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Embryology, Anatomy, and Physiology of the Male Reproductive System
Published in Karl H. Pang, Nadir I. Osman, James W.F. Catto, Christopher R. Chapple, Basic Urological Sciences, 2021
Colle’s fascia − superficial layer at the root of the penis.Attached posteriorly to the perineal membrane and to the inferior ischiopubic rami.
Bladder exstrophy and epispadias
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
The umbilicus is ligated and trimmed but retained. A glans stay suture will aid retraction. Incisions are made beginning in the midline above the umbilicus, extending around the margins of the bladder, onto the root of the penis and on either side of the urethral plate as far as the distal limit of the verumontanum (Figure 79.5). The incisions are deepened with diathermy but the distal incisions may be left superficial at this stage.
Soft Tissue Management
Published in Jeff Garner, Dominic Slade, Manual of Complex Abdominal Wall Reconstruction, 2020
The standard abdominoplasty is the technique of choice in the context of ventral hernia repair. It has the benefit of providing good access to the hernia while at the same time allowing the surgeon to remove the excess skin and place the scar in a position that will be concealed by underwear or swimwear. The incision should be marked pre-operatively at the level of the pubic bone ensuring there is at least 5 cm of vertical height between the incision and the vulval commissure or root of the penis to prevent the vulva being pulled up and distorted post-operatively. The incision is extended laterally just medial to the groin crease and then joined up to a mark just below the anterior superior iliac spine. Once the inferior incision is made, a second circular incision is made around the umbilicus, if present, at the point where the abdominal wall skin becomes indented by the umbilicus. The umbilical stalk should then be dissected free of the abdominal skin down to the level of the rectus fascia leaving a small cuff of fat to ensure its blood supply. The abdominal skin is raised in a suprafascial plane ensuring that the umbilicus remains attached to the abdominal wall up to the costal margin and xiphoid.
Application of bulbocavernosus reflex combined with anal sphincter electromyography in the diagnosis of MSA and PD
Published in International Journal of Neuroscience, 2022
Xiaoting Niu, Yifan Cheng, WangWang Hu, Zijian Fan, Wanli Zhang, Bei Shao, Binbin Deng
The BCR examinee took a stone cutting position. A saddle-shaped surface electrode was placed at the root of the penis (male) or clitoris (female). A concentric needle recording electrode was inserted into the left and right bulbocavernous muscles successively (Figure 1). The stimulation intensity was 7 times the sensory threshold, and the electrode impedance was maintained less than 5 k Ω. Twenty reflected waves were recorded with a scanning time of 5 ms/div, a bandwidth of 100 ms, and a bandwidth of 10 Hz. Twenty reflected waves were recorded, and the average latency was calculated. The BCR index reflected the conduction function of the pudendal afferent nerve, the efferent nerve and the sacral 2-4 reflex arc. An abnormal recording was judged as (1) prolonged BCR latency or (2) if no BCR was elicited.
Restoration of the penile sensory pathway through end-to-side dorsal root neurorrhaphy in rats
Published in The Journal of Spinal Cord Medicine, 2022
Hao Zhang, Shuaishuai Chai, Qiufeng Pan, Bing Li
After the morphological examination, the rest of the rats in the three groups were re-anesthetized to assess the erection elicited by DNP stimulation. After making a 1-cm midline incision in the penile root region, the penis was freed from the skin, and the right branch of the DNP was carefully isolated. After that, a 24-gauge needle mounted on a PE 50 catheter, which was filled with heparin saline (250 U/mL), was inserted into the lateral surface of the corpus cavernosum and connected with a pressure transducer. The isolated DNP was stimulated with a bipolar hook electrode using continuous square-wave pulses (1 mA, 40 Hz; pulse width, 0.1 ms; duration, 60∼80 s).19 Paraffin oil was applied to protect the nerve from dryness and insulate the electrode from surrounding tissues. The intracavernous pressure (ICP) signal converted by the transducer was processed and recorded by BL-420F biological signal converter system (Chengdu TME Technology Co., Ltd., China). Nerve stimulation was repeated in each rat three times. The maximal increase of ICP (ΔICP) and the average latency from the start of the stimulus to the beginning of the ICP rise were used for statistical analysis.19,20
The Effectiveness of Jet (Needle-Free) Injector to Provide Anesthesia in Child Circumcision under Local Anesthesia
Published in Journal of Investigative Surgery, 2022
Pain score during local anesthetic injection and circumcision, and also anesthesia start time were determined separately for both groups by a nurse. Pain score measurements were repeated in the postoperative observation room at 10, 45 and 90 minutes after the circumcision was over. Pain score was determined using FLACC (Face, Legs, Activity, Cry, Consolability) pain scale (Table 1) [8]. Five minutes after the induction of anesthesia, the onset time of local numbness was determined by holding the foreskin with a clamp at one minute intervals. Circumcision was carried out if the FLACC score was below 4. In the second measurement performed just before the circumcision. If the FLACC score is 4 and above, additional analgesic dose was applied. The FLACC score was measured once. However, when the circumcision procedure exceeded 10 minutes, a second measurement was made and the average of the two scores was taken. Additional anesthetic drugs were applied in jet injector group at equal intervals with 4 more shots administered around the penis. In conventional needle group, 1 mg/kg lidocaine was applied circumferentially to the root of the penis. Circumcisions were performed using the thermocouple device (Thermo-Med TM 802B device, Thermo Medikal, Adana, Turkey) with the guillotine method [9]. In case of need, 13 mg/kg dose of paracetamol was used as a postoperative analgesic, and 5 mg/kg ibuprofen was given for analgesic need after discharge.