Adult ; Humans ; Male ; Penis ; injuries ; surgery ; Rupture ; surgery

Paraffin injection for penile augmentation and the resulting complications are not rarer in Korea. However, adequate management of these patients is not well known. Herein we present 20 cases of penile paraffinoma. The most common presentation was pain on erection. Penile paraffinoma usually involved skin and all the subcutaneous tissue including Buck's fascia, and extended into pubis and/or scrotum in 7 patients. Out of 20 patients, earlier 4 were managed by partial excision and primary closure, and all the 4 required secondary. operation because of complications or persistent symptoms. Remaining l6 patients were managed by wide excision of all the involved layers in to and adequate coverage of denuded penis by intact penile skin, scrotal skin flap, or Cecil`s two stage operation. Of remaining l6 cases, only 2 required additional operation; the one by the full thickness skin graft of partial scrotal flap necrosis, the other by the wound repair. All the 20 patients showed successful outcome. We think that the best treatment of penile paraffinoma is complete excision and primary scrotal skin flap neoplasty."
Fascia ; Humans ; Korea ; Male ; Necrosis ; Paraffin ; Penis ; Scrotum ; Skin ; Subcutaneous Tissue ; Transplants ; Wounds and Injuries

PURPOSE: The records of 12 patients diagnosed with a fracture of the penis were reviewed to assess the usefulness, not only of penile ultrasonography, but also the outcome of an emergent surgical operation for a fracture of the penis. MATERIALS AND METHODS: Twelve patients with a fracture of the penis, as a result of blunt trauma (mean age 41 years old), were reviewed. Of the 12 patients, 9 fractured their penis during sexual intercourse, and 3 during penile manipulation. Patients were managed with an emergent surgical operation, which was performed on the basis of a preoperative cavernosography, penile ultrasonography and retrograde urethrography. All 12 patients were treated with a surgical operation, with follow-up examinations performed 2 weeks later. However, only 5 patients were followed-up over a long period (average 3.5 year). RESULTS: To identify the rupture site of the corpus cavernosum, both penile ultrasonography and cavernosography were performed, and the precise rupture site also confirmed. All patients presented successful outcomes, with the exception of 3 that complained of intermittent painful erections. Five patients were able to preserve potency during the long evaluation period following the operation. However, two patients complained about a mild curvature of the penis and three had intermittent painful erections. CONCLUSIONS: Using penile ultrasonography for the purpose of diagnosing patients with a fractured penis is useful as an investigative methods, and the use of an additional diagnostic tool is almost unnecessary. Despite minimal complications (2 penile curvatures and 3 intermittent painful erections), the result of an emergent surgical operation was excellent for the preservation of sexual potency in patient with a fracture of the penis.
Coitus ; Follow-Up Studies ; Humans ; Male ; Penis* ; Rupture ; Ultrasonography* ; Wounds and Injuries

PURPOSE: A clinical review was performed to evaluate the effectiveness of the partial neurectomy of the dorsal nerve of the penis on the treatment of premature ejaculation. PATIENTS AND METHODS: The study was made on 143 patients with premature ejaculation (mean age 38 years; range 22~53 years) who underwent the partial neurectomy of the dorsal nerve of the penis from January 1997 to September 1999. All patients were evaluated by change on pre- and post-operative ejaculatory latency and biothesiometry, postoperative satisfaction, management on unsatisfactory patients and postoperative complication. RESULTS: Pre- and post-operative vibration perception threshold of glans penis on biothesiometry was significantly decreased from mean 2~3 mA (range 1~6 mA) to 8~10 mA (range 3~15 mA) (p<0.01). Change on pre- and post-operative ejaculatory latency was prolonged from mean 1~3 minutes (55.2%) to 5~10 minutes (47.6%)(p<0.01). The postoperative results were satisfactory in 117 cases (81.8%). At follow-up 2 to 34 months postoperatively, 17 cases (11.8%) were complicated by glans pain, discomfort(7 cases), penile edema (6 cases), wound dehiscence(3 cases), and delayed ejaculation (1 case). CONCLUSION: The partial neurectomy of the dorsal nerve of the penis is an effective treatment in the comprehensive management of the premature ejaculation with glans hypersensitivity, for good results, a simple operative technique and a few postoperative complication. However, it must be followed up for long-term effectiveness and its complication.
Edema ; Ejaculation ; Follow-Up Studies ; Humans ; Hypersensitivity ; Male ; Penis* ; Postoperative Complications ; Premature Ejaculation* ; Vibration ; Wounds and Injuries

