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Emergency Medicine Clinics of North... Nov 2019The penis is an organ of enormous importance and is vital for both excretory and reproductive function. The anatomy of the penis itself can lead to many of its emergent... (Review)
Review
The penis is an organ of enormous importance and is vital for both excretory and reproductive function. The anatomy of the penis itself can lead to many of its emergent conditions and a thorough understanding of the anatomy and physiology is central to recognition of these conditions. Physicians should have a high clinical suspicion for penile emergencies and perform a thorough physical examination to make a proper diagnosis. Prompt diagnosis and proper management are essential for minimizing dysfunction of this vital organ.
Topics: Emergencies; Humans; Male; Paraphimosis; Penile Diseases; Penis; Phimosis; Priapism
PubMed: 31563196
DOI: 10.1016/j.emc.2019.07.001 -
The Medical Clinics of North America Mar 2018Urologic emergencies can involve the kidneys, ureters, bladder, urethra, penis, scrotum, or testicles. History and physical examination are essential to diagnosis,... (Review)
Review
Urologic emergencies can involve the kidneys, ureters, bladder, urethra, penis, scrotum, or testicles. History and physical examination are essential to diagnosis, whereas imaging is increasingly used to confirm diagnoses. Acute urinary retention should be relieved with Foley placement. Penile emergencies include paraphimosis, which can be treated by foreskin reduction, whereas penile fracture and priapism require urologic intervention. Fournier gangrene and testicular torsion are scrotal emergencies requiring emergent surgery. Nephrolithiasis, although painful, is not an emergency unless there is concern for concomitant urinary tract infection, both ureters are obstructed by stones, or there is an obstructing stone in a solitary kidney.
Topics: Acute Disease; Emergencies; Female; Female Urogenital Diseases; Fournier Gangrene; Humans; Male; Male Urogenital Diseases; Nephrolithiasis; Paraphimosis; Penis; Priapism; Referral and Consultation; Rupture; Spermatic Cord Torsion; Urinary Retention; Urologic Diseases
PubMed: 29406065
DOI: 10.1016/j.mcna.2017.10.013 -
The Surgical Clinics of North America Jun 2016The diagnosis and management of urologic emergencies are incorporated into the basic training of all urology residents. In institutions without access to urologic... (Review)
Review
The diagnosis and management of urologic emergencies are incorporated into the basic training of all urology residents. In institutions without access to urologic services, it is usually left to the General Surgeon or Emergency Medicine physician to provide timely care. This article discusses diagnoses that are important to recognize and treatment that is practically meaningful for the non-Urologist to identify and treat. The non-Urology provider, after reading this article, will have a better understanding and a higher comfort level with treating patients with urologic emergencies.
Topics: Acute Disease; Emergency Treatment; Female; Fournier Gangrene; Humans; Male; Paraphimosis; Priapism; Pyonephrosis; Spermatic Cord Torsion; Urinary Retention
PubMed: 27261785
DOI: 10.1016/j.suc.2016.02.001 -
International Journal of STD & AIDS Jul 2019
Topics: Adenoviridae; Adenovirus Infections, Human; Adult; Anti-Bacterial Agents; Cephalexin; Conjunctivitis; Humans; Male; Paraphimosis; Polymerase Chain Reaction; Treatment Outcome; Urethritis
PubMed: 31072279
DOI: 10.1177/0956462419842448 -
Therapeutische Umschau. Revue... Jun 2020Urologic Emergencies: Paraphimosis Paraphimosis presents a rare but acute urological emergency whereby the foreskin becomes entrapped behind the coronary sulcus of the...
Urologic Emergencies: Paraphimosis Paraphimosis presents a rare but acute urological emergency whereby the foreskin becomes entrapped behind the coronary sulcus of the penis. Therapy is quick and feasible, even in an outpatient setting. In most cases compression of the preputial edema and subsequent reposition of the prepuce is sufficient. Rarely, surgical intervention in form of a dorsal incision of the constriction is required. With partial or full phimosis being the underlying condition, paraphimosis occurs predominantly in infants and toddlers. However, persistent or secondary phimosis can lead to paraphimosis in advanced age.
