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At least 127 records · Page 7Linked to original sources
PubMed1995

Correction of retractile concealed penis.

Several different mechanisms may account for the concealed appearance of the penis. A particular type of concealed penis is the retractile penis, due to dysgenetic fibrous bands tethering the penis to the prepubic subcutaneous tissue. The retractile nature of the concealment can be confirmed by flexion of the hips. A simple technique for surgical correction of the retractile penis is described. While there are many different methods to correct a concealed penis, proper selection of the technique based on understanding of the pathophysiology is critical to a successful outcome.

Child↗
PubMed1994

The feminine self and penis envy.

This paper examines the integrative role of inner genitality in the formation of penis internalisations, which form part of the feminine self. Penis envy, operating simultaneously with the anxiety arising from a realisation of the introitus under the influence of inner genitality, organises functioning inner and outer female penis structures. This three-dimensionality of inner genitality, penis envy and anxiety for penetration is the condition of a functioning femininity. In the light of an analytic case history, the author follows the thawing out of a phallic defence position and the awakening of the obstructed genitality. Phallicity is seen as a traumatic defence structure, which prevents the development of functioning penis identifications. In the phallic mental world, the penis takes on an idealised and concrete meaning. Its desirability is denied, and the woman excludes her inner genitality from her relationship to it as an object. When most obstructed in her womanhood, a woman becomes a phallus herself. She lives in an imitative identity, in which the internalising psychic functions have come to a standstill. In such a mind, the ultimate purpose of defence is to avoid annihilation anxiety.

Adult↗
PubMed1994

[Congenital anomalies of the penis in children. A few consideration about 92 cases].

The authors present their experience of 92 cases of anomalies of the penis, hypospadias excepted, occurring in children between 12 months and 10 years old, during the last 5 years, in their Pediatric Surgical Department. In the literature, there are reported only many single cases of these anomalies, for the most part associated in serious multiple malformations, or with hypospadias. The children included in this report present the anomalies of the penis as a sole malformations. The classification of these anomalies was made by embryological criteria and by the frequency of occurrence. In 41 cases there was congenital curvature of the penis, in 9 cases there was a webbed penis, in 6 cases a concealed penis. Torsion of the penis occurred in 6 cases (in 5 anticlockwise) the microphallus in 5 cases. The "hypospadias without hypospadias" occurred in 5 cases, in the others there was an association among these anomalies. The authors emphasize the importance of these malformations for the children and their families, also in order to prevent, also serious, psychological effects.

Child↗
PubMed1997

Nitric oxide in the penis: physiology and pathology.

PURPOSE: The significance of nitric oxide in the physiology of the penis was evaluated, including its role in pathophysiological mechanisms and pathological consequences involving this organ. MATERIALS AND METHODS: Animal and human studies pertaining to nitric oxide in the penis were reviewed and analyzed in the context of current descriptions of the molecular biology and physiological effects of this chemical. RESULTS: Potential sources of nitric oxide in the penis include neurons, sinusoidal endothelium and corporeal smooth muscle cells. Nitric oxide is perceived to exert a host of functional roles by binding with specific molecular targets. Its synthesis and action in the penis are influenced by many different regulatory factors. CONCLUSIONS: Nitric oxide exerts a significant role in the physiology of the penis, operating chiefly as the principal mediator of erectile function. Alterations in the biology of nitric oxide likely account for various forms of erectile dysfunction. The diverse physiological roles of nitric oxide suggest that it may also directly contribute to or cause pathological consequences involving the penis.

Animals↗
PubMed1997

[Fracture of the penis: description of a case].

