RESUMO
PURPOSE: Penile fracture (PF) affects 1,14 to 10,48 men in every 100.000 men in East Asia, and the primary aetiology is sexual intercourse, but the knowledge regarding the most dangerous sexual position is not well explained. This study compares three sexual positions: man on top position (MTP), woman on top position (WTP), and doggy style position (DSP), leading to PF potential. MATERIALS AND METHODS: A search of sexual position-related PF in Google Scholar, PubMed, Cochrane, and PMC Europe was performed. Criteria inclusion was the full text of relevant articles which describ the number of sexual positions. It was analyzed by odds ratio, random model effect, and the OR and 95%CI were calculated. RESULTS: 12 relevant papers involving 490 patients comprised 169 MTP, 120 WTP, 158 DSP, and 43 no intercourse cases. Meta-analysis of all sexual positions was a MTP P= 0,04, WTP P=0,49, and DSP P=0,0005. CONCLUSION: The man-dominant positions (MTP and DSP) were significantly potential for PF, which speculated that when a man is dominant and very excited, intercourse may become highly vigorous and impact trauma. This study found that man's dominant position consists of DSP and the MTP significantly lead to PF.
Assuntos
Doenças do Pênis , Pênis , Masculino , Feminino , Humanos , Pênis/lesões , Comportamento Sexual , CoitoRESUMO
PURPOSE: Considerable controversy exists regarding the surgery for concealed penis. We describe a new technique for repairing concealed penis by symmetrical pterygoid flap surgery. METHODS: From January 2016 to July 2022, we evaluated 181 cases of concealed penis that were surgically treated using the symmetrical pterygoid flap surgery. We measured the penile size preoperative and 2, 4, 12 weeks, and 1 year postoperative to confirm the improvement. A questionnaire was administered to the patients and parents to assess satisfaction regarding penile size, morphology, and hygiene. RESULT: The perpendicular penile length was1.59±0.32cm preoperative and 3.82±1.02 cm after the procedure (p < 0.05), and 4.21±1.91cm after one year of postoperative (p < 0.05). The overall satisfaction of patients was 97.89%, while the overall satisfaction of older children patients (age>7) was 75.24%. Parents focus more on the penile exposure size, while patients focus more on the penile morphology. Almost every patient had postoperative penile foreskin edema. However, this symptom had spontaneously resolved by 4-6 weeks. The complications such as skin necrosis, tissue contracture, or wound infection were 4.42%. CONCLUSION: The symmetrical pterygoid flap surgery is an effective surgical technique for the management of concealed penis in children producing predictable results and excellent satisfaction of the parents and patients.
Assuntos
Doenças do Pênis , Procedimentos de Cirurgia Plástica , Criança , Masculino , Humanos , Adolescente , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Retalhos Cirúrgicos , Pênis/cirurgia , Prepúcio do Pênis/cirurgia , Doenças do Pênis/cirurgiaRESUMO
Introducción. La enfermedad de Peyronie es una malformación adquirida del pene, originada por la deposición de placas fibróticas en la túnica albugínea. La prevalencia en Estados Unidos oscila entre el 0.39% y 11.8%, en Europa 8.9%, en Latinoamérica no existe un porcentaje puntual de prevalencia actual debido a la escasez de reportes de esta patología. Este análisis bibliométrico busca describir la evolución terapéutica de la Enfermedad de Peyronie en la literatura de los últimos 62 años, así como la distribución geográfica de estas publicaciones. Metodología. Estudio observacional, descriptivo, un análisis bibliométrico desde 1957 hasta 2019, utilizando GoPubMed y FABUMED. Resultados. Se obtuvieron 721 referencias sobre tratamiento quirúrgico en enfermedad de Peyronie, con un aumento de la producción científica a lo largo del periodo de estudio. The Journal of Urology fue la revista con mayor cantidad de publicaciones, el 57.9% dentro de la categoría de artículo científico. El país líder fue Estados Unidos con 191 publicaciones. Discusión. Existe poca literatura sobre los avances terapéuticos para el tratamiento de enfermedad de Peyronie, lo que dificulta la comparación de las investigaciones a lo largo de los años en diferentes zonas del mundo. La investigación en Latinoamérica es escasa. Conclusión. La investigación sobre el tratamiento quirúrgico en enfermedad de Peyronie muestra un patrón ascendente en la productividad científica durante los años estudiados. Los países con mayores ingresos económicos son de mayor desarrollo en el tema y en menor medida regiones con recursos limitados. El análisis evidencia la importancia de aumentar producción científica en Colombia, así como estimular la investigación sobre este tema, ya que existen muy pocas publicaciones sobre la evolución del tratamiento quirúrgico para esta enfermedad. Palabras clave: Induración Peniana; Enfermedades del Pene; Bibliometría; Fibrosis; Erección Peniana
