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Emergency Radiology Feb 2022While penile pathology is uncommon, prompt diagnosis and treatment of emergent and urgent penile pathology are necessary to prevent complications. This paper will review... (Review)
Review
While penile pathology is uncommon, prompt diagnosis and treatment of emergent and urgent penile pathology are necessary to prevent complications. This paper will review the imaging findings of the most common critical penile pathologies, including traumatic, vascular, infectious, foreign body-related, and urethral pathology, in addition to penile prosthesis complications. Each entity will be discussed in the context of presentation and treatment and complications of each pathology will be discussed.
Topics: Diagnostic Imaging; Emergency Service, Hospital; Humans; Male; Penile Prosthesis; Penis; Urethra
PubMed: 34596782
DOI: 10.1007/s10140-021-01988-1 -
Sexual Medicine Reviews Jul 2021Inflatable penile prosthesis (IPP) technology is a mainstay in the treatment of erectile dysfunction refractory to medical management. Technological advancements in the... (Review)
Review
INTRODUCTION
Inflatable penile prosthesis (IPP) technology is a mainstay in the treatment of erectile dysfunction refractory to medical management. Technological advancements in the design of 3-piece IPPs have been improved to optimize concealability and surgical placement since the 1980s. Recent advancements over the past 10 years include pump, reservoir, tubing, and cylinder updates.
OBJECTIVES
This review examines the latest updates in IPP technology, reviews recent relevant research, and is based on over 32 years of experience performing IPP surgery in addition to concurrent postoperative management.
METHODS
A literature review was conducted for studies published over the last 10 years through March 2020 with an emphasis on technical updates of IPP, specifically the pump, reservoir, tubing, and cylinder, and their functional outcomes. Anti-infective coating and transgender innovations, in addition to postoperative management, are also reviewed.
RESULTS
Technological advancements include a flat reservoir designed for improved discreteness and a prosthesis with optimized tubing length, a one-touch deflatableĀ 3-piece system, narrow-base cylinders, a 0Ā° angle design between the cylinders and tubing to aid in cylinder placement, a soft molding cylinder tip redesign that better mimics human anatomy, and a 3-piece IPP specifically designed for neophallus use. Furthermore, the Food and Drug Administration approved the submuscular reservoir placement.
CONCLUSION
Penile prosthesis has evolved over time to improve functional outcomes, ease of use, and minimize postoperative complications and pain. Penile prosthesis implantation continues to be a life-changing procedure for patients and it is imperative for surgeons to be up-to-date on the latest developments and research in order to provide the best functional outcomes for those they take care of. Dinerman BF, Telis L, Eid JF. New Advancements in Inflatable Penile Prosthesis. Sex Med Rev 2021;9:507-514.
Topics: Erectile Dysfunction; Humans; Male; Penile Implantation; Penile Prosthesis; Penis; Prosthesis Implantation
PubMed: 33610493
DOI: 10.1016/j.sxmr.2020.09.007 -
Indian Journal of Dermatology,... 2017
Topics: Condylomata Acuminata; Humans; Male; Penile Neoplasms; Penis; Young Adult
PubMed: 27647354
DOI: 10.4103/0378-6323.190869 -
MBio Jul 2017Sexual transmission of HIV requires exposure to the virus and infection of activated mucosal immune cells, specifically CD4 T cells or dendritic cells. The foreskin is a... (Clinical Trial)
Clinical Trial Randomized Controlled Trial
