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The Journal of Sexual Medicine Oct 2012When a clinically uninfected penile prosthesis has malfunctioned, removal of the broken prosthesis and simultaneous replacement with a new prosthesis is generally... (Review)
Review
INTRODUCTION
When a clinically uninfected penile prosthesis has malfunctioned, removal of the broken prosthesis and simultaneous replacement with a new prosthesis is generally accepted as the treatment of choice. During prosthesis replacement, questions inevitably arise as to whether or not a washout of the implant spaces with saline or antiseptic solution should be undertaken. Since removal of the reservoir from the retropubic space is often challenging, the operating surgeon must decide whether to remove all the components or leave the reservoir in situ.
AIM
To present strategies for optimal outcomes in inflatable penile prosthesis revision surgery.
METHODS
We review the current literature to find evidence regarding indications and support for washout procedures, strategies to achieve the lowest infection rates, and the need for total vs. single prosthesis component removal at the time of revision surgery. For illustration, we present the case of a clinically uninfected, malfunctioning penile prosthesis that requires replacement.
MAIN OUTCOME MEASURES
Survival from revision surgery for infection and medical complication based on published literature in peer-reviewed journals.
RESULTS
Recent peer-reviewed publications were summarized for guidance in addressing the dilemmas of revision surgery.
CONCLUSIONS
Penile prosthesis revision in a clinically uninfected patient has a higher infection rate than a first-time implantation. The combination of infection-retardant coated components, vigorous washout, proper preparation of skin incision site, use of perioperative antibiotics, and avoiding contact between the patient's skin and the implant will lower infection rates. Compared with single-component exchange, complete component removal appears to confer advantages related to future infection and malfunction. More work is needed to establish optimal strategies for handling reservoirs since clinical experience shows minimal risk of future infection in retained reservoirs.
Topics: Humans; Male; Middle Aged; Penile Prosthesis; Penis; Prosthesis Failure; Prosthesis-Related Infections; Reoperation; Treatment Outcome
PubMed: 23046282
DOI: 10.1111/j.1743-6109.2012.02932.x -
Sexually Transmitted Infections Feb 2022
Topics: Adrenal Cortex Hormones; Antifungal Agents; Antiviral Agents; Herpes Genitalis; Herpes Zoster; Humans; Male; Middle Aged; Penis
PubMed: 33727338
DOI: 10.1136/sextrans-2020-054927 -
PloS One 2018Penile acquisition of HIV infection contributes substantially to the global epidemic. Our goal was to establish a preclinical macaque model of penile HIV infection for...
Penile acquisition of HIV infection contributes substantially to the global epidemic. Our goal was to establish a preclinical macaque model of penile HIV infection for evaluating the efficacy of new HIV prevention modalities. Rhesus macaques were challenged once or twice weekly with consistent doses of SHIVsf162P3 (a chimeric simian-human immunodeficiency virus containing HIV env) ranging from 4-600 TCID50 (50% tissue culture infective dose), via two penile routes, until systemic SHIV infection was confirmed. One route exposed the inner foreskin, glans and urethral os to virus following deposition into the prepuce (foreskin) pouch. The second route introduced the virus non-traumatically into the distal urethra only. Single-route challenges resulted in dose-dependent rates of SHIV acquisition informing selection of optimal SHIV dosing. Concurrent SHIV challenges via the prepuce pouch (200 TCID50) and urethra (16 TCID50) resulted in infection of 100% (10/10) animals following a median of 2.5 virus exposures (range, 1-12). We describe the first rhesus macaque repeat-exposure SHIV challenge model of penile HIV acquisition. Utilization of the model should further our understanding of penile HIV infection and facilitate the development of new HIV prevention strategies for men.
Topics: Animals; Disease Models, Animal; Foreskin; HIV Infections; Humans; Macaca mulatta; Male; RNA, Viral; Simian Acquired Immunodeficiency Syndrome; Simian Immunodeficiency Virus; Urethra; Viral Load
PubMed: 29584769
DOI: 10.1371/journal.pone.0194837 -
AIDS (London, England) Jan 2016A large portion of anogenital cancers is caused by high-risk human papillomavirus (hrHPV) infections, which are especially common in HIV-infected men. We aimed to... (Comparative Study)
Comparative Study
OBJECTIVES
A large portion of anogenital cancers is caused by high-risk human papillomavirus (hrHPV) infections, which are especially common in HIV-infected men. We aimed to compare the incidence and clearance of anal and penile hrHPV infection between HIV-infected and HIV-negative MSM.
DESIGN
Analyses of longitudinal data from a prospective cohort study.
