-
Cureus Jun 2021Objective The population's ever-growing concern with genital aesthetic dysfunctions reflects an increasing demand in the field of intimate aesthetics. For this reason,...
Objective The population's ever-growing concern with genital aesthetic dysfunctions reflects an increasing demand in the field of intimate aesthetics. For this reason, as well as the lack of a standardized evaluation, this paper aims to develop a form that facilitates the initial investigation of aesthetic genital dysfunctions. Methods An evaluation form for female and male genital dyschromia was developed between July and November 2018. Following initial development, the form was evaluated for quality and was updated by a panel of specialists (a psychologist, two pelvic dysfunction physiotherapists, and two dermato-functional physiotherapists) via email and through a content validity questionnaire. The face validity of the form was assessed by five physiotherapy and medical students who were randomly selected. The students answered a questionnaire evaluating the proposed form. The reliability of the form was established through the test-retest procedure by evaluating its reproducibility over time. Results The "Genital Dyschromia Evaluation Form'' (composed of identification, anamnesis, and physical examination sections) was approved by the specialist panel. They suggested questions to be added in the anamnesis (dermatological lesions or fungal and bacterial infections) and physical examination (hyperemia, edema in the perianal and internal thigh region) sections. As for the image analysis, an increase in quality, resolution, and sharpness was suggested. Lastly, for the cutaneous phototype evaluation, the DoctorSkinFototipo® digital analyzer device was chosen since it is small, portable, easily positioned on the genital area, and can be readily cleaned between patients. Conclusion The "Genital Dyschromia Evaluation Form" is a questionnaire approved by specialists and could represent a suitable option for health professionals.
PubMed: 34322333
DOI: 10.7759/cureus.15840 -
The Journal of Sexual Medicine Dec 2018The objective of genital enlargement surgery is to increase length and/or girth for cosmetic reasons; however, newer techniques have been recently reported to be...
INTRODUCTION
The objective of genital enlargement surgery is to increase length and/or girth for cosmetic reasons; however, newer techniques have been recently reported to be associated with only minor complications in a small percentage of patients.
AIM
We aim to report the severe complications of penile augmentation surgery seen at a referral center and describe their subsequent management.
METHODS
Institutional review board approval was obtained. We reviewed our prospectively collected database for all patients who presented with complications of genital enlargement surgery from 2002-2016.
MAIN OUTCOME MEASURE
Interventions following complications of genital enlargement surgery.
RESULTS
11 Patients were identified. Mean age was 47 (21-77) years. Prior procedures included subcutaneous injection of silicone outside a medical setting, girth enhancement procedures involving the subcutaneous placement or injection of substances including fat, other substances, or subcutaneous silicone implants. All patients who underwent subcutaneous penile implant underwent removal prior to presentation. Adverse changes included sexually disabling penile deformity and severe shortening, curvature, edema, subcutaneous masses, infection, non-healing wounds, and sexual dysfunction. 10 patients underwent corrective surgery, with 2 requiring multiple procedures and 3 requiring split-thickness skin grafting. All 10 patients had an improved cosmetic appearance and those who had disabling shortening had significantly improved functional length.
CLINICAL IMPLICATIONS
Report of such adverse events should assist in appropriate perioperative counseling prior to genital enhancement surgery.
STRENGTH & LIMITATIONS
Few reports of debilitating complications of penile enlargement exist in literature. However, without knowing the overall number of procedures performed, the true complication incidence is not known.
CONCLUSION
Penile and scrotal enhancement surgery can be associated with major disabling complications, leading to deformity and functional compromise in men with prior normal anatomy and function. Patients should be aware of these risks. Furr J, Hebert K, Wisenbaugh E, et al. Complications of Genital Enlargement Surgery. J Sex Med 2018;15:1811-1817.
Topics: Adult; Aged; Humans; Male; Middle Aged; Penile Diseases; Penile Implantation; Penile Prosthesis; Penis; Postoperative Complications; Silicones; Urogenital Surgical Procedures
PubMed: 30446473
DOI: 10.1016/j.jsxm.2018.10.007 -
Cureus Mar 2020Diagnostic paracentesis is a routinely practiced, typically safe procedure performed in the emergency department. Genital swelling post-paracentesis is a rare...
