Detailed anatomy of the corpora-glans ligament via the P45 plastination method / Anatomía detallada de los ligamentos cuerpo cavernoso-glande mediante el método de plastinación P45

SUMMARY: The corporo-glans ligament is the ligament connecting the corpus cavernosum and the glans of the penis. The anatomical description of the corporo-glans ligaments shape is still uncertain, this knowledge affects penile reconstructive procedures. The anatomy of the corporo-glans ligament was analyzed and recorded via observing sagittal sections of 10 different penile P45 plastination sections. According to the P45 plastination sections, the corporo-glans junction displayed a fibrous tissue band connecting the distal ends of the two corpus cavernous (CC) with the glans penis (GP). The fibrous band was a round-obtuse shape and ran deep into the glans of the penis and occupied about 2/3 of the whole GP. The original end was laid in a socket embedded in the GP. The density of the fibers of the ligament at the original end close to the tunica albuginea was less than that of the other parts. The fibers originating from the tunica albuginea, directly extended to the blind end of the two CC, covering the distal end of the two CC.

El ligamento cuerpo cavernoso-glande es el ligamento que conecta el cuerpo cavernoso y el glande del pene. La descripción anatómica de la forma de los ligamentos cuerpo cavernoso -glande aún es incierta; este conocimiento afecta los procedimientos reconstructivos del pene. La anatomía del ligamento cuerpo cavernoso-glande se analizó y registró mediante la observación de 10 secciones sagitales diferentes del pene a través de plastinación P45. Según las secciones de plastinación, la unión cuerpo-glande mostraba una banda de tejido fibroso que conectaba los extremos distales de los dos cuerpos cavernosos con el glande del pene. La banda fibrosa tenía una forma redonda y obtusa y se adentraba profundamente en el glande del pene ocupando alrededor de 2/3 de él. En su origen se coloca en un espacio profundo en el glande del pene. La densidad de las fibras del ligamento cuerpo cavernoso-glande en su origen cercano a la túnica albugínea era menor que el de las otras partes. Las fibras que se originan en la túnica albugínea, se extienden directamente hasta el extremo ciego de los dos cuerpos cavernosos, cubriendo el extremo distal de estos.

Gross Anatomy of Urethra and Penis in Uncastrated and Castrated Buck of Black Bengal Goat

SUMMARY: Urethral process, sigmoid flexure, urethra at the pelvic arch and neck of urinary bladder in goats are very much prone to form obstructive urolithiasis. The present study was carried out to establish baseline work on the normal measurement of the urethral passage and different segments of penis of uncastrated and castrated Black Bengal (BB) goat which will be supportive for obstructive urolithiasis management. Different segment of penis along with urethra of 25 uncastrated and 25 castrated male Black Bengal goats were collected from different slaughter house of Chattogram City Corporation. The length and diameter of male urethra and different segment of penis in uncastrated buck were significantly higher (p<.001) than castrated buck. The length of the pelvic urethra was 5.88 ± 0.111 cm and 4.58 ± 0.15 cm in uncastrated and castrated buck respectively. The length of the neck of urinary bladder; root, body, sigmoid flexure, glans penis and urethral process of the penis in uncastrated and castrated buck were 0.688 ± 0.156 cm and 0.38 ± 0.048 cm, 5.02 ± 0.09 cm and 4.24±0.10 cm, 23.48 ± 0.37 cm and 22.74 ± 0.43 cm, 9.2 ± 0.107 cm and 8.18 ± 0.29 cm, 1.92 ± 0.032 cm and 1.44 ± 0.10 cm, 2.32 ± 0.029 cm and 1.78 ± 0.07 cm respectively. The diameter of the neck of urinary bladder, root, body, sigmoid flexure, glans penis and urethral process of the penis in uncastrated and castrated buck were 1.94 ± 0.041 cm and 1.44 ± 0.05 cm, 3.7 ± 0.049 cm and 3.3 ± 0.144 cm, 2.63 ± 0.066 cm and 1.86 ± 0.08 cm, 2.77 ± 0.90 cm and 2.18 ± 0.07 cm , 1.81 ± 0.034 cm and 1.4 ± 0.06 cm, 0.66 ± 0.014 cm and 0.56 ± 0.05 cm respectively. Finally, total lengths of penis in uncastrated and castrated buck were 30.42±0.459 cm and 28.42±0.553 cm respectively. The length and diameter of the neck of the urinary bladder, root, sigmoid flexure, urethral process of the penis are clinically more important for obstructive urolithiasis.

