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PubMed1990

Abnormal development of the os penis in male mice treated neonatally with tamoxifen.

The os penis of male C57BL/Tw mice given 5 daily injections of 100 micrograms tamoxifen (Tx) starting on the day of birth (day 0) was examined at ages of 5-60 days; the bones of males given Tx injections for 5 days starting at 0-10 days and of those given neonatal injections of 100 micrograms clomiphene or nafoxidine were examined at 60 days. In the control males given the vehicle alone, the proximal segment of the os penis, composed of a compact cell mass found at day 0, developed at 5 days into the membrane bone with bone marrow and hyaline cartilage; the distal segment, composed of mesenchymatous cells until 10 days, developed at 30 days into fibrocartilage characterized by a distribution of type I collagen. By contrast, in Tx mice, fibrocartilage in the distal segment, and hyaline cartilage characterized by a distribution of type II collagen, and bone marrow in the proximal segment disappeared by 30 days. The maximum area of the proximal and distal segments gradually increased with age in control mice, whereas the proximal segment area remained unchanged in Tx mice. In clomiphene and nafoxidine mice at 60 days, the proximal segment was composed of hyaline cartilage; however, the distal segment lacked fibrocartilage. Hyaline cartilage in the proximal segment and fibrocartilage in the distal segment disappeared in all 60-day-old mice given Tx starting within 5 days. Neonatal castration did not suppress the formation of bone marrow and fibrocartilage in the os penis, though the bone size was smaller than in the intact controls. Formation of spines on the glans penis skin was suppressed by Tx given within 5 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1992

Clinical study of the longitudinal deformation of the flaccid penis and of its variations with aging.

The length changes of the flaccid penis provoked by a maximum manual stretching of the glans have been measured in 905 men in order to study its biomechanical qualities. Our study shows that the flaccid penis is deformable, extensible and elastic in its longitudinal axis. The analysis of the variations of these biomechanical properties with aging shows a significant decrease. Thus, the biomechanical behavior of the flaccid penis during stretching is highly different in young men and old men. This distortion difference according to age proves the physiological importance of the penile distortion since impotence significantly increases with age. As the vascular mechanisms may be disregarded during flaccidity, these penile physical features of the flaccid penis are only due to tissue mechanisms. Consequently, any distortion loss would reflect a tissue impairment, very likely a progressive senile fibrosis of cavernous tissues.

Adolescent↗

PubMed1991

Androgen receptor levels in the rat penis are controlled differently in distinctive cell types.

The rat phallus grows during sexual maturation as serum androgen concentrations rise to adult levels, and growth ceases when sexual maturity is attained despite the continued presence of adult serum androgen levels. This cessation of growth is correlated temporally with a diminution in the levels of androgen receptor, as detected by assays of ligand binding. To determine whether the change in androgen receptor content occurs in all cells in the tissue, immunohistochemical studies of the penile androgen receptor were performed in rats of different ages. In immature animals and animals castrated prepubertally, the androgen receptor is detected in virtually all cell types, including the corpus cavernosum penis, the small lateral cavernous bodies, the corpus cavernosum urethra, skin, urethra, and os penis. By contrast, in the mature rat penis minimal androgen receptor is evident within the corporal tissue and os, although immunoreactivity remains detectable in the penile skin and urethra. It is concluded that the cessation of androgen-mediated growth correlates with a decrease in androgen receptor levels in the body of the penis.

Aging↗

PubMed2004

Circumcision in 'buried penis'--a cautionary tale.

BACKGROUND: The aim of a circumcision is to remove sufficient foreskin from the penile shaft and preputial epithelium to uncover the glans. Removal of too much preputial skin may lead to an unsatisfactory cosmetic and functional result. Patients with a congenital anomaly known as 'buried penis' are particularly susceptible to this. In this condition, abnormal dartos fascial bands or muscle fibres tether the penile shaft and as a result conceal its true length. CASE REPORT: A 5-year-old boy underwent circumcision but his 'buried penis' was not recognised by the surgeon pre-operatively. Unfortunately, his penile shaft was left almost entirely denuded of skin as a result. The wound required a full thickness graft. Follow-up at 1 year has so far been satisfactory. CONCLUSIONS: This case highlights the importance of early recognition of a buried penis when considering circumcision. It demonstrates the abnormal anatomy of a buried penis and its management. It also provides a potential reconstructive option in cases of excess skin removal.

