-
Andrology Sep 2021Because it is a superficial structure, the penis is ideally suited to ultrasound imaging. A number of disease processes, including Peyronie's disease, penile fractures... (Review)
Review
BACKGROUND
Because it is a superficial structure, the penis is ideally suited to ultrasound imaging. A number of disease processes, including Peyronie's disease, penile fractures and tumors, are clearly visualized with ultrasound. Baseline and dynamic assessment of cavernosal arterial changes after pharmaco-stimulation with alprostadil allows standardized diagnosis of arterial and venogenic causes of erectile dysfunction (ED).
OBJECTIVE
To illustrate how to correctly perform flaccid and dynamic penile duplex ultrasound (D-PDU) and in which patients to recommend it.
MATERIALS/METHODS
An extensive search of the literature was carried out on Pubmed with the insertion of the following Medical Subjects Headings (MeSH) terms and keywords "penile color Doppler ultrasound" "peak systolic velocity" "end-diastolic velocity", "acceleration time", "resistance index".
EVIDENCE
In our experience, arterial erectile dysfunction is identified after standardized intracavernous injection (ICI) of alprostadil (10 mcg) when values of peak systolic velocity (PSV) are <35 cm/s and, in the most severe forms, for values <25 cm/s. Arterial insufficiency can also be identified by increased acceleration time (AT) values (>110 ms) and/or by a lack of visualization of helicine arteries at power Doppler mode along with incomplete achievement of penile rigidity. The veno-occlusive incompetence is determined when end-diastolic velocity (EDV) values are >4.5-5 cm/s or in the case of resistance index (RI) values <0.75. The assessment of additional surrogate markers of endothelial dysfunction, that is, intima-media thickness, mean platelet volume (MPV), endothelial progenitor cells (EPC), endothelial cell specific molecule-1(endocan) are also useful in assessing the patient's cardiovascular risk but are still considered investigational in the interpretation of D-PDU results.
CONCLUSION
D-PDU scan after ICI with vasoactive drugs is a safe procedure and represents the gold standard for the diagnostics of penile pathologies and should be performed in men with ED not responding to oral conventional therapies and/or in those requiring accurate stratification of cardiovascular risk.
Topics: Alprostadil; Carotid Intima-Media Thickness; Erectile Dysfunction; Humans; Male; Penile Diseases; Penile Induration; Penis; Ultrasonography, Doppler, Color; Ultrasonography, Doppler, Duplex; Vasodilator Agents
PubMed: 33960127
DOI: 10.1111/andr.13029 -
Journal of Cutaneous Medicine and... 2024
Topics: Humans; Male; Penis; Penile Diseases
PubMed: 38323555
DOI: 10.1177/12034754241229337 -
The Journal of Emergency Medicine Feb 2017
Topics: Adult; Humans; Male; Penile Diseases; Penile Erection; Rupture
PubMed: 27793501
DOI: 10.1016/j.jemermed.2016.10.015 -
JAMA Dermatology Oct 2023
Topics: Male; Humans; Foscarnet; Penile Diseases; Antiviral Agents; Ulcer; Skin Diseases; Penis
PubMed: 37647057
DOI: 10.1001/jamadermatol.2023.2592 -
Sexual Medicine Reviews Apr 2020Glans hypermobility presents a rarely observed complication of penile prosthesis implantation. It may result in patient dissatisfaction because of painful intercourse,... (Review)
Review
INTRODUCTION
Glans hypermobility presents a rarely observed complication of penile prosthesis implantation. It may result in patient dissatisfaction because of painful intercourse, difficulties during penetrative sex, and a poor cosmetic result. This problem may prevent the patient from using an otherwise fully functional implant.
AIM
To summarize current knowledge, clarify terminology, and review treatment options of multifaceted diagnosis of floppy glans.
METHODS
Analysis of published literature and experience of authors' institution.
MAIN OUTCOME MEASURE
We reviewed publications that outlined incidence, pathophysiology, diagnostics, and management strategies of floppy glans phenomenon.
RESULTS
Floppy glans phenomenon can result from the soft glans, incorrect position, or size of the implant cylinders or the anatomy of the glans. A careful physical examination with a fully inflated implant will indicate the direction of the droop and can be very helpful in distinguishing the underlying cause of the deformity. In ambiguous cases obtaining a correct diagnosis will often involve imaging-magnetic resonance imaging or penile ultrasound scanning of the inflated device. Cooperation with an experienced uroradiologist is invaluable in such cases. The glanspexy procedure should be performed according to the surgeon's experience and preference.