RESUMEN: El proceso uretral, el ángulo sigmoideo, la uretra en el arco pélvico y el cuello de la vejiga urinaria en las cabras son muy propensos a formar urolitiasis obstructiva. El presente estudio se llevó a cabo para establecer un trabajo de referencia sobre la medición normal del pasaje uretral y diferentes segmentos de pene de cabra de Bengala Negra (BB) no castrada y castrada, que serán de apoyo para el manejo de la urolitiasis obstructiva. Se recolectaron diferentes segmentos de pene junto con la uretra de 25 machos de cabras de Bengala negras sin castrar y 25 castrados de diferentes mataderos de Chattogram City Corporation. La longitud y el diámetro de la uretra y los diferentes segmentos del pene en el macho no castrado fueron significativamente más altos (p <0,001) que en el macho castrado. La longitud de la uretra pélvica fue de 5,88 ± 0,111 cm y 4,58 ± 0,15 cm en animales sin castrar y castrados, respectivamente. La longitud del cuello de la vejiga urinaria; raíz, cuerpo, flexión sigmoidea, glande del pene y proceso uretral del pene en el macho sin castrar y castrado fueron 0,688 ± 0,156 cm y 0,38 ± 0,048 cm, 5,02 ± 0,09 cm y 4,24 ± 0,10 cm, 23,48 ± 0,37 cm y 22,74 ± 0,43 cm , 9,2 ± 0,107 cm y 8,18 ± 0,29 cm, 1,92 ± 0,032 cm y 1,44 ± 0,10 cm, 2,32 ± 0,029 cm y 1,78 ± 0,07 cm, respectivamente. El diámetro del cuello de la vejiga urinaria, la raíz, el cuerpo, el ángulo sigmoide, el glande del pene y el proceso uretral del pene en el macho no castrado y castrado fueron 1,94 ± 0,041 cm y 1,44 ± 0,05 cm, 3,7 ± 0,049 cm y 3,3 ± 0,144 cm. 2,63 ± 0,066 cm y 1,86 ± 0,08 cm, 2,77 ± 0,90 cm y 2,18 ± 0,07 cm, 1,81 ± 0,034 cm y 1,4 ± 0,06 cm, 0,66 ± 0,014 cm y 0,56 ± 0,05 cm respectivamente. Finalmente, las longitudes totales de pene en machos castrados y no castrados fueron de 30,42 ± 0,459 cm y 28,42 ± 0,553 cm respectivamente. La longitud y el diámetro del cuello de la vejiga urinaria, la raíz, el ángulo sigmoideo y el proceso uretral del pene son clínicamente más importantes para la urolitiasis obstructiva.

Morphology and biometry of the reproductive organs of adult males of Trachemys scripta elegans reared in São Paulo state, Brazil / Morfologia e biometria dos órgãos reprodutivos de machos adultos de Trachemys scripta elegans criados em São Paulo, Brasil

Trachemys scripta elegans is an American underwater chelonian illegally marketed in Brazilian pet shops. When abandoned in nature, it compromises native species, threatening local biodiversity. However, little is known about the body development and structure of its reproductive tract. The objective of the present study was to investigate the morphology and biometry of testis, epididymis and penis, as well as the biometry of the body and secondary sexual characters in this species. Twenty-seven adult males were used aiming to contribute to preservation actions in captivity, population control, and scientific research, as well as to interspecific comparisons. Sex identification by the third claw length was effective, and the specimens presented harmonious and positive body development between mass, carapace, plastron, and height, with unimodal tendency and higher frequency of maximum carapace length at 15cm. The testes and epididymides presented biometric similarity between the antimeres and anatomical and histological structure similar to that of other species of chelonians and mammals, except for the type of epithelium. The findings suggest that there is conserved morphology between slider turtles and homology in relation to mammals. Histological similarity to the reproductive organs of other amniotes, including humans, may give rise to scientific and comparative studies, essential for the establishment of conservation strategies in reptiles.(AU)

Trachemys scripta elegans é um quelônio subaquático americano ilegalmente comercializado em pet shops brasileiros. Ao ser abandonado na natureza, compromete as espécies nativas, ameaçando à biodiversidade local. No entanto, pouco se conhece sobre o desenvolvimento corporal e a estrutura do seu aparelho reprodutor. O objetivo do presente trabalho foi investigar a morfologia e a biometria dos testículos, epidídimos e pênis, a biometria corporal e dos caracteres sexuais secundários. Foram utilizados 27 machos adultos desta espécie, visando contribuir com ações de preservação em cativeiro, controle populacional e pesquisas científicas, além de comparações interespecíficas. A identificação sexual pelo comprimento da terceira garra foi efetiva e os espécimes apresentaram desenvolvimento corporal harmônico e positivo entre massa, carapaça, plastrão e altura, com tendência unimodal e maior frequência de comprimento máximo de carapaça em 15,0cm. Testículos e epidídimos apresentaram semelhança biométrica entre os antímeros e estrutura anatômica e histológica semelhantes à de outras espécies de quelônios e mamíferos, excetuando-se pelo tipo de epitélio. Os achados sugerem haver morfologia conservada entre os cágados e homologia em relação aos mamíferos. A semelhança histológica com os órgãos reprodutivos de outros amniotas, incluindo os humanos, pode dar ensejo a estudos científicos e comparativos, essenciais para estabelecimento de estratégias de conservação em répteis.(AU)

Morphological analysis of the elastic and collagen fibers in the ram penis / Análise morfológica de fibras elásticas e colágenas no pênis de ovinos

