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Viruses May 2022Globally, most Human Immunodeficiency Virus type 1 (HIV) transmission occurs through vaginal-penile sex (heterosexual transmission). The local immune environment at the... (Review)
Review
Globally, most Human Immunodeficiency Virus type 1 (HIV) transmission occurs through vaginal-penile sex (heterosexual transmission). The local immune environment at the site of HIV exposure is an important determinant of whether exposure during sex will lead to productive infection, and the vaginal and penile immune milieus are each critically shaped by the local microbiome. However, there are key differences in the microbial drivers of inflammation and immune quiescence at these tissue sites. In both, a high abundance of anaerobic taxa (e.g., ) is associated with an increased local density of HIV target cells and an increased risk of acquiring HIV through sex. However, the taxa that have been associated to date with increased risk in the vagina and penis are not identical. Just as importantly, the microbiota associated with comparatively less inflammation and HIV risk-i.e., the optimal microbiota-are very different at the two sites. In the vagina, spp. are immunoregulatory and may protect against HIV acquisition, whereas on the penis, "skin type" flora such as are associated with reduced inflammation. Compared to its vaginal counterpart, much less is known about the dynamics of the penile microbiome, the ability of clinical interventions to alter the penile microbiome, or the impact of natural/induced microbiome alterations on penile immunology and HIV risk.
Topics: Female; HIV Infections; HIV-1; Humans; Inflammation; Male; Penis; Vagina
PubMed: 35746636
DOI: 10.3390/v14061164 -
Sources, Selection, and Microenvironmental Preconditioning of Cells for Urethral Tissue Engineering.International Journal of Molecular... Nov 2022Urethral stricture is a common urinary tract disorder in men that can be caused by iatrogenic causes, trauma, inflammation, or infection and often requires... (Review)
Review
Urethral stricture is a common urinary tract disorder in men that can be caused by iatrogenic causes, trauma, inflammation, or infection and often requires reconstructive surgery. The current therapeutic approach for complex urethral strictures usually involves reconstruction with autologous tissue from the oral mucosa. With the goal of overcoming the lack of sufficient autologous tissue and donor site morbidity, research over the past two decades has focused on cell-based tissue-engineered substitutes. While the main focus has been on autologous cells from the penile tissue, bladder, and oral cavity, stem cells from sources such as adipose tissue and urine are competing candidates for future urethral regeneration due to their ease of collection, high proliferative capacity, maturation potential, and paracrine function. This review addresses the sources, advantages, and limitations of cells for tissue engineering in the urethra and discusses recent approaches to improve cell survival, growth, and differentiation by mimicking the mechanical and biophysical properties of the extracellular environment.
Topics: Male; Humans; Urethra; Tissue Engineering; Conditioning, Psychological; Urinary Bladder; Penis
PubMed: 36430557
DOI: 10.3390/ijms232214074 -
Forensic Science, Medicine, and... Jun 2022Three morbidly obese men aged 69, 49 and 45 years with respective BMIs of 46.3, 49.1 and 59.3 died suddenly from underlying cardiovascular disease. At autopsy all were...
Three morbidly obese men aged 69, 49 and 45 years with respective BMIs of 46.3, 49.1 and 59.3 died suddenly from underlying cardiovascular disease. At autopsy all were found to have marked penile shortening typical of an entity known as "buried penis." This condition arises in adulthood most commonly from morbid obesity as the penile shaft becomes enveloped by encroaching suprapubic adipose tissue. It is associated with infective, obstructive and malignant complications. Histology will be required to identify less-common causative conditions or any inflammatory or premalignant/malignant changes.
Topics: Adipose Tissue; Adult; Body Mass Index; Humans; Male; Obesity, Morbid; Penis
PubMed: 35195846
DOI: 10.1007/s12024-022-00461-w -
Asian Journal of Andrology 2021Hyaluronic acid injection is becoming a popular way for penile augmentation. However, only few studies and follow-ups have investigated the various complications of...
