Various techniques have been described for reconstructing the skin of the penile shaft; however, no universally accepted standard exists for correcting buried penis in adults. We aimed to describe a new technique for correcting an adult-acquired buried penis through a diamond-shaped incision at the penopubic junction. We retrospectively analyzed data from patients treated with our technique between March 2019 and June 2023 in the Department of Andrology, Nanjing Drum Tower Hospital (Nanjing, China). Forty-two adult males with buried penises, with a mean (±standard deviation [s.d.]) age of 26.6 (±6.6) years, underwent surgery. All patients were obese, with an average (±s.d.) body mass index of 35.56 (±3.23) kg m -2 . In addition to phalloplasty, 32 patients concurrently underwent circumcision, and 28 underwent suprapubic liposuction. The mean (±s.d.) duration of the operation was 98.02 (±13.28) min. The mean (±s.d.) duration of follow-up was 6.71 (±3.43) months. The length in the flaccid unstretched state postoperatively was significantly greater than that preoperatively (mean ± s.d: 5.55±1.19 cm vs 1.94±0.59 cm, P < 0.01). Only minor complications, such as wound disruption (7.1%) and infection (4.8%), were observed. The mean (±s.d.) score of patient satisfaction was 4.02 (±0.84) on a scale of 5. This technique provides excellent cosmetic and functional outcomes with a minimal risk of complications. However, additional clinical studies are needed to evaluate the long-term effects of this procedure.
Humans ; Male ; Patient Satisfaction ; Adult ; Lipectomy/methods* ; Penis/surgery* ; Retrospective Studies ; Treatment Outcome ; Plastic Surgery Procedures/methods* ; Young Adult ; Penile Diseases/surgery* ; Urologic Surgical Procedures, Male/methods*

Genital dissatisfaction is well known in female and adults. Less is known about male adolescents and their genital satisfaction. The aim of this study was to investigate and report the role of surgery in male adolescents to improve the evaluation of their genitalia. We considered all patients treated for external genital pathology in the period of adolescence. Inclusion and exclusion criteria were created. Patients underwent an evaluation test before and after surgery. During the study period, 137 patients were treated, and at the end of the study, 98 cases were considered for analysis. The most frequent pathologies were webbed penis and penile curvature. A postoperative score improvement was noted and patients with concealed penis and webbed penis showed a better postoperative outcome. Overweight was considered an important factor associated with a worse preoperative score. Evaluation of the external genitalia is important in adolescents, and it is an understudied problem. Overweight may be associated with a worse evaluation of one's genital and should be clinically considered to avoid related social problems in adulthood. Therefore, cosmetic genital surgery should be considered even in male adolescents.
Adolescent ; Adult ; Female ; Genital Diseases, Male/surgery* ; Genitalia ; Humans ; Male ; Overweight ; Penile Diseases ; Penis/surgery*

Penile prosthesis implantation is the gold standard of surgical therapy for patients with medication-refractory erectile dysfunction. However, this umbrella definition includes significant heterogeneity and associated risk profiles that should be candidly discussed and addressed perioperatively. Factors associated with operative success and patient satisfaction are often surgery specific; however, risk profiling via patient selection, preoperative optimization, proper device selection, and intraoperative consideration are highly correlated. Some examples of common risk profiles include comorbidity(ies) such as cardiovascular disease, diabetes mellitus, prior abdominal surgery, Peyronie's disease, and psychological risk factors. Similarly, integration of surgeon- and patient-amenable characteristics is key to decreasing risk of infection, complication, and need for revision. Finally, patient risk profiling provides a unique context for proper device selection and evidence-based intraoperative considerations.
Cardiovascular Diseases/epidemiology* ; Comorbidity ; Diabetes Mellitus/epidemiology* ; Erectile Dysfunction/surgery* ; Humans ; Male ; Mental Disorders/epidemiology* ; Patient Satisfaction ; Patient Selection ; Penile Implantation/methods* ; Penile Induration/epidemiology* ; Penile Prosthesis ; Postoperative Complications/prevention & control* ; Prosthesis-Related Infections/prevention & control* ; Reoperation ; Risk Assessment ; Surgical Wound Infection/prevention & control*