Child, Preschool↗

PubMed2004

Aromatase is abundantly expressed by neonatal rat penis but downregulated in adulthood.

Although synthesis of estrogen by male gonads has been well documented for over half a century, it is only recently that the role of estrogen in male reproductive events has gained appreciation. We recently reported abundant expression of estrogen receptor (ER)-alpha and -beta in different cell types of the rat penis, whose levels diminished with advancing age. The present study, which builds on data from the ER study, was designed to determine whether the penis is capable of generating its own local estrogen by examining evidence of the expression of aromatase, a microsomal enzymatic complex which irreversibly converts androgens to estrogens, using immunohistochemistry, Western blotting, in situ hybridization and real-time PCR analyses. Secondly, the effects of sex steroid hormones on penile aromatase were examined. Discrete aromatase immunoreactive cells were localized in primordial corpus cavernosum, corpus spongiosus and os penis, blood vessels and sensory corpuscle of glans penis. In situ hybridization signals corresponded with immunohistochemical findings. Western blot, enzyme immunoassay and real-time PCR analyses of rat penile samples revealed an age-dependent expression of aromatase and estrogen, with levels at week 1 almost resembling those of the ovary, but they decreased sharply by week 8, and decreased further by week 35. This expression pattern was strikingly similar to that of ER-alpha reported previously. Testosterone and diethylstilbesterol administered prenatally upregulate levels of aromatase mRNA and protein, and estrogen postnatally. Dihydrotestosterone upregulated aromatase mRNA and protein, but not estrogen. We conclude that estrogen acts via ER in a paracrine and/or autocrine manner to regulate penile events, particularly during development, and that estrogen synthesis is regulated by estrogen and androgens.

Animals↗

PubMed1989

[The mechanism of blood outflow from the cavernous tissue of human penis by computer graphics].

There are two theories concerning the mechanisms of human penile erection and its maintenance. One theory goes that the artery responsible for blood inflow into the cavernous space relaxes, while the vein responsible for blood outflow actively contracts. The other theory asserts that no active closing mechanism in present in the penile venous system, but rather the erection is totally controlled by the amount of blood inflow. In order to corroborate the vascular construction of the penis, we prepared serial sections of the penis specimens obtained at autopsy and observed these sections by light microscopy, and we investigated the construction of veins which let blood flow out from the corpus cavernosum penis by computer graphics. As a result, we were unable to find any valves in the blood outflow system. Moreover, efferent vessels were seen to let blood flow from the cavernous spaces, after running immediately below the tunica albuginea for a small distance, to the tunica albuginea, running obliquely through inner veins toward the outside of the tunica albuginea in the direction of the long axis of the penis; then these veins are continuous to the veins on the tunica albuginea. From the above-mentioned structures we can infer the following mechanism of penile erection.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed2002

[A case of complete self-mutilation of penis].

Self-mutilation of the penis is extremely rare. A 69-year-old man was admitted after having amputated his own penis completely from its root. He had no history of psychiatric illness, but his physical condition on admission was abnormal. We performed urethrocutaneostomy, rather than replantation of the penis, because of the danger that he would reinjure himself. The patient was treated by a psychiatrist under a diagnosis of alcoholic dementia. To our knowledge, this is the 24th case of self-mutilation of the penis reported in the Japanese literature.

Aged↗

PubMed2002

[Thirteen-year follow-up in 8 cases of penis reconstruction by ilio-inguinal and umbilical-thoracic compound flaps].

OBJECTIVE: To observe the long-term effect of ilio-inguinal and umbilical-thoracic compound flaps in one-stage reconstruction of the penis. METHODS: Eight patients, who received one-stage reconstruction of the penis using ilio-inguinal and umbilical-thoracic compound flaps, were all followed up regularly at 6 months, 1, 3, 7 and 13 years postoperatively. The color, diameter, length, and sense recovery of the organ, along with urodynamics and satisfaction degree of both patients and their wives were recorded. RESULTS: The reconstructed organ retained the original color all through the follow-up, but had shrunk and shortened to some degree within the first 3 years after the operation, a condition that was stabilized afterwards. The sense of the proximal end of the constructed organ began to recover six months after the operation and almost assumed normal sense. The sense of the distal end also recovered, though relatively slowly. Few long-term complications were observed, and the patients and their wives were reasonably satisfied with the reconstructed organs in terms of their shape and function. CONCLUSION: Good long-term effect of one-stage reconstruction of the penis can be achieved by using illio-inguinal and umbilical-thoracic compound flaps, which can be adopted clinically in cases of penis reconstruction.