Diagnostic paracentesis is a routinely practiced, typically safe procedure performed in the emergency department. Genital swelling post-paracentesis is a rare complication with few documented case reports. We report a case of isolated penile edema after a diagnostic paracentesis performed in the emergency department. The patient is a 63-year-old male who came to the emergency department with a two-day history of isolated penile swelling after undergoing a diagnostic paracentesis in the emergency department as part of his workup during a recent hospital admission. On exam, the paracentesis site was noticeably low, beneath the inguinal ligament on the right side. His genital exam showed a circumcised penis with significant soft tissue swelling that involved the entire penile shaft sparing the glans and scrotum. There was no penile tenderness on palpation or urethral discharge. The testicles and scrotum revealed no signs of edema or tenderness, hernias, or abnormal lie. Of note, the patient reported that he had a less severe episode of penile swelling approximately one year ago after a paracentesis in a similarly low site, which resolved spontaneously. The features and timing of this presentation, added to the patient's previous episode over a year ago, pointed to this being a sequela of the paracentesis he had undergone during his last hospital stay. After evaluation and consultation with the urology service, he was discharged home with expectant management and outpatient follow-up. His symptoms resolved spontaneously after one week. To our knowledge, there have been no published reports of isolated penile edema after a diagnostic paracentesis. This case could be used when teaching the proper technique for performing a paracentesis and its potential complications.
PubMed: 32313770
DOI: 10.7759/cureus.7329 -
SAGE Open Medical Case Reports 2023Abdominal paracentesis is a common and safe procedure used to remove ascitic fluid from the body. It is performed in both the inpatient and outpatient setting and can be...
Abdominal paracentesis is a common and safe procedure used to remove ascitic fluid from the body. It is performed in both the inpatient and outpatient setting and can be used for both diagnostic and therapeutic purposes. The most common complications of this procedure include a persistent fluid leak, an infection from the puncture site and an abdominal wall hematoma. The finding of sudden-onset massive genital swelling is a rare, and only occasionally reported, complication of a paracentesis. This article will discuss the case of a 58-year-old male with decompensated liver cirrhosis who presented with sudden-onset scrotal and penile swelling within 12 h after a paracentesis. After ruling out other causes of scrotal swelling, it was concluded that this is likely a complication of the recent paracentesis. The scrotal swelling was treated with conservative management including oral diuretic therapy and scrotal elevation, and the patient showed significant improvement in symptoms in 2 days. The cause of post-paracentesis scrotal edema is not widely studied; however, it is hypothesized to be caused by a fistula tract that forms between the peritoneal cavity and the Camper's and Scarpa's fascia which causes fluid to collect in the scrotum.
PubMed: 36816822
DOI: 10.1177/2050313X231156402 -
Basic and Clinical Andrology Jul 2022Fournier's gangrene (FG) is a necrotizing fasciitis caused by aerobic and anaerobic bacterial infection that involves genitalia and perineum. Males, in their 60 s, are...
BACKGROUND
Fournier's gangrene (FG) is a necrotizing fasciitis caused by aerobic and anaerobic bacterial infection that involves genitalia and perineum. Males, in their 60 s, are more affected with 1.6 new cases/100.000/year. Main risk factors are diabetes, malignancy, inflammatory bowel disease. FG is a potentially lethal disease with a rapid and progressive involvement of subcutaneous and fascial plane. A multimodal approach with surgical debridement, antibiotic therapy, intensive support care, and hyperbaric oxygen therapy (HBOT) is often needed. We present the inpatient management of an FG case during the Covid-19 pandemic period. A narrative review of the Literature searching "Fournier's gangrene", "necrotizing fasciitis" on PubMed and Scopus was performed.
CASE PRESENTATION
A 60 years old man affected by diabetes mellitus, with ileostomy after colectomy for ulcerative colitis, was admitted to our Emergency Department with fever and acute pain, edema, dyschromia of right hemiscrotum, penis, and perineal region. Computed tomography revealed air-gas content and fluid-edematous thickening of these regions. Fournier's Gangrene Severity Index was 9. A prompt broad-spectrum antibiotic therapy with Piperacillin/Tazobactam, Imipenem and Daptomycin, surgical debridement of genitalia and perineal region with vital tissue exposure, were performed. Bedside daily surgical wound medications with fibrine debridement, normal saline and povidone-iodine solutions irrigation, iodoform and fatty gauze application, were performed until discharge on the 40 postoperative day. Every 3 days office-based medication with silver dressing, after normal saline and povidone-iodine irrigation and fibrinous tissue debridement, was performed until complete re-epithelialization of the scrotum on the 60 postoperative day.