The indirect measurement of arterial blood flow using Doppler Ultrasound was investigated to ascertain is significance and applicability in the diagnosis of impotence due to vascular insufficiency. The following results were obtained with a control group of 20 capable of normal erection and a group of 8 complaining of impotence with complete failure of erection. 1. the result of detection of the radial artery, dorsal and deep penile artery of the penis of the control group-the detection of the radial artery could be made with certainty whereas the dorsal and deep penile artery of the penis were difficult. since it varies with the individual. the ratio of frequency of the radial artery and the detectable penile artery was 1:0.779. 2. Of eight subjects with failure of erection due to trauma or spinal cord injury, one showing vascular insufficiency of the penis by pelvic angiography had a radial artery to penile artery ratio of 1:0.1, a typical finding in vascular insufficiency; whereas, in an another subject with urethral injury, the ratio was lowered to 1:0.3. In perspective, the limitation of the Doppler Ultrasound lies in the standardization equipment of and the technique of detection. However, in the investigation of impotence of vascular cause, Dopper Ultrasound should be the initial study because of its simplicity, safety and noninvasiveness. Further investigation is to be warranted.
Angiography ; Arteries ; Diagnosis* ; Erectile Dysfunction ; Female ; Impotence, Vasculogenic* ; Male ; Penis ; Radial Artery ; Spinal Cord Injuries ; Ultrasonography*

Various different objects have been reported to strangulate the penis. We reported on a patient who used metal radiator clamps for an extended period of time. Workup included history, physical examination and urinalysis. The patient was taken to the operating room for further evaluation with cystourethroscopy and orthopedic wire cutters were used to break the metal bands.
Constriction, Pathologic ; Humans ; Male ; Middle Aged ; Penile Diseases ; etiology ; Penis ; injuries ; Rupture ; therapy

OBJECTIVETo reconstruct a penis with sensation and erectile function maintained by corpora cavernosa lengthening and skin flap transferring in the penis defect cases.

METHODSThe procedure was based on the use of releasing the suspensory ligaments and part of crus, various flaps were designed as coverage material. Penis residual stump was advanced to anterior portion of the newly reconstruction penile body as "glans".

RESULTS40 patients with penis defect have been operated by the above methods. In the cases, length of the penis varied from 0.5-4.0 cm in the flaccid, 1.5-5.0 cm in erect state before operation. And after operation, it turned to 5.0-8.5 cm in the flaccid, 7.0-12.5 cm in erect state. Most of the patients recovered gross tactile sensation and had satisfactory erectile function.

CONCLUSIONWith this method, the reconstructed penis tends to have a better appearance and function. It's a more optimal method compared with the conventional operation.

Adult ; Humans ; Male ; Penile Erection ; Penis ; injuries ; innervation ; surgery ; Reconstructive Surgical Procedures ; methods ; Sensation

OBJECTIVEPenile fracture, being defined as rupture of the tunica albuginea of the corpus cavernosum, is uncommon. Here, we analyze findings on our patients during a 10-year period and evaluate the role of retrograde urethrography.

METHODSFrom February 2002 to April 2012, 116 patients were admitted with penile fracture at Ghaem Medical Center. Patient history and physical examination were taken at their admittance to detect probable urethral injury. Before surgery, retrograde urethrography was performed in all patients. The size and site of the tunical rupture were recorded. Then the rupture of tunica albuginea was sutured with nonabsorbable (3-0 nylon) sutures and the ties were placed on the internal surface (continuous method). All patients were followed up for 12 months.

RESULTSPatients' mean age was (32.78 ± 10.61) years and ranged (16-62) years. The mechanism of trauma was sexual intercourse in 103 patients (89%) and masturbation in 13 patients (11%). The most common site of injury found after exploration was right (55%) and lateral (74%) of the corpus cavernosum. The size of the tunical rupture was from 0.5 to 3.0 cm (mean 1.88 ± 0.72). Three of the patients had Marphan's syndrome. Urethral injury was detected by retrograde urethrography in 4 patients (3%) who had macroscopic hematuria and urethrorrhagia. During 12 months follow-up, no complication was seen.

CONCLUSIONThere is no need to perform retrograde urethrography unless the patients have gross hematuria or urethrorrhagia. The key to success in treatment of penile fracture is to achieve a rapid diagnosis based on history and a physical examination, avoid unnecessary imaging tests and perform immediate surgery to reconstruct the site of injury.

Adolescent ; Adult ; Humans ; Male ; Middle Aged ; Penis ; injuries ; surgery ; Rupture ; Sutures ; Urethra ; diagnostic imaging ; Young Adult

Penile amputation and successful replantation is very uncommon, and there is no routine standardized procedures for dealing with this medical condition. Here we report two cases of penile amputation and replantation involving different degrees of vascular insult leading to different pathogenesis, clinical presentation, surgical approach and prognosis. This report described the microsurgical procedure and postoperative care using bipedicled scrotal flap to achieve successful engraftment and function. A review of the published data and future methods to increase success of such surgical procedures is provided.
Adult ; Amputation, Traumatic ; surgery ; Humans ; Male ; Microsurgery ; Penis ; blood supply ; injuries ; surgery ; Replantation ; methods

We described a 27-year-old case of avulsion and traumatic degloving of penile with extensive penis skin necrosis. Under general anesthesia, donor skin was partially resected from lower limbs according to defect area of penile skin. Then shear the shape of graft was sheared, sutured to hostage skin defect and enswathed with tension. The posto-perative appearance and function of the penis were satisfactory. It is suggest the homologous free skin flap from lower limbs is suitable for penile skin repair and beneficial to patient resulting in satisfactory erection and shape.
Accidents, Occupational ; Adult ; Debridement ; Humans ; Male ; Necrosis ; surgery ; Penis ; injuries ; Skin Transplantation ; methods ; Surgical Flaps