Sexual transmission of HIV requires exposure to the virus and infection of activated mucosal immune cells, specifically CD4 T cells or dendritic cells. The foreskin is a major site of viral entry in heterosexual transmission of HIV. Although the probability of acquiring HIV from a sexual encounter is low, the risk varies even after adjusting for known HIV risk factors. The genital microbiome may account for some of the variability in risk by interacting with the host immune system to trigger inflammatory responses that mediate the infection of mucosal immune cells. We conducted a case-control study of uncircumcised participants nested within a randomized-controlled trial of male circumcision in Rakai, Uganda. Using penile (coronal sulcus) swabs collected by study personnel at trial enrollment, we characterized the penile microbiome by sequencing and real-time PCR and cytokine levels by electrochemiluminescence assays. The absolute abundances of penile anaerobes at enrollment were associated with later risk of HIV seroconversion, with a 10-fold increase in , , , and increasing the odds of HIV acquisition by 54 to 63%, after controlling for other known HIV risk factors. Increased abundances of anaerobic bacteria were also correlated with increased cytokines, including interleukin-8, which can trigger an inflammatory response that recruits susceptible immune cells, suggesting a mechanism underlying the increased risk. These same anaerobic genera can be shared between heterosexual partners and are associated with increased HIV acquisition in women, pointing to anaerobic dysbiosis in the genital microbiome and an accompanying inflammatory response as a novel, independent, and transmissible risk factor for HIV infection. We found that uncircumcised men who became infected by HIV during a 2-year clinical trial had higher levels of penile anaerobes than uncircumcised men who remained HIV negative. We also found that having higher levels of penile anaerobes was also associated with higher production of immune factors that recruit HIV target cells to the foreskin, suggesting that anaerobes may modify HIV risk by triggering inflammation. These anaerobes are known to be shared by heterosexual partners and are associated with HIV risk in women. Therefore, penile anaerobes may be a sexually transmissible risk factor for HIV, and modifying the penile microbiome could potentially reduce HIV acquisition in both men and women.
Topics: Adolescent; Adult; Anaerobiosis; Bacteria, Anaerobic; Case-Control Studies; Circumcision, Male; Dysbiosis; Female; Foreskin; HIV Infections; HIV Seropositivity; Heterosexuality; Humans; Interleukin-8; Male; Microbiota; Middle Aged; Mucous Membrane; Penis; Prevotella; Real-Time Polymerase Chain Reaction; Risk Factors; Sexual Partners; Uganda; Young Adult
PubMed: 28743816
DOI: 10.1128/mBio.00996-17 -
American Journal of Reproductive... Mar 2011Recent evidence that circumcision decreases HIV infection in heterosexual men by 50-60% has focused research on the foreskin as a target of HIV infection. In this review... (Review)
Review
Recent evidence that circumcision decreases HIV infection in heterosexual men by 50-60% has focused research on the foreskin as a target of HIV infection. In this review article, we discuss potential mechanisms underlying the circumcision effect and re-examine the assumption that the foreskin is the principle penile HIV infection site. HIV target cells are present in the foreskin epithelium, but are also found in the epithelia of the penile shaft, glans/corona, meatus and urethral introitus. Sexually transmitted infections (STIs) can affect any of these sites and increase susceptibility to HIV acquisition by eroding the protective epithelial layer and by attracting and activating HIV target cells in the epithelium. The moist subpreputial cavity, which encompasses the entire penile tip in most uncircumcised men including the glans, meatus and urethral introitus, plays an important role in STI acquisition. Circumcised men have a lower rate of STIs that infect not only the foreskin but also other distal penile sites, especially the urethra. Likewise, the foreskin may trap HIV and HIV-infected cells after intercourse thereby increasing the risk of HIV acquisition not only through the inner foreskin but also other sites covered by the foreskin. The subpreputial cavity also hosts a unique microbiome that may also play a role in HIV infection. We hypothesize that the penile urethra may be the primary HIV acquisition site in circumcised men and possibly also in non-circumcised men because of the presence of superficial HIV target cells and a high incidence of STIs at this site. Both innate and adaptive immune defense mechanisms are operative in the lower male genital region. The penile urethral mucosa contains accumulations of IgA(+) plasma cells and T lymphocytes and may provide a responsive target for future mucosal vaccines to prevent HIV sexual transmission.