The penis represents the organ of the male's copulation. It is essential to know the reproductive biology and the morphology of the reproductive organs to increase animal production. In order to contribute to this knowledge and provides information on the ram reproductive morphology, the purpose of this work was to describe the distribution, based on light microscopy, of the collagen and elastic fibers in the ram penis. For that, were collected transverse fragments of the penis (root, sigmoid flexure, body and glans) of seven rams. The specimens were fixed in paraformaldehyde for 24h and destined for the histological routine. The extracellular matrix of the ram penis was composed of collagen and elastic fibers. The penis was enveloped by the tunica albuginea, consisting essentially of collagen fibers, which were arranged in two layers: an outer longitudinal and an inner circular. This tunic emitted septa that penetrated the corpus cavernosum. The elastic fibers appeared transversely and longitudinally in the corpus cavernosum, corpus spongiosum, and next to the neurovascular bundle of the penis. This structure was not different to that reported for other domestic ruminants such as cattle and buffaloes.(AU)

O pênis representa o órgão da cópula do macho. É fundamental que se conheça a biologia reprodutiva e a morfologia dos órgãos reprodutores para o incremento da produção animal. Com o objetivo de contribuir para este conhecimento e fornecer informações sobre a morfologia reprodutiva de ovinos, o propósito deste trabalho foi descrever a distribuição, com base na microscopia de luz, das fibras colágenas e elásticas no pênis de ovinos. Para tanto, foram coletados fragmentos transversais do pênis (raiz, flexura sigmoide, corpo e glande) de sete ovinos. Os exemplares foram fixados em paraformaldeído por 24h e destinados à rotina histológica. A matriz extracelular do pênis de ovinos estava constituída por fibras colágenas e elásticas. O pênis estava envolvido pela túnica albugínea, formada essencialmente por fibras colágenas, que estavam arranjadas em duas camadas: longitudinal externa e circular interna. Esta túnica emitiu septos que penetraram no corpo cavernoso. As fibras elásticas apareceram de modo transversal e longitudinal nos corpos cavernoso e esponjoso e junto ao feixe vásculo-nervoso do pênis de ovinos. Esta estrutura mostrou-se similar ao encontrado em outros ruminantes domésticos como bovinos e bubalinos.(AU)

Histological characterization of reproductive tract and fetal annexes of the West Indian Manatee (Trichechus manatus) from Brazil / Caracterização histológica do trato reprodutor e anexos fetais do peixe-boi marinho (Trichechus manatus) do Brasil

The West Indian manatee (Trichechus manatus) is one of the most threatened aquatic mammals in Brazil, and is currently classified as "endangered" (MMA). The objective of this study was to characterize histologically the reproductive tract and fetal annexes of stranded manatees in northeastern Brazil. Tissue samples were collected from the reproductive tract of 23 manatees, which were fixed in 10% buffered formalin, processed using standard histological protocols and stained with hematoxylin eosin. We qualitatively described the histological and histomorphometric characteristics of each structure. Six ovaries were analyzed. In four ovaries, we found a large number of primordial and primary follicles. Two ovaries were different from the others: one had inflammatory infiltration and the other had a thickening in the cortex and absence of follicles. We also analyzed seven uteri (of which four were in the proliferative phase, two in the secretory phase, and one in the recovery phase), four placentas, one vagina, six testes (four were in the immature phase, one in the pubertal phase, and one in the mature phase), two epididymides, two penises, and one umbilical cord. The histological and morphometric findings in our work will support future analyses of the reproductive tract of T. manatus from Brazil.(AU)

O peixe-boi marinho (Trichechus manatus) é um dos mamíferos aquáticos mais ameaçados do Brasil e, atualmente é classificado como "em perigo" (MMA). O objetivo deste estudo foi caracterizar histologicamente o trato reprodutor e os anexos fetais de peixes-bois marinhos encalhados no Nordeste do Brasil. Foram coletadas amostras de tecidos do trato reprodutor de 23 peixes-bois marinhos (T. manatus), que foram fixadas em formol tamponado a 10%, processados usando protocolos histológicos padrão e corados com hematoxilina eosina. Foi realizada a descrição qualitativa das características histológicas e histomorfométricas de cada estrutura. Foram analisados seis ovários. Em quatro ovários, foi encontrado um grande número de folículos primordiais e primários. Dois ovários eram diferentes dos outros: um tinha infiltração inflamatória e o outro tinha um espessamento no córtex e ausência de folículos. Também foram analisadas sete amostras uterinas (das quais quatro estavam na fase proliferativa, duas na fase secretória e uma na fase de recuperação), quatro placentas, uma vagina, seis testículos (quatro na fase imatura, um na fase puberal e um na fase madura), dois epidídimos, dois pênis e um cordão umbilical. Os achados histológicos e morfométricos em nosso trabalho apoiarão futuras análises do trato reprodutivo de T. manatus do Brasil.(AU)

Inflatable penile prosthesis as tissue expander: what is the evidence?