CONCLUSIONS
Understanding the different glans abnormalities and unified terminology is crucial for optimization of the treatment. Medical therapy can always be tried before revision surgery, as long as it is safe for the patient and function of the implant. The accuracy of the position and size of the implant should always be thoroughly assessed before a diagnosis of the real glans hypermobility is made and treatment provided. Skrodzka M, Heffernan Ho D, Ralph D. Floppy Glans-Classification, Diagnosis And Treatment. Sex Med Rev 2020;8:303-313.
Topics: Humans; Male; Penile Diseases; Penile Implantation; Penis
PubMed: 31474579
DOI: 10.1016/j.sxmr.2019.07.003 -
Atencion Primaria Mar 2020
Topics: Genital Diseases, Male; Humans; Insecticides; Male; Penile Diseases; Permethrin; Pruritus; Scabies; Scrotum; Young Adult
PubMed: 31109721
DOI: 10.1016/j.aprim.2019.04.003 -
International Braz J Urol : Official... 2020Obesity is increasing in prevalence worldwide and an increasingly commonly encountered condition is adult acquired buried penis (AABP). We review the current management... (Review)
Review
Obesity is increasing in prevalence worldwide and an increasingly commonly encountered condition is adult acquired buried penis (AABP). We review the current management of AABP and relevant literature. Management of AABP requires a combination of genitourinary reconstructive techniques and plastic surgery techniques that are unique to this condition. We offer our experience and tips and tricks for the treatment of AABP.
Topics: Humans; Male; Obesity; Penile Diseases; Penis; Prevalence; Plastic Surgery Procedures
PubMed: 32167731
DOI: 10.1590/S1677-5538.IBJU.2020.99.06 -
Annales de Dermatologie Et de... Jan 2018
Review
Topics: Anti-Inflammatory Agents; Clobetasol; Debridement; Humans; Hyperplasia; Lasers, Gas; Male; Penile Diseases; Penis; Precancerous Conditions
PubMed: 29100616
DOI: 10.1016/j.annder.2017.09.173 -
Current Opinion in Urology Jul 2019Tissue engineering and regenerative medicine has emerged as a new scientific interdisciplinary field focusing on developing new strategies to repair or recreate tissues... (Review)
Review
PURPOSE OF REVIEW
Tissue engineering and regenerative medicine has emerged as a new scientific interdisciplinary field focusing on developing new strategies to repair or recreate tissues and organs. This review gathers findings on erectile dysfunction and, Peyronie's disease from recent preclinical and clinical studies under heading of stem-cell regenerative medicine.
RECENT FINDINGS
Over the last 2 years, preclinical studies on rat models demonstrated the tangible beneficial role of stem cells and stromal vascular fraction in the context of preventing fibrosis and restoring erectile function in different animal models of Erectile dysfunction and Peyronie's disease. There are not solid evidences in the clinical settings.
SUMMARY
Large randomized, double blind clinical trials are needed to prove the efficacy of stem-cell therapy on human patients. Owing to the lack of solid evidences, the stem-cell therapy should be only administrated in a clinical research setting.
Topics: Animals; Double-Blind Method; Humans; Male; Penile Diseases; Penis; Rats; Regenerative Medicine; Stem Cell Transplantation; Tissue Engineering
PubMed: 31008782
DOI: 10.1097/MOU.0000000000000636 -
The Canadian Journal of Urology Feb 2021Pyoderma gangrenosum (PG) is a cutaneous inflammatory disorder that results in painful ulcers. Isolated penile PG is an exceedingly rare entity that has only been... (Review)
Review
Pyoderma gangrenosum (PG) is a cutaneous inflammatory disorder that results in painful ulcers. Isolated penile PG is an exceedingly rare entity that has only been reported in a handful of cases. This case highlights the course of a 71-year old man with a locally destructive, nonhealing penile ulceration who was ultimately diagnosed with PG. He underwent extensive work up to reach the diagnosis. His disease progression was halted with systemic steroids and Methotrexate. We present his clinical course and a review of the literature to highlight the need for early recognition of this potentially devastating condition and to outline management options.
Topics: Aged; Humans; Male; Penile Diseases; Pyoderma Gangrenosum
PubMed: 33625348
DOI: No ID Found