Buried Penis: A Rare Cause of Lower Urinary Tract Symptoms in the Pediatric Population.

A buried penis is a probably underdiagnosed entity. It is defined as a penis of normal size that appears to be smaller than expected due to concealment within the pubic tissue. This case report explores the presentation of a 12-month-old male infant with exuberant ballooning of the prepuce during micturition, requiring manual expression of urine for the duration of two months prior to presentation. The penis was not visible above the skin level, with only the glands covered by prepuce protruding. However, the penis could be exposed when holding the base of the penis, revealing a regular-sized penis. The clinical diagnosis of a buried penis with megaprepuce was assumed, and the patient was referred to the pediatric surgery department for further management. Corrective surgery was performed nine months later with excellent cosmetic and functional results. The buried penis has a typical appearance with a partially visible or completely invisible penis, with only the glans covered by prepuce protruding, and it can be completely asymptomatic or cause micturition difficulties, sexual dysfunction, and recurrent urinary tract infections or balanitis. The diagnosis is clinical and the treatment is surgical, although the surgical approach is controversial.

[Penile epithelioid hemangioma]. / A hímvesszo epithelioid haemangiomája.

Epithelioid hemangioma is a benign vascular tumor. Complete surgical excision is curative, there is no tendency to recurrence or metastasize. Its penile occurrence is extremely rare, only 33 cases have been reported in English literature. A patient with epithelioid hemangioma of the deep dorsal vein of the penis is reported. To our knowledge, this is the first report of penile epithelioid hemangioma in Hungarian literature. The 64-year-old patient presented to our department with painful erection caused by a palpable penile mass. Physical examination revealed a mobile subcutaneous nodule on the dorsum of the penis. Penile ultrasound showed a 10 mm homogeneous, well circumscribed lesion superficial to the tunica albuginea of the corpora cavernosa without intralesional blood flow. Local excision was performed through a dorsal longitudinal penile incision. The deep dorsal vein was dissected circumferentially, then the lesion was removed following ligation of the vein proximal and distal to the mass. Histopathological examination revealed epithelioid hemangioma. At three months after surgery, the patient reported complete resolution of pain, his International Index of Erectile Function Score was 21. At four years after the operation, there were no signs of recurrence or metastasis. Successful treatment of epithelioid hemangioma of the penis requires in-depth knowledge of processes resulting in penile subcutaneous masses, therefore the differential diagnosis is detailed in discussion. Orv Hetil. 2023; 164(21): 836-840.

Penile Fracture with Urethral Rupture: The Feasibility of Repair through Penoscrotal Approach.

Penile fracture with an associated urethral injury is a rare urological emergency resulting from trauma to the erect penis during vigorous sexual intercourse. The patient often presents with swelling of the penis, discoloration of the penile skin, localized pain, and hematuria with a typical history of sudden detumescence during intercourse. Subcoronal penile degloving incision has been conventionally described and is frequently used by many clinicians for the management of penile fracture-urethral injury. Here, we describe a case of complex penile fracture managed through the vertical penoscrotal incision. The penoscrotal approach confers excellent exposure to both the ruptured corpus cavernosum and urethra. This approach ensures successful outcomes in such an emergency procedure without having disadvantages of the degloving incision.

Mondor's penile disease requiring thrombectomy: A case report and literature review / Enfermedad de Mondor con necesidad de cirugía: reporte de un caso y revisión de la literatura

The thrombophlebitis of the superficial dorsal vein of the penis, called Mondor's penile disease (PMD), is a condition with a low incidence worldwide. In general, it is considered a self-limited disease that usually resolves with conservative management and very rarely requires surgical intervention. We report the case of a 41-year-old patient, who presented PMD which persists after medical treatment with nonsteroidal antiinflammatory drug and low molecular weight heparin. Surgery was decided and thrombectomy plus resection of the superficial penile vein was performed with satisfactory results. A review of the literature is presented, focusing on the limited available evidence of surgical management. (AU)

La tromboflebitis de la vena dorsal superficial del pene, también llamada enfermedad de Mondor, es una condición infrecuente que generalmente es auto-limitada. Usualmente mejora con el tratamiento conservador y rara vez requiere intervención quirúrgica. Reportamos el caso de un paciente de 41 años que a pesar del uso de antiinflamatorios no esteroideos y de heparina de bajo peso molecular no tuvo resolución del cuadro clínico. Se realizó trombectomía y resección de la vena dorsal superficial del pene de manera satisfactoria. Se presenta una revisión de la literatura, enfocada en la poca evidencia disponible sobre el manejo quirúrgico en esta enfermedad. (AU)

Corpus cavernosum abscess: A case report.