Hyaluronic acid injection is becoming a popular way for penile augmentation. However, only few studies and follow-ups have investigated the various complications of hyaluronic acid injection and their corresponding management. In this study, a total of 230 patients who had penile augmentation with hyaluronic acid injection from January 2018 to December 2019 were examined on follow-up for penile girth, complications, and their corresponding management. At 1-month, 3-month, and 6-month postoperative follow-ups, the penile circumference had increased by 2.66 ± 1.24 cm, 2.28 ± 1.02 cm, and 1.80 ± 0.83 cm, respectively. During the entire 6-month follow-up, 4.3% had complications such as subcutaneous bleeding, subcutaneous nodules, and infection. There were no systemic or local allergic reactions among all the patients. All complications were treated accordingly, and no further deterioration or severe sequelae were observed. Although complications of hyaluronic acid injections are mild and rare, these may affect the patient's satisfaction postoperatively. Preoperative redundant prepuce may increase the incidence of penile edema or postoperative gel migration. Standardization of the surgery protocol and elucidation of the effects of other injection parameters are still lacking. Nevertheless, it still highlights the importance of preoperative preparation and surgical technique.
Topics: Adult; Aftercare; China; Humans; Hyaluronic Acid; Injections; Male; Middle Aged; Patient Satisfaction; Penis; Postoperative Complications
PubMed: 33533738
DOI: 10.4103/aja.aja_78_20 -
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 -
Urology Dec 2020The implantation of penile protheses for the surgical treatment of erectile dysfunction has risen in popularity over the past several decades. Considerable advances have... (Review)
Review
The implantation of penile protheses for the surgical treatment of erectile dysfunction has risen in popularity over the past several decades. Considerable advances have been made in surgical protocol and device design, specifically targeting infection prevention. Despite these efforts, device infection remains a critical problem, which causes significant physical and emotional burden to the patient. The aim of this review is to broaden the discussion of best practices by not only examining practices in urology, but additionally delving into the field of orthopedic surgery to identify techniques and approaches that may be applied to penile prothesis surgery.
Topics: Anti-Bacterial Agents; Anti-Infective Agents; Antibiotic Prophylaxis; Biofilms; Cost-Benefit Analysis; Erectile Dysfunction; Humans; Male; Operating Rooms; Orthopedic Procedures; Penile Implantation; Penile Prosthesis; Penis; Prosthesis-Related Infections; Staphylococcus aureus; Surgical Wound Infection; Urology
PubMed: 32991908
DOI: 10.1016/j.urology.2020.08.060 -
Abdominal Radiology (New York) Jul 2020To discuss the imaging appearances of various pathologies affecting adult male urethra and to review the role of imaging in the assessment of artificial urinary... (Review)
Review
To discuss the imaging appearances of various pathologies affecting adult male urethra and to review the role of imaging in the assessment of artificial urinary sphincters and penile prostheses. Diagnosis of common male urethral diseases heavily depends on two conventional fluoroscopic techniques namely retrograde urethrography and voiding cystourethrography. These are useful in evaluating common urethral diseases like traumatic injury, infections, and strictures. Cross-sectional imaging can be useful in evaluating periurethral pathologies. Artificial urinary sphincters, slings, and periurethral bulking agents are used in the management of urinary incontinence and imaging can be utilized to detect complications in these devices. Cross-sectional imaging especially MRI plays a significant role in evaluating the different types of penile prostheses and their malfunctioning.
Topics: Adult; Humans; Magnetic Resonance Imaging; Male; Penile Prosthesis; Urethra; Urethral Diseases; Urinary Sphincter, Artificial
PubMed: 31834460
DOI: 10.1007/s00261-019-02356-x -
International Journal of Impotence... Nov 2023Inflatable Penile Prostheses (IPP) implantation is a surgical treatment for patients desiring definitive treatment for erectile dysfunction. While this procedure has... (Review)
Review
Inflatable Penile Prostheses (IPP) implantation is a surgical treatment for patients desiring definitive treatment for erectile dysfunction. While this procedure has proven to be effective, it also carries its own set of unique risks that need to be carefully considered. The article reviews the current understanding of complications associated with penile prosthetic surgery and provides strategies to mitigate these adverse events. This article covers various aspects of IPP implantation, including the risks of infection, bleeding, injury to nearby structures, glans ischemia, and device malfunction. It also discusses the importance of careful preoperative screening to identify risk factors and the implementation of infection reduction strategies such as antimicrobial prophylaxis, skin prep, and operative techniques. In addition, it emphasizes the need for postoperative vigilance and prompt management of any complications that may arise. Overall, the article provides a comprehensive overview of the risks and strategies for mitigating complications associated with IPP implantation. Our recommendations are given based on the current consensus in the field and highlight the importance of careful planning, attention to detail, and effective communication between healthcare providers and patients. Despite the potential risks, this review underscores the fact that complications following penile prosthesis implantation are relatively rare.