Since their popularization, genitourinary prosthetics have remained a gold-standard therapy for the treatment of erectile dysfunction and stress urinary incontinence and in cases of testicular loss or dysfunction. They have also represented an area of significant innovation, which has contributed to excellent long-term outcomes. Given this history, the objective of the current review was to provide a 5-10-year outlook on anticipated trends and developments in the field of genitourinary prosthetics. To accomplish this objective, a PubMed and patent search was performed of topics relating to penile and testicular prostheses and urinary sphincters. In regard to penile prostheses, findings demonstrated several new concepts including temperature-sensitive alloys, automated pumps, devices designed specifically for neophalluses, and improved malleable designs. With artificial urinary sphincters, new concepts include the ability to add or remove fluid from an existing system, two-piece systems, and new mechanisms to occlude the urethra. For testicular prosthetics, future implementations may not only better replicate the feel of a biological testicle but also add endocrinological functions. Beyond device innovation, the future of prosthetics is also one of expanding geographic boundaries, which necessitates variable cost modeling and regulatory considerations. Surgical trends are also changing, with a greater emphasis on nonnarcotic, postoperative pain control, outpatient surgeries, and adjunctive techniques to lengthen the penis and address concomitant stress incontinence, among others. Concomitant with device and surgical changes, future considerations also include a greater need for education and training, particularly given the rapid expansion of sexual medicine into developing nations.
Erectile Dysfunction/surgery* ; Humans ; Male ; Penile Implantation ; Penile Prosthesis/trends* ; Prostheses and Implants/trends* ; Prosthesis Design/trends* ; Prosthesis Implantation/trends* ; Testicular Diseases/surgery* ; Urinary Incontinence, Stress/surgery* ; Urinary Sphincter, Artificial/trends* ; Urologic Surgical Procedures, Male/trends*

With the onset of a metabolic syndrome epidemic and the increasing life expectancy, erectile dysfunction (ED) has become a more common condition. As incidence and prevalence increase, the medical field is focused on providing more appropriate therapies. It is common knowledge that ED is a chronic condition that is also associated with a myriad of other disorders. Conditions such as aging, diabetes mellitus, hypertension, obesity, prostatic hypertrophy, and prostate cancer, among others, have a direct implication on the onset and progression of ED. Characterization and recognition of risk factors may help clinicians recognize and properly treat patients suffering from ED. One of the most reliable treatments for ED is penile prosthetic surgery. Since the introduction of the penile prosthesis (PP) in the early seventies, this surgical procedure has improved the lives of thousands of men, with reliable and satisfactory results. The aim of this review article is to characterize the epidemiology of men undergoing penile prosthetic surgery, with a discussion about the most common conditions involved in the development of ED, and that ultimately drive patients into electing to undergo PP placement.
Diabetes Complications/surgery* ; Diabetes Mellitus/epidemiology* ; Erectile Dysfunction/surgery* ; Humans ; Hypertension ; Impotence, Vasculogenic/surgery* ; Male ; Pelvic Bones/injuries* ; Penile Implantation/statistics & numerical data* ; Penile Induration/surgery* ; Penile Prosthesis ; Penis/injuries* ; Prostatectomy/adverse effects* ; Prostatic Neoplasms/surgery* ; Radiation Injuries/surgery* ; Radiotherapy/adverse effects* ; Reoperation ; Spinal Cord Injuries/epidemiology* ; Vascular Diseases/epidemiology* ; Wounds and Injuries/epidemiology*

Objective: To evaluate the clinical effect of embedding sutures of single inner- and outer-prepuce flap in the treatment of concealed penis. METHODS: This retrospective analysis included 37 cases of concealed penis treated by embedding sutures of single inner- and outer-prepuce flap between July 2011 and May 2015. Catheters were pulled out from the patients within 24 hours and the dressing removed about 1 week after surgery. All the patients were followed up for 12－24 months postoperatively for evaluation of the long-term outcomes of surgery. RESULTS: One-stage wound healing was achieved in all the patients. No foreskin flap necrosis, inflammation, edema, voiding dysfunction, or painful erection was found during the follow-up. The penises were extended by 2－4 cm. No complications were observed axcept 8 cases of mild prepuce edema, which all subsided with 6 months postoperatively. CONCLUSIONS Embedding sutures of single inner- and outer-prepuce flap, with the advantages of simple operation, rapid recovery and few complications, is a desirable surgical option for the treatment of concealed penis.
Foreskin ; Humans ; Male ; Penile Diseases ; surgery ; Penis ; abnormalities ; surgery ; Postoperative Complications ; pathology ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Surgical Flaps ; pathology ; transplantation ; Suture Techniques ; Sutures ; Urologic Surgical Procedures, Male ; methods ; Wound Healing

OBJECTIVETo observe the clinical effects of two different circumcision procedures with the Shang Ring and compare their advantages and disadvantages.