Topics: Child, Preschool; Emergencies; Emergency Service, Hospital; Humans; Male; Paraphimosis; Phimosis
PubMed: 32870094
DOI: 10.1024/0040-5930/a001182 -
Emergency Medicine Australasia : EMA Feb 2016
Review
Topics: Analgesia; Child; Child, Preschool; Conscious Sedation; Humans; Infant; Male; Paraphimosis
PubMed: 26781045
DOI: 10.1111/1742-6723.12532 -
International Journal of Impotence... May 2022Preputioplasty denotes various surgical techniques directed at resolving phimosis without the need for radical or partial circumcision. This narrative review summarizes... (Review)
Review
Preputioplasty denotes various surgical techniques directed at resolving phimosis without the need for radical or partial circumcision. This narrative review summarizes the best-known surgical techniques of preputioplasty. A MEDLINE and EMBASE-based literature search of original manuscripts and case reports published in English has been carried out using the following key words: "circumcision", "partial circumcision", "phimosis", "paraphimosis", and "preputioplasty". Six different procedures are explored in more detail and illustrated. The complication rates of all surgical procedures presented here are reported to be low. In cases of medical (rather than cultural and religious) indications, foreskin-preserving procedures present useful alternatives to circumcision in the routine clinical practice of urologists and pediatric surgeons.
Topics: Child; Circumcision, Male; Foreskin; Humans; Male; Phimosis
PubMed: 34853437
DOI: 10.1038/s41443-021-00505-9 -
Dermatology Online Journal Jul 2018Intimate body piercings involving the nipple and genitalia have increased in prevalence in both men and women. Despite this increase, there is a deficiency in the... (Review)
Review
Intimate body piercings involving the nipple and genitalia have increased in prevalence in both men and women. Despite this increase, there is a deficiency in the literature regarding the short and long-term complications of body piercings, including an increased risk of infection, malignancy, and structural damage to the associated tissue. Breast abscesses associated with nipple piercing can be mistaken as inflammatory carcinoma. Male genital piercings have been associated with urethral rupture, paraphimosis, urethral obstruction, scar formation, and squamous cell carcinoma, whereas female genital piercings may lead to a higher risk of pregnancy and sexually transmitted infections. There are additional problems related to piercings during pregnancy and thereafter. Nipple piercings can hinder breast feeding by inhibiting the milk letdown reflex, increasing nipple sensitivity, and causing discomfort to the infant. Removal of genital piercings during pregnancy could introduce bacteria into the piercing tract, but retaining the piercings could theoretically hinder childbirth. Prevention of complications is critical. Patients must understand the risks of piercings and disclose relevant medical conditions to the practitioner before the procedure. The piercings should be carried out in a hygienic and sterile manner. Finally, physicians should maintain a non-judgmental attitude to encourage patients to seek medical care for complications.
Topics: Body Piercing; Breast Diseases; Female; Genital Diseases, Female; Genital Diseases, Male; Genitalia, Female; Humans; Male; Nipples; Penis; Umbilicus
PubMed: 30261561
DOI: No ID Found -
Urology Aug 2022To provide a summary of surgical technique and outcomes for Heineke-Mikulicz preputioplasty (HMP), a foreskin-preserving surgical treatment for phimosis in the adult...
OBJECTIVE
To provide a summary of surgical technique and outcomes for Heineke-Mikulicz preputioplasty (HMP), a foreskin-preserving surgical treatment for phimosis in the adult population.
METHODS
We retrospectively reviewed 7 patients who underwent HMP by a single surgeon from May 2017 to May 2021. Variables included patient demographics, intraoperative considerations, and post-operative course. HMP is performed using a 2-3 cm vertical incision over the phimotic band on the dorsal surface to just above Buck's fascia. Additional incisions are made on the ventral surface if phimosis remains persistent after dorsal release. The incision is closed horizontally in 2 layers.
RESULTS
Seven patients underwent HMP. Median age was 47.3 and median BMI was 24.3. Five patients reported bothersome phimosis and 1 each reported paraphimosis and frenular tethering. Six patients requested foreskin sparing surgery as a personal preference and 1 patient was an intraoperative consult. Topical betamethasone was attempted in 3 of 7 patients. The median time from diagnosis to surgery was 2 months. Median operative time was 45.5 minutes and median estimated blood loss was 5 mL. Two patients required both dorsal and ventral incisions. No intraoperative complications were reported and all patients were discharged the same day. At median follow-up of 1.8 months, 1 patient reported bothersome phimosis secondary to scar formation treated successfully with triamcinolone.
CONCLUSION
HMP is a safe and effective method of treating even very significant phimosis in patients trying to avoid circumcision or intraoperative consults where preferences may be unclear. Our method takes less time than traditional circumcision with a comparable recovery and complication profile.
Topics: Adult; Circumcision, Male; Foreskin; Humans; Intraoperative Care; Male; Middle Aged; Penis; Phimosis; Retrospective Studies; Surgical Wound; Treatment Outcome
PubMed: 35430235
DOI: 10.1016/j.urology.2022.03.030