This study aimed to investigate the curative effect of spiral embedded flap urethroplasty for the treatment of meatal stenosis after penile carcinoma surgery. From January 2015 to January 2021, we used our technique to treat strictures of the external urethral orifice in seven patients, including four cases of meatal stenosis after partial penile resection and three cases of meatal stenosis after perineal stoma. All patients had previously undergone repeat urethral dilatation. The patients underwent spiral embedded flap urethroplasty to enlarge the outer urethral opening. The patients' mean age at the time of surgery was 60 (range: 42-71) years, the mean operative time was 43 min, and the median follow-up period was 18 months. The patients voided well post-operatively, and urinary peak flow rates ranged from 18.3 ml s^-1 to 30.4 ml s^-1. All patients were successful with absence of urethral meatus stricture. The present study showed that using spiral embedded flap urethroplasty to treat meatal stenosis after penile carcinoma surgery is an effective surgical technique with good long-term outcomes.
Male ; Humans ; Urologic Surgical Procedures, Male/methods* ; Penile Neoplasms/surgery* ; Constriction, Pathologic/surgery* ; Treatment Outcome ; Urethral Stricture/surgery* ; Urethra/surgery* ; Amputation, Surgical ; Carcinoma/surgery* ; Retrospective Studies

Male ; Humans ; Penile Neoplasms/surgery* ; Constriction, Pathologic/surgery* ; Urethral Stricture/surgery* ; Surgical Flaps/surgery* ; Amputation, Surgical ; Penis/surgery* ; Plastic Surgery Procedures ; Hypospadias/surgery*

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*

Humans ; Male ; Middle Aged ; Penile Neoplasms/surgery* ; Penis/surgery* ; Tomography, X-Ray Computed ; Treatment Outcome

Objective: To investigate the effect of surgery on advanced penile cancer without distant metastasis and the factors influencing the prognosis. METHODS: Between September 2007 and July 2015, we treated 8 cases of advanced penile cancer without distant metastasis by penectomy and lymph node dissection. The patients were aged 37－67 (mean 51.1) years. We followed up the patients for 4－60 (mean 19.25) months postoperatively and analyzed the surgical effects and the factors affecting the prognosis. RESULTS: Three of the patients remained alive while the other 5 (62.5%) died at 4－13 (mean 9) months after surgery. No significant complications were observed and myocutaneous flap repair showed good prognosis in 4 of the patients with largearea skin defect. CONCLUSIONS Surgery is comparatively a valuable option for the treatment of advanced penile cancer without distant metastasis, though with a poor prognosis, and the important factor affecting its prognosis is lymph node metastasis. Flap repair can solve the problem of largearea skin defect after surgery. However, evidence is not yet sufficient to prove the effectiveness of multimodality therapy of this malignancy.
Adult ; Aged ; Combined Modality Therapy ; Follow-Up Studies ; Humans ; Lymph Node Excision ; Lymphatic Metastasis ; Male ; Middle Aged ; Penile Neoplasms ; mortality ; pathology ; surgery ; Penis ; surgery ; Prognosis ; Surgical Flaps

Prostate cancer has the highest incidence among malignant tumors of the urinary system in China. Radical prostatectomy (RP) is the most effective treatment for localized prostate cancer with a good long-term prognosis. Erectile dysfunction (ED) is a common complication after RP, which seriously affects the patient's quality of life. With the rising incidence and early diagnosis of prostate cancer, the proportion of young cases of RP is increasing, and so is the importance of the treatment of post-RP ED. The restoration of erectile function after RP is closely related to the timing of penile rehabilitation as well as to pre- and intra-operative measures such as surgical strategies and methods. Common options for the treatment of post-RP ED include oral medication of phosphodiesterase type 5 inhibitors, application of vasoactive substances in the urethra or corpus cavernosum, use of vacuum erection devices, and implantation of penile prosthesis. Stem cell therapy, nerve transplantation, low-intensity extracorporeal shockwave therapy, and erythropoietin have shown great potential in penile rehabilitation after RP. At present, the stress is placed on the remission of symptoms in the treatment of ED. Stem cell therapy may reverse the cause of disease or cure ED by reversing its pathophysiological changes. A series of clinical trials of stem cell therapy are underway and have preliminarily confirmed the safety of stem cell therapy and proved that it can improve erectile function in patients with post-RP ED. This review focuses on the progress in the prevention and treatment of ED after RP.
China ; Erectile Dysfunction ; prevention & control ; therapy ; Humans ; Male ; Penile Erection ; Penile Prosthesis ; Phosphodiesterase 5 Inhibitors ; therapeutic use ; Postoperative Complications ; prevention & control ; therapy ; Prostatectomy ; adverse effects ; Prostatic Neoplasms ; surgery ; Quality of Life ; Stem Cell Transplantation ; Treatment Outcome ; Vacuum ; Vasodilator Agents ; therapeutic use

OBJECTIVETo explore the optimal methods for the reconstruction and preservation of the glans after partial penis resection in the treatment of early-stage penile cancer.