Corpus cavernosum abscess is a rare infection of the genitourinary tract. In this case report, we present a 42-year-old patient admitted with pain and edema in the penile shaft twenty-four days after drainage by puncture of the cavernous body due to ischemic priapism. Al-Ghorab procedure together snake-maneuver and broad-spectrum antibiotic therapy were performed. Despite manifesting erectile dysfunction, he evolved without penile deviations.

Mondor's penile disease requiring thrombectomy: A case report and literature review.

The thrombophlebitis of the superficial dorsal vein of the penis, called Mondor's penile disease (PMD), is a condition with a low incidence worldwide. In general, it is considered a self-limited disease that usually resolves with conservative management and very rarely requires surgical intervention. We report the case of a 41-year-old patient, who presented PMD which persists after medical treatment with nonsteroidal antiinflammatory drug and low molecular weight heparin. Surgery was decided and thrombectomy plus resection of the superficial penile vein was performed with satisfactory results. A review of the literature is presented, focusing on the limited available evidence of surgical management.

Update on Diseases in Chinchillas: 2013-2019.

Chinchillas have been used mostly as fur animals and as animal models for human ontological diseases and only recently have been recognized as excellent, long-lived, and robust pet rodents. This review aims to provide updated information on emerging disease conditions in pet chinchillas, such as Streptococcus equi subsp zooepidemicus and Pseudomonas aeruginosa. Furthermore, this review article provides updated information on previously documented disorders, such as urolithiasis and middle ear disease, in chinchillas. This article is intended to serve as a complement to the current veterinary reference literature and to provide valuable and clinically relevant information for veterinarians treating chinchillas.

Penile calciphylaxis: a conservative approach.

Penile calciphylaxis or calcific uremic arteriolopathy is a rare urological condition often associated with patients undergoing renal dialysis for end-stage renal disease. The majority of cases are associated with systemic calciphylaxis. The pathophysiology, diagnosis and management of penile calciphylaxis as an individual entity has brought little attention. The rates of comorbidity and mortality of these patients are often particularly high. Early diagnosis and a multidisciplinary approach are therefore essential. We report a case of penile calciphylaxis in a 59-year-old man with end-stage renal failure on haemodialysis who was successfully managed conservatively.

[Application value of ultrasonography in penile diseases].

Penile disease is one of the male urological diseases. Although the penis is a small organ, once the problem occurs, it often brings great trouble to the patient. Therefore, the accurate diagnosis of penile disease is particularly important. High-frequency ultrasonography, with its advantages of noninvasiveness, safety, low cost, easy operation and reproducibility, can clearly show the structure and blood flow of the penis and has a significant value in the diagnosis and follow-up of penile diseases such as vascular erectile dysfunction, priapism, penile injury, penile neoplastic and non neoplastic nodules. Meanwhile, the development of new technologies such as shear wave elastography (SWE) and contrast enhanced ultrasound (CEUS) has made up for the shortcomings of traditional ultrasound imaging, expanded the application of ultrasound in penile diseases, and improved the efficiency of ultrasound diagnosis of the diseases. This article focuses on the application value of ultrasound in erectile dysfunction, priapism, penile cavernous injury and penile tubercle, as well as the latest progress in such new technologies as SWE and CEUS applied to penile diseases.

Recurrent Pilonidal Sinus Cyst on Penis.

Pilonidal sinus, including one or more sinus canals and hairs, is a disease with a chronic course showing acute attacks which is often encountered in the general population, usually affecting young adults, at a rate in males twice that of females. Pilonidal sinus on the penis is so rare that very few cases have been reported in literature. A 20-year-old male presented to the urology outpatient clinic with the complaint of a suppurative lesion with discharge on the skin of the penis which had been ongoing for approximately three months. Clinical examination revealed an indurated, erythematous, ulcerative lesion, 3 cm x 2 cm in size, in the middle of the ventral aspect of the penile shaft. We present the first case in literature of recurrent pilonidal sinus related to Actinomyces israelii, located on the penis.