METHODS
MSM aged 18 years or older were recruited in Amsterdam, the Netherlands, and followed-up semi-annually for 24 months. At each visit, participants completed risk-factor questionnaires. Anal and penile self-samples were tested for HPV DNA using the SPF10-PCR DEIA/LiPA25 system. Effects on incidence and clearance rates were quantified via Poisson regression, using generalized estimating equations to correct for multiple hrHPV types.
RESULTS
Seven hundred and fifty MSM with a median age of 40 years (interquartile 35-48) were included in the analyses, of whom 302 (40%) were HIV-infected. The incidence rates of hrHPV were significantly higher in HIV-infected compared with HIV-negative MSM [adjusted incidence rate ratio (aIRR) 1.6; 95% confidence interval (CI) 1.3-2.1 for anal and aIRR 1.4; 95%CI 1.0-2.1 for penile infection]. The clearance rate of hrHPV was significantly lower for anal [adjusted clearance rate ratio (aCRR) 0.7; 95%CI 0.6-0.9], but not for penile infection (aCRR 1.3; 95%CI 1.0-1.7). HrHPV incidence or clearance did not differ significantly by nadir CD4 cell count.
CONCLUSION
Increased anal and penile hrHPV incidence rates and decreased anal hrHPV clearance rates were found in HIV-infected compared with HIV-negative MSM, after adjusting for sexual behavior. Our findings suggest an independent effect of HIV infection on anal hrHPV infections.
Topics: Adult; Anal Canal; DNA, Viral; HIV Infections; Homosexuality, Male; Humans; Incidence; Longitudinal Studies; Male; Middle Aged; Netherlands; Papillomaviridae; Papillomavirus Infections; Penis; Prospective Studies
PubMed: 26474302
DOI: 10.1097/QAD.0000000000000909 -
Journal of Comparative Pathology Oct 2020We describe a case of penile tuberculosis in a bull. The prepuce was thickened, firm and pale with multifocal to coalescent caseous nodules, and the inguinal and...
We describe a case of penile tuberculosis in a bull. The prepuce was thickened, firm and pale with multifocal to coalescent caseous nodules, and the inguinal and mesenteric lymph nodes were moderately enlarged. Lesions in the prepuce, penis and lymph nodes were characterized by multifocal to coalescent areas of caseous necrosis and marked granulomatous inflammation. Acid-fast bacilli were seen within necrotic foci and Langhans giant cells. Mycobacteriumtuberculosis var. bovis was identified in inguinal lymph nodes by the polymerase chain reaction technique and by bacterial isolation. Although rare, tuberculosis should be considered in the differential diagnosis of granulomatous lesions in the genital tract of bulls.
Topics: Animals; Cattle; Cattle Diseases; Granuloma; Lymph Nodes; Male; Penis; Polymerase Chain Reaction; Tuberculosis
PubMed: 33222874
DOI: 10.1016/j.jcpa.2020.08.001 -
Medicina (Kaunas, Lithuania) Nov 2023Penile augmentation using filler injections is gaining popularity; however, complications such as foreign body reactions can arise, leading to issues like penile...
Penile augmentation using filler injections is gaining popularity; however, complications such as foreign body reactions can arise, leading to issues like penile ulceration and necrosis, subsequently necessitating reconstruction. The existing method of the reconstruction of the penis is primarily aimed at filling the deficit. In this paper, we describe a case in which a scrotal flap and autologous augmentation were utilized to treat a soft tissue defect caused by a delayed infection following a penile filler injection. The patient, a 41-year-old male, had received an Aquafilling (Biomedica, Prague, Czech Republic) filler injection seven years earlier and later developed a delayed infection. After debridement, the penile defect spanned the entire shaft, and the circumference of the flaccid penis was 7.5 cm. Using a bilateral scrotal flap technique, the lower margins of both flaps were rolled inward after de-epithelialization to achieve autologous augmentation. Over the three-month post-surgery follow-up, neither infections nor flap necrosis were observed. The penile circumference increased to 12 cm, and the patient reported high satisfaction with the outcome. This new surgical technique can be widely applied as treatment for a variety of penile defects.
Topics: Male; Humans; Adult; Plastic Surgery Procedures; Surgical Flaps; Penis; Scrotum; Necrosis
PubMed: 38004047
DOI: 10.3390/medicina59111998 -
International Journal of Impotence... Nov 2020
Meta-Analysis
Topics: Humans; Male; Penile Diseases; Penile Implantation; Penile Prosthesis; Penis; Prosthesis-Related Infections; Risk Factors
PubMed: 32152469
DOI: 10.1038/s41443-020-0250-8 -
Journal of Medical Primatology Feb 2016An established macaque model to assess HIV interventions against penile transmission is currently not available. Physiological changes during penile erections may affect...
