyte layers of papillomas, CIS and SCCs. CONCLUSION: This study proposes combining a refined histological protocol for analysis of equine penile lesions with PCR- and/or RISH based EcPV2-screening and p53/MCM7 IHC to more accurately determine the type of lesion. This may help to guide the choice of optimum treatment strategy, especially at early stages of disease.


Assuntos
Doenças dos Cavalos/patologia , Infecções por Papillomavirus/veterinária , Neoplasias Penianas/veterinária , Pênis/patologia , Animais , DNA Viral/análise , Doenças dos Cavalos/virologia , Cavalos , Hibridização In Situ/veterinária , Masculino , Papillomaviridae/classificação , Infecções por Papillomavirus/patologia , Neoplasias Penianas/patologia , Neoplasias Penianas/virologia , Lesões Pré-Cancerosas/patologia , Lesões Pré-Cancerosas/veterinária , Lesões Pré-Cancerosas/virologia
11.
ABCS health sci ; 44(2): 92-95, 11 out 2019. tab
Artigo em Português | LILACS | ID: biblio-1022339

RESUMO

INTRODUÇÃO: A Síndrome de Fournier consiste em uma fasciite necrosante que afeta tecido subcutâneo e pele do períneo e genitais externos. Caracterizada como uma urgência cirúrgica, seu tratamento é baseado em três pilares: debridamento de tecidos necróticos e infectados; controle sistêmico e antibioticoterapia; e reparação dos tecidos afetados. OBJETIVO: Identificar o perfil clínico de pacientes diagnosticados com Síndrome de Fournier em um hospital de urgências. MÉTODOS: Trata-se de um estudo descritivo, retrospectivo e de abordagem quantitativa. A amostra consistiu de pacientes diagnosticados com Síndrome de Fournier acompanhados pela comissão de curativos do hospital no período de agosto de 2016 a agosto de 2017, que receberam alta ou foram a óbito. RESULTADOS: A amostra do estudo foi composta por 14 pacientes, sendo em sua totalidade pacientes do sexo masculino, entre 21 e 82 anos e idade média de 55 anos. Em 50% dos casos, foi necessário internação em Unidade de Terapia Intensiva (UTI). Quanto ao desfecho, 78,6% (11) receberam alta hospitalar e 21,4% (3) evoluíram para óbito. CONCLUSÃO: A assistência a pacientes com Síndrome de Fournier ocorre de forma despadronizada, o que ocasiona altas taxas de mortalidade. A elaboração de protocolos específicos é necessária.


INTRODUCTION: Fournier's Syndrome consists of a necrotizing fasciitis that affects subcutaneous tissue and skin of the perineum and external genitalia. Characterized as a urological urgency, its treatment is based on three pillars: debridement of necrotic and infected tissues; systemic control and antibiotic therapy; and repair of the affected tissues. OBJECTIVE: To identify the clinical profile of patients diagnosed with Fournier's Syndrome in an emergency hospital. METHODS: This is a descriptive, retrospective and quantitative study. The sample consisted of patients diagnosed with Fournier's Syndrome and attended by the hospital curative committee from August 2016 to August 2017, who were discharged or died. RESULTS: The study sample consisted of 14 medical records, all of them were male, aged between 21 and 82 years and mean age of 55 years. In 50% of the cases admittance to the Intensive Care Unit (ICU) was necessary. Regarding the outcome, 78.6% (11) were discharged from hospital and 21.4% (3) died. CONCLUSION: Assistance to patients with Fournier Syndrome is poorly standardized, resulting in high mortality rates. Development of specific protocols is necessary.


Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Pênis/lesões , Lesões dos Tecidos Moles , Gangrena de Fournier , Fasciite Necrosante , Pênis/patologia , Idoso de 80 Anos ou mais , Infecções do Sistema Genital/complicações , Infecções do Sistema Genital/patologia
12.
Schweiz Arch Tierheilkd ; 161(9): 553-557, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488396

RESUMO

INTRODUCTION: A 2-year-old Holstein Friesian bull with a penile tumour was referred to the University of Veterinary Medicine Hannover, Foundation, Germany, where the tumour was resected and diagnosed as a fibropapilloma. A urethral fistula was diagnosed eight days postoperatively and was present nine months later, although the bull had normal copulation behaviour and satisfactory fertility. Surgical removal of fibropapillomas in close proximity to the urethra is an effective treatment. A urethral fistula, which may occur as a postsurgical complication, did not have an adverse effect on copulation capacity and fertility of the bull.