Follow-Up Studies↗

PubMed2003

[Thrombosis of the superficial dorsal vein of the penis (penile Mondor's phlebitis). The interest of Doppler examination].

INTRODUCTION: Thrombosis of the superficial dorsal vein of the penis (TSDVP) is a frequent and benign pathology that is often underestimated. OBSERVATION: A patient consulted for acute erectile dysfunction and pain in the base of the penis due to a TSDVP, which was treated with non-steroidal anti-inflammatory agents and anticoagulants and was followed-up by Doppler ultrasound examination of the penis. CONCLUSION: Essentially clinical, the diagnosis of TSDVP can benefit from Doppler ultrasound of the penis in difficult cases, because it is a useful tool for correct diagnosis and therapeutic management of the pathology.

Acute Disease↗

PubMed2005

[Reconstruction of the remnant penis: a 52-case report].

OBJECTIVE: To explore the effects of the combined method of abdominal axial flap transposition and penile elongation for the treatment of the remnant penis. METHODS: Fifty-two cases of the remnant penis treated with the combined method from 1984 April to February 2004 were analyzed retrospectively. Follow-up ranged from 0.5 to 20 years postoperatively. RESULTS: The lengths (both in normal and erectile conditions) and the circumferences of the penis gained after operation were (5.6 +/- 1.4) cm, (6.8 +/- 2.5 cm and (6.9 +/- 2.3) cm respectively. The recovery rates of the sensory function were 94.2% and 100% in the glans (immediately and 3 months after operation) and 32.7%, 51.9% and 75% in the flap area (3, 6 and 12 months postoperatively). The two-point distinguishing sense in the glans and the flap area was (5.1 +/- 0.9) mm and(7.9 +/- 1.3) mm 5 years after operation. Early complications included distant flap necrosis (3 cases), disruption of the wound (2 cases), part necrosis of the skin graft in the abdominal wall (2 cases) and poor contours occurred in 4 cases in the later period because of the thickness of the flaps. All of them were corrected with satisfactory results. CONCLUSION: The combined method of abdominal axial flap transposition and penile elongation was recommendable for the treatment of the remnant penis because of its positive effects and less complications.

Adolescent↗

PubMed2006

[Hypospadias and congenital curvature of the penis in children and their surgical treatment].

Hypospadias is a congenital defect of the penis in which the urethral orifice is located on the ventral aspect of the glans penis or, more proximally, on the shaft or scrotum. Some type of hypospadias occurs in approximately 1 in 200 boys. The defect can be minimal or so severe that the sex of the newborn is difficult to determine. Many boys with hypospadias also have a congenital curvature of the penis that needs correction. Corrective surgery is done preferably between the ages of 6 and 12 months. The aim of surgery is to obtain a functionally and cosmetically normal penis while limiting the psychological burden on the child as much as possible. The common surgical procedures include: meatal advancement and glanuloplasty (MAGPI), the tubularised incised plate (TIP) technique according to Snodgrass, and vascularised foreskin flap-plasty. Urethral surgery for hypospadias is accompanied by a relatively high number of complications and should therefore be carried out by surgeons with sufficient experience.

Humans↗

PubMed2006

[Correction of pediatric concealed penis by using a modified Devine' s technique].

OBJECTIVE: To discuss the diagnosis of pediatric concealed penis and evaluate the results after the correction of the pediatric concealed penis. METHODS: Twenty patients with pediatric concealed penis were treated by using a modified Devine's technique. RESULTS: The appearance with a straightening penile was achieved in all of the patients. All of the patients recovered well after the operation without any complications. CONCLUSIONS: The modified Devine' s technique could be a safe and effective method for the correction of the pediatric concealed penis with satisfactory outcome.

Adolescent↗

PubMed1990

[Elongation of the penis].

A series of 42 cases of brachy-penis were treated with an incision at the base of the penis. The superficial suspension ligament was divided and the penis was elongated 3-6 cm. Most of the patients were followed up for 5-42 months. The sensation and erect function of the penis remained nearly normal. The procedure was safe and effective and without any complications.

Adult↗

PubMed1989

My views about the applied anatomy on the penis and the physiopathology of erection.

