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Al-Beltagi M, Saeed NK, Bediwy AS, Shaikh MA, Elbeltagi R. Microphallus early management in infancy saves adulthood sensual life: A comprehensive review. World J Clin Pediatr 2024; 13:89224. [PMID: 38947989 PMCID: PMC11212752 DOI: 10.5409/wjcp.v13.i2.89224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/30/2024] [Accepted: 03/20/2024] [Indexed: 06/07/2024] Open
Abstract
Microphallus/Micropenis is a rare condition with significant physical and psychological implications for affected individuals. This article comprehensively reviews micropenis, its etiology, epidemiology, and various treatment options. We conducted a thorough literature review to collect relevant information on micropenis and microphallus, as well as related disorders. Our primary databases were PubMed, Medline, and Google Scholar. We searched for articles published in English between 2000 and 2023. Our analysis included 67 review articles, 56 research studies, 11 case reports, one guideline, and one editorial. Our search terms included "microphallus", "micropenis", "congenital hypogonadotropic hypogonadism", "androgen insensitivity syndrome", "pediatric management of micropenis", "testosterone therapy", and "psychosocial implications of micropenis". We focused on diagnosing micropenis and related conditions, including hormonal assessments, medical and surgical treatment options, psychosocial and psychological well-being, sexual development of adolescents, and sociocultural influences on men's perceptions of penile size. Additionally, we explored parenting and family dynamics in cases of micropenis and disorders of sex development, implications of hormonal treatment in neonates, and studies related to penile augmentation procedures and their effectiveness. The article highlights the importance of early diagnosis and intervention in addressing the physical and psychological well-being of individuals with micropenis. Surgical procedures, such as penile lengthening and girth enhancement, and non-surgical approaches like hormonal therapy are explored. The significance of psychological support, education, and lifestyle modifications is emphasized. Early management and comprehensive care are crucial for individuals with micropenis, from infancy to adolescence and beyond. A multidisciplinary approach involving urologists, endocrinologists, and mental health professionals is recommended. Regular assessment of treatment effectiveness and the need for updated guidelines are essential to provide the best possible care. Healthcare professionals should prioritize early diagnosis, and neonatologists should measure stretched penile length in neonates. A collaborative effort is needed among professionals, parents, and affected individuals to create a supportive environment that recognizes worth beyond physical differences. Continuous research and evidence-based updates are crucial for improving care standards.
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Affiliation(s)
- Mohammed Al-Beltagi
- Department of Pediatric, Faculty of Medicine, Tanta University, Tanta 31511, Egypt
- Department of Pediatric, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Bahrain
- Department of Pediatric, University Medical Center, Sulaiman Al Habib Medical Group, Manama 26671, Bahrain
| | - Nermin Kamal Saeed
- Department of Medical Microbiology Section and Pathology, Salmaniya Medical Complex, Ministry of Health, Kingdom of Bahrain, Manama 12, Bahrain
- Department of Medical Microbiology Section and Pathology, Irish Royal College of Surgeon, Busaiteen 15503, Bahrain
| | - Adel Salah Bediwy
- Department of Pulmonology, Faculty of Medicine, Tanta University, Tanta 31527, Egypt
- Department of Pulmonology, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Bahrain
- Department of Pulmonology, University Medical Center, Sulaiman Al Habib Medical Group, Manama 26671, Bahrain
| | - Majed A Shaikh
- Department of Pediatrics, Ibn Al Nafees Hospital, Manama 54533, Bahrain
| | - Reem Elbeltagi
- Department of Medicine, The Royal College of Surgeons in Ireland-Bahrain, Busiateen 15503, Bahrain
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Falcone M, Bettocchi C, Carvalho J, Ricou M, Boeri L, Capogrosso P, Cocci A, Corona G, Gül M, Hatzichristodoulou G, Jones TH, Kadioğlu A, Kalkanli A, Martinez-Salamanca JI, Milenkovic U, Morgado LA, Russo GI, Serefoğlu EC, Tharakan T, Verze P, Minhas S, Salonia A. European Association of Urology Guidelines on Penile Size Abnormalities and Dysmorphophobia: Summary of the 2023 Guidelines. Eur Urol Focus 2023:S2405-4569(23)00197-9. [PMID: 37709592 DOI: 10.1016/j.euf.2023.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/10/2023] [Accepted: 08/31/2023] [Indexed: 09/16/2023]
