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The Urologic Clinics of North America Aug 2013Penile skin loss may occur after trauma, infection, or as a result of surgical resection. This article reviews indications for reconstruction of the penile skin, skin... (Review)
Review
Penile skin loss may occur after trauma, infection, or as a result of surgical resection. This article reviews indications for reconstruction of the penile skin, skin anatomy, and skin graft physiology. Choice of reconstructive options, skin grafting techniques, and complications of skin grafting are also discussed.
Topics: Humans; Male; Penis; Skin Transplantation; Wound Healing
PubMed: 23905942
DOI: 10.1016/j.ucl.2013.04.004 -
Clinical and Experimental Dermatology Jan 2019Penile lymphoedema (with and without cellulitis) is a rare, often chronic, clinically heterogeneous entity with an uncertain pathogenesis and an important differential...
BACKGROUND
Penile lymphoedema (with and without cellulitis) is a rare, often chronic, clinically heterogeneous entity with an uncertain pathogenesis and an important differential diagnosis. It creates significant physical and psychosexual morbidity, and presents considerable therapeutic challenges. The existing literature is limited.
AIM
To describe and share our updated cumulative experience of a cohort of patients with penile lymphoedema.
METHODS
This was a retrospective review of the case records of patients with chronic penile lymphoedema seen in two dedicated male genital dermatology clinics between January 2011 and July 2016.
RESULTS
In total, 41 cases were identified. Over a third had Crohn disease (CD) (which was occult in one-third of these), and over a third had serological evidence of streptococcal infection. All patients responded to systemic antibiotics and specialized urological surgery circumcision and excision).
CONCLUSIONS
Penile lymphoedema should be investigated to exclude underlying pathology especially CD and streptococcal infection. Treatment with antibiotics should be considered early and long term to try to preserve the foreskin: most patients are uncircumcised. Some patients may benefit from a course or courses of oral steroids. The development of gross dysfunction of the prepuce usually dictates circumcision and excision of lymphoedematous tissue once the situation is medically stabilized.
Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Chronic Disease; Circumcision, Male; Crohn Disease; Diagnosis, Differential; Humans; Lymphedema; Male; Middle Aged; Penile Diseases; Penis; Retrospective Studies; Streptococcal Infections; Young Adult
PubMed: 30009576
DOI: 10.1111/ced.13609 -
The Journal of Infectious Diseases May 2010The relationship between circumcision and the acquisition and clearance of human papillomavirus (HPV) infection was examined in a cohort of 357 men followed up at...
The relationship between circumcision and the acquisition and clearance of human papillomavirus (HPV) infection was examined in a cohort of 357 men followed up at 2-month intervals for an average of 431 days. There were no differences in HPV acquisition by circumcision status. Clearance of HPV infection, including infection with oncogenic types, was slower in the glans/coronal sulcus of the penis of uncircumcised men than circumcised men. The median duration of HPV infection of the glans/coronal sulcus was significantly longer in uncircumcised men (154 days) than circumcised men (91 days) (P=.04). Circumcision may protect against HPV-associated disease by enhancing the resolution of infection.
Topics: Adult; Circumcision, Male; Foreskin; Humans; Male; Papillomaviridae; Papillomavirus Infections; Penile Diseases; Penis; Risk Factors; Time Factors
PubMed: 20350160
DOI: 10.1086/651607 -
The Journal of Urology Jan 1988Late deep wound infection caused by hematogenous bacterial spread from a remote focus is a rare but disastrous complication of prosthetic devices. Six patients with...
Late deep wound infection caused by hematogenous bacterial spread from a remote focus is a rare but disastrous complication of prosthetic devices. Six patients with probable late hematogenous infection are described. The initial implantation was free of contamination and infection, and a long functional interval ensued. A febrile process associated with a painful, swollen penis followed a probable remote infection source that was not covered with prophylactic antibiotics. All prostheses required removal. Prophylactic antibiotics may prevent these late hematogenous infections.
Topics: Adult; Bacterial Infections; Equipment Contamination; Erectile Dysfunction; Humans; Male; Middle Aged; Penis; Postoperative Complications; Premedication; Prostheses and Implants
PubMed: 3336104
DOI: 10.1016/s0022-5347(17)42287-7 -
The New England Journal of Medicine Jul 1973
Topics: Adult; Coitus; Diagnosis, Differential; Edema; Humans; Male; Penile Diseases; Penis; Sexually Transmitted Diseases
PubMed: 4740198
DOI: 10.1056/nejm197307122890224 -
Archives of Dermatology Aug 1973
Topics: Adult; Edema; Humans; Male; Military Medicine; Penile Diseases; Penis; Sexual Behavior; Sexually Transmitted Diseases; Thailand; United States; Vietnam
PubMed: 4740650
DOI: No ID Found -
Cancer Epidemiology, Biomarkers &... Nov 2014We assessed human papillomavirus (HPV) seroconversion following anal and penile HPV infection in HIV-negative and HIV-infected men who have sex with men (MSM).
