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The Journal of Sexual Medicine Feb 2022Several treatment options for urethral complications following metoidioplasty in transmen are described in the literature, yet little is known with regard to the...
BACKGROUND
Several treatment options for urethral complications following metoidioplasty in transmen are described in the literature, yet little is known with regard to the surgical outcomes.
AIM
The aim of this study was to analyze the surgical outcomes after treatment of urethral strictures and urethral fistulas following metoidioplasty.
METHODS
A multicenter retrospective cohort study was conducted with transmen treated for strictures and fistulas after metoidioplasty in 3 tertiary referral centers.
OUTCOMES
The primary outcome was the recurrence-free rate after surgical treatment of urethral strictures and urethral fistulas over a time period of 3 years postoperatively.
RESULTS
Of 96 transmen included in this study with a urethral complication, 44 (46%) experienced a urethral fistula, 31 (32%) a urethral stricture, and 21 (22%) both complications simultaneously. The recurrence-free rate for urethral strictures following endoscopic management (ie, urethral dilation or direct visual internal urethrotomy) was 61% after 1, 50% after 2, and 43% after 3 years, compared to 82% following open treatment options after 1, 2, and 3 years (P = .002). Open treatment options were Heineke-Mikulicz procedure (7/9, 78% success), excision and primary anastomosis (3/3, 100%), 2-stage without graft (9/9, 100%), pedicled flap urethroplasty (1/1, 100%), and buccal mucosa graft urethroplasty (2/4 [50%] single-stage, 1/1 [100%] 2-stage). The recurrence-free rate for small urethral fistulas located at the pendulous urethra was 79% after 1, and 72% after 2 and 3 years, compared to 45% after 1, and 41% after 2 and 3 years for large fistulas, generally located at the urethral anastomoses of the fixed urethra. Treatment options for urethral fistulas were fistulectomy (26/48, 54%), fistulectomy & (redo) colpectomy (7/11, 64%), buccal mucosa graft urethroplasty (1/1, 100%), and retubularization of the urethral plate (3/4, 75%). A colpectomy before or during reoperation of a urethral fistula at the proximal urethral anastomosis showed higher success rates compared to without a colpectomy (7/11 [64%] vs 2/13 [15%] respectively, P = .03).
CLINICAL IMPLICATIONS
This study provides insight in the treatment possibilities and corresponding outcomes of urethral complications following metoidioplasty in transmen.
STRENGTHS & LIMITATIONS
Strengths were the relatively large sample size and the overview of multiple treatment options available. Limitations were the heterogeneity of the cohort, underexposure of some surgical modalities, and absence of patient-reported outcomes.
CONCLUSION
Open surgical techniques show better long-term outcomes in the management of urethral strictures compared to endoscopic options, and a colpectomy is beneficial before or during urethral fistula repair at the proximal urethral anastomosis. de Rooij FPW, Falcone M, Waterschoot M, et al. Surgical Outcomes After Treatment of Urethral Complications Following Metoidioplasty in Transgender Men. J Sex Med 2022;19:377-384.
Topics: Humans; Male; Mouth Mucosa; Retrospective Studies; Transgender Persons; Treatment Outcome; Urethra; Urethral Stricture; Urologic Surgical Procedures, Male
PubMed: 34974989
DOI: 10.1016/j.jsxm.2021.12.006 -
PhytoKeys 2022A new species from Gangwon-do, South Korea, is described and illustrated, based on its morphology and distribution. is different from , another similar species in...
A new species from Gangwon-do, South Korea, is described and illustrated, based on its morphology and distribution. is different from , another similar species in South Korea, in some ways: possesses a serrate leaf margin with flat tooth tip, while possesses a crenate leaf margin with erect tooth tip; it has an erect inflorescence, while has a pendulous inflorescence; it has a smaller flower which is 2-2.6 cm long, while has a flower of 2.3-3.2 cm; the flower is white or pinkish-white with yellowish and purplish spots, while has a white lower sepal and pinkish-white lateral united petals with yellowish spots; the distal part of the lower sepal is mostly not coiled or rarely 1-coiled, while that of is never coiled; the spur tip is expanded, round and slightly biparted, while that of is expanded, ellipsoidal and clearly biparted. A taxonomic description, a holotype and photos of morphological characteristics of the new species are provided. A table which includes the morphological comparison and a geographical distribution map are presented as well.