Abstract
CONTEXT Recommendations regarding the management of penile size abnormalities and dysmorphophobia are important in guiding evidence-based clinical practice. OBJECTIVE To present a summary of the 2023 European Association of Urology sexual and reproductive health evidence-based recommendations for the management of penile size abnormalities and dysmorphophobia. EVIDENCE ACQUISITION A broad and comprehensive scoping exercise covering all areas of the guidelines was performed. Databases searched included Medline, EMBASE, and the Cochrane Libraries. A level of evidence and a strength of recommendation were assigned for each recommendation according to the evidence identified. The evidence cutoff date for the 2023 guidelines is June 1, 2022. EVIDENCE SYNTHESIS Well-structured studies reporting high level of evidence, with standardized PROMS were deficient on penile size abnormalities and dysmorphohobia. A shared definition for short penis/micropenis was also lacking. Categorisation of penile abnormalities according to congenital, acquired, and dysmorphophobic aetiology is deemed compulsory. A detailed medical and psychosexual history and precise measurements of penile size are essential in the diagnostic pathway. Patients with normal penile size who are seeking penile augmentation should be referred for psychological evaluation for potential dysmorphophobic disorders. Penile length and girth enhancements can be achieved via a multitude of treatments, but a personalised management plan is crucial for satisfactory results. Endocrinological therapies, when indicated, are effective in the prepubertal setting only. Vacuum therapy has a limited evidence base in treatment protocols, although acceptable outcomes have been reported for penile traction therapy. Surgical techniques to enhance penile length and girth have limited evidence and should only be proposed after extensive patient counselling. CONCLUSIONS Management of penile abnormalities and dysmorphophobia is a complex issue with considerable ethical concerns. The adoption of a structured diagnostic and therapeutic pathway is crucial, as recommended in the guidelines. PATIENT SUMMARY Requests for medical/surgical treatments to increase penis size have increased dramatically worldwide. Several conservative and surgical treatments are available. However, few patients receive clear information on the benefits and possible harms of these treatments. These guidelines aim to provide a structured path to guide both physicians and patients in the selection of appropriate treatment(s) to increase penis size.
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Affiliation(s)
- Marco Falcone
- Department of Urology, Molinette Hospital, A.O.U. Città della Salute e della Scienza, University of Turin, Turin, Italy.
| | - Carlo Bettocchi
- Department of Andrology and Male Genitalia Reconstructive Surgery, University of Foggia, Foggia, Italy
| | - Joana Carvalho
- William James Center for Research, Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Miguel Ricou
- Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Luca Boeri
- Department of Urology, IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Capogrosso
- Department of Urology and Andrology, Ospedale di Circolo and Macchi Foundation, Varese, Italy
| | - Andrea Cocci
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, University of Florence, Florence, Italy
| | - Giovanni Corona
- Endocrinology Unit, Medical Department, Maggiore-Bellaria Hospital, Bologna, Italy
| | - Murat Gül
- Department of Urology, School of Medicine, Selcuk University, Konya, Turkey
| | | | - T Hugh Jones
- Centre for Diabetes and Endocrinology, Barnsley Hospital NHS Trust, Barnsley, UK
| | - Ates Kadioğlu
- Department of Urology, İstanbul University School of Medicine, İstanbul, Turkey
| | - Arif Kalkanli
- Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey
| | | | - Uros Milenkovic
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - L Afonso Morgado
- Urology Service, Centro Hospitalar Universitário São João, Porto, Portugal; Department of Biomedicine, Faculty of Medicine, Porto University, Porto, Portugal
| | - Giorgio I Russo
- Urology Section, Department of Surgery, University of Catania, Catania, Italy
| | - Ege Can Serefoğlu
- Department of Urology, Biruni University School of Medicine, Istanbul, Turkey
| | - Tharu Tharakan
- Department of Urology, Charing Cross Hospital, Imperial Healthcare NHS Trust, London, UK
| | - Paolo Verze