Assuntos
Fístula/veterinária , Papiloma/veterinária , Animais , Bovinos , Doenças dos Bovinos/patologia , Doenças dos Bovinos/cirurgia , Fístula/etiologia , Fístula/patologia , Alemanha , Masculino , Papiloma/complicações , Papiloma/patologia , Papiloma/cirurgia , Pênis/patologia , Pênis/cirurgia , Uretra/patologia
13.
Andrologia ; 51(9): e13351, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31264245

RESUMO

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


Assuntos
Derme Acelular , Preenchedores Dérmicos/uso terapêutico , Lipectomia/métodos , Doenças do Pênis/cirurgia , Pênis/cirurgia , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Adulto , Estudos de Viabilidade , Humanos , Ligamentos/cirurgia , Lipectomia/efeitos adversos , Masculino , Obesidade/complicações , Obesidade/terapia , Tamanho do Órgão , Satisfação do Paciente , Seleção de Pacientes , Doenças do Pênis/etiologia , Doenças do Pênis/patologia , Pênis/patologia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Resultado do Tratamento , Procedimentos Cirúrgicos Urológicos Masculinos/efeitos adversos
14.
Andrologia ; 51(9): e13371, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31347717

RESUMO

In comparison to other antidepressant drugs, erectile dysfunction (ED) is more pronounced in paroxetine use. On the other hand, orange (Citrus sinensis) peels commonly consumed in various forms are used in folkloric medicine for ED management. Thus, this study evaluated the effect of orange peels infusion on sexual behaviour, nitric oxide (NO) level and some enzymes (arginase, phosphodiesterase-5 [PDE-5], acetylcholinesterase [AChE] and adenosine deaminase [ADA]) in paroxetine-treated rats. Erectile dysfunction was induced with paroxetine (10 mg/kg body weight). The animals were grouped into five (n = 6): normal rats; paroxetine-induced rats; paroxetine-induced rats treated with sildenafil citrate (5 mg/kg); paroxetine-induced rats treated with orange peels infusion (50 mg/kg); Paroxetine induced rats treated with orange peel infusions (100 mg/kg). The results revealed a significant decrease in sexual behaviour, NO level and the activities of antioxidant enzymes, while there was a significant increase in arginase, PDE-5, AChE and ADA activities in paroxetine-induced rats. However, orange peel infusions ameliorated erectile dysfunction in paroxetine-treated rats. This study showed some possible biochemical basis underlying the use of orange peels infusion in erectile dysfunction management.


Assuntos
Antidepressivos de Segunda Geração/toxicidade , Antioxidantes/administração & dosagem , Citrus sinensis/química , Disfunção Erétil/tratamento farmacológico , Paroxetina/toxicidade , Extratos Vegetais/administração & dosagem , Acetilcolinesterase/metabolismo , Adenosina Desaminase/metabolismo , Animais , Arginase/metabolismo , Nucleotídeo Cíclico Fosfodiesterase do Tipo 5/metabolismo , Modelos Animais de Doenças , Disfunção Erétil/induzido quimicamente , Disfunção Erétil/patologia , Feminino , Proteínas Ligadas por GPI/metabolismo , Humanos , Masculino , Proteínas de Membrana/metabolismo , Óxido Nítrico/metabolismo , Ereção Peniana/efeitos dos fármacos , Pênis/efeitos dos fármacos , Pênis/patologia , Ratos , Comportamento Sexual/efeitos dos fármacos , Citrato de Sildenafila/administração & dosagem , Resultado do Tratamento
15.
BMJ Case Rep ; 12(6)2019 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-31167770

RESUMO

Male genital tract angiomyofibroblastoma (AMF) is a rare benign tumour, with a total of 34 cases reported in literature. We are presenting a case of AMF of the glans penis in a 68-year-old man who presented with a progressively increasing in size large lesion located on the tip of his penis. Following routine investigations, the lesion was surgically excised with no adjuvant treatment, the patient was followed-up for 5 years with no evidence of local, nodal or distant recurrence. As AMF of the glans penis is extremely rare, there is not enough literature to support management guide lines, but it appears that AMF responds very well to complete surgical excision; occasional cases of recurrence have been previously reported, so a long-term follow-up is advised.