Topics: Male; Humans; Penile Implantation; Penis; Erectile Dysfunction; Penile Prosthesis; Retrospective Studies
PubMed: 37828138
DOI: 10.1038/s41443-023-00773-7 -
Virology Journal Oct 2020This study aims to screen the male human papillomavirus (HPV) infection status and genotyping in Qingcheng District, Qingyuan City, Guangdong Province, China to provide...
BACKGROUND
This study aims to screen the male human papillomavirus (HPV) infection status and genotyping in Qingcheng District, Qingyuan City, Guangdong Province, China to provide a reference basis for formulating prevention strategies for HPV infection.
METHODS
The present study collected urethral epithelium or scraped penile epidermis from high-risk male patients in Qingyuan People's Hospital during the last five years, extracted DNA fragments using the boiling method, and detected 23 types of HPV genotypes by PCR-reverse blot hybridization.
RESULTS
The positive detection rate was 54.31% of 1044 males with high risk of HPV (567/1044). Among these males, the positive detection rate of HPV was the highest in patients initially diagnosed with warts, and the rate was 66.47%. Five main HPV types are identified as follows: HPV6 18.87% (197/1044), HPV11 10.25% (107/1044), HPV52 8.81% (92/1044), HPV16 6.90% (72/1044), and HPV51 5.08% (53/1044). Among these HPV-infected patients, single infection mainly by low-risk HPV6 and HPV11 accounted for 56.61% (321/567); high- and low-risk combined HPV co-infections accounted for 29.10% (165/567). The HPV infected patients was mainly between 21 and 40 years old, and the HPV infection rate was higher with increased age.
CONCLUSIONS
The HPV infection rate in the Qingyuan area is higher than in other areas and the main infection is single infection. Furthermore, HPV52, HPV16, and HPV51 are the main high-risk infection types, while HPV6 and HPV11 are the main low-risk infection types.
Topics: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; China; Coinfection; DNA, Viral; Epithelial Cells; Genotype; Humans; Male; Middle Aged; Papillomaviridae; Papillomavirus Infections; Penis; Retrospective Studies; Risk Factors; Young Adult
PubMed: 33076966
DOI: 10.1186/s12985-020-01423-w -
Archivio Italiano Di Urologia,... Feb 2023Siliconoma represents an inflammatory tissue response to extravasated silicone. Penile enhancing silicone injections have been described for over 50 years. Most of the...
INTRODUCTION
Siliconoma represents an inflammatory tissue response to extravasated silicone. Penile enhancing silicone injections have been described for over 50 years. Most of the publications report complications including negative effects on penile appearance and function which require corrective procedures. Penile circumferential skin and siliconoma excision with skin grafting has been described in multiple case reports and series as an effective and feasible option to remove the silicone and achieve good esthetic results.
METHODS
We describe a simple and feasible single stage procedure removing the siliconoma with adjacent non-viable skin while preserving 50% of healthy penile skin and resurfacing the defect with a split-thickness skin graft to treat a long-term complication of penile silicone injection associated with recurrent infections and a chronic skin ulceration.
CONCLUSION
Partial excision of the affected penile skin and sili-conoma with defect resurfacing with a split-thickness skin graft is a feasible with good functional and cosmetic outcomes.
Topics: Male; Humans; Penis; Skin Transplantation; Silicones
PubMed: 36924371
DOI: 10.4081/aiua.2023.11150