- Department of Medicine and Surgery, Scuola Medica Salernitana, University of Salerno, Fisciano, Italy
| | - Suks Minhas
- Department of Urology, Charing Cross Hospital, Imperial Healthcare NHS Trust, London, UK
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
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Lubner MG, Marko J, Hu R, Kawashima A, Potretzke TA, Frazier AA, Whiting R, Udager AM. Malignant Neoplasms of the Penis with Radiologic and Pathologic Correlation. Radiographics 2023; 43:e230025. [PMID: 37471245 DOI: 10.1148/rg.230025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
Penile malignancy is the third most common male-specific genitourinary malignancy, with squamous cell carcinoma representing the most common histologic type. Squamous cell carcinoma is an epithelial malignancy, frequently developing from the mucosal surfaces of the foreskin, glans, and coronal sulcus and manifesting as a distal infiltrative or ulcerated mass. This typically occurs in men from the 6th to 8th decades of life, and risk factors include human papillomavirus, phimosis, presence of foreskin and poor hygiene, chronic inflammatory conditions such as lichen sclerosus, trauma, and smoking. Primary urethral malignancies including urothelial carcinoma and adenocarcinoma can occur but may lack this distal predilection. Sarcoma, melanoma, leukemia or lymphoma, and metastatic disease are less common sources of penile malignancy. Because of the sensitive nature of penile malignancies, there may be delays in seeking care and in subsequent diagnosis. Recently, the staging guidelines for penile cancer have been updated concurrently with a shift toward more penile-preserving therapies, which have led to a larger role of imaging in diagnosis, staging, and treatment planning for penile malignancies. A variety of imaging modalities may play a role in the identification and staging of penile malignancy, including an increased use of MRI for local staging of tumors, CT and PET/CT for identification of nodal and distant disease, and US for image-guided biopsy. The authors discuss an imaging approach to a spectrum of penile malignancies, with an emphasis on radiologic and pathologic correlation and how knowledge of normal tissue types and anatomic structures can aid in the diagnosis and staging of these tumors. ©RSNA, 2023 Quiz questions for this article are available in the supplemental material.
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Affiliation(s)
- Meghan G Lubner
- From the Department of Radiology (M.G.L.) and Department of Pathology and Laboratory Medicine (R.H.), University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Sciences Center, 600 Highland Ave, Madison, WI 53792; American College of Radiology Institute for Radiologic Pathology, Silver Spring, Md (M.G.L., J.M., A.A.F.); Department of Radiology, Mayo Clinic Arizona, Scottsdale, Ariz (A.K.); Department of Radiology, Mayo Clinic, Rochester, Minn (T.A.P.); Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Md (A.A.F.); Department of Radiology, Moncrief Army Health Clinic, Fort Jackson, Columbia, SC (R.W.); and Department of Pathology, University of Michigan Medical School, Ann Arbor, Mich (A.M.U.)
| | - Jamie Marko
- From the Department of Radiology (M.G.L.) and Department of Pathology and Laboratory Medicine (R.H.), University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Sciences Center, 600 Highland Ave, Madison, WI 53792; American College of Radiology Institute for Radiologic Pathology, Silver Spring, Md (M.G.L., J.M., A.A.F.); Department of Radiology, Mayo Clinic Arizona, Scottsdale, Ariz (A.K.); Department of Radiology, Mayo Clinic, Rochester, Minn (T.A.P.); Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Md (A.A.F.); Department of Radiology, Moncrief Army Health Clinic, Fort Jackson, Columbia, SC (R.W.); and Department of Pathology, University of Michigan Medical School, Ann Arbor, Mich (A.M.U.)
| | - Rong Hu
- From the Department of Radiology (M.G.L.) and Department of Pathology and Laboratory Medicine (R.H.), University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Sciences Center, 600 Highland Ave, Madison, WI 53792; American College of Radiology Institute for Radiologic Pathology, Silver Spring, Md (M.G.L., J.M., A.A.F.); Department of Radiology, Mayo Clinic Arizona, Scottsdale, Ariz (A.K.); Department of Radiology, Mayo Clinic, Rochester, Minn (T.A.P.); Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Md (A.A.F.); Department of Radiology, Moncrief Army Health Clinic, Fort Jackson, Columbia, SC (R.W.); and Department of Pathology, University of Michigan Medical School, Ann Arbor, Mich (A.M.U.)
