Fracture of the penis a rare condition, properly defined as a tear of the fibrous sheath of the corpora cavernosa occurred by direct blow or bending of the penis during erection. Its characteristic pathology is a tear in the tunica albuginea of the corpora cavernosa with hemorrhage, hematoma formation and distortion of the organ. Herein we reported a case of fracture of the penis, occurred by rolling in bed during erection in 26 years old man and repaired surgically.
Adult ; Hematoma ; Hemorrhage ; Humans ; Male ; Pathology ; Penis*

OBJECTIVETo evaluate the histopathological characteristics and clinical implication of sarcolemma tissue in prepubertal concealed penis.

METHODSAfter measurement of the penile length, 10 prepubertal children with congenital concealed penis underwent modified Devine's operation (treatment group), and another 10 normal prepubertal children received circumcision (control group). The anatomic features of the penile sarcolemma tissue was observed intraoperatively, and its fibrosis was evaluated by Masson trichrome staining.

RESULTSThe penile length of the treatment group was significantly shorter than that of the control group preoperatively ([1.49 +/- 0.17 ] cm vs [4.26 +/- 0.23 ] cm, P < 0.01). The degree of penile concealment was correlated with the distal point of the attachment of its sarcolemma fibrous tissue: the closer the distal attachment point was to the coronary ditch, the more serious was penile concealment. The proportion of the area of collagen fibers in the penile sarcolemma tissue was significantly higher in the treatment group than in the control ([65.6 +/- 6.9]% vs [37.1 +/- 4.7]%, P < 0.01).

CONCLUSIONSarcolemma fibrosis was obvious in congenital concealed penis, and the key to its management is drastic removal of all the fibrous sarcolemma tissue.

Child ; Circumcision, Male ; Fibrosis ; Humans ; Male ; Penis ; abnormalities ; pathology ; surgery ; Phimosis ; pathology ; surgery ; Sarcolemma ; pathology

OBJECTIVETo explore the influence of concealed penis on the morphology of the corpus cavernosum in rats.

METHODSRat models of concealed penis were established by intra-pocket-suture of the root of the penis. Fifty rats were equally assigned to Groups A (2-month) and B (4-month), each further divided into a buried (n = 15) and a normal subgroup (n = 10). Changes in the morphology of the penile cavernous tissue were observed under the light microscope and transmission electron microscope.

RESULTSCompared with Group A, Group B showed significant ultra-structural pathological changes in the corpus cavernosum, including abnormal arrangement of endothelial and smooth muscle cells, massive hyperplasia of interstitial tissues, narrowed cavernous sinus, atrophic smooth muscle cells, degenerated mitochondria, dilated endoplasmic reticula, decreased dense bodies and contractile fibers, and cytoplasmic vacuolization. No significant differences were found in the appearance and weight of the corpus cavernosum between the buried and normal groups (P > 0.05).

CONCLUSIONConcealed penis does not significantly affect the appearance and weight of the corpus cavernosum, but causes ultra-structural pathological changes in it with the lengthening of time.

Animals ; Male ; Penis ; pathology ; ultrastructure ; Phimosis ; pathology ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo investigate the clinical pathological characteristics, diagnosis and differential diagnosis of Paget's disease of the scrotum and penis.

METHODSThirteen cases of Paget's disease of the scrotum and penis were analyzed by light microscopy, alcian-blue (AB)/periodic-acid-Schiff (PAS) and immunohistochemical staining.

RESULTSPaget's disease of the scrotum and penis mainly affected old individuals aged 55-84 (mean 71) years. Macroscopically, typical presentations of Paget's disease of the scrotum and penis were eczematoid lesions. Microscopically, Paget cells were distributed singly or in groups (as strands, nests or glandular patterns) within the epidermis. Paget cells were typically stained for AB/PAS, positive for CK7, CEA and EMA, and negative for CK5/6, S-100 and P63. The positive rates of GCDFP-15 and CK20 expressions were 76.92% (10/13)and 53.85% (7/13) respectively.

CONCLUSIONPaget's disease of the scrotum and penis is a low-malignancy cutaneous tumor with typical clinical and pathological features. Pathologic diagnosis is based on immunohistochemical findings.

Aged ; Aged, 80 and over ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Paget Disease, Extramammary ; pathology ; Penile Neoplasms ; pathology ; Penis ; pathology ; Scrotum ; pathology

OBJECTIVETo further understand the clinicopathological, ultrastructural and molecular features of penile pseudoangiosarcomatous squamous cell carcinoma (PASCC), and improve its diagnosis and treatment.