PubMed: 36760723
DOI: 10.3897/phytokeys.211.90236 -
The Surgeon : Journal of the Royal... Oct 2022Primary urethral carcinoma is a rare clinical entity with an incidence of 1 case per million in the United Kingdom. Cancers of the distal urethra are most commonly of...
INTRODUCTION
Primary urethral carcinoma is a rare clinical entity with an incidence of 1 case per million in the United Kingdom. Cancers of the distal urethra are most commonly of squamous subtype and often associated with Human Papilloma Virus infection. Penile preserving techniques are recommended in tumours of the pendulous urethra with a number of surgical approaches described. Herein, we describe the surgical management of 7 patients presenting with primary urethral carcinoma.
METHODS
Seven patients diagnosed with primary urethral carcinoma of the distal urethra were identified using a prospectively maintained penile cancer database at our institution from May 2017 to November 2020.
RESULTS
The mean age at presentation was 56.5 (33-80) years. Presenting symptoms included visible lesion, LUTS and a groin mass. Three patients had lesions located within the glanular urethra and had a distal urethrectomy and primary closure. Two patients with lesions extending proximal to the glanular urethra and into or beyond the fossa navicularis had a distal urethrectomy with a hypospadic neomeatus formation. One patient with tumour extending into the glans penis underwent distal urethrectomy and partial glansectomy with split thickness skin graft. A partial penectomy was performed for one patient with urethral tumour invading the corporal heads. Mean follow-up was 23.4 (±17.0) months. There have been no disease recurrences to date.
CONCLUSION
Penile preserving techniques are feasible in patients with tumours of the pendulous urethra and do not appear to compromise local control.
Topics: Carcinoma; Humans; Male; Neoplasm Recurrence, Local; Penile Neoplasms; Urethra; Urethral Neoplasms
PubMed: 35012866
DOI: 10.1016/j.surge.2021.08.011 -
The Science of the Total Environment Dec 2023Unstable agricultural systems, such as unreliable fruit production, threaten global food security and could negatively impact human nutrition. However, methods of...
Unstable agricultural systems, such as unreliable fruit production, threaten global food security and could negatively impact human nutrition. However, methods of maintaining a stable fruit supply have received little attention. Therefore, this study explored the impact of a systematic service model on the establishment of an integrated soil-fruit-climate management (ISM) approach and stabilization of apple yield based on a fixed-effects model using sample data from Fuji apple farmers in China for six consecutive years (2016-2021). The results showed that the systematic service model dramatically improved the adoption of ISM-based technology. By 2021, the rate of ISM technology adoption among farmers reached 84.4 %, especially pendulous branch-fruiting technology and Osmia pollination, which increased by 82.2 % and 37.8 %, respectively, compared to that in 2016. With the adoption of the ISM approach, apple yields and tree loadings stabilized over time. For example, the yield change rate and tree loading change rate were 14.8 % and 7.3 % lower, respectively, in 2021 than in 2016. We demonstrated through a fixed-effects analysis that the ISM approach exerts a fully mediated effect on the mechanism of action of service measure quantity disclosure, which positively impacted the rate of change in yield and tree loadings. This finding indicated that the six-in-one systematic service model of soil testing, pest and disease diagnosis, course training, meteorological monitoring, on-site guidance, and experimental demonstration established by the Science and Technology Backyard model resolved the information, goal, and hardware gaps that limited the adoption of this technology by farmers and promoted the construction of an integrated soil-fruit-climate management approach, which in turn has stabilized the apple production system.
Topics: Humans; Animals; Malus; Fruit; Soil; Agriculture; Climate
PubMed: 37844636
DOI: 10.1016/j.scitotenv.2023.167840 -
The Journal of Craniofacial SurgeryGiant lipomas are uncommon in the neck or craniofacial region. A 55-year-old male presented with a large pendulous mass arising from the dorsal aspect of his neck, which...