Fracture of the penis is not a frequent event and it consists of a rupture of the tunica albuginea of the corpora cavernosa and sometimes of the urethra; the lesion occurs when the penis is erect because during erection the tunica albuginea is very thin and not flexible and it can be easily damaged by a trauma; most lesions occur during intercourse for impact of the erect penis against the female perineum or the pubic synphisis, but lesions during masturbation, fightings or falling off the bed are also described [1-2-3]. Clinically there are pain, detumescence, hematoma and recurvatum of the penis toward the opposite side of the lesion and hematuria if also the urethra is damaged. Usually diagnosis is quite easy with a good anamnesis, clinical examination and echotomography which can reveal presence of hematoma and hypoechogenic areas along the tunica albuginea or the urethra that appears irregular. Nowadays, fractures of the penis need a surgical approach to obtain good results avoiding consequences such as recurvatum or fibrotic areas [3-4-7-8]. We describe two cases of fracture of the penis occurred in two young men during masturbation and treated surgically with excellent results: twelve and eighteen months respectively after surgery patients are well and can enjoy a normal sexual activity with no problems at all.

Adult↗
PubMed1999

A new technique for correction of the hidden penis in children and adults.

PURPOSE: A phenomenon known as hidden penis has numerous origins, including congenital buried penis and obesity with descent of the escutcheon. No previous report to our knowledge mentions abnormal hypermobility of ventral skin and dartos fascia, which is a major cause of surgical treatment failures. Because the skin and dartos fascia are inadequately attached to Buck's fascia, the corporeal bodies telescope proximally inside the scrotum and pubis. Therefore, the subdermis of the penoscrotal junction must also be tacked to the tunica albuginea ventrally to stabilize the proximal penile skin and prevent the penis from retracting into the scrotum. The surgical technique for correction of the hidden penis in adult and pediatric patients with adequate penile shaft skin is described. MATERIALS AND METHODS: Surgery for hidden penis from multiple causes was performed in 6 adults and 7 children. Tacking sutures were taken from the subdermis of the ventral penoscrotal junction to the tunica albuginea in all cases. A combination procedure with either suprapubic dermatolipectomy, tacking of the penopubic subdermis to the rectus fascia, penoscrotal Z plasty, circumcision revision or lateral penile shaft Z plasty also was performed in some patients. RESULTS: Improvement was noted in all cases. One child requires suprapubic lipectomy for optimal improvement and 3 minor wound problems occurred. CONCLUSIONS: Surgery for hidden penis achieves marked aesthetic and often functional improvement. Surgical failure can be diminished by placing ventral tacking sutures from the tunica albuginea to the subdermis of the penoscrotal junction.

Adult↗
PubMed2004

Tuberculid of the penis with a scab on the nodule.

Tuberculids of the penis are extremely rare. The clinical features of tuberculids of the penis have been reported as ulceration or scars. We have experienced a case of tuberculid of the penis that appeared as a scab on nodule. A 56-year-old man presented with a 4-month history of a painless subcutaneous nodule at the glans penis. Pathological findings of the nodule showed granulomatous inflammation. Tuberculin tests were strongly positive, but tubercle bacilli could not be detected. The diagnosis was tuberculid of the penis and the patient received antituberculosis chemotherapy. The present paper reports an interesting and rare case of tuberculid of the penis with a scab on nodule.

Humans↗
PubMedDate not supplied

[Verrucous carcinoma of the penis: report of 2 cases].

OBJECTIVE: To report two cases of verrucous carcinoma of the penis, a rare tumor with a characteristic course and specific treatment that accounts for approximately 1% of tumors in the male. METHODS: Two patients, aged 86 and 51 years, with verrucous carcinoma of the penis are described. Treatment was by partial penectomy and resection of the glans penis, respectively. The anatomopathological characteristics and prognostic aspects are reviewed. RESULTS/CONCLUSIONS: Verrucous carcinoma of the penis usually presents as an exophytic lesion in the glans penis or prepuce and should be distinguished from epidermoid carcinoma which carries a worse prognosis and requires a different therapeutic approach. The differential diagnosis is based on the biopsy findings. Verrucous carcinoma of the penis carries a good prognosis and can be managed by conservative surgery (partial penectomy).

Aged↗
PubMed1998

[Expression of oncogene ras product p21 protein in the tissues of penis cancer and its surrounding tissues].