Assuntos
Angiofibroma/patologia , Neoplasias de Tecido Muscular/patologia , Pênis/patologia , Idoso , Angiofibroma/cirurgia , Diagnóstico Diferencial , Humanos , Masculino , Neoplasias de Tecido Muscular/cirurgia , Resultado do Tratamento
16.
Int J Radiat Oncol Biol Phys ; 105(2): 400-409, 2019 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-31175904

RESUMO

PURPOSE: To assess whether BIO 300, a synthetic genistein nanosuspension, improves the therapeutic index in prostate cancer treatment by preventing radiation-induced erectile dysfunction (ED) without reducing tumor radiosensitivity. METHODS AND MATERIALS: Male Sprague-Dawley rats were exposed to 25 Gy of 220-kV prostate-confined x-rays. Animals were randomized to receive sham radiation therapy (RT), RT alone, RT with daily BIO 300 at 2 experimental dosing regimens, or RT with daily genistein. Erectile response was evaluated over time. Penile shaft tissue was harvested for histologic analyses. Murine xenograft studies using prostate cancer cell lines determined the effects of BIO 300 dosing on RT efficacy. RESULTS: Prostate-confined RT significantly decreased apomorphine-induced erectile response (P < .05 vs sham RT). Erection frequency in animals receiving prophylactic treatment with BIO 300 starting 3 days before RT was similar to sham controls after RT. Treatment with synthetic genistein did not mitigate loss in erectile frequency. At week 14, post-RT treatment with BIO 300 resulted in significantly higher quality of erectile function compared with both the RT arm and the RT arm receiving genistein starting 3 days before irradiation (P < .05). In hormone-sensitive and insensitive prostate tumor-bearing mice, BIO 300 administration did not negatively affect radiation-induced tumor growth delay. CONCLUSIONS: BIO 300 prevents radiation-induced ED, measured by erection frequency, erectile function, and erection quality, when administered 3 days before RT and continued daily for up to 14 weeks. Data also suggest that BIO 300 administered starting 2 hours after RT mitigates radiation-induced ED. Data provide strong nonclinical evidence to support clinical translation of BIO 300 for mitigation of ED while maintaining treatment response to RT.


Assuntos
Disfunção Erétil/prevenção & controle , Genisteína/uso terapêutico , Nanopartículas/uso terapêutico , Ereção Peniana/efeitos dos fármacos , Lesões Experimentais por Radiação/complicações , Protetores contra Radiação/uso terapêutico , Animais , Pressão Sanguínea , Modelos Animais de Doenças , Drogas em Investigação/uso terapêutico , Disfunção Erétil/etiologia , Fibrose , Masculino , Camundongos , Camundongos Nus , Ereção Peniana/efeitos da radiação , Pênis/irrigação sanguínea , Pênis/patologia , Próstata/efeitos da radiação , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley , Fluxo Sanguíneo Regional , Suspensões/uso terapêutico , Transplante Heterólogo
17.
J Med Case Rep ; 13(1): 122, 2019 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-31036080

RESUMO

BACKGROUND: Penile swellings are not very common. They usually present as an obvious lesion visible and palpable either on the penile shaft, glans, or prepuce. Rarely, benign swellings may be concealed by phimosis and can present as "club" penis. CASE PRESENTATION: We report the case of a 30-year-old Indian male man who presented with the complaint of difficulty in retracting his foreskin and a club-shaped distal penis. There were palpable lumps on either side of the glans penis which were concealed by the foreskin; hence, a proper preoperative clinical diagnosis was not possible. Circumcision revealed the presence of two discrete cystic swellings from inner prepuce which were excised. Histopathology was suggestive of epidermoid cysts. CONCLUSIONS: Although epidermoid cysts are common cutaneous swellings, they are rarely seen on the penis. They generally present as a small solitary swelling on the penile surface and occurrence at multiple sites is very rare. Epidermoid cysts arising from inner prepuce, hiding within and presenting as club penis have not been reported. Thus, benign lumps should be considered an etiology for phimosis.