BACKGROUND
We assessed human papillomavirus (HPV) seroconversion following anal and penile HPV infection in HIV-negative and HIV-infected men who have sex with men (MSM).
METHODS
MSM aged ≥18 years were recruited in Amsterdam, the Netherlands (2010-2011), and followed up semiannually. Antibodies against 7 high-risk HPV types in baseline and 12-month serum samples were tested using a multiplex immunoassay. Baseline, 6-, and 12-month anal and penile samples were tested for HPV DNA using the SPF10-PCR DEIA/LiPA25 system. Statistical analyses were performed using logistic regression with generalized estimating equations.
RESULTS
Of 644 MSM included in the analysis, 245 (38%) were HIV-infected. Median age was 38 years for HIV-negative and 47 years for HIV-infected MSM (P < 0.001). Seroconversion against ≥1 of the 7 HPV types was observed in 74 of 396 (19%) HIV-negative and 52 of 223 (23%) HIV-infected MSM at risk (P = 0.2). Incident [adjusted OR (aOR) 2.0; 95% confidence interval (CI), 1.1-3.4] and persistent (aOR 3.7; 95% CI, 1.5-9.5) anal HPV infections were independently associated with type-specific seroconversion in HIV-negative MSM. In HIV-infected MSM, there was a nonsignificant positive association between penile HPV infection at any time point and seroconversion (aOR 1.7; 95% CI, 0.9-3.2).
CONCLUSIONS
Incident or persistent anal HPV infection was an independent determinant of seroconversion in HIV-negative MSM.
IMPACT
Our data support that seroresponse may vary per anatomic site and that persistent HPV infections are more likely to elicit a detectable humoral immune response.
Topics: Adult; Anal Canal; HIV Infections; Homosexuality, Male; Humans; Male; Papillomaviridae; Papillomavirus Infections; Penis; Risk Factors
PubMed: 25169974
DOI: 10.1158/1055-9965.EPI-14-0199 -
AIDS (London, England) Jan 2009Factors governing events between exposure of male genital mucosa surfaces and the establishment of infection are poorly understood. Furthermore, little is known about...
OBJECTIVE
Factors governing events between exposure of male genital mucosa surfaces and the establishment of infection are poorly understood. Furthermore, little is known about the safety and efficacy of microbicides on male genital mucosa.
DESIGN
Here we present a novel penile tissue explant model to characterize the mechanisms of HIV-1 infection of male genital tissue and evaluate candidate microbicides.
METHODS
Mucosal explant culture conditions were determined for glans, urethra and foreskin obtained from gender reassignment and circumcision. Density and distribution of CD4 and CD1a cells were visualized by microscopy. In vitro HIV-1 infection was determined by measuring p24 release, whereas microbicide biocompatibility and efficacy were assessed by measurement of tissue viability, cytokine expression and p24 production.
RESULTS
Cultured glans and foreskin showed comparable epithelial thickness but some differences in CD4 and CD1a cell density. All tissue sites examined (foreskin, glans, meatus, urethra) were equally susceptible to R5 HIV-1 infection, which was productively disseminated by migratory cells emigrating from tissue. In contrast, X4 HIV-1 failed to infect mucosal tissue and dissemination by migratory cells was less efficient. The three candidate microbicides poly(methyl 2-propionamidoacrylate), PRO 2000 and Cyanovirin-N, showed good tissue compatibility and efficient prevention of HIV-1 infection, causing only minor changes in tissue cytokine profile.
CONCLUSION
The described model provides a useful model to study the determinants of HIV-1 infection of male genital tissue and is likely to be an important tool for the future development of microbicide candidates and concepts.
Topics: Adenine; Antiviral Agents; CD4-Positive T-Lymphocytes; Cytokines; Foreskin; HIV Infections; HIV-1; Humans; Langerhans Cells; Male; Naphthalenesulfonates; Organophosphonates; Penis; Polymers; Tenofovir; Tissue Culture Techniques; Urethra; Virus Replication
PubMed: 19114867
DOI: 10.1097/QAD.0b013e328321b778 -
The Journal of Sexual Medicine Sep 2018Penile prosthesis implantation into scarred corporeal bodies is one of the most challenging procedures in prosthetic urologic surgery, especially following infection and...