OBJECTIVE: To explore the clinical significance of expression of oncogene ras product p21 protein in the tissues of penis cancer and its surrounding tissues. METHOD: Oncogene ras product p21 protein in 32 cases of penis cancer, 32 cases of para-carcinoma tissues and in 16 cases of normal penis tissues were detected by immunohistochemical ABC method. RESULT: p21 protein expressed in 28 cases of penis cancer and 8 cases of para-carcinoma tissues, but it did not express in 16 cases of normal penis. Expression of p21 protein was related to pathological grading and clinical stage i. e, expression of p21 protein enhanced with the increasing of grading and stage. The positive cases of p21 protein expression in para-carcinoma tissue had worse impact on the prognosis of early recurrence and metastasis. CONCLUSION: p21 protein could be used as predictor of malignant potential and prognosis of penis cancer.

Humans↗
PubMed1991

[A case of malignant melanoma of the penis].

An 83-year-old male presented in October, 1988, with pigmented tumor lesions on the penis. The main tumor mass accompanied with necrotic bleeding, measuring 5 cm in diameter was located on the fore skin and glans penis. On the proximal shaft of the penis, there were three other black tumors, measuring from 0.5 to 3 cm in diameter. The distal urethra of the penis was clinically involved in the tumor mass and bilateral inguinal lymph nodes were palpable. Chest X-ray and liver scan both revealed multiple metastases. Tumor biopsy confirmed malignant melanoma. Phallectomy and bilateral inguinal lymph node biopsies were performed in October, 1988. Pathological findings revealed that a malignant melanoma had developed from the fore skin and glans penis, extended into the penile urethra and metastasized to bilateral inguinal lymph nodes. The patient gradually deteriorated in general condition and died of cancer 28 days later. The prognosis of malignant melanoma of the penis seems to be extremely poor.

Aged↗
PubMed1998

Anatomical alignment for the correction of buried penis.

PURPOSE: We report a straightforward surgical technique for the correction and anatomical alignment of the skin in patients with various degrees of buried penis. MATERIALS AND METHODS: A combined series of 74 patients 7 months to 10 years old who were treated for buried penis at 2 institutions during a 7-year period. Patients presented with various symptoms, including balanitis, urinary tract infection, painful voiding, ballooning of the foreskin and urinary retention. In 29 patients (38%) trapped penis was due to previous circumcision. In our estimation the major anatomical defect in buried penis is an insufficient attachment of the dartos fascia and penile skin to Buck's fascia. Our technique involves making a circumferential incision of the inner preputial skin layer proximal to the corona, unfurling it from the shaft skin and leaving a coronal collar of approximately 1 cm. The annular band that usually constricts the corpora on retraction of the penile skin is incised, and the remaining proximal penile skin and dartos fascia are dissected off Buck's fascia proximally to the base of the penis. The penile dermis is sutured to the lateral aspect of the tunica albuginea at the penopubic junction and mid shaft of the penis. This technique restores normal anatomical relationships with excellent cosmetic results and negligible complications. RESULTS: At a median 5-year followup cosmesis was excellent in all cases. Two patients with micropenis who required revision responded to endocrine therapy. CONCLUSIONS: Excellent cosmetic results were obtained in all cases using this surgical technique.

Child↗
PubMed1981

Rupture of the corpus cavernosum of the penis.

Rupture of the corpus cavernosum ("fracture" of the penis) is an uncommon injury that occurs in an erect penis. The tunica albuginea is torn during coitus or as a result of external forces, resulting in sudden pain, swelling, and discoloration of the penis. Urethral rupture is associated with the cavernous injury in approximately 10% of cases. Treatment of the injury aims at full functional and cosmetic recovery. Nonoperative treatment results in a 10% incidence of penile deformity and requires a substantial hospital stay. However, surgical repair eliminates resultant deformity and allows for earlier hospital discharge. Three patients had fractured penises, including one penis associated with a torn urethra. Early surgical repair was performed in each patient, and the results were excellent. Prompt surgical repair should be given to all patients with a fractured penis.

Adult↗
PubMed1983

Noradrenergic innervation of the penis in control and streptozotocin-diabetic rats: evidence of autonomic neuropathy.