Giant lipomas are uncommon in the neck or craniofacial region. A 55-year-old male presented with a large pendulous mass arising from the dorsal aspect of his neck, which he had known about for 20 years. Discomfort during sleeping, frequent headaches, and chronic neck pain were his chief complaints. Computed topography revealed a well-circumscribed lipomatous lesion. A decrease in cervical spine lordosis was noted on sagittal x-rays. Surgical excision with local flap coverage was performed. The specimen weighed 2800 g. The patient reported immediate resolution of neck pain, and complete resolution of headaches following surgery. An increase in the degree of lordosis was seen in sagittal x-rays. Histopathological results confirmed the diagnosis of lipoma. Although most giant dorsal neck lipomas are benign, they may be a cause for neck pain, headaches and degenerative changes in the cervical spine, undermining the quality of life. Such symptoms should be assessed, and removal recommended.
Topics: Headache; Humans; Lipoma; Male; Middle Aged; Neck; Neck Pain; Quality of Life
PubMed: 36041133
DOI: 10.1097/SCS.0000000000008683 -
Poultry Science May 2024The chicken comb is an essential secondary sexual characteristic to measure sexual maturity and is closely related to reproductive performance. Pendulous comb (PC) and...
The chicken comb is an essential secondary sexual characteristic to measure sexual maturity and is closely related to reproductive performance. Pendulous comb (PC) and upright comb (UC) are 2 common comb phenotypes in hens, which have been highly associated with egg production performance. However, the reasons for the formation of PC remain undetermined. In this study, we first characterized the PC and UC chicken at start (at 175 d age), peak (at 217 d age), and postlaying (at 300 d age) and found that PC and UC could transform for each other. Furthermore, we suggested that PC chicken demonstrated better egg production performance than UC chicken, especially characterizing comb type in the start-laying period. Moreover, we performed histological evaluation of PC and UC tissue, which suggested that the low density of collagen fibers and acid mucopolysaccharides might lead to the formation of PC. To further explore the possible reasons for PC formation, we performed an untargeted metabolomic analysis of serum between PC and UC chicken in the start, peak, and postlaying periods. The enrichment analysis of period-unique differentially expressed metabolites (DEMs) between PC and UC showed that the different metabolic pathways and nutritional levels might contribute to the formation of PC in the different laying periods. Our research provided critical insights into the phenotypic diversity of chicken comb, establishing a foundation for early selection of chicken egg production performance.
PubMed: 38820880
DOI: 10.1016/j.psj.2024.103867 -
Sensors (Basel, Switzerland) Jan 2023The error coefficients of the pendulous integrating gyroscopic accelerometer (PIGA) mainly include the bias, scale factor, and nonlinear error. Previous works have fully...
The error coefficients of the pendulous integrating gyroscopic accelerometer (PIGA) mainly include the bias, scale factor, and nonlinear error. Previous works have fully studied and suppressed the bias and scale factor of PIGAs. At present, the nonlinear error is the most critical factor restricting the measurement accuracy of PIGAs. To address this barrier, a study on the analysis and suppression of the nonlinear error of PIGAs at the instrument level was carried out. Firstly, the error model of a PIGA is established by kinematics and dynamics analyses. Then, nonlinear error is analyzed based on the established model. Finally, a suppression method for the nonlinear error is proposed based on the analysis results. The nonlinear error analysis found that (1) the nonlinear error includes a quadratic term error caused by unequal inertia and the inertia product, cross-coupling error is caused by lateral accelerations, and error is caused by unequal stiffness; (2) unequal inertia and the inertia product were the most critical factors resulting in nonlinear error. Based on the results in the nonlinear error analysis, the suppression method for error focuses on unequal inertia and the inertia product. The proposed method of analysis and suppression was validated experimentally as the quadratic term coefficient was reduced by an order of magnitude from 1.9 × 10/ to 1.91 × 10/.
PubMed: 36772260
DOI: 10.3390/s23031221 -
Brazilian Journal of Microbiology :... Dec 2023Bacteria are regarded as predisposing and perpetuating factors causing otitis externa (OE), whereas auricular anatomy is a predisposing factor. This study aims to...