From 1964 till 1977 I had the opportunity to make a study on circa 300 cadaver-penises (ROMANIA). My goal was to begin the surgical treatment of the organic impotency. Parallel with the investigations in mortuo (Table I), I began the explorations in vivo: clinical, general; and especially: "local" exploration of the executive organ, the penis; the methods used are enumerated in table II. The aims were: a) the diagnosis and b) the possibility of surgical treatment of organic impotence. After 1977, in west Germany, I could continue only my clinical work; (diagnosis and surgery). Till now I examined circa 5000 men with or without potency troubles; I could perform circa 1900 operations, in the last 9 years almost only with penile implants. I developed my own patterns. In this way, I could discover in mortuo and then confirm in vivo: The importance of the penile structures for a true potency; I described a "virile morphogram of the penis" (table III). The frequency of the anatomical variations --New, unknown causes of organic impotence at the level of the penis. Thus I described as first in 1975 (in rumanian) the "leakage factor" of the corpora cavernosa; later I described the frequency of fibroses in the corpus cavernosum penis (CCP). I could demonstrate that "the fixed impotency", especially in ageing men, is almost always organic (somato-psychic). Permanently improving the surgical proceeding helped me to reduce to a minimum the always possible complications. For instance: in the last 9 years, in circa 1400 operations with penile implants I had no infection more. As a rule a surgical proceeding must succeed, if possible, "from the first and for ever". It is for that, the penile implants have the most important place in the treatment of organic impotence, (not only as "ultima ratio").

Autopsy↗

PubMed1988

[A case of Mondor's disease of the penis].

A case of Mondor's disease of the penis in a 40-year-old man is reported. The patient complained of a small subcutaneous induration (0.5 x 1.0 cm) with slight tenderness in the dorsal region of the penile shaft. On examination, the linear cord was palpated running both distally and proximally from the induration. This lesion was removed under local anesthesia, and the induration and the cord were found to be part of the superficial dorsal vein of the penis. The venous wall was thick and the thrombus was packed in it. Histological findings showed the proliferation of connective tissue of the vessel wall and partially granulating thrombus in the canal. From these findings, we confirmed the diagnosis of Mondor's disease of the penis. The etiology of this disease, especially in comparison with non-venereal sclerosing lymphangitis of the penis (N.S.L.P.) is discussed.

Adult↗

PubMed1985

[Sonography of the penis shaft].

The development of highly frequent transducers has created new diagnostic possibilities for the sonography in the area of the body of the penis. We controlled the valency of this technique on our patients. While the usual clinical and radiological methods still predominate in the diagnostics of traumas of the penis and diseases of the cavernous bodies, the ultrasound gives new possibilities of the exact classification in the carcinoma of the penis and the induratio penis plastica. Thus the basis for the development of alternative therapeutic methods is given.

Diagnosis, Differential↗

PubMed1985

[Tuberculosis of the penis: report of a case and review of the literature].

Tuberculosis of the penis is a rare disease. We report a case of tuberculosis of the penis. A 51-year-old man noticed a painless induration with a central ulceration on the glans penis. He had a history of tuberculosis of cervical lymph-nodes, right epididymis and leg skin. Examination of the other parts showed no evidence of tuberculosis. Tuberculin test was strongly positive. The skin lesion of the glans was excised. The pathology was epithelioid cell granuloma with Langhans' giant cell, indicative of tuberculosis. But acid-fast bacilli were not detected in the Ziehl-Neelsen preparation of the tissue. The patient was treated with isoniazid, rifampicin and cycloserine. After the treatment for approximately 5 months, recurrence was not observed and enlargement of cervical lymphadenopathy improved. We reviewed 39 cases of tuberculosis of the penis reported in Japan during the past 14 years.

Antitubercular Agents↗

PubMed1978

Angiography of the crus penis in the ram and buck during erection.

Serial angiography was used to determine blood flow patterns to the penis of rams and bucks. Animals were anesthetized and the internal pudendal artery was catheterized so that contrast medium could be injected toward the crus penis area. By comparing vascular patterns of the ram and buck during erection, it was found that flow patterns of the corpus cavernosum penis (CCP) and corpus spongiosum penis (CSP) were similar for both species. Contraction of the ischiocavernosus muscles occluded the arterial inflow and venous outflow to the CCP, making it a closed system during peak erection. However, during erection, the contrast medium continued to flow into the CSP, showing that it is not a closed system. In the vasodilatation phase, the CSP usually filled before and more intensely than did the CCP.

Angiography↗