Topics: Adaptive Immunity; Circumcision, Male; Foreskin; HIV Infections; Humans; Immunity, Innate; Male; Penis; Sexually Transmitted Diseases; Urethra
PubMed: 21214659
DOI: 10.1111/j.1600-0897.2010.00941.x -
Urologic Oncology Jan 2014Human papillomavirus infection (HPV) has been implicated in penile cancer, and although the annual incidence is estimated to be 1,570 in the United States, there are... (Review)
Review
Human papillomavirus infection (HPV) has been implicated in penile cancer, and although the annual incidence is estimated to be 1,570 in the United States, there are areas of the world in which the incidence is as much as 20-fold higher. Ample data in the literature support testing and vaccination against HPV-related cervical cancer, but for men and penile cancer, these data are lacking. However, some preliminary data would suggest that HPV not only plays an important role in a significant subset of patients with penile cancer but also may be a target for penile cancer prevention as well via initiation of a vaccination program in high-risk male populations.
Topics: Alphapapillomavirus; Host-Pathogen Interactions; Humans; Male; Papillomavirus Infections; Papillomavirus Vaccines; Penile Neoplasms; Penis; Prognosis; Risk Factors
PubMed: 24239463
DOI: 10.1016/j.urolonc.2013.08.010 -
BMC Microbiology Apr 2020To date, the microbiota of the human penis has been studied mostly in connection with circumcision, HIV risk and female partner bacterial vaginosis (BV). These studies...
BACKGROUND
To date, the microbiota of the human penis has been studied mostly in connection with circumcision, HIV risk and female partner bacterial vaginosis (BV). These studies have shown that male circumcision reduces penile anaerobic bacteria, that greater abundance of penile anaerobic bacteria is correlated with increased cytokine levels and greater risk of HIV infection, and that the penile microbiota is an important harbour for BV-associated bacteria. While circumcision has been shown to significantly reduce the risk of acquiring human papillomavirus (HPV) infection, the relationship of the penile microbiota with HPV is still unknown. In this study, we examined the penile microbiota of HPV-infected men as well as the impact of HIV status.
RESULTS
The penile skin microbiota of 238 men from Cape Town (South Africa) were profiled using Illumina sequencing of the V3-V4 hypervariable regions of the 16S rRNA gene. Corynebacterium and Prevotella were found to be the most abundant genera. Six distinct community state types (CSTs) were identified. CST-1, dominated by Corynebacterium, corresponded to less infections with high-risk HPV (HR-HPV) relative to CSTs 2-6. Men in CST-5 had greater relative abundances of Prevotella, Clostridiales, and Porphyromonas and a lower relative abundance of Corynebacterium. Moreover, they were significantly more likely to have HPV or HR-HPV infections than men in CST-1. Using a machine learning approach, we identified greater relative abundances of the anaerobic BV-associated bacteria (Prevotella, Peptinophilus, and Dialister) and lower relative abundance of Corynebacterium in HR-HPV-infected men compared to HR-HPV-uninfected men. No association was observed between HIV and CST, although the penile microbiota of HIV-infected men had greater relative abundances of Staphylococcus compared to HIV-uninfected men.
CONCLUSIONS
We found significant differences in the penile microbiota composition of men with and without HPV and HIV infections. HIV and HR-HPV infections were strongly associated with greater relative abundances of Staphylococcus and BV-associated bacterial taxa (notably Prevotella, Peptinophilus and Dialister), respectively. It is possible that these taxa could increase susceptibility to HIV and HR-HPV acquisition, in addition to creating conditions in which infections persist. Further longitudinal studies are required to establish causal relationships and to determine the extent of the effect.