BACKGROUND
Penile prosthesis implantation into scarred corporeal bodies is one of the most challenging procedures in prosthetic urologic surgery, especially following infection and extrusion of a penile implant. Several instruments and techniques have been used for making dilatation of scarred corporeal bodies easier and safer in expert hands. Nevertheless, in some cases, implantation is not possible.
AIM
This work presents extracorporeal transseptal implantation as a last resort in such cases.
METHODS
In 39 patients with extensive corporeal fibrosis, penile prosthesis implantation is attempted. After failure of alternative techniques, extracorporeal implantation is resorted to in 10 patients. The corpus spongiosum is identified and protected. Diathermy knife is used to cut a longitudinal window into 1 corpus cavernosum, through the septum and into the contralateral corpus cavernosum. A single semirigid implant rod is inserted through the window at the base of the penis, halfway through. The 2 limbs of the rod are bent upward toward the glans, to assume a U shape. The limbs of the U are brought together at midshaft by a gathering suture passed through the corpora cavernosa and septum. The tips of the U are anchored under the glans.
OUTCOMES
Achievement of acceptable coital relationship.
RESULTS
The procedure allowed acceptable coital relationship and concealment in 9/10 cases. In 1 case, infection occurred. Reimplantation with the same method was performed 6 months later, and the implant survived adequately. Perforation, migration, and urethral injury were not encountered.
CLINICAL IMPLICATIONS
This technique may help salvage abandoned cases with corporal fibrosis, particularly when the necessary expertise for alternative techniques is unavailable or when such techniques fail.
STRENGTHS & LIMITATIONS
The technique presented is fairly straightforward and safe. However, the number of cases and duration of follow-up are limited.
CONCLUSION
Extracorporeal transseptal penile prosthesis implantation can salvage cases with severe corporeal fibrosis when all alternatives fail. Shaeer O, Shaeer K. Extracorporeal Transseptal Penile Prosthesis Implantation for Extreme Cases of Corporeal Fibrosis: Shaeer Implantation Technique. J Sex Med 2018;15:1350-1356.
Topics: Adult; Fibrosis; Humans; Male; Penile Implantation; Penile Prosthesis; Penis; Salvage Therapy
PubMed: 30057279
DOI: 10.1016/j.jsxm.2018.06.010 -
Sexually Transmitted Infections Sep 2013Submission of self-collected penile samples collected at home could remove barriers that men face in getting tested for sexually transmitted infections (STIs).
BACKGROUND
Submission of self-collected penile samples collected at home could remove barriers that men face in getting tested for sexually transmitted infections (STIs).
METHODS
From December 2006 to July 2012, sexually active men aged ≥14 years were recruited by an educational internet program (http://www.iwantthekit.org) which offered free testing for Trichomonas vaginalis infection. Kits were ordered online and swabs were sent via US mail to the laboratory and tested by nucleic acid amplification tests. Demographics and sexual risk factors were accessed by questionnaires. Men called or were contacted to receive their results. Risk factors for trichomonas infection were determined by multivariate logistic regression
RESULTS
Of 4398 men requesting kits, 1699 (38.6%) returned swabs by mail (55.4% returned in 2012). Forty-one percent of men were aged <25 years, 43% were black subjects and 45% were white. The overall prevalence for trichomonas in the 1699 men was 3.7%; the highest prevalence by age group was for men aged 40-49 years (5.2%) and, by year, 216 men screened in 2008 had the highest prevalence (12.5%). Risk factors for 919 men whose risk information was collected by questionnaire (prevalence 6.0%) indicated that 9.6% had a concurrent chlamydia infection. Significantly associated risks factors included: black race (adjusted OR 2.67), residence in Illinois (OR 12.02), age 30-39 years (OR 6.63) and age >40 years (OR 5.31).
CONCLUSIONS
A fairly high prevalence of trichomonas and sexual risk factors were demonstrated from internet recruitment of men. This method of engaging men to get screened for trichomonas may augment screening in STI clinics.
Topics: Adolescent; Adult; Humans; Illinois; Internet; Male; Middle Aged; Molecular Diagnostic Techniques; Parasitology; Penis; Prevalence; Risk Factors; Self Administration; Specimen Handling; Surveys and Questionnaires; Trichomonas Infections; Trichomonas vaginalis; Young Adult
PubMed: 23354525
DOI: 10.1136/sextrans-2012-050946