METHODSBetween January 2012 and June 2015, we treated 6 cases of early- stage penile cancer by partial penis resection, inner thigh skin graft, and glans reconstruction and followed them up for 0.5-3 years.

RESULTSThe length of the penis before and after operation was ([6.5 ± 1.2] vs [4.5 ± 1.8] cm) in the flaccid state and ([12.8 ± 2.3] vs [9.1 ± 2.1] cm) in the erectile state. The sense of the reconstructed glans was completely recovered at 3 months after surgery. The glans skin was pale red and soft, nearly normal at 12 months, with no obvious graft contracture or scar formation. All the patients achieved normal erection and their partners were satisfied with their intercourse. No recurrence or metastasis was observed.

CONCLUSIONThe strategy of partial penis resection, inner thigh skin graft and glans reconstruction, simple, effective, and with few complications, is one of the best treatments of early-stage penile cancer, which not only ensures radical removal of the tumor but also maximally reserves the function of the organ.

Humans ; Male ; Penile Neoplasms ; surgery ; Penis ; surgery ; Reconstructive Surgical Procedures ; Skin Transplantation ; Thigh

OBJECTIVETo investigate the factors influencing the prognosis of penis-sparing surgery (PSS) for early-stage penile cancer.

METHODSWe retrospectively studied the clinical data about 45 cases of early-stage penile cancer treated by PSS from January 2007 to December 2014. We calculated the rate of local recurrence-free survival by the Kaplan-Meier method, and conducted univariate and multivariate COX regression analyses on the relevant factors including the patient's age, marital status, tumor location, tumor size, postoperative sexual life, histological grade, and TNM stage.

RESULTSOne-year and three-year local recurrence-free survival rates were 95.5% and 52.2%, respectively. Multivariate analysis demonstrated that the histological grade (P = 0.039) and postoperative sexual life (P = 0.049) were independent factors for the prognosis of PSS. Logistic regression showed the patients age to be significantly associated with histological grade (P = 0.014).

CONCLUSIONHistological grade and postoperative sexual life are important independent prognostic factors of PSS for early-stage penile cancer, and the patients age is associated with the prognosis of PSS through its influence on the tumor grade.

Age Factors ; Disease-Free Survival ; Humans ; Kaplan-Meier Estimate ; Logistic Models ; Male ; Multivariate Analysis ; Neoplasm Grading ; Organ Sparing Treatments ; Penile Neoplasms ; surgery ; Penis ; surgery ; Prognosis ; Proportional Hazards Models ; Quality of Life ; Retrospective Studies

Prostate cancer, bladder cancer, and rectal cancer are common malignancies in the male pelvis. The incidence rate of erectile dysfunction (ED) following radical prostatectomy, cystectomy or rectal cancer surgery is about 25% - 100%. The main cause of post-surgery ED is mainly attributed to injury of neurovascular bundles, which may lead to reduced oxygenation in and fibrosis of the penile tissue. Early penile rehabilitation after surgery can improve or restore the erectile function of the patients. This article focuses on penile rehabilitation after radical pelvic surgery.
Cystectomy ; Erectile Dysfunction ; etiology ; rehabilitation ; Humans ; Male ; Pelvic Neoplasms ; surgery ; Penile Erection ; Penis ; Postoperative Complications ; rehabilitation ; Postoperative Period ; Prostatectomy ; adverse effects ; Prostatic Neoplasms ; surgery ; Rectal Neoplasms ; surgery ; Urinary Bladder Neoplasms ; surgery

INTRODUCTIONPenile cancer is an uncommon disease affecting only about one in 100,000 men worldwide in a year. The diagnosis of the condition is frequently delayed, and the disease and its treatment frequently result in significant morbidity in patients.

METHODSWe herein describe seven cases of penile tumours: six cases of squamous cell carcinomas and one case of B-cell lymphoma that presented to our hospital's urology department between March 2011 and October 2012. We reviewed the literature to discuss the clinical presentation, natural history and current management of penile cancer.

RESULTSThe patients were followed up for 1-24 months. They were managed according to their disease stage and lymph node status. Four out of seven patients showed disease progression during the follow-up period.

CONCLUSIONThe accurate staging of inguinal nodes in cases of low-risk disease is important to prescribe appropriate surgery for the inguinal nodes. Aggressive management of inguinal and pelvic lymph nodes remains the cornerstone in the treatment of high-risk disease cases.

Aged ; Carcinoma, Squamous Cell ; diagnosis ; secondary ; surgery ; Humans ; Lymph Node Excision ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Penile Neoplasms ; diagnosis ; pathology ; surgery ; Urologic Surgical Procedures, Male ; methods