Topics: Adult; Bacteria; Circumcision, Male; Cross-Sectional Studies; DNA, Ribosomal; HIV Infections; High-Throughput Nucleotide Sequencing; Humans; Longitudinal Studies; Machine Learning; Male; Microbiota; Papillomavirus Infections; Penis; Phylogeny; RNA, Ribosomal, 16S; Retrospective Studies; Sequence Analysis, DNA; South Africa
PubMed: 32252632
DOI: 10.1186/s12866-020-01759-x -
Abdominal Radiology (New York) Sep 2020MRI can delineate finer details of penile anatomy and pathology due to inherent higher soft-tissue contrast and spatial resolution. It can characterize inflammation and... (Review)
Review
MRI can delineate finer details of penile anatomy and pathology due to inherent higher soft-tissue contrast and spatial resolution. It can characterize inflammation and identify abscesses, localize penile fractures, guide surgical planning in penile fibrosis and Peyronie's disease, and depict components of the penile prosthesis and its complications. MRI is a great investigative tool for penile neoplasms, including locally infiltrative neoplasms where clinical examination is limited, and local staging is crucial for surgical planning.
Topics: Abscess; Humans; Magnetic Resonance Imaging; Male; Penile Induration; Penile Prosthesis; Penis
PubMed: 31154485
DOI: 10.1007/s00261-019-02080-6 -
Acta Dermatovenerologica Croatica : ADC Nov 2022We report the case of a 55-year-old man with penile squamous cell carcinoma (SCC). We found a mass in the patient's penis, which gradually increased in size. We...
We report the case of a 55-year-old man with penile squamous cell carcinoma (SCC). We found a mass in the patient's penis, which gradually increased in size. We performed a partial penectomy to remove the mass. Histopathology revealed a highly differentiated squamous cell carcinoma. Human papillomavirus (HPV) DNA was detected by polymerase chain reaction. HPV was found to be present in the squamous cell carcinoma, and sequencing analysis showed that it was type 58.
Topics: Male; Humans; Middle Aged; Papillomavirus Infections; Carcinoma, Squamous Cell; Penile Neoplasms; Penis; Papillomaviridae
PubMed: 36812278
DOI: No ID Found -
Genitourinary Medicine Apr 1988Fifty men whose sexual partners were 50 women with histologically proved cervical intraepithelial neoplasia (CIN) grade III (severe dysplasia or carcinoma in situ) were...
Fifty men whose sexual partners were 50 women with histologically proved cervical intraepithelial neoplasia (CIN) grade III (severe dysplasia or carcinoma in situ) were studied. A further 25 men whose current regular sexual partners were 25 women with chlamydial cervicitis were recruited as controls. If either of the partners in either group had genital condylomata acuminata or a known history of similar lesions, the couple was excluded from the study. Abnormal penile epithelium, which was detected by colposcopy after application of 5% acetic acid to the penile skin, was reported in 25 men in the study group compared with three in the control group. Histologically proved subclinical penile infection with human papillomavirus (HPV) was present in 23 men in the study group compared with three in the control group (p less than 0.01). Of the 50 men in the study group, four had histologically proved severe penile dysplasia or carcinoma in situ with evidence of HPV infection, the disease being subclinical in each case and diagnosed on histology of a specimen obtained by colposcopically directed biopsy. HPV DNA was detected on filter hybridisation of penile scrapes from 15 of the 23 men in the study group with histologically proved penile HPV infection, HPV16 DNA being detected in 10 of them. HPV DNA was detected on DNA-DNA hybridisation of biopsy material in seven of 18 men with histologically proved penile HPV infection. Five of these biopsy specimens were positive for HPV16 DNA. Only one man in the control group had HPV DNA detected in a penile scrape. This patient had histologically proved subclinical penile HPV infection. Such lesions may represent an important male reservoir of HPV types implicated in genital squamous carcinogenesis in both sexes.
Topics: Adult; Epithelium; Female; Humans; Male; Papillomaviridae; Penile Diseases; Penis; Sexual Partners; Tumor Virus Infections; Uterine Cervical Neoplasms
PubMed: 2838408
DOI: 10.1136/sti.64.2.90