METHODSA 47-year-old male patient with penile PASCC was reported and the relevant literature reviewed. The main clinical manifestations of the patient were a typical surface ulceration with hemorrhage and purulent secretion with a foul smell, a papillary mass about 5.0 cm x 5.0 cm x 4.0 cm for 1 year on the foreskin of the penis, and 3 enlarged bilateral inguinal lymph nodes. CT scanning showed no enlarged lymph nodes in the abdomen and pelvis, and X-ray examination revealed no abnormality in the chest.

RESULTSThe diagnosis was established by biopsy. Partial penectomy and bilateral inguinal lymphadenectomy (T2N2M0) were performed, followed by adjuvant pelvic radiotherapy. Two months later, total penectomy was necessitated by penile flap necrosis and local recurrence. Eleven months after the first surgery, the patient died of extensive metastasis to the pelvis and lungs. Under the light microsope, the tumor was mainly composed of vessel-like lacunar reticularis spindle cells and a few local squamous cancer cells. Careful examination revealed some focal areas with evident transition from squamous nests to the more acantholytic areas extending towards the pseudoangiosarcomatous spaces. Pathogenetically, it appeared to be the variant of acantholytic squamous cell carcinoma. Immunohistochemically, most tumor cells were strongly positive for keratin (AE1/AE3) and focally positive for EMA, with the typical squamous cells focally positive for 34betaE12 and vimentin. The vessels that proliferated in the tumor were decorated by CD31, CD34 and factor VIII-related antigens, but the tumor cells were negative for HMB45, SMA, Desmin and CEA. HPV DNA (HPVpan, HPV6B/11, HPV16/18, HPV31/33) was not detected by in situ hybridization in the primary and metastatic tumors.

CONCLUSIONPASCC is a specific and extremely rare subtype of penile SCC with dramatic similarity to angiosarcoma under the microscope, with poor prognosis. Its diagnosis depends on histopathological, immunohistochemical and ultrastructural studies. Such a presentation underscores the importance of timely consultation, early diagnosis and prompt treatment.

Carcinoma, Squamous Cell ; pathology ; virology ; Humans ; Male ; Middle Aged ; Papillomaviridae ; isolation & purification ; Penile Neoplasms ; pathology ; virology ; Penis ; pathology ; virology

BACKGROUNDBased on our clinical experience, the number of dorsal penile nerves in patients with primary premature ejaculation (PPE) is not consistent with the average number (2 branches). In this study, we evaluated the number and distribution of dorsal penile nerves among healthy Chinese adults and patients with PPE.

METHODSThe dorsal nerve of the penis, the deep dorsal vein of the penis, and the dorsal artery of the penis between the deep fascia of the penis and the albuginea penis were carefully educed, observed, and counted in 38 adult autopsy specimens. The number and distribution of the dorsal penile nerve in 128 surgical patients with PPE were determined.

RESULTSThe numbers of dorsal penile nerves of the 38 cases were as follows: 7 branches in 1 case; 6 branches in 1 case; 5 branches in 6 cases; 4 branches in 9 cases; 3 branches in 14 cases; and 2 branches in 7 cases. Most of the dorsal nerves were parallel to each other and in the dorsum of the penis. In only 8 cases, the branches were connected by some communicating branches. In 4 cases, 1 or 2 thin dorsal nerves continued their pathway over the ventral aspect of the penis. The average number of branches of the dorsal penile nerve in patients with PPE was 7.16.

CONCLUSIONSBased on the study of 38 cases, the average number of dorsal penile nerves was 3.55 branches and that of patients with PPE was greater. These preliminary results suggest that the excessive dorsal penile nerves may have an impact on PPE via increased sensitivity and provide topographic data for the possible treatment of PPE.

Adult ; Ejaculation ; Humans ; Male ; Middle Aged ; Penis ; innervation ; Sexual Dysfunction, Physiological ; pathology ; Young Adult

BACKGROUNDWhile the abnormal appearance of the concealed penis has been well recognized, the effect of buried penis on the structure and function of corpus cavernosum has not been well studied. To explore this issue, we established a rat model and evaluated the effect of buried penis on cavernosum weight, contents and ultrastructure of tissue, and nitric oxide synthase (NOS) activity.

METHODSTwo hundred and ten rats were randomly divided into 3 equal cohorts for 2, 4 and 6 months study (groups A, B and C). Each group was randomly divided into buried group (n = 40), control group (n = 15), and normal group (n = 15), respectively. Intra-purse-string suture of the root of the penis was used to establish the model. Macroscopic development was judged by measuring the weight of the corpus cavernosum. Masson's trichrome staining was performed for observing microstructure while a transmission electron microscope was used for observing ultrastructure. The NOS activity was detected by a NOS activity assay kit.