ABSTRACT Objective: Many patients who undergo inflatable penile prosthesis (IPP) replacement are often upsized to larger cylinders, suggesting the IPP may serve as a tissue expander and increase internal penile length. The objective of this study is to evaluate whether cylinder length increases with subsequent IPP insertion. Materials and Methods: We queried American Medical Systems and Coloplast Patient Information Form databases to identify patients who underwent IPP placement and replacement between 2004-2013. Patients were grouped by device type and time to replacement (<2 or ≥2 years). We selected the 2-year mark for subgroup analysis to allow time for tissue expansion to occur and to exclude patients who underwent early explantation (e.g. erosion or infection). Results: Two thousand, seven hundred and forty nine patients (1,532 AMS 700 LGX, 717 AMS 700 CX, and 500 Coloplast Titan) met the inclusion criteria. Mean time between implants was earlier for LGX (29 months) than CX (39 months) and Titan (48 months) patients (p<0.001). Patients who underwent device replacement at <2 years did not experience an increase in mean cylinder length. On the contrary, patients who underwent device replacement at ≥2 years did experience significant increases in mean cylinder length (LGX 1.2 cm, CX 1.1 cm, and Titan 0.9 cm, p<0.001). The mean increases in length at ≥2 years were similar between the 3 devices (p=0.20). Sixty percent of patients demonstrated increases of >0.5 cm and 40% demonstrated increases of ≥1 cm. Conclusions: As demonstrated, the IPP may provide tissue expansion over time. Further evaluation is needed to determine if increased cylinder length correlates to increased functional length and patient satisfaction.

Perceptions about penis size among supposedly healthy 40 to 60-year-old Brazilian men: a cross-sectional pilot study / Percepções sobre o tamanho do pênis em homens brasileiros supostamente saudáveis de 40 a 60 anos: um estudo piloto transversal

CONTEXT AND OBJECTIVE: Many men seek medical treatments complaining that their penises are too small (short) when in fact they are not (they are not cases of micropenis). The objective of the present study was to evaluate men's satisfaction with their own bodies and sex life and the prevalence of erectile dysfunction, among men who were not seeking medical or psychological advice. DESIGN AND SETTING: Cross-sectional study in a private, philanthropic hospital in São Paulo, Brazil. METHODS: In this study, 300 male blood donors aged between 40 and 60 years old answered a questionnaire, in privacy, about their sex life and their satisfaction with their own bodies. They were also screened for erectile dysfunction by means of the International Index of Erectile Function questionnaire. RESULTS: Seven men (2.3%) reported that they were dissatisfied with their penis size (they thought that it was small), and among these, one was found to have mild erectile dysfunction. However, none of them had sought medical attention. Among these seven, only two had normal body mass index; the other five were overweight (three) or obese (two). CONCLUSION: The prevalence of dissatisfaction with penis size was low. Among the seven dissatisfied men, only one had erectile dysfunction, of mild type, and all of them felt potent. .

CONTEXTO E OBJETIVO: Muitos homens buscam tratamento médico com a queixa de que seus pênis são muito pequenos (curtos), quando na verdade não são (não são casos de micropênis). O objetivo do presente estudo foi avaliar a satisfação com o próprio corpo e vida sexual e a prevalência de disfunção erétil entre homens que não estavam buscando aconselhamento médico ou psicológico. TIPO DE ESTUDO E LOCAL: Estudo transversal, em um hospital privado filantrópico em São Paulo, Brasil. MÉTODOS: Neste estudo, 300 homens doadores de sangue, com idade entre 40 e 60 anos, responderam um questionário, em privacidade, sobre sua vida sexual e satisfação com o próprio corpo. Eles também foram rastreados para disfunção erétil por meio do questionário International Index of Erectile Function. RESULTADOS: Sete homens (2,3%) disseram estar insatisfeitos com o tamanho de seus pênis (achavam que era pequeno), e entre estes, um tinha disfunção erétil leve. Entretanto, nenhum deles procurou aten-dimento médico. Entre esses sete, somente dois estavam com índice de massa corporal normal, três estavam com sobrepeso e dois eram obesos. CONCLUSÃO: A prevalência de insatisfação com o tamanho do pênis foi pequena. Entre os sete homens insatisfeitos, apenas um tinha disfunção erétil, leve, e todos se sentiam potentes. .

Penile length, digit length, and anogenital distance according to birth weight in newborn male infants

PURPOSE: Anogential distance (AGD) and the 2:4 digit length ratio appear to provide a reliable guide to fetal androgen exposure. We intended to investigate the current status of penile size and the relationship between penile length and AGD or digit length according to birth weight in Korean newborn infants. MATERIALS AND METHODS: Between May 2013 and February 2014, among a total of 78 newborn male infants, 55 infants were prospectively included in this study. Newborn male infants with a gestational age of 38 to 42 weeks and birth weight>2.5 kg were assigned to the NW group (n=24) and those with a gestational age<38 weeks and birth weight<2.5 kg were assigned to the LW group (n=31). Penile size and other variables were compared between the two groups. RESULTS: Stretched penile length of the NW group was 3.3+/-0.2 cm, which did not differ significantly from that reported in 1987. All parameters including height, weight, penile length, testicular size, AGD, and digit length were significantly lower in the LW group than in the NW group. However, there were no significant differences in AGD ratio or 2:4 digit length ratio between the two groups. CONCLUSIONS: The penile length of newborn infants has not changed over the last quarter century in Korea. With normal penile appearance, the AGD ratio and 2:4 digit length ratio are consistent irrespective of birth weight, whereas AGD, digit length, and penile length are significantly smaller in newborns with low birth weight.