Application value of ultrasonography in penile diseases / 中华男科学杂志

Penile disease is one of the male urological diseases. Although the penis is a small organ, once the problem occurs, it often brings great trouble to the patient. Therefore, the accurate diagnosis of penile disease is particularly important. High-frequency ultrasonography, with its advantages of noninvasiveness, safety, low cost, easy operation and reproducibility, can clearly show the structure and blood flow of the penis and has a significant value in the diagnosis and follow-up of penile diseases such as vascular erectile dysfunction, priapism, penile injury, penile neoplastic and non neoplastic nodules. Meanwhile, the development of new technologies such as shear wave elastography (SWE) and contrast enhanced ultrasound (CEUS) has made up for the shortcomings of traditional ultrasound imaging, expanded the application of ultrasound in penile diseases, and improved the efficiency of ultrasound diagnosis of the diseases. This article focuses on the application value of ultrasound in erectile dysfunction, priapism, penile cavernous injury and penile tubercle, as well as the latest progress in such new technologies as SWE and CEUS applied to penile diseases.

Role of tubularization of urethral plate in development of urethrocutaneous fistula post hypospadias repair.

INTRODUCTION: This study aimed to demonstrate the outcome of hypospadias repair in the pediatric population using the tubularized urethral plate technique and to compare the incidence of fistula between incised and unincised urethral plate. METHODOLOGY: This is a retrospective cohort study of pediatric patients who had hypospadias repair in a tertiary hospital in Jeddah, Saudi Arabia, between January 2000 and December 2012. They were divided into two main groups according to the status of the urethral plate: Group A included patients who had incision of the urethral plate just before tubularization, and Group B included patients who underwent tubularization without incision. RESULTS: After reviewing 310 medical records, 106 patients were included in the final analysis, with a median age of 2 years (interquartile range = 3 years). There was no statistically significant relationship between types of hypospadias and the development of fistula (P = 0.26). In Group A, we identified 87 patients (82%), and in Group B, there were 19 patients (18%). The overall incidence of fistula was 34.9% (n = 37). The incidence of fistula in Groups A and B was 36% (n = 31) and 32% (n = 6), respectively. This difference was not statistically significant. Despite a high fistula rate, only 12 patients (11%) were required to repeat surgery. CONCLUSION: Incision of the urethral plate did not affect the fistula rate. In comparison to international literature, the incidence of fistula was significantly higher which could be explained by the fact that one-third of those patients had a previous hypospadias repair.

Autologous platelet-rich plasma (PRP) in chronic penile lichen sclerosus: the impact on tissue repair and patient quality of life.

PURPOSE: Lichen sclerosus (LS) is a chronic inflammatory skin condition that frequently involves the anogenital region. Ongoing research is focused on finding more effective treatments for tissue repair and reducing symptoms. The aim of this study is to evaluate the effectiveness of platelet-rich plasma (PRP) local injections in penile LS. METHODS: Forty-five male patients affected by penile LS underwent injections of autologous PRP in the affected skin areas. Age at diagnosis and at first treatment, number of treatments, clinical conditions (phimosis, splitting, inflammation, synechiae, meatus stenosis), symptoms (pain, burning, itching), and functional impairment were considered. Treatment efficacy was also evaluated through the Investigator's Global Assessment (IGA) on a six-point Likert scale and the Dermatology Life Quality Index (DLQI). RESULTS: The patient age at LS diagnosis was 36.20 ± 9.19 years, while the mean age at the first PRP treatment was 42.96 ± 11.32 years (p < 0.001). The number of treatments/patient ranged from 2 to 10. The follow-up was 17.60 ± 5.63 months. After PRP injections, it was observed in all patients a significant improvement in clinical conditions, with reduction/disappearance of symptoms. Topical steroid therapy, interrupted before PRP treatment, was not restarted by any patient. Only one patient underwent a later circumcision procedure. Both IGA scale and DLQI score showed a significant difference (p < 0.001) before and after PRP treatment. CONCLUSIONS: PRP treatment in penile LS seems to be helpful to regenerate scarring, reduce symptoms, and improve patient quality of life. Further studies are necessary to evaluate long-term results.