| | - Akira Kawashima
- From the Department of Radiology (M.G.L.) and Department of Pathology and Laboratory Medicine (R.H.), University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Sciences Center, 600 Highland Ave, Madison, WI 53792; American College of Radiology Institute for Radiologic Pathology, Silver Spring, Md (M.G.L., J.M., A.A.F.); Department of Radiology, Mayo Clinic Arizona, Scottsdale, Ariz (A.K.); Department of Radiology, Mayo Clinic, Rochester, Minn (T.A.P.); Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Md (A.A.F.); Department of Radiology, Moncrief Army Health Clinic, Fort Jackson, Columbia, SC (R.W.); and Department of Pathology, University of Michigan Medical School, Ann Arbor, Mich (A.M.U.)
| | - Theodora A Potretzke
- From the Department of Radiology (M.G.L.) and Department of Pathology and Laboratory Medicine (R.H.), University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Sciences Center, 600 Highland Ave, Madison, WI 53792; American College of Radiology Institute for Radiologic Pathology, Silver Spring, Md (M.G.L., J.M., A.A.F.); Department of Radiology, Mayo Clinic Arizona, Scottsdale, Ariz (A.K.); Department of Radiology, Mayo Clinic, Rochester, Minn (T.A.P.); Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Md (A.A.F.); Department of Radiology, Moncrief Army Health Clinic, Fort Jackson, Columbia, SC (R.W.); and Department of Pathology, University of Michigan Medical School, Ann Arbor, Mich (A.M.U.)
| | - Aletta Ann Frazier
- From the Department of Radiology (M.G.L.) and Department of Pathology and Laboratory Medicine (R.H.), University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Sciences Center, 600 Highland Ave, Madison, WI 53792; American College of Radiology Institute for Radiologic Pathology, Silver Spring, Md (M.G.L., J.M., A.A.F.); Department of Radiology, Mayo Clinic Arizona, Scottsdale, Ariz (A.K.); Department of Radiology, Mayo Clinic, Rochester, Minn (T.A.P.); Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Md (A.A.F.); Department of Radiology, Moncrief Army Health Clinic, Fort Jackson, Columbia, SC (R.W.); and Department of Pathology, University of Michigan Medical School, Ann Arbor, Mich (A.M.U.)
| | - Ryan Whiting
- From the Department of Radiology (M.G.L.) and Department of Pathology and Laboratory Medicine (R.H.), University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Sciences Center, 600 Highland Ave, Madison, WI 53792; American College of Radiology Institute for Radiologic Pathology, Silver Spring, Md (M.G.L., J.M., A.A.F.); Department of Radiology, Mayo Clinic Arizona, Scottsdale, Ariz (A.K.); Department of Radiology, Mayo Clinic, Rochester, Minn (T.A.P.); Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Md (A.A.F.); Department of Radiology, Moncrief Army Health Clinic, Fort Jackson, Columbia, SC (R.W.); and Department of Pathology, University of Michigan Medical School, Ann Arbor, Mich (A.M.U.)
| | - Aaron M Udager
- From the Department of Radiology (M.G.L.) and Department of Pathology and Laboratory Medicine (R.H.), University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Sciences Center, 600 Highland Ave, Madison, WI 53792; American College of Radiology Institute for Radiologic Pathology, Silver Spring, Md (M.G.L., J.M., A.A.F.); Department of Radiology, Mayo Clinic Arizona, Scottsdale, Ariz (A.K.); Department of Radiology, Mayo Clinic, Rochester, Minn (T.A.P.); Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Md (A.A.F.); Department of Radiology, Moncrief Army Health Clinic, Fort Jackson, Columbia, SC (R.W.); and Department of Pathology, University of Michigan Medical School, Ann Arbor, Mich (A.M.U.)