The noradrenergic sympathetic innervation of the penis of control and 4-month streptozotocin-diabetic rats was examined with the glyoxylic acid histofluorescence method. Noradrenergic varicosities were found in the corpora cavernosa in a dense subtunical plexus and in the perisinusoidal and trabecular regions of the erectile tissue, in the corpus spongiosum in perisinusoidal tissue, around large arteries and veins, and around small tortuous arterioles and small draining veins of the corpora cavernosa and spongiosum. Noradrenergic varicosities were diminished in number and fluorescent intensity in all regions of the penis of diabetic rats compared with controls. The subtunical plexus was absent, perisinusoidal and trabecular varicosities were sparse, and only occasional intermittent, discontinuous, dull fluorescent fibers or plexuses were found around the vessels. Quantitation with high-performance liquid chromatography revealed a significant reduction of norepinephrine in the penis of diabetic rats compared with controls. The present study suggests that long-term streptozotocin diabetes in the rat is accompanied by sympathetic autonomic neuropathy of the penis that seems to parallel changes in the noradrenergic content of penile corpora of men with diabetes and erectile impotence. The streptozotocin-diabetic rat merits further study to explore the relationship between noradrenergic innervation of the penis and erectile tissue.

Animals↗
PubMed1994

Co-localization of nitric oxide synthase and vasoactive intestinal peptide immunoreactivity in neurons of the major pelvic ganglion projecting to the rat rectum and penis.

Nitric oxide synthase (NOS)- and vasoactive intestinal peptide (VIP)-immunoreactive neurons projecting to the upper rectum or penis were examined using retrograde tracing combined with immunohistochemistry in the major pelvic ganglion of male rats. Five days after injection of Fluoro-Gold (FG) into the upper rectum or penis, the major pelvic ganglion was treated with colchicine. FG injected into the upper rectum labelled many ganglion neurons in the major pelvic ganglion. Immunohistochemistry showed that 37% of FG-labelled neurons were immunoreactive for NOS and 33% for VIP. After injection of FG into the penis, 41% of FG-labelled neurons were immunoreactive for NOS and 25% for VIP. Serial cryostat sections stained for NOS and VIP, respectively, showed the co-localization of NOS and VIP in the ganglion cells projecting to the rectum and penis. In the major pelvic ganglion of the colchicine-treated animals, about 17% of the ganglion cells were immunoreactive for NOS and 32% were immunoreactive for VIP. These neurons were small in diameter (less than 30 microns). A histogram showing cell sizes in cross-sectional areas of NOS-immunoreactive neurons coincided with that of VIP-immunoreactive neurons. Most of the NOS- and VIP-immunoreactive neurons were less than 600 microns. These results indicate that small neurons containing both NOS and VIP in the major pelvic ganglion project to the rectum and penis. In the penile erectile tissues and enteric ganglia, NO and VIP may be released from the same axons and may act concomitantly on the target tissue.

Amino Acid Oxidoreductases↗
PubMed1998

Plaque excision and dermal graft in the surgical treatment of plastic induration of the penis (Peyronie's disease).

Excision of the fibrous plaque from the full thickness of the tunica albuginea of the corpora cavernosa of the penis was performed in 16 patients with Peyronie's disease in the course of seven years. The resulting gap was covered with a dermal flap. The dorsal vascular and neural bundles were separated from the tunica albuginea together with Buck's fascia. This method caused only very slight damages in the circulation and innervation of the penis. The patients were satisfied with the straightness of their penis. The method has the following advantages: it may be applied even in case of extensive, cartilaginous, calcified plaques; the hourglass deformation of the penis may be corrected; it does not result in the shortening of the penis; the complete excised plaque may be examined histologically.

Adult↗
PubMed2002

Concealed penis.