CONCLUSIONS
FG is burdened by a high mortality rate, up to 30%. In the literature, HBOT could improve wound restoration and disease-specific survival. Unfortunately, in our center, we do not have HBOT. Moreover, one of the pandemic period problems was the patient's displacement and outpatient hospital management. For all these reasons we decided for a conservative inpatient management. Daily cleaning of the surgical wound allowed to obtain its complete restoration avoiding surgical graft and hyperbaric oxygen chamber therapy, without foregoing optimal outcomes.
PubMed: 35850577
DOI: 10.1186/s12610-022-00162-y -
The First Report of Isolated Clitoral Hood Hair-Thread Tourniquet Syndrome: A Study of Six Patients.Cureus Jun 2022Background and objective Hair-thread tourniquet syndrome (HTTS) is a rare and potentially dangerous condition that occurs when a hair strand or fabric thread is wrapped...
Background and objective Hair-thread tourniquet syndrome (HTTS) is a rare and potentially dangerous condition that occurs when a hair strand or fabric thread is wrapped around the penis, clitoris, toes, fingers, or other appendages, leading to focal edema, ischemia, and necrosis. This study aimed to examine the cases of six female patients with isolated clitoral hood HTTS. Methods This was a retrospective study involving six female patients (age range: two to six years) with isolated clitoral hood tourniquet who presented to the outpatient department (OPD) and emergency room (ER) of the pediatric and adolescent gynecology service at King Abdulaziz University Hospital, Jeddah, Saudi Arabia between January 2010 and December 2021. Data related to patients' clinical presentation, symptom duration, and management were recorded. Results The most common symptom of isolated clitoral hood HTTS in all six cases was pain, followed by redness, itching, discomfort while sitting, and dysuria. Local signs included edema in three cases, tight hair tourniquet around a portion of the clitoral hood in four cases, and loose hair tourniquet around a portion of the clitoral hood in two cases, one of which was during the first episode in a patient who had recurrence (Case 1). Sedation and local anesthetic were used in five cases involving the local removal of four hairs and a strangulated skin. This was followed by local care and antibiotic ointment application. The edges were closed by interrupted stitches in two of the cases as the resulting wounds were broad. Limited clitoral unhooding was performed under general anesthesia in one patient, who had repeated bouts of autoamputation of parts of the hood tissue with resulting disfiguration of the remaining redundant hood, to avoid the additional risk of organ loss. Only two patients experienced recurring episodes. Conclusions A high index of suspicion should be maintained when encountering these patients, which can facilitate a prompt resolution to save the affected tissue. HTTS should be suspected in all females presenting with a prominent clitoral hood, genital pain, structural abnormality, swelling, or discomfort. This is the first study to report isolated clitoral hood HTTS; it describes the presentation, manifestation, and management of patients with HTTS. It also addresses preventive strategies to alert mothers and treating physicians of the pediatric and adolescent-age group females to the defect and its underlying causes, particularly when patients have genital structural abnormalities such as excessive clitoral hood labial hypertrophy or ambiguous genitalia.
PubMed: 35784985
DOI: 10.7759/cureus.26472 -
Ethiopian Journal of Health Sciences Jan 2022Lymphangioma circumscriptum is a rare benign disorder of lymphatic channels in deep dermal and subcutaneous layers. It can occur either as a congenital abnormality or as...
Lymphangioma circumscriptum is a rare benign disorder of lymphatic channels in deep dermal and subcutaneous layers. It can occur either as a congenital abnormality or as acquired damage to previously normal lymphatic channels. It occurs in different parts of the body, and the vulva is one of the parts which is commonly affected. Here, we presented a 39 years old para 2 who presented with vulvar swelling. She was diagnosed with acquired lymphangioma circumscriptum of the vulva and superficial vulvectomy was done.
Topics: Adult; Edema; Female; Humans; Lymphangioma; Vulva; Vulvar Neoplasms
PubMed: 35250235
DOI: 10.4314/ejhs.v32i1.25 -
Revista Espanola de Enfermedades... May 2023A 50-year-old male, with a medical history of Lynch syndrome and transurethral-resection (TUR) secondary to multifocal bladder tumour (pT1-high grade) with normal...