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Di Serafino M, Pucci L, Iacobellis F, Fasbender Jacobitti M, Ronza R, Sabatino V, De Luca L, Iossa V, Langella NA, Persico F, Grimaldi D, Schillirò ML, Lessoni L, Notorio M, Carrino M, Romano L. MRI-Cavernosography: A New Diagnostic Tool for Erectile Dysfunction Due to Venous Leakage: A Diagnostic Chance. Diagnostics (Basel) 2023; 13:2178. [PMID: 37443571 DOI: 10.3390/diagnostics13132178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/15/2023] [Accepted: 06/16/2023] [Indexed: 07/15/2023] Open
Abstract
Erectile dysfunction caused by venous leakage is a vascular disease in which blood fails to accumulate in the corpora cavernosa due to the abrupt drainage of blood from the penis secondary to an abnormal venous network that affects 1 to 2% of men under 25 years old and about 10 to 20% over 60 years old, who do not raise a sufficient erection for penetrative sex. The study of the venous leak and its characterization in young patients with erectile dysfunction represent a diagnostic challenge, and imaging remains the best way to diagnose this condition. In the article, it is described the methods of execution and the diagnostic role of the cavernous MRI in the study of vasogenic erectile dysfunction from the venous leak, proposing it as a good alternative to the cavernous CT, considering the satisfactory results in terms of diagnostic interpretation, the absence of ionizing radiation, the higher soft tissue resolution of the imaging method and the lower administration of contrast agent.
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Affiliation(s)
- Marco Di Serafino
- Department of General and Emergency Radiology, "Antonio Cardarelli" Hospital, 80131 Naples, Italy
| | - Luigi Pucci
- Department of Andrology, "Antonio Cardarelli" Hospital, 80131 Naples, Italy
| | - Francesca Iacobellis
- Department of General and Emergency Radiology, "Antonio Cardarelli" Hospital, 80131 Naples, Italy
| | | | - Roberto Ronza
- Department of General and Emergency Radiology, "Antonio Cardarelli" Hospital, 80131 Naples, Italy
| | - Vittorio Sabatino
- Department of General and Emergency Radiology, "Antonio Cardarelli" Hospital, 80131 Naples, Italy
| | - Luigi De Luca
- Department of Andrology, "Antonio Cardarelli" Hospital, 80131 Naples, Italy
| | - Vincenzo Iossa
- Department of Andrology, "Antonio Cardarelli" Hospital, 80131 Naples, Italy
| | | | - Francesco Persico
- Department of Andrology, "Antonio Cardarelli" Hospital, 80131 Naples, Italy
| | - Dario Grimaldi
- Department of General and Emergency Radiology, "Antonio Cardarelli" Hospital, 80131 Naples, Italy
| | - Maria Laura Schillirò
- Department of General and Emergency Radiology, "Antonio Cardarelli" Hospital, 80131 Naples, Italy
| | - Luca Lessoni
- Department of General and Emergency Radiology, "Antonio Cardarelli" Hospital, 80131 Naples, Italy
| | - Maurizio Notorio
- Department of General and Emergency Radiology, "Antonio Cardarelli" Hospital, 80131 Naples, Italy
| | - Maurizio Carrino
- Department of Andrology, "Antonio Cardarelli" Hospital, 80131 Naples, Italy
| | - Luigia Romano
- Department of General and Emergency Radiology, "Antonio Cardarelli" Hospital, 80131 Naples, Italy
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Diffusion-Weighted MRI in the Genitourinary System. J Clin Med 2022; 11:jcm11071921. [PMID: 35407528 PMCID: PMC9000195 DOI: 10.3390/jcm11071921] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 03/25/2022] [Accepted: 03/28/2022] [Indexed: 12/12/2022] Open
Abstract
Diffusion weighted imaging (DWI) constitutes a major functional parameter performed in Magnetic Resonance Imaging (MRI). The DW sequence is performed by acquiring a set of native images described by their b-values, each b-value representing the strength of the diffusion MR gradients specific to that sequence. By fitting the data with models describing the motion of water in tissue, an apparent diffusion coefficient (ADC) map is built and allows the assessment of water mobility inside the tissue. The high cellularity of tumors restricts the water diffusion and decreases the value of ADC within tumors, which makes them appear hypointense on ADC maps. The role of this sequence now largely exceeds its first clinical apparitions in neuroimaging, whereby the method helped diagnose the early phases of cerebral ischemic stroke. The applications extend to whole-body imaging for both neoplastic and non-neoplastic diseases. This review emphasizes the integration of DWI in the genitourinary system imaging by outlining the sequence's usage in female pelvis, prostate, bladder, penis, testis and kidney MRI. In gynecologic imaging, DWI is an essential sequence for the characterization of cervix tumors and endometrial carcinomas, as well as to differentiate between leiomyosarcoma and benign leiomyoma of the uterus. In ovarian epithelial neoplasms, DWI provides key information for the characterization of solid components in heterogeneous complex ovarian masses. In prostate imaging, DWI became an essential part of multi-parametric Magnetic Resonance Imaging (mpMRI) to detect prostate cancer. The Prostate Imaging-Reporting and Data System (PI-RADS) scoring the probability of significant prostate tumors has significantly contributed to this success. Its contribution has established mpMRI as a mandatory examination for the planning of prostate biopsies and radical prostatectomy. Following a similar approach, DWI was included in multiparametric protocols for the bladder and the testis. In renal imaging, DWI is not able to robustly differentiate between malignant and benign renal tumors but may be helpful to characterize tumor subtypes, including clear-cell and non-clear-cell renal carcinomas or low-fat angiomyolipomas. One of the most promising developments of renal DWI is the estimation of renal fibrosis in chronic kidney disease (CKD) patients. In conclusion, DWI constitutes a major advancement in genitourinary imaging with a central role in decision algorithms in the female pelvis and prostate cancer, now allowing promising applications in renal imaging or in the bladder and testicular mpMRI.