A small phallus causes great concern regarding genital adequacy. A concealed penis, although of normal size, appears small either because it is buried in prepubic tissues, enclosed in scrotal tissue penis palmatus (PP), or trapped due to phimosis or a scar following circumcision or trauma. From July 1978 to January 2001 we operated upon 92 boys with concealed penises; 49 had buried penises (BP), while PP of varying degrees was noted in 14. Of 29 patients with a trapped penis, phimosis was noted in 9, post-circumcision cicatrix (PCC) in 17, radical circumcision in 2, and posttraumatic scarring in 1. The BP was corrected at 2-3 years of age by incising the inner prepuce circumferentially, degloving the penis to the penopubic junction, dividing dysgenetic bands, and suturing the dermis of the penopubic skin to Buck's fascia with nonabsorbable sutures. Patients with PP required displacement of the scrotum in addition to correction of the BP. Phimosis was treated by circumcision. Patients with a PCC were recircumcised carefully, preserving normal skin, but Z-plasties and Byars flaps were often required for skin coverage. After radical circumcision and trauma, vascularized flaps were raised to cover the defect. Satisfactory results were obtained in all cases although 2 patients with BP required a second operation. The operation required to correct a concealed penis has to be tailored to its etiology.

Adolescent↗
PubMed1986

The neuroanatomical basis for the protopathic sensibility of the human glans penis.

The human glans penis is covered by stratified squamous epithelium and a dense layer of connective tissue equivalent to the dermis of typical skin. Rete ridges of the epidermis are irregular and vary in height depending on location, age, and presence or absence of a foreskin. The papillary layer of the dermis blends into and is continuous with the dense connective tissue forming the tunica albuginea of the corpus spongiosum of the glans penis. The most numerous nerve terminals are free nerve endings (FNEs) present in almost every dermal papilla, as well as scattered throughout the deeper dermis. FNEs are characterized by an incomplete Schwann cell investment, and contain irregularly scattered neurofilaments and neurotubules, clusters of mitochondria, vesicles of variable size and various inclusions. The ratio of FNEs to corpuscular receptors is approximately 10:1 and a similar ratio of small to large axons is seen in dermal nerves. Genital end bulbs are present throughout the glans, but are most numerous in the corona and near the frenulum. The unique corpuscular receptor of the glans penis consists of axon terminals that at an ultrastructural level resemble a tangled skein of FNEs. Simple, Pacinian and Ruffini corpuscles were occasionally identified predominantly in the corona glandis. Epidermal Merkel nerve endings and other types of mechanoreceptors typically found in primate glabrous skin (lip or digit) are not present. Rarely, dermal Merkel cells have been identified associated with genital end bulbs. The abundance of FNEs in isolated as well as corpuscular form can be correlated with the embryogenesis and known neurophysiologic and psychophysical parameters of sensory function of the glans penis. Finally, the divergence in reported values for the threshold of tactile and painful stimuli when applied to glabrous skin of fingertip and glans penis can be considered as an example of dissociated sensibility. The anatomical basis for this dissociation is the abundance of FNEs and absence of Merkel terminals and typical Meissner corpuscles in the covering of the glans, and the converse in glabrous skin of the digit.

Adolescent↗
PubMed1995

A new approach to the surgical correction of buried penis.

Buried penis has been variously attributed to obesity with excessive suprapubic fat, severe phimosis with trapping of the penis within the prepubic tissues, and inadequate fixation of the penile shaft skin at the base resulting in tenting. Previous attempts at surgical correction, by excising suprapubic fat, fixing penile shaft skin to the base of the penis, and circumcising, have failed to give satisfactory results and, indeed, procedures like circumcision will make the condition even worse. The technique developed by the author is based on the recognition that this condition exists because of the displacement of the root of the penis below its normal position, resulting in the surrounding fat and dartos tissues enveloping the penile shaft. In this procedure, dissection at the root of the penis is carried out deep down to the corporal bodies. All fibrotic tissue that binds the penile shaft is excised. The lengthened penile shaft is anchored at its base by suturing the surrounding tissue onto the tunica. This technique has been applied in 22 patients ranging in age from 5 months to 11 years. Apart from two technical problems, all other patients had satisfactory correction with good functional results.

Child↗