Penoplasty with T-shaped incision and three-point fixation for concealed penis / 中华男科学杂志

<p><b>Objective</b>To search for a safe and effective method of penoplasty with low incidence of complications for concealed penis by evaluating penoplasty with T-shaped incision and three-point fixation in comparison with modified Devine's technique.</p><p><b>METHODS</b>We retrospectively analyzed 169 cases of concealed penis treated in our center by penoplasty with T-shaped incision and three-point fixation (group A, n = 110) or modified Devine's surgery (group B, n = 59). We compared the operation time, postoperative complications, and recurrence rate between the two groups of patients.</p><p><b>RESULTS</b>Operations were successfully completed in all the cases, the urinary catheters removed at 3 days and the elastic bandages applied for 2 to 4 weeks. The patients were followed up for 4 to 12 months. The penis was satisfactorily exposed. The operative time was significantly shorter in group A than in B (［52.8 ± 6.9］ vs ［61.5 ± 10.6］ min, P < 0.001), the postoperative complication rate was obviously lower in the former than in the latter (prepuce edema: 17.27% ［19/110］ vs 33.89% ［20/59］, P = 0.021; bleeding: 0.90% ［1/110］ vs 3.38% ［2/59］, P = 0.552; skin necrosis: 0.90% ［1/110］ vs 5.08% ［3/59］, P = 0.123; skin infection: 0.90% ［1/110］ vs 5.08% ［3/59］, P = 0.123), and so was the recurrence rate (0.90% ［1/110］ vs 6.77% ［4/59］, P = 0.032).</p><p><b>CONCLUSIONS</b>Penoplasty with T-shaped incision and three-point fixation deserves to be popularized clinically for its advantages of minor invasion, clear exposure, reliable penile fixation, low incidence of postoperative complications and recurrence, and satisfactory outcomes.</p>

Etiological factors for calculus-associated seminal vesiculitis: Analysis of calculus composition in 6 cases / 中华男科学杂志

Objective@#To explore the etiological factors for calculus-associated seminal vesiculitis by analyzing the composition of seminal vesicle calculus samples.@*METHODS@#This retrospective study included 6 cases of recurrent hematospermia diagnosed with seminal vesicle calculus by non-contrast pelvic CT. The patients were aged 28 to 69 years, with persistent or recurrent hematospermia for 3 months to 6 years, and 5 of them with a history of acute urethritis. All the patients underwent seminal vesiculoscopy, which confirmed calculus-associated seminal vesiculitis. The calculus samples were obtained with a spiral dislodge and their composition was determined with a second-generation infrared calculus composition analyzer. The patients were followed up for 2 to 12 weeks postoperatively, during which non-contrast pelvic CT was employed for observation of recurrent calculus in the reproductive tract.@*RESULTS@#Pelvic CT scanning indicated recurrence of seminal vesicle calculus in 3 cases at 12 weeks postoperatively, of which, 2 were accompanied with recurrent hematospermia, both observed at 4 weeks after operation. As for the composition of the calculus, the infrared calculus composition analyzer revealed struvite (magnesium ammonium phosphate hexahydrate) in 5 cases and a mixture of calcium oxalate dihydrate, calcium oxalate monohydrate, and carbonate apatite in the other one.@*CONCLUSIONS@#Seminal vesicle calculi are most commonly composed of struvite, and infection is the main etiological factor for calculus-associated seminal vesiculitis.

Application value of Toshiba 320-row dynamic volumetric CT angiography in the diagnosis of venous erectile dysfunction / 中华男科学杂志

<p><b>Objective</b>To investigate the application value of Toshiba 320-row dynamic volumetric CT angiography in the diagnosis of venous erectile dysfunction (VED).</p><p><b>METHODS</b>We enrolled in this study 33 patients diagnosed with ED by audiovisual sexual stimulation screening in the outpatient department. Penile erection was induced in the patients by injection of 2 mg phentolamine plus 30 mg papaverine into the corpus cavernosum, followed by that of contrast agent of iobitridol through the vein and corpus cavernosum successively. Then 320-row dynamic volumetric CT angiography was performed and the images of the corpus cavernosum in the arterial and venous phases were collected and processed.</p><p><b>RESULTS</b>Different degrees of abnormal venous drainage were observed in 29 of the patients, including 7 cases (24.1%) of back deep venous leakage, 6 cases (20.7%) of foot venous leakage, 3 cases (10.3%) of dorsal superficial venous leakage, 1 case (3.5%) of intervertebral venous leakage, 2 cases (6.9%) of cavernous venous leakage, and 10 cases (34.5%) of mixed venous leakage. Ten of the patients underwent surgery, dorsal deep penile vein ligation in 2 cases, dorsal deep vein embedding plus foot vein ligation in 4, and foot vein ligation in the other 4. Eight of the patients were followed up for 3－12 months post-operatively, during which 2 achieved obvious erectile improvement, while the other 6 gained normal penile erection.</p><p><b>CONCLUSIONS</b>Toshiba 320-row dynamic volumetric CT angiography is a reliable method for the diagnosis of VED, which displays the precise location of venous leakage for clinical treatment, with the advantages of clearer images, lower doses of contrast agent and radiation, and faster examination than X-ray penile angiography.</p>