RESULTSBuried penis had no significant influence on the appearance and weight of the corpus cavernosum. Buried penis resulted in decreased smooth muscle content (P > 0.05 in group A, and P < 0.05 in groups B and C) and increased fibrous connective tissue content (P > 0.05 in groups A and B, and P < 0.05 in group C) compared with the normal and control groups. Ultrastructural abnormalities of corpus cavernosum were observed in the 6-month buried group. Moreover, there was decrease of NOS activity in groups B and C (P < 0.05 in group B and P < 0.01 in group C) when compared with the normal and control groups.

CONCLUSIONBuried penis affects the structure and function of corpus cavernosum in rats and the effect is positively correlated with the buried time, but there is no significant effect on the macroscopic development.

Animals ; Male ; Nitric Oxide Synthase ; metabolism ; Penis ; anatomy & histology ; pathology ; physiopathology ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo find the best treatment of penile strangulation and to analyze the sexual psychological factors of the patients.

METHODSWe retrospectively analyzed the experiences in removing foreign objects around the penis in 21 patients aged 19 - 61 years with the strangulation time varying from 10 hours to 4 days. The objects were mostly made of metal or plastics.

RESULTSAll the objects were successfully removed, 5 of them with the help of lubricant, 4 by aspirating the corpus cavernosum, 8 by shipping with pliers, 2 with the diamond-tipped dental drill, and the other 2, which virtually defied cutting, by aspirating the corpus cavernosum following degloving surgery.

CONCLUSIONIn removing foreign objects around the penis, simpler methods should be given precedence over more complex ones, and for those that virtually defy cutting, the best option is degloving surgery with particular attention to the survival of the penile skin flap.

Adult ; Foreign Bodies ; psychology ; surgery ; Humans ; Male ; Middle Aged ; Penis ; pathology ; surgery ; Retrospective Studies ; Young Adult

AIMTo present a simple technique during penile prosthesis implantation that promotes the perception of increased phallic length.

METHODSThe penoscrotal web is defined. A "check mark" incision is made with excision of scrotal tissue. Excellent exposure is provided for implantation of the cylinders, pump and reservoir. Wound closure is performed longitudinally.

RESULTSThis technique is a modified extension of surgeries described in the pediatric literature for webbed penis. Loss of penile length following penile implantation surgery is worrisome for patients suffering from erectile dysfunction (ED). This technique helps with patient satisfaction, cosmetic results, and improves perception of penile length.

CONCLUSIONVentral phalloplasty is a safe, technically simple procedure that may be performed in concert with penile prosthesis implantation or as a stand alone procedure under certain circumstances.

Erectile Dysfunction ; surgery ; Humans ; Male ; Penile Implantation ; adverse effects ; methods ; Penis ; pathology ; surgery

This study explored the usefulness of two-dimensional shear wave elastography (2D-SWE) in the early assessment of corpora cavernosa fibrosis (CCF). New Zealand male rabbits were randomly assigned to an experimental group or a control group. Recombinant human transforming growth factor beta 1 (TGF-β1) was injected into the dorsal penis tissue of rabbits in the experimental group. Conventional ultrasound and 2D-SWE examinations were performed before and 20 days after injection. Penile histological analysis was performed by hematoxylin-eosin staining, sirius red staining, and immunohistochemistry. Measurement of 2D-SWE examination results was performed using shear wave elastography quantitative measurement (SWQ). Histological analysis outcomes were the proportion of smooth muscle cells (SMCs), collagen fibers (CFs), collagen type I (Col I), and collagen type III (Col III), as well as the SMCs/CFs ratio, measured by sirius red staining. Other histological analysis outcomes were the positive area proportion (PAP) of TGF-β1 (PAP_T), fibronectin (PAP_F), and Col III (PAP_C), measured by immunohistochemistry. After recombinant human TGF-β1 injection, SWQ was higher in the experimental group than that in the control group (P < 0.001); however, there were no differences in conventional ultrasound results. There were significant differences in histological outcomes between the two groups (all P < 0.05). These results indicated that 2D-SWE was superior for identifying early histological changes in CCF.
Animals ; Elasticity Imaging Techniques/methods* ; Fibrosis ; Male ; Penis/pathology* ; Rabbits ; Transforming Growth Factor beta1/metabolism*