Stereological study of the elastic fiber and smooth muscle cell system in the bovine and buffalo penis / Estereologia do sistema elástico e das células musculares lisas no pênis fibroelástico zebuino e bubalino

Samples of ten penises of Mediterranean buffaloes and ten penises of Red Sindhi cattle were used. The thickness of the tunica albuginea (TA), distribution of smooth muscle cells (SMC) and volume density (Vv) of elastic system fibers in TA, corpus cavernosum (CC) and corpus spongiosum (CS) were evaluated. The Vv of elastic system fibers in buffalo and bovine penis was respectively 4.07% ±0.88% and 3.36% ±1.21% in TA; 17.32% ±2.21% and 13.14% ±1.27% (CC), 26.58% ±4.31% and 31.36% ±3.67% (CS). The CC of buffalo presented higher Vv of elastic fibers than bovine, while in the CS the Vv of elastic fibers in buffaloes was smaller than in cattle. The TA thickness showed a significant difference among the species studied. The arrangement of SMC in the bovine penises and in the water buffalo suggests that this pattern is common to animals that have fibroelastic penises.

O pênis dos zebuinos e bubalinos são classificados como do tipo fibroelástico, sendo grande parte de sua rigidez conferida pelas fibras colágenas e elásticas presentes na matriz extracelular. Embora alguns estudos tenham abordado estes componentes em bovinos europeus, os dados na literatura sobre zebuínos e bubalinos são escassos. Nós avaliamos a espessura da túnica albugínea, a distribuição das células musculares lisas e a densidade volumétrica (Vv) das fibras do sistema elásticona túnica albugínea, no corpo cavernoso e esponjoso do pênis de animais jovens adultos inteiros.Foram utilizados 10 fragmentos de pênis de búfalos da raça Mediterrâneo e 10 fragmentos de pênis de bovinos da raça Red Sindi. Os fragmentos de pênis foram processados de acordo com a técnica histológica de rotina para inclusão em parafina e corados pela Fucsina Resorcina de Weigert, Picro Sirius Red, Tricrômio de Gomori e anticorpo anti α actina. As fibras elásticas foram determinadas em 25 campos aleatórios de cada fragmento, utilizando o sistema teste modelo M42. A Vv das fibras do sistema elástico no pênis do búfalo e bovino foram(média e desvio padrão respectivamente) de 4,07% ±0,88 e 3,36% ±1,21 na túnica albugínea; 17,32% ±2,21 e 13,14% ±1,27 no corpo cavernoso; 26,58% ±4,31 e 31,36% ±3,67 no corpo esponjoso, respectivamente. Houve diferença na Vv das fibras elásticas entre as duas espécies, no corpo cavernoso e no corpo esponjoso. Na espessura da túnica albugínea houve diferença significativa entre o búfalo Mediterrâneo (1,4mm ±0,11) e o bovino Red Sindi (1,76mm ±0,23). Nas duas espécies, as fibras musculares lisas foram encontradas apenas associadas ao endotélio de revestimento dos seios cavernosos. Com base nestes resultados, podemos concluir que existem diferenças na proporção entre os componentes da matriz extracelular nas espécies estudadas, fato que deve ser considerado nos procedimentos clínicos e cirúrgicos veterinários e continua a ser investigado.

Canine perineal hypospadias / Hipospadia perineal canina

Canine hypospadias is a rare condition that can occur in male and female dogs. Affected animals may present signs of urinary incontinence, recurrent urinary tract infections, periurethral dermatitis or can remain asymptomatic. Periurethral hypospadias in a 14-week-old mongrel dog and its surgical repair are addressed.

Hipospadia canina é uma condição rara que pode ocorrer em cães machos e fêmeas. Animais afetados podem apresentar sinais de incontinência urinária, infecções recorrentes do trato urinário, dermatite periuretral ou podem permanecer assintomáticos. Hipospadia periuretral em cão de 14 semanas de idade, sem raça definida, e sua reparação cirúrgica são abordadas.

A prospective evaluation of plastibell® circumcision in older children

Introduction and Objective Circumcision is one of the oldest surgical procedures and one of the most frequently performed worldwide. It can be done by many different techniques. This prospective series presents the results of Plastibell® circumcision in children older than 2 years of age, evaluating surgical duration, immediate and late complications, time for plastic device separation and factors associated with it. Materials and Methods We prospectively analyzed 119 children submitted to Plastic Device Circumcision with Plastibell® by only one surgeon from December 2009 to June 2011. In all cases the surgery was done under general anesthesia associated with dorsal penile nerve block. Before surgery length of the penis and latero-lateral diameter of the glans were measured. Surgical duration, time of Plastibell® separation and use of analgesic medication in the post-operative period were evaluated. Patients were followed on days 15, 45, 90 and 120 after surgery. Results Age at surgery varied from 2 to 12.5 (5.9 ± 2.9) years old. Mean surgical time was 3.7 ± 2.0 minutes (1.9 to 9 minutes). Time for plastic device separation ranged from 6 to 26 days (mean: 16 ± 4.2 days), being 14.8 days for children younger than 5 years of age and 17.4 days for those older than 5 years of age (p < 0.0001). The diameter of the Plastibell® does not interfered in separations time (p = 0,484). Late complications occurred in 32 (26.8%) subjects, being the great majority of low clinical significance, especially prepucial adherences, edema of the mucosa and discrete hypertrophy of the scar, all resolving with clinical treatment. One patient still using diaper had meatus stenosis and in one case the Plastibell® device stayed between the glans and the prepuce and needed to be removed manually. conclusions Circumcision using a plastic device is a safe, ...