A 50-year-old male, with a medical history of Lynch syndrome and transurethral-resection (TUR) secondary to multifocal bladder tumour (pT1-high grade) with normal subsequent follow-ups, consulted for anal pain, rectal tenesmus and fever for 3 weeks. On examination, he presented perianal oedema and, on digital rectal examination, a right lateral orifice was palpable at 6cm from the anal margin. CT scan revealed a defect-in-continuity in the right rectal wall which communicated with bilateral perirectal collections extending towards the puborectalis-levator ani. On the right side, it extended towards the ischiorectal fossa and, on the left side it continued with another collection that displaced the corpus cavernosum. Urgent transanal debridement of abscess with biopsy and cultures was performed. Subsequent evolution was torpid. The clinical history was reviewed, as the patient had undergone repeated bladder catheterizations after TUR and BCG therapy one year before. Abdominal tomography with urethral contrast and cystourethrography were performed, which confirmed the presence of a fistula in the bulbomembranous urethra that communicated with the perirectal abscesses. Cultures and biopsies were negative for mycobacteria and malignancy was ruled out. A new surgical exploration was carried out, enlarging the transanal drainage orifice, making a temporary intestinal stoma and bladder catheterization. After eighteen weeks, the healing of the fistula was verified through of a new cystourethrography. Reconstruction of the intestinal transit has now been scheduled, after radiologically and endoscopically verifying the closure of the rectal orifice.
Topics: Male; Humans; Middle Aged; Abscess; Urethra; Rectal Diseases; Rectum; Fistula
PubMed: 36695767
DOI: 10.17235/reed.2023.9456/2023 -
BMJ Case Reports Nov 2015Massive oedema of the vulva appears to be a sequel of an underlying systemic disease in pregnant women. Isolated vulval oedema in pregnancy is rare. Vulval oedema has... (Review)
Review
Massive oedema of the vulva appears to be a sequel of an underlying systemic disease in pregnant women. Isolated vulval oedema in pregnancy is rare. Vulval oedema has been treated, depending on pathophysiology, with steroids, furosemide, albumin and continuous epidural analgaesia. We present a case of vulval oedema, where the oedema was confined to the labia minora in a healthy young pregnant woman. The patient was in pain and extreme discomfort due to the labial swelling, and caesarean section was being considered for delivery as the massive oedema would obstruct the birth canal. The swelling, however, resolved successfully by simple drainage. In the literature, there have been cases delivered by caesarean section as vulval swelling was causing an obstruction.
Topics: Adult; Cesarean Section; Edema; Female; Humans; Hypoalbuminemia; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Severity of Illness Index; Vulva; Vulvar Diseases
PubMed: 26538126
DOI: 10.1136/bcr-2014-206666 -
Acta Cirurgica Brasileira 2023Our aim was to investigate protective effects of daidzein treatment on ischemia-reperfusion (I/R) injury-induced ovarian tissue by immunohistochemical techniques.
PURPOSE
Our aim was to investigate protective effects of daidzein treatment on ischemia-reperfusion (I/R) injury-induced ovarian tissue by immunohistochemical techniques.
METHODS
Thirty Sprague Dawley female rats were categorized into three groups as sham, I/R group, and I/R+daidzein groups. Bloods were analyzed for malondialdehyde (MDA), glutathione peroxidase (GSH), and myeloperoxidase (MPO), and ovaries were processed for histological tissue protocol.
RESULTS
Both MDA and MPO values were increased in I/R group compared to sham and I/R+daidzein groups. GSH content was increased in I/R+daidzein group compared to I/R groups. In I/R group, theca and follicular cells were degenerated with apoptosis and dilatation and congestion, edema. In I/R+daidzein group, daidzein improved pathologies. In the I/R group, Bax expression was positive with follicular cells, granulosa cells and inflammatory cells. In the I/R+daidzein group, positive Bax reaction was observed in the epithelial, antral, and inflammatory cells. In I/R group, Bcl-2 reaction was in germinative epithelial cells, cells of antral follicle. In the I/R+daidzein group, Bcl-2 expression level was reduced after daidzein treatment.
CONCLUSIONS
After the I/R procedure, ovarian cells and follicles were degenerated with apoptosis and inflammation. After daidzein treatment, Bax and Bcl-2 signal were decreased. It was observed that daidzein stopped the apoptotic process.
Topics: Rats; Animals; Female; Rats, Sprague-Dawley; Ovary; bcl-2-Associated X Protein; Ischemia; Reperfusion Injury; Proto-Oncogene Proteins c-bcl-2; Reperfusion; Malondialdehyde; Apoptosis
PubMed: 37909594
DOI: 10.1590/acb384423