BACKGROUND
An established macaque model to assess HIV interventions against penile transmission is currently not available. Physiological changes during penile erections may affect susceptibility to infection and drug pharmacokinetics (PK). Here, we identify methods to establish erections in macaques to evaluate penile transmission, PK, and efficacy under physiologic conditions.
METHODS
Penile rigidity and length were evaluated in eight rhesus macaques following rectal electrostimulation (RES), vibratory stimulation (VS), or pharmacological treatment with Sildenafil Citrate (Viagra) or Alprostadil.
RESULTS
Rectal electrostimulation treatment increased penile rigidity (>82%) and length (2.5 ± 0.58 cm), albeit the response was transient. In contrast, VS alone or coupled with Viagra or Alprostadil failed to elicit an erection response.
CONCLUSION
Rectal electrostimulation treatment elicits transient but consistent penile erections in macaques. High rigidity following RES treatment demonstrates increased blood flow and may provide a functional model for penile PK evaluations and possibly simian immunodeficiency virus (SIV) transmission under erect conditions.
Topics: Alprostadil; Animals; Anti-Retroviral Agents; Disease Models, Animal; Electric Stimulation; Macaca mulatta; Male; Penile Diseases; Penile Erection; Penis; Sildenafil Citrate; Simian Acquired Immunodeficiency Syndrome; Vasodilator Agents; Vibration
PubMed: 26778321
DOI: 10.1111/jmp.12207 -
Urologic Oncology Jun 2022The majority of penile malignant tumors are squamous cell carcinomas. They are pathologically defined as epithelial neoplasms originating in the squamous cells of the... (Review)
Review
The majority of penile malignant tumors are squamous cell carcinomas. They are pathologically defined as epithelial neoplasms originating in the squamous cells of the inner mucosal lining of the glans, coronal sulcus or foreskin. Tumor location and site of origin is preferentially in glans (70%) followed by foreskin (25%) and coronal sulcus (5%). Despite the variable geographic distribution, pathological features of penile carcinomas in areas of high- and low-risk are similar. Penile tumors are morphologically heterogeneous. A major advance, based on biological, etiological and prognostic factors, is the 2016 WHO classification separating epithelial penile neoplasia, precancerous and invasive, in non-HPV and HPV-related.
Topics: Carcinoma, Squamous Cell; Humans; Male; Neoplasm Staging; Papillomavirus Infections; Penile Neoplasms; Penis
PubMed: 33008752
DOI: 10.1016/j.urolonc.2020.09.010 -
Clinical Infectious Diseases : An... May 2017The epidemiology of penile human papillomavirus (HPV) infection is not well understood. Our objective was to determine the prevalence of penile HPV infection in the...
BACKGROUND
The epidemiology of penile human papillomavirus (HPV) infection is not well understood. Our objective was to determine the prevalence of penile HPV infection in the United States.
METHODS
We analyzed a nationally representative sample of civilian noninstitutionalized US men from the National Health and Nutritional Examination Survey (NHANES) 2013-2014. Penile swab samples were collected from men aged 18-59 years. For detection of HPV types, a Roche Linear Array test was performed. We used NHANES sampling weights to estimate the population prevalence of penile HPV infection.
RESULTS
The overall prevalence of any HPV infection was 45.2% (95% confidence interval [CI], 41.3%-49.3%). The prevalence of any high-risk HPV types and low-risk HPV types (mutually exclusive of high-risk HPV) was 30.5% (95% CI, 28.0%-33.0%) and 14.8% (95% CI, 12.7%-17.2%), respectively. Overall HPV prevalence increased with increasing age: the prevalence was lowest among 18- to 24-year-old men (33.8%) and highest among 55- to 59-year-old men (53.4%). HPV types 16 and 18 were detected in 4.3% (95% CI, 3.2%-5.7%) and 1.7% (95% CI, 1.1%-2.6%) of men, respectively. The prevalence of any HPV infection was almost 80% among men who reported having ≥16 lifetime sexual partners and using condoms intermittently.
CONCLUSIONS
Our findings indicate that penile HPV is common among men in the United States. Almost one-third of all men are infected with high-risk HPV. Prevalence of penile HPV infection increases with increasing age.
Topics: Adolescent; Adult; Age Factors; Humans; Male; Middle Aged; National Health Programs; Papillomaviridae; Papillomavirus Infections; Penile Diseases; Penis; Prevalence; Risk Factors; Sexual Behavior; Sexual Partners; Surveys and Questionnaires; United States; Young Adult
PubMed: 28205678
DOI: 10.1093/cid/cix159