Age-related changes in the concentration of elastic fibers in different regions of the rabbit penis

PURPOSE: To investigate whether elastic fiber content in the corpus cavernosum (CC), corpus spongiosum (CS) and tunica albuginea (TA) of the rabbit penis undergoes modifications with age. METHODS: Rabbits were sacrificed, in groups of ten animals each, at 30, 120, 240, and 730 days of age. Histological sections were obtained from the penile middle shaft and were stained with Weigert's resorsin fuchsin. The content of elastic fibers was determined using stereological methods, and was expressed as volume fraction. RESULTS: At 730 days of age, elastic fiber content was increased by 54% (p<0.004), 78% (p<0.004), and 87% (p<0.004) in the TA, CC, and CS, respectively, compared with animals aged 30 days. After 30 days of age, the concentration gradually and significantly increased until 240 days of age. In 730-day old animals, the concentration, compared with the previous age group, was unchanged in the CC and decreased by 20% (p<0.004) in the TA. CONCLUSIONS: Elastic fiber contents in the rabbit penis correlate with properties of penile tissues. Although after one month of age there is a gradual increase in these concentrations, in two-year old animals this trend is interrupted, which suggests that this could be an early alteration due to senescence.

Penile enlargement with methacrylate injection: is it safe? / Aumento peniano com injeção de metacrilato: isto é seguro?

Penis size is a great concern for men in many cultures. Despite the great variety of methods for penile augmentation, none has gained unanimous acceptance among experts in the field. However, in this era of minimally invasive procedure, injection therapy for penile augmentation has become more popular. Here we report a case of methacrylate injection in the penis that evolved with penile deformity and sexual dysfunction. This work also reviews the investigation and management of this pathological condition.

A 36-year-old male sought medical care with a complaint of penile deformity and sexual dysfunction after methacrylate injection. The treatment administered was surgical removal. Satisfactory cosmetic and functional results were reached after two months.

There is a need for better structured scientific research to evaluate the outcomes and complication rates from all penile augmentation procedures. .

O tamanho peniano é uma grande preocupação para homens em diversas culturas. Apesar da grande variedade de possíveis métodos para o aumento peniano, nenhum ganhou aceitação unânime por especialistas no assunto. Mas na era dos procedimentos minimamente invasivos, a terapia de injeção para aumento peniano tem se tornado mais popular. Aqui relatamos um caso de injeção de metacrilato no pênis que evoluiu com deformidade peniana e disfunção sexual. Este trabalho também revisa a investigação e gerenciamento desta afecção.

Um homem de 36 anos procurou atendimento médico com queixa de deformidade peniana e disfunção sexual após injeção de metacrilato. Remoção cirúrgica foi realizada como tratamento. Após dois meses, satisfatórios resultados cosmético e funcional foram alcançados.

Trabalhos científicos mais bem estruturados para avaliar as taxas de complicação e resultados de todos os procedimentos para aumento peniano são necessários. .

The interpretation of the figure of the prophet Jonah by Michelangelo on the ceiling of the sistine chapel: anatomical urological vision

PURPOSE:A detailed analysis in the iconography and pictorial appearance of the scene of the "Prophet Jonah" painted by the artist Michelangelo Buonarroti (1475-1564) on the ceiling of the Sistine Chapel between the years 1508 and 1512. MATERIALS AND METHODS:Literature review on the Italian Renaissance period and the life of Michelangelo Buonarroti and analysis of historical aspects of the evolution of studies of human anatomy in this period and the works of the artist. RESULTS:A comparative analysis of the representation of the figure of the fish on the left thigh of "Jonah" with a cross section of penis shows a curious similarity. The pictorial and iconographic analysis reveals an intensity of light on the pubic area and the position of the prophet with the legs spread apart and left hand placed on this region. A tube-shaped cloth covers the region and the angel at the side seems to be looking at this anatomical region of "Jonah". In fact, sets of iconographic and pictorial relate to the deciphered code. CONCLUSIONS: This description helps to confirm the relationship of the Renaissance art with the human anatomy; science has been much studied in this period. The design of a cross section of the penis is revealed with the two cavernous bodies with the septum between them and the spongy body. Considering the circumstances in which Michelangelo had painted, subjectivity was fundamental due to religious motivations added to the vigorous implications of a limited scientific knowledge typical of that era.

Forma e função dos músculos perineais da viscacha (Lagostomus maximus) / Shape and function of the perineal muscles of viscacha (Lagostomus maximus)

Entre as espécies de roedores já estudadas podemos destacar a grande variação na morfologia do aparelho reprodutor masculino. Assim, considerando a importância ecológica dos roedores, e a grande representatividade numérica quanto geográfica destes animais, bem como a escassez que aborda a anatomia reprodutiva, desenvolvemos este trabalho com um roedor histricomorfo da América do Sul, a viscacha. Este animal apresenta algumas características reprodutivas bem peculiares, desta forma descreveremos a anatomia macroscópica da musculatura perineal, e o papel dos músculos no comportamento copulatório desta espécie. A região perineal da viscacha é composta por cinco músculos, sendo que três músculos encontram-se dispostos no diafragama urogenital superficial, Musculus ischiocavernosus, M. bulbocavernosus e M. bulbospongiosus, e pelos músculos que se encontram no diafragma pélvico, M. levator ani e M. retractor penis. Sendo assim, destacamos que o estudo do assoalho pélvico em animais silvestres é de grande valia, uma vez que contribuem com o melhor entendimento dos mecanismos relacionados â ereção e ejaculação; ou seja colaboram com os estudos sobre a reprodução dos animais.