METHODSA total of 527 adult males with phimosis or redundant prepuce underwent Shang Ring circumcision by conventional outward replacement (n = 254) and inward placement (n = 273), respectively. We observed the in-ring nocturnal pain, complications, ring-removal pain, degree of edema, recovery time, and patients' satisfaction after surgery, and compared them between the two groups.

RESULTSCompared with the conventional outward placement (5.9%) of the Shang Ring, the inward placement method showed the advantages of mild in-ring nocturnal pain, a low complication rate, significantly reduced ring-removal pain, and mild edema, but exhibited longer healing time.

CONCLUSIONIn Shang Ring circumcision for phimosis and redundant prepuce in adult males, each of the outward and inward placement methods has advantages and disadvantages of its own, but the latter is more advantageous and feasible.

Adult ; Circumcision, Male ; adverse effects ; instrumentation ; Edema ; etiology ; Foreskin ; abnormalities ; surgery ; Humans ; Male ; Pain, Postoperative ; Patient Satisfaction ; Penile Diseases ; etiology ; Penis ; abnormalities ; surgery ; Phimosis ; surgery ; Prostheses and Implants ; Wound Healing

OBJECTIVETo observe the clinical effects of the no-flip procedure with the Chinese Shang Ring when circumcising adult males with redundant prepuce or phimosis, and to discuss its advantages and disadvantages.

METHODSUsing the no-flip Shang Ring technique, we performed circumcision for 167 adult males aged 18 -72 (mean 27.8) years with redundant prepuce or phimosis, and analyzed the clinical data, including the operation time, postoperative complications, ring-removal time, and postoperative appearance of the penis.

RESULTSComplete follow-up data of 94 cases (56.29%) were obtained. The mean operation time was (5.03 +/- 0.71) minutes and the average ring-removal time was (18.83 +/- 6.70) days. The primary postoperative complications were edema (35 cases [37.23%] at 2 weeks and 9 cases [9.57%] at 4 weeks), including 2 severe cases (2.13%), and infection (3 cases [3.19%]). The pain scores were 2.01 +/- 2.46 during the procedure and 4.52 +/- 2.53 at 24 hours postoperatively. Slipping of the outer ring occurred in 1 case, and delayed removal of the ring in 30 cases (31.91%).

CONCLUSIONAdult male circumcision with the no-flip Shang Ring technique is recommended for its short operation time, simple procedure, fewer postoperative complications, less pain, and better incision appearance.

Adult ; Aged ; Circumcision, Male ; adverse effects ; instrumentation ; methods ; Edema ; etiology ; Humans ; Male ; Middle Aged ; Operative Time ; Pain, Postoperative ; etiology ; Penile Diseases ; etiology ; Penis ; abnormalities ; surgery ; Phimosis ; surgery ; Postoperative Complications ; Postoperative Period ; Prostheses and Implants ; Young Adult

We report a patient who developed pyoderma gangrenosum in the penis with invasion of the distal urethra. The patient was treated with prednisolone and thalidomide, followed by a reconstructive surgical repair using a scrotal island flap. We report this case with a brief review of the literature.
Anti-Inflammatory Agents/therapeutic use ; Female ; Humans ; Immunosuppressive Agents/therapeutic use ; Male ; Middle Aged ; *Penile Diseases/drug therapy/pathology/surgery ; Penis/*pathology ; Prednisolone/therapeutic use ; *Pyoderma Gangrenosum/drug therapy/pathology/surgery ; Thalidomide/therapeutic use ; Treatment Outcome

Penile augmentation by the injection of mineral oil provokes many serious, undesirable effects. Although there are reports of complications such as deformity, ulceration, necrosis, and erectile dysfunction, Fournier's gangrene resulting from the injection of petroleum jelly into the penis has not been reported. Here, we present a 42-year-old man with penile vaselinoma causing Fournier's gangrene which was treated successfully with aggressive surgical debridement, followed by penoscrotal reconstruction using groin and bilateral superomedial thigh flaps.
Adult ; Fournier Gangrene/chemically induced/pathology/*surgery ; Humans ; Injections, Subcutaneous ; Male ; Penile Diseases/pathology/*surgery ; Petrolatum/administration & dosage/*adverse effects ; Reconstructive Surgical Procedures ; *Surgical Flaps ; Thigh/surgery