Assuntos
Circuncisão Masculina/métodos , Cistos/cirurgia , Prepúcio do Pênis/cirurgia , Doenças do Pênis/patologia , Pênis/patologia , Fimose/cirurgia , Adulto , Humanos , Masculino , Doenças do Pênis/cirurgia , Pênis/cirurgia , Resultado do Tratamento
18.
Int J STD AIDS ; 30(7): 707-709, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31112488

RESUMO

An atypical early primary syphilis case presentation with multiple umbilicated papular lesions on the penis and a nonreactive syphilis serology was misdiagnosed as molluscum contagiosum. Over a period of eight weeks, prior to dermatologic consultation, the papules enlarged, ulcerated, and healed. New plaque and patch formation on the penis and scrotum led to a differential diagnosis of inverse psoriasis vs. syphilis. Histological examination of a shave biopsy specimen revealed numerous Treponema pallidum organisms and repeat syphilis serological test results confirmed a syphilis diagnosis. Lesions responded to treatment with benzathine penicillin. One must keep a high index of suspicion for syphilis in light of its diverse presentation and increasing incidence.


Assuntos
Doenças do Pênis/diagnóstico , Úlcera Cutânea/diagnóstico , Sífilis/diagnóstico , Treponema pallidum/isolamento & purificação , Biópsia , Cancro/microbiologia , Humanos , Masculino , Penicilina G Benzatina/uso terapêutico , Doenças do Pênis/tratamento farmacológico , Pênis/patologia , Escroto/patologia , Pele/patologia , Úlcera Cutânea/patologia , Sífilis/tratamento farmacológico , Adulto Jovem
19.
Tumori ; 105(6): NP43-NP47, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31072230

RESUMO

INTRODUCTION: Though metastatic disease is a common presentation of pancreatic adenocarcinoma, localization to the penis is an extremely rare event despite its abundant vascularization. Primary cancers responsible for penile metastases usually occur in prostate and rectum and are often associated with disseminated malignancy and poor prognosis. CASE DESCRIPTION: A 66-year-old man was diagnosed with adenocarcinoma of the tail of the pancreas after the onset of thrombosis of the dorsal vein of the penis; pubis ultrasound and total body computed tomography scan were negative for metastases at other sites. The patient was submitted to distal pancreatectomy with splenectomy for a pT3 N1 G4 pancreatic ductal adenocarcinoma. Three weeks after discharge, the patient returned to the outpatient clinic complaining of a painful permanent turgidity of the penis shaft. Ultrasound revealed a complete replacement of the cavernosal bodies by multiple nodular masses and a penile biopsy confirmed metastases from the primary pancreatic cancer. The patient started chemotherapy with NAB-paclitaxel and gemcitabine, with excellent control of symptoms. However, the disease progressed to bone and liver and the patient died 9 months after surgery. CONCLUSIONS: Penile localization is an extremely rare event and a standard of care has not been elaborated. Treatments are palliative and mainly aimed at pain relief and can comprise chemotherapy, radiotherapy, and surgery. Identification of venous thrombosis as an early sign of involvement could potentially offer patients an earlier diagnosis and a better treatment option.


Assuntos
Neoplasias Pancreáticas/patologia , Neoplasias Penianas/diagnóstico , Neoplasias Penianas/secundário , Trombose Venosa/diagnóstico , Idoso , Biópsia , Terapia Combinada , Evolução Fatal , Humanos , Masculino , Estadiamento de Neoplasias , Neoplasias Penianas/terapia , Pênis/patologia , Avaliação de Sintomas , Tomografia Computadorizada por Raios X , Trombose Venosa/etiologia
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