Surgical management for penile fracture: A retrospective, observational, multicenter study.

INTRODUCTION: The objective of this study is to make an inventory of surgical practices and their consequences in the short and medium term on sexuality and micturition comfort. MATERIALS AND METHODS: It is a retrospective multicenter study over ten years on 63 men who had an operation for a fracture of the corpora cavernosa associated or not with a urethral lesion. Patient history, clinical presentation, surgical management as well as postoperative data were collected from operative reports. Residual penis curvature, IIEF5 score, IPSS score and residual pain were collected during a telephone interview during data collection. RESULTS: No statistically significant difference was demonstrated for IIEF5, IPSS, sequelae curvature, pain during intercourse, time to resumption of sexual life, rate of surgical resumption between use of absorbable or non-absorbable threads and between the realization of an overlock or a separate point. We found a significant difference in the time taken to resume sexual activity, between surgical exploration by degloving compared to elective surgical exploration. CONCLUSION: Our study shows great variability in the surgical management of penile fractures, with no influence in the short and medium term on sexuality and urination comfort. Medium-term complications such as erectile dysfunction, curvature of the penis and pain during sexual intercourse seem frequent and insufficiently diagnosed, but decrease during urological follow-up.

Orally administered isoflavones are present as glucuronides in the human prostate.

Better knowledge of the bioavailability and metabolism of isoflavones in prostate tissue is needed to further investigate their mechanisms of action in the context of prostate cancer prevention. A total of 12 men with benign prostatic hyperplasia received soy extract supplementation (3 Evestrel capsules, providing a total of 112.5 mg isoflavones aglycone eq/day) for 3 days before prostate surgery. Blood and prostate tissues were sampled and metabolites were identified using electrospray ionization liquid chromatography tandem mass spectrometry (LC-ESI-MS/MS) and chemically synthesized standards of glucuronidated isoflavones. The main metabolites were the same in prostate tissue and in plasma, namely, 2 monoglucuronides of daidzein and 2 monoglucuronides of genistein. Concentrations of total isoflavones measured in prostate reached 1.05 +/- 0.62 nmol/g tissue (range 0.30-2.23) at the time of sampling, 12 h after the last isoflavone supplementation. At that time point, prostate concentrations were lower than plasma concentrations in all volunteers: 0.47 nmol/g vs. 0.66 microM for daidzein and 0.58 nmol/g vs. 0.78 microM for genistein. Isoflavone mechanisms of action should thus be investigated in in vitro cell studies using physiological conditions, intracellular concentrations below 5 nmol/g and no intracellular deconjugation of the monoglucuronide metabolites.

[Giant ureterohydronephrosis of the lower segment due to obstructive megaureter in a context of ureteropelvic duplication]. / Urétérohydronéphrose géante du système inférieur par méga-uretère obstructif sur duplicité pyélo-urétérale.

Ureterohydronephrosis of the lower segment in a context of ureteric duplication is a rare entity and is usually associated with vesicoureteric reflux. The authors report the case of a 35-year-old woman with giant ureterohydronephrosis of the lower segment secondary to partial ureteric duplication due to primary megaureter discovered in a context of infection. After primary percutaneous drainage of the collection, treatment consisted of partial nephrectomy with preservation of the good quality upper segment.