[Ladder step strategy for surgical repair of congenital concealed penis in children].

OBJECTIVE: To assess the feasibility of the ladder step strategy in surgical repair of congenital concealed penis in children. METHODS: This study included 52 children with congenital concealed penis treated in the past two years by surgical repair using the ladder step strategy, which consists of five main steps: cutting the narrow ring of the foreskin, degloving the penile skin, fixing the penile skin at the base, covering the penile shaft, and reshaping the prepuce. The perioperative data of the patients were prospectively collected and statistically described. RESULTS: Of the 52 patients, 20 needed remodeling of the frenulum and 27 received longitudinal incision in the penoscrotal junction to expose and deglove the penile shaft. The advanced scrotal flap technique was applied in 8 children to cover the penile shaft without tension, the pedicled foreskin flap technique employed in 11 to repair the penile skin defect, and excision of the webbed skin of the ventral penis performed in another 44 to remodel the penoscrotal angle. The operation time, blood loss, and postoperative hospital stay were 40－100 minutes, 5－30 ml, and 3－6 days, respectively. Wound bleeding and infection occurred in 1 and 5 cases, respectively. Follow-up examinations at 3 and 6 months after surgery showed that all the children had a satisfactory penile appearance except for some minor complications (2 cases of penile retraction, 2 cases of redundant ventral skin, and 1 case of iatrogenic penile curvature). CONCLUSIONS: The ladder step strategy for surgical repair of congenital concealed penis in children is a simple procedure with minor injury and satisfactory appearance of the penis.

Ladder step strategy for surgical repair of congenital concealed penis in children / 中华男科学杂志

<p><b>Objective</b>To assess the feasibility of the ladder step strategy in surgical repair of congenital concealed penis in children.</p><p><b>METHODS</b>This study included 52 children with congenital concealed penis treated in the past two years by surgical repair using the ladder step strategy, which consists of five main steps: cutting the narrow ring of the foreskin, degloving the penile skin, fixing the penile skin at the base, covering the penile shaft, and reshaping the prepuce. The perioperative data of the patients were prospectively collected and statistically described.</p><p><b>RESULTS</b>Of the 52 patients, 20 needed remodeling of the frenulum and 27 received longitudinal incision in the penoscrotal junction to expose and deglove the penile shaft. The advanced scrotal flap technique was applied in 8 children to cover the penile shaft without tension, the pedicled foreskin flap technique employed in 11 to repair the penile skin defect, and excision of the webbed skin of the ventral penis performed in another 44 to remodel the penoscrotal angle. The operation time, blood loss, and postoperative hospital stay were 40－100 minutes, 5－30 ml, and 3－6 days, respectively. Wound bleeding and infection occurred in 1 and 5 cases, respectively. Follow-up examinations at 3 and 6 months after surgery showed that all the children had a satisfactory penile appearance except for some minor complications (2 cases of penile retraction, 2 cases of redundant ventral skin, and 1 case of iatrogenic penile curvature).</p><p><b>CONCLUSIONS</b>The ladder step strategy for surgical repair of congenital concealed penis in children is a simple procedure with minor injury and satisfactory appearance of the penis.</p>

Transient distal penile corporoglanular shunt as an adjunct to aspiration and irrigation procedures in the treatment of early ischemic priapism.

PURPOSE: Ischemic priapism, a compartment syndrome, requires urgent treatment in order to nourish the corpora cavernosa. As the first step, aspiration of blood and irrigation of the cavernosal bodies is performed to prevent fibrotic activity and secure erectile capability. During aspiration, there are risks of cardiovascular side effects of adrenergic agonists. We aimed to evaluate a transient distal penile corporoglanular shunt technique in place of aspiration and irrigation techniques for treatment of early ischemic priapism. MATERIALS AND METHODS: A transient distal penile shunt was applied to 15 patients with early ischemic priapism between January 2011 and May 2012. Priapism duration, history, causes, pain, and any prior management of priapism were assessed in all patients. A complete blood count and penile Doppler ultrasonography were performed, which showed attenuated blood flow in the cavernosal artery. A sterile closed system blood collection set, which has two needles and tubing, was used for the transient distal penile shunt. RESULTS: Ten of 15 patients with early ischemic priapism were successfully treated with this transient shunt technique. No additional procedures were needed after the resolution of rigidity in the 10 successfully treated patients. CONCLUSIONS: The transient nature of this technique is an advantage over aspiration and irrigation in the treatment of early ischemic priapism. Our results indicate that the technique can be offered for patients with an ischemic priapism episode of no more than 7 hours.