Bacteria are regarded as predisposing and perpetuating factors causing otitis externa (OE), whereas auricular anatomy is a predisposing factor. This study aims to investigate bacterial populations in the external auditory canals of healthy dogs and dogs with OE. Four categories of ear swabs included healthy erect-ear dogs, erect-ear dogs with OE, healthy pendulous-ear dogs and pendulous-ear dogs with OE. After bacterial DNA extraction, 16S rDNAs were amplified using specific primers within a V3/V4 region. Following DNA library construction, high-throughput sequencing was performed on MiSeq (Illumina). CLC Microbial Genomics Module was used to determine the rarefaction curve, bacterial classification, relative abundance, richness and diversity index. The results demonstrated that healthy dogs had higher bacterial richness and diversity than the dogs with OE. Comparable with culture-dependent methods described previously, this study revealed predominant Corynebacterium spp., Pseudomonas spp., Staphylococcus spp., and Proteus spp. in OE cases. Furthermore, high-throughput sequencing might disclose some potential emerging pathogens including Tissierella spp., Acinetobacter spp., and Achromobacter spp., which have not been reported in previous canine OE cases. Nevertheless, larger sample sizes are further required for an extensive evidence-based investigation.
Topics: Dogs; Animals; Otitis Externa; DNA, Ribosomal; Bacteria; Staphylococcus; Pseudomonas; Dog Diseases
PubMed: 37889464
DOI: 10.1007/s42770-023-01166-0 -
American Journal of Men's Health May 2018This study aimed to report penile dimensions in diabetic and nondiabetic men with erectile dysfunction (ED) and correlate their dimensions with other study variables. A... (Comparative Study)
Comparative Study
This study aimed to report penile dimensions in diabetic and nondiabetic men with erectile dysfunction (ED) and correlate their dimensions with other study variables. A case-control study was designed through retrospective data analysis of diabetic and nondiabetic patients consulting for ED and a control group ( n = 105, each group). Study data retrieved included history, clinical evaluation, and penile dimensions (pendulous length [PL], total length [TL], and circumference [CF]) at flaccid and erect states. Results identified that patients had lower values (mean, cm) for almost all penile dimensions. The diabetic patients identified significant differences in most dimensions, whether in flaccid (PL: 7.46 vs. 7.51 and 7.81, p = .11; TL: 11.8 vs. 12.77 and 12.88, p = .000; CF: 8.84 vs. 9.1 and 9.14, p = .016) or erect state (PL: 9.66 vs. 9.61 and 10, p = .092; TL: 13.96 vs. 14.88 and 15.04, p = .000; CF: 11.56 vs. 12.06 and 11.92, p = .018) as compared with the nondiabetic patients and controls, respectively. No significant correlation was detected between the dimensions and age, durations of diabetes and ED, or erectile function scores. In conclusion, diabetic and nondiabetic patients with ED presented, in varying degrees, significant decline in their penile dimensions, and this was more prevalent in diabetic patients. As changes in penile size could be a silent corollary of comorbidities, monitoring the changes in penile dimensions should be an important component of the clinical checkup of any patient with ED, especially a diabetic patient.
Topics: Adult; Aged; Case-Control Studies; Diabetes Mellitus; Erectile Dysfunction; Humans; Male; Middle Aged; Penis; Retrospective Studies
PubMed: 26130730
DOI: 10.1177/1557988315592026 -
The Journal of Veterinary Medical... Jul 2021A 12-year-old, 3.5-kg, intact female dog was presented with polyuria, polydipsia, and a pendulous abdomen. Laboratory examinations showed elevated hepatobiliary enzyme...
A 12-year-old, 3.5-kg, intact female dog was presented with polyuria, polydipsia, and a pendulous abdomen. Laboratory examinations showed elevated hepatobiliary enzyme levels and neutrophilic leukocytosis. The adrenocorticotropic hormone stimulation test confirmed hyperadrenocorticism (HAC). Trilostane therapy managed the clinical condition and cortisol concentration. However, lymphocytosis and nonregenerative anemia developed after HAC remission. Bone marrow aspiration analysis revealed a lymphoproliferative disorder with a clonal T-cell population. Accordingly, the patient was diagnosed with T-cell chronic lymphocytic leukemia (CLL) and concurrent HAC. Thereafter, chemotherapy was initiated, which improved the lymphocytosis. However, euthanasia was performed because of worsening quality of life at 45 weeks after the first presentation. These results suggested that CLL could be masked by excessive endogenous cortisol and discovered after HAC remission.
Topics: Adrenocortical Hyperfunction; Animals; Dog Diseases; Dogs; Female; Leukemia, Lymphocytic, Chronic, B-Cell; Pituitary ACTH Hypersecretion; Pregnancy; Quality of Life
PubMed: 34039785
DOI: 10.1292/jvms.21-0018