Introduction. Peyronie's disease is an acquired malformation of the penis, caused by the deposition of fibrotic plaques in the tunica albuginea. The prevalence in the United States ranges between 0.39% and 11.8%, in Europe 8.9%, in Latin America there is no specific percentage of current prevalence due to the scarcity of reports of this pathology. This bibliometric analysis seeks to describe the therapeutic evolution of Peyronie's Disease in the literature over the last 62 years, as well as the geographic distribution of these publications. Methodology. This is an observational, descriptive study, with a bibliometric analysis from 1957 to 2019, using GoPubMed and FABUMED. Results. 721 references on surgical treatment in Peyronie's disease were obtained, with an increase in scientific production throughout the study period. The Journal of Urology was the journal with the highest number of publications, 57.9% within the scientific article category. The leading country was the United States with 191 publications. Discussion. There is a limited amount of literature on therapeutic advances for the treatment of Peyronie's disease, which makes it difficult to compare research over the years in different areas of the world. Research in Latin America is scarce. Conclusion. Research on surgical treatment in Peyronie's disease shows an increasing pattern in scientific productivity over the years. Countries with higher economic income have greater development in the subject and to a lesser extent regions with limited resources. The analysis shows the importance of increasing scientific production in Colombia, as well as stimulating research on this topic, since there are few publications on the evolution of surgical treatment for this disease. Keywords: Penile Induration; Penile Diseases; Bibliometrics; Fibrosis; Penile Erection
Introdução. A doença de Peyronie é uma malformação adquirida do pênis, causada pela deposição de placas fibróticas na túnica albugínea. A prevalência nos Estados Unidos varia entre 0.39% e 11.8%, na Europa 8.9%, na América Latina não existe um percentual específico de prevalência atual devido à escassez de relatos desta patologia. Esta análise bibliométrica tem como objetivo descrever a evolução terapêutica da Doença de Peyronie na literatura dos últimos 62 anos, bem como a distribuição geográfica destas publicações. Metodologia. Estudo observacional, descritivo, análise bibliométrica de 1957 a 2019, utilizando GoPubMed e FABUMED. Resultados. Foram obtidas 721 referências sobre tratamento cirúrgico na doença de Peyronie, com aumento da produção científica ao longo do período do estudo. The Journal of Urology foi o periódico com maior número de publicações, 57.9% dentro da categoria artigo científico. O país líder foram os Estados Unidos com 191 publicações. Discussão. Há pouca literatura sobre avanços terapêuticos para o tratamento da doença de Peyronie, o que dificulta a comparação de pesquisas ao longo dos anos em diferentes partes do mundo. As pesquisas na América Latina são escassas. Conclusão. As pesquisas sobre o tratamento cirúrgico da doença de Peyronie mostram um padrão crescente de produtividade científica ao longo dos anos estudados. Os países com maior rendimento económico são mais desenvolvidos no assunto e, em menor medida, regiões com recursos limitados. A análise mostra a importância de aumentar a produção científica na Colômbia, bem como estimular a pesquisa sobre o tema, uma vez que existem poucas publicações sobre a evolução do tratamento cirúrgico desta doença. Palavras-chave: Induração Peniana; Doenças do Pênis; Bibliometria; Fibrose; Ereção Peniana
Assuntos
Doenças do Pênis , Induração Peniana , Fibrose , Ereção Peniana , BibliometriaRESUMO
Objetivo: La disfunción venooclusiva peneana se reconoce como causa de disfunción eréctil en algunos pacientes jóvenes sin otros factores de riesgo. El objetivo del estudio es reportar los resultados de una cirugía de esta patología en pacientes menores de 40 años, con seguimiento hasta 6 meses postratamiento. Método: Estudio descriptivo en una cohorte retrospectiva de historias clínicas con 50 pacientes que cumplían criterios de inclusión, evaluados y sometidos a cirugía estandarizada por el mismo cirujano entre 01/2014 y 10/2021. Al grupo se le practicó un puntaje de síntomas (Sexual Health Inventory for Men [SHIM]) antes de la cirugía y a los 3 y 6 meses de esta. Los resultados del SHIM pre- y posoperatorio se relacionaron con los diferentes grados de disfunción eréctil (grave, moderada y leve), y adicionalmente se dividieron en tres grupos según criterios definidos en exitoso, moderado y deficiente. El diagnóstico de fugas venosas se hizo mediante ecografía Doppler peneana con vasoactivo, registrando fugas venosas, grado de fibrosis peneana y presencia de glande blando. El protocolo del estudio fue aprobado por el Comité de Investigación del Hospital Pablo Tobón Uribe, de Medellín. Resultados: El rango de edad al momento del procedimiento fue de 18-50 años, con una edad media de 31,2 años, y el inicio de la disfunción eréctil a los 23,4 años. El tiempo de evolución de la enfermedad antes de intentar la cirugía varió entre 2 y 21 años (7,5 años en promedio). El estado de disfunción eréctil según el SHIM preoperatorio fue 4 (8%) grave, 46 (92%) moderada y no hubo ningún caso leve. Los desenlaces posoperatorios a 6 meses fueron 11 (22%) moderada, 20 (40%) leve y 19 (38%) sin disfunción eréctil. Adicionalmente, según análisis interno al SHIM, 34 (68%) fueron exitosos, 6 (12%) moderados y 10 (20%) deficientes. Conclusiones: La ligadura de fugas venosas dorsales peneanas tiene buenos resultados a mediano plazo en cuanto a calidad de la erección y satisfacción del paciente.