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Boissier R, Long JA, Chiron P, Savoie PH. [Non-infectious emergencies of the lower urinary tract and genitals]. Prog Urol 2021; 31:1022-1038. [PMID: 34814986 DOI: 10.1016/j.purol.2021.08.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/02/2021] [Accepted: 08/07/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The objective of this narrative review was to report the most relevant data on the contemporary management of the main non-infectious emergencies of the lower urinary tract and genital organs. METHODS A narrative synthesis of the articles (French, English) available on the Pubmed database was carried out in June 2021. A request to the health surveillance network for emergencies and deaths (SurSaUD®, Santé Publique France) revealed original data on the epidemiology of non-infectious lower urinary tract and genital organs emergencies. RESULTS Non-infectious emergencies of the low urinary tract and genital organs represent a large panel of traumatic and non-traumatic situations, which constitute the 3rd reasons in urology for a consultation at the emergency department after, infectious disease (1st) and non-traumatic/non-infectious emergencies of the upper urinary tract (2nd). Hematuria is the 3rd urological reason for men for a consultation at the emergency department. Globally, pelvic trauma and genital traumatism mainly concern men. These emergencies rarely affect the prognosis but can be integrated into more complete situations which are likely to impact their treatment, particularly in multiple traumas. CONCLUSIONS In this article we report the epidemiology and the principles of management of non-infectious emergencies of the lower urinary tract and genital organs.
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Affiliation(s)
- R Boissier
- Aix-Marseille Université, Service de Chirurgie urologique et de Transplantation rénale, CHU La Conception, APHM, Marseille, France.
| | - J A Long
- Service d'urologie et de la transplantation rénale, CHU Grenoble, France; TIMC-IMAG CNRS 5525, France
| | - P Chiron
- Service d'urologie, Hôpital D'instruction des Armées BEGIN, Saint Mandé, France
| | - P-H Savoie
- Service d'urologie, Hôpital d'Instruction des Armées Sainte Anne, BP 600, 83800 Toulon cedex 09, France
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The Management of Penile Fracture: a Review of the Literature with Special Consideration for Patients Undergoing Collagenase Clostridium Histolyticum Injection Therapy. Curr Urol Rep 2021; 22:13. [PMID: 33471204 DOI: 10.1007/s11934-020-01025-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2020] [Indexed: 01/20/2023]
Abstract
PURPOSE OF REVIEW To review the current literature on acute management of traumatic penile fracture, with a specific discussion of those injuries following collagenase clostridium histolyticum (CCH) injections for the treatment of Peyronie's disease. RECENT FINDINGS The immediate repair of traumatic penile fracture injury is associated with significantly better prognosis for long-term sexual health. Corporal disruption following CCH administration has several distinct features, and the trend is to manage these patients conservatively in the absence of urethral injury. Traumatic penile fracture repair continues to have excellent results when performed immediately following injury. The post-CCH treatment setting portends increased difficulty during surgical management and can be successfully managed in most cases by conservative measures.
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