Among the rodent species studied we can highlight the wide variation in the morphology of the male reproductive system. Thus, considering the ecological importance of rodents, and the large number and geographical representation of this animal, as well as shortages regarding the reproductive anatomy, we developed this study with viscacha, a South American histricomorph rodent. As this species has some very peculiar reproductive features, we described the gross anatomy of the perineal muscles and the role of copulatory behavior. The perineal region of viscacha is composed of five muscles, three of which are arranged in the superficial genitourinary diaphragm, as Musculus ischiocavernosus, M. bulbocavernosus and M. bulbospongiosus, and the muscles that lie at the pelvic diaphragm, M. levator ani and M. retractor penis. Therefore, we emphasize that the study of the pelvic floor in wild animals is of great value, then contribute to a better understanding of the mechanisms related to erection and ejaculation or collaborate with studies on the reproduction of animals.

História natural do comprimento peniano após prostatectomia radical: um estudo prospectivo de longo prazo / Natural history of penile length after radical prostatectomy: a prospective long-term

A prostatectomia radical (PR) é um dos procedimentos mais utilizados para o tratamento do câncer de próstata (CaP) localizado, porém apesar da maior compreensão da anatomia local e do desenvolvimento tecnológico, esta cirurgia permanece associada à elevada morbidade na esfera sexual. A redução do comprimento peniano após a PR é uma queixa freqüente na prática urológica, porém não há dados na literatura a respeito da variação deste comprimento em um longo período de acompanhamento. A determinação da história natural do comprimento peniano após PR, assim como possíveis fatores de risco ou de proteção é de fundamental importância para o aconselhamento e tratamento dos pacientes submetidos a esta cirurgia. O objetivo deste estudo é determinar a história natural do comprimento peniano após a PR em um acompanhamento de cinco anos, assim como avaliar o papel da função erétil na variação do comprimento peniano destes pacientes. Foram avaliados prospectivamente os comprimentos penianos de 105 pacientes com câncer de próstata localizado submetidos PR aberta. Participação em programas de reabilitação peniana e deformidades anatômicas do pênis foram considerados critérios de exclusão. A medição do comprimento real peniano sob máxima tração (CRTmax) foi realizada antes da PR e aos 3, 6, 12, 24, 36, 48 e 60 meses no pós-operatório. O domínio da função erétil do índice internacional de função erétil (IIEF-EF) foi utilizado para avaliar a função erétil. Houve redução média de 1 cm no CRTmax em 3 meses após a PR e essa diferença permaneceu até 24 meses (p<0,001). Após este período, a diferença reduziu gradativamente, deixando de ser estatisticamente significativa em 48 meses (-0,3 cm, p=0,080) e 60 meses (+0,4 cm, p=0,065). A função erétil foi um preditor para o retorno precoce do comprimento do pênis. Um encurtamento peniano médio de 1 cm é esperado nos primeiros 24 meses após PR. No entanto, há uma tendência para a recuperação deste comprimento após 24 meses...

Radical prostatectomy (RP) is one of the most common treatment for localized prostate cancer (PCa), but despite the advances in the local anatomy knowledge and the technological development, this surgery remains related to high morbidity in the sexual sphere. The reduction in penile length after RP is a common complaint in urologic practice, but there is no data regarding this issue in a long follow-up period. The determination of the natural history of penile length after RP and possible risk factor is necessary for the counseling and treatment of patients undergoing this surgery. The objective of this study is to determine the natural history of penile length after RP in a five years follow-up and to investigate the role of erectile function in the penile length variation. We prospectively evaluated the penile length of 105 patients with localized prostate cancer submitted to open RP. Participation in penile rehabilitation programs and anatomical deformities of the penis were considered exclusion criteria. Measurements of the real length under maximum penile traction (RSLmax) were performed before and after RP at 3, 6, 12, 24, 36, 48 and 60 months postoperatively. The erectile function domain of the International Index of Erectile Function (IIEF-EF) was used to assess erectile function. There was a mean reduction of 1 cm in RSLmax in 3 months after the PR and this difference remained up to 24 months (p <0.001). After this period, the difference decreased gradually and was not statistically significant at 48 months (-0.3 cm, p = 0.080) and 60 months (+0.4 cm, p = 0.065). Erectile function was a predictor for the early recovery of penile length. In conclusion, a mean penile shortening about 1 cm is expected in the first 24 months after RP. However, there is a tendency for the recovery of this length after 24 months postoperatively, with a return to the original length at 48 months. The normal erectile function after RP is a predictor for early recovery...