Objective: Penile venocclusive dysfunction is recognized as a cause of erectile dysfunction in some young patients with no other risk factors. The objective of the study is to report the results of surgery for this pathology in patients under 40 years of age, with follow-up up to 6 months post-treatment. Method: A descriptive study was carried out in a retrospective cohort of medical records with 50 patients with inclusion criteria, evaluated and submitted to standardized surgery by the same surgeon between 01/2014 and 10/2021. A symptom score (Sexual Health Inventory for Men [SHIM]) was applied to the group, before surgery, and 3 and 6 months after. The pre- and post-operative SHIM results have been related to the different degrees of erectile dysfunction and, additionally, they were divided into three groups according to criteria defined as successful, moderate, and poor. The diagnosis of venous leaks was made by vasoactive penile Doppler ultrasound, recording venous leaks, degree of penile fibrosis and presence of soft glans penis. The study protocol was approved by the Research Committee of the Pablo Tobon Uribe Hospital, in Medellín. Results: Age range at the time of the procedure 18-50 years, mean age 31.2 years and onset of erectile dysfunction 23.4 years. Time of evolution of the disease before attempting surgery varied between 2 and 21 years (average 7.5 years). Erection status according to the preoperative SHIM was severe erectile dysfunction 4 (8%) and moderate 46 (92%). The outcomes at 6 months were 11 (22%) with moderate erectile dysfunction, 20 (40%) switched to mild and19 (38%) were left without erectile dysfunction. Additionally, according to additional analysis to the SHIM, 34 (68%) were successful, 6 (12%) moderate and 10 (20%) poor. Conclusions: Ligation of penile dorsal venous leaks has good medium-term results in terms of erection quality and patient satisfaction.
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Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Idoso , Doenças do PênisRESUMO
PURPOSE: Total corpora mobilization (TCM) is a novel technique that is used for penile reconstruction in cases of micropenis and penile amputation. Its principle is based on Kelly's procedure for bladder exstrophy (1). In contrast to the Kelly procedure, TCM is performed entirely through the perineum with the patient in the lithotomy position. MATERIALS AND METHODS: TCM was performed on three patients. The first was a boy who suffered trauma from a dog bite at an age of eight months. At 23 years old he underwent TCM. The second patient had genital self-amputation induced by psychiatric disorder. After treatment, at 27 years old, he desired surgery for penile reconstruction. The third patient had partial androgen insensitivity syndrome (PAIS) with a micropenis and at 23 years old had TCM procedure. The patients were placed in the lithotomy position with a perineal incision in the midline. A subperiosteal incision was made and the corpora cavernosa were detached from the pubic arch and the ischial rami. The periosteum and the neurovascular bundles were preserved. Subsequently the corpora cavernosa was mobilized upward and the periosteum that was left attached to them was sutured to the pubis. RESULTS: At twenty-four, nine, and six months, respectively, in the follow-up process, all patients expressed satisfaction with the final cosmetic appearance, penile length, and erectile function. CONCLUSION: TCM may prove to be an alternative for patients with a functional disturbance because of small penile length, though a higher number of cases and a more extended follow-up are needed to draw a more definitive conclusion.
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Extrofia Vesical , Doenças do Pênis , Animais , Extrofia Vesical/cirurgia , Cães , Doenças dos Genitais Masculinos , Humanos , Masculino , Ereção Peniana , Pênis/anormalidades , Pênis/cirurgiaRESUMO
INTRODUCTION: Diphallia is a rare anomaly. It has a range of appearances from a small accessory penile to complete duplication. METHODS: We present a 2 year-old boy with complete penile duplication. The left penile was the largest. NMR (Nuclear Magnetic Resonance) suggested one corporal body for each penile and VCUG (Voiding Cystourethrogram) showed a normal urethra in the right penile and stricture at glandular and mid penile urethra of the left penis. A Y confluence to bulbar urethra was observed confirming only one prostate and bladder. RESULTS: The cystoscopy through the right penile identified the urethral confluence in the bulbar area. We performed a meatotomy in the left penile to insert the cystoscope and confirmed the blind ending urethra. We decided to remove this penile. The penile was degloved entirely and clamped and took out the corpora at the base. DISCUSSION: Diphallia can have three presentations: only glans duplication, bifid diphallia and complete diphallia (two corpora cavernosa and a corpus spongiosum for each penile). In our case, each penile presented only one corpora cavernosa and the decision taken was based on urethral patency. CONCLUSION: The treatment should always be planned individually whereas associated anomalies with the goal of attaining satisfactory functional and cosmetic results.