Transient Distal Penile Corporoglanular Shunt as an Adjunct to Aspiration and Irrigation Procedures in the Treatment of Early Ischemic Priapism

PURPOSE: Ischemic priapism, a compartment syndrome, requires urgent treatment in order to nourish the corpora cavernosa. As the first step, aspiration of blood and irrigation of the cavernosal bodies is performed to prevent fibrotic activity and secure erectile capability. During aspiration, there are risks of cardiovascular side effects of adrenergic agonists. We aimed to evaluate a transient distal penile corporoglanular shunt technique in place of aspiration and irrigation techniques for treatment of early ischemic priapism. MATERIALS AND METHODS: A transient distal penile shunt was applied to 15 patients with early ischemic priapism between January 2011 and May 2012. Priapism duration, history, causes, pain, and any prior management of priapism were assessed in all patients. A complete blood count and penile Doppler ultrasonography were performed, which showed attenuated blood flow in the cavernosal artery. A sterile closed system blood collection set, which has two needles and tubing, was used for the transient distal penile shunt. RESULTS: Ten of 15 patients with early ischemic priapism were successfully treated with this transient shunt technique. No additional procedures were needed after the resolution of rigidity in the 10 successfully treated patients. CONCLUSIONS: The transient nature of this technique is an advantage over aspiration and irrigation in the treatment of early ischemic priapism. Our results indicate that the technique can be offered for patients with an ischemic priapism episode of no more than 7 hours.

Penile Squamous Cell Carcinoma Diagnosed following Treatment of Urethrocutaneous Fistula after CO2 Laser Therapy for Misdiagnosed Penile Lesion: Report of a Case / 대한남성과학회지

The complications of the treatment of penile lesion are wide ranging, urethrocutaneous fistula being one of the less common. This complication affects the ventral aspect of the penis. We present a rare case of urethrocutaneous fistula after vaporization of penile lesion by CO2 Laser. One fistula was at ventral aspect of the penis. A 43-year-old male presented with passage of urine from one opening. He had undergone a vaporization by CO2 laser, 2 times. Urethrocutaneous fistula repairs was performed with biopsy of the edge of fistula site. Squamous cell carcinoma was confirmed. He subsequently underwent a partial penectomy. It is very important that biopsy was performed before vaporization of even small size skin lesion. This case is reported along with a brief review of the literature.

Glans necrosis / Necrose de glande

Ischemic necrosis of the glans penis is a rare entity. To this day, roughly fifteen cases have been described. Certain physiological abnormalities are commonly found in association with this condition, including diabetes, chronic renal failure and peripheral vascular disease. Usually the penile lesion suffers black-mummy-shaped necrosis or liquefaction and progresses from dry to wet gangrene. Correct diagnosis and early treatment are essential for a successful treatment.

Necrose isquêmica do pênis é uma situação rara. Atualmente há cerca de 15 casos relatados na literatura. Distúrbios fisiológicos estão comumente associados aos episódios de necrose de glande, como diabetes, insuficiência renal crônica e doença vascular periférica. Freqüentemente a lesão peniana se mumifica, porém ela pode evoluir com liquefação tecidual, progredindo para lesão peniana úmida. O diagnóstico correto e intervenção precoce são essenciais para o sucesso do tratamento

Superficial Thrombophlebitis of the Dorsal Vein of the Penis (Penile Mondor's Disease) / 대한비뇨기과학회지

Herein, two cases of penile Mondor's disease are described. The first was a 45-year-old man who complained of a small subcutaneous induration, with localized discomfort at the distal rim of the coronal sulcus of the penis. The other was a 46-year-old man who complained of similar symptoms of penile induration. The lesions were surgically removed under local anesthesia, and found to be thromboses of the penile superficial dorsal vein. As a result, the diagnoses of Mondor's disease of the penis were confirmed.