Tadalafil rehabilitation therapy preserves penile size after bilateral nerve sparing radical retropubic prostatectomy

OBJECTIVE: To evaluate the change in penile size r bilateral nerve sparing retropubic radical prostatectomy (BNSRRP) and possible effect of Tadalafil. MATERIALS AND METHODS: A total of 65 patients underwent BNSRRP and they were evaluated prospectively for a whole year of follow-up . The patients were randomized to control without rehabilitation (Group 1) or Tadalafil rehabilitation group (Group 2). The patients were evaluated at months 3, 6 and 12 postoperatively for erectile function, penile measurements (flaccid penile length, penile length at maximum erection, penile circumference at flaccid status, and penile circumference at maximum erection), penile abnormalities and general health status. Statistical analysis was performed by Chi-Square test and significance was defined as p value < 0.05. RESULTS: In Group 1 there was significant decrease in penile measurements at month 3 compared to preoperative measurements. There was decrease in all parameters at month 6 compared to month 3 but only the decrease in penile length at maximum erection was significant. There were no significant differences between postoperative months 6 and 12 for all measurements. In Group 2 there was a tendency to decrease in all measurements at month 3 compared to baseline. There was no significant difference for penile measurements between postoperative 3rd and 6th months and between 6th month and the first year. CONCLUSION: Although further large sampled trials are needed to describe the possible positive effect of tadalafil or other PDE5-I's on penile size after BNSRRP, tadalafil rehabilitation is effective in preserving penile size especially in the early postoperative period after BNSRRP.

Estudo estrutural do pênis de fetos humanos normais e anencéfalos no segundo trimestre de gestação / Structural study of the penis of normal and anencephalic human fetuses in the second trimester of pregnancy

A anecencefalia é o Defeito do Tubo Neural (DTN) mais severo em fetos humanos. Há uma demanda crescente para reposição tissular em doenças crônicas e cirurgias reconstrutoras. Tecidos fetais têm sido utilizados como substitutos para órgãos sólidos. Comparar a estrutura e morfologia do corpo cavernoso e corpo esponjoso de pênis de fetos humanos anencéfalos e de controle a fim de propor um novo modelo para estudos biológicos e transplantes teciduais. Foram estudados 11 pênis de fetos de controle de 14 a 23 Semanas Pós Concepção (SPC), e cinco pênis de fetos anencéfalos de 18 a 22 SPC. Os órgãos foram removidos e processados pelas técnicas histo e imunohistoquímicas rotineiras. A análise do tecido conjuntivo, células musculares lisas e fibras elásticas foram realizadas em lâminas dos espécimes. Os dados foram expressos em Densidade de àrea (Da) utilizando-se um software de processamento digital. As médias foram comparadas utilizando-se o Teste - T não pareado e quando aplicável, a regressão linear simples foi utilizada. Foi considerada significância estatística se p<0,05. O septo intercavernoso encontrava-se presente em todas as amostras. Não foram observadas diferenças da Da do tecido colágeno e musculatura lisa dos pênis de fetos anencéfalos quando comparados aos normais. A regressão linear simples sugere que durante o desenvolvimento humano há um aumen2to gradual do tecido colágeno (R2=0,45) e uma diminuição da musculatura lisa (R =0,62) no corpo cavernoso de ambos os grupos. A elastina encontrava-se presente apenas em fetos a partir da 20ª SPC. Não houve diferença na estrutura da genitália entre fetos normais e enencéfalos. Apresença da elastina em fetos a partir da 20ª SPC é um dado objetivo da manutenção da capacidade de ereção nestes grupos. A histo e imunohistoquímica sugerem que o desenvolvimento do pênis destes fetos encontra-se inalterado. Futuros estudos deverão ser realizados com o objetivo de avaliar fetos anencéfalos como um potencial ...

Anencephaly is the most severe neural tube defect (NTD) in human fetuses. There is an increasing need for tissue replacement in chronic diseases and reconstructive surgeries. Fetal tissues have been used as a substitute for native organs. Compare the structure and morphology of the corpora cavernosa and spongiosum of penises from anencephalic and normal human fetuses to propose a new model for biological studies and tissue transplantation. We studied 11 penises from normal human fetuses, aged 14 to 23 weeks post-conception (WPC), and 5 penises from anencephalic fetuses, aged 18 to 22 WPC. The organs were removed and processed by routine histological and immunolabeling techniques. Analysis of connective tissue (Cot), smooth muscle (SMC) and elastic fibers (EF) were performed in sections. Data were expressed as area density (Ad) using digital processing and software. Means were statistically compared using the unpaired t test and linear regression was performed. Statistical significance was considered if p < 0.05. The Intracavernosal septum was present in all samples. We did not observe differences in the Ad of Cot and SMC in the penises of anencephalic fetuses when compared to normal ones. The simple linear regression suggested that during human development there is a gradual increase in Cot (R2= +0.45) and a decrease of SMC (R2=- 0.62) in the corpora cavernosa in both groups studied. Elastin was observed only in fetuses from 20th WPC. There was no difference in the structure of the corpora cavernosa and corpus spongiosum of anencephalic fetuses compared to normal ones. Elastin was documented from 20th WPC, which suggests the maintenance of erectile function. Histochemistry and immunolabeling suggested that penile shaft development is maintained and unaltered in anencephalic fetuses. Further studies should be performed to analyze anencephalic fetuses as a potential tissue donating group and a model for biological studies