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Rhabdomyosarcoma
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Gideon Sandler, Andrea Hayes-Jordan
Paratesticular RMS originates from the epididymis, spermatic cord, testis, and tunica albuginea, is usually spindle cell, and usually presents early as a painless scrotal mass. It is usually primarily resectable by inguinal orchiectomy (Figure 61.4) with high ligation and complete resection of the spermatic cord and has an excellent prognosis (Table 61.4: Procedure 4). If the tumor is biopsied via the scrotum or fixed to it, or if there is tumor spillage, hemiscrotectomy or hemiscrotal RT is recommended in order to avoid recurrence. The contralateral testis should be transposed out of the field and into the abdomen or a thigh pouch to preserve fertility.
Emergency Surgery
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
Alastair Brookes, Yiu-Che Chan, Rebecca Fish, Fung Joon Foo, Aisling Hogan, Thomas Konig, Aoife Lowery, Chelliah R Selvasekar, Choon Sheong Seow, Vishal G Shelat, Paul Sutton, Colin Walsh, John Wang, Ting Hway Wong
Why does a penile fracture occur?As the penis changes from flaccid to erect, the tunica albuginea thins from 2 to 0.5 mm, stiffens and loses elasticity predisposing it to injury and fracture. The tunica albuginea is thinnest ventrally, making it most prone to injury.
Andrology
Published in Manit Arya, Taimur T. Shah, Jas S. Kalsi, Herman S. Fernando, Iqbal S. Shergill, Asif Muneer, Hashim U. Ahmed, MCQs for the FRCS(Urol) and Postgraduate Urology Examinations, 2020
Peyronie’s disease is a connective tissue disorder involving the growth of fibrous plaques in tunica albuginea of the penis. It affects up to 10% of all men. It’s more common in Caucasian men over the age of 40. It is associated with diabetes mellitus and smoking. There is evidence to suggest that the inflammation associated with Peyronie’s is at least partly mediated through the action of TGFβ. Pentoxifylline a possible medical treatment option is a TGβ1 inhibitor.
The impact of COVID-19 on the male reproductive tract and fertility: A systematic review
Published in Arab Journal of Urology, 2021
Pallav Sengupta, Kristian Leisegang, Ashok Agarwal
Chen et al. [47] (2020), in a retrospective study of a cohort of 142 confirmed COVID-19-positive patients (age range 24–93 years), examined US reports made at the bedside. These cases were classified as mild or moderate (41.9%) and severe or critical (58.5%), with the latter group significantly older and more likely to have coronary heart disease or chronic obstructive pulmonary disease compared to the mild/moderate group. Acute orchitis was present in 10% of all patients, with 7% presenting with acute epididymitis, and 15% presenting with acute epididymo-orchitis. Additional manifestations observed in all patients was a thickened tunica albuginea (25.4%), increased testicular vascular flow (20,4%), increased epididymal vascular flow (16,9%), heterogeneous echogenicity of testis (9.9%), scrotal swelling (8.5%), enlargement of epididymis (7.7%), hydrocele (7,7%), enlargement of testis (7%), heterogeneous echogenicity of epididymis (5.6%), and abscesses in the epididymis (2.8%). Severe and critical cases had significantly increased percentage of patients with thickened tunica albuginea, heterogeneous echogenicity of the testis, increased testicular and epididymal vascular flow and absence in the epididymis compared to mild and moderate cases. Importantly, there was an increased risk of scrotal infection within this age group of the cohort.
Use of calcium channel blockers in dermatology: a narrative review
Published in Expert Review of Clinical Pharmacology, 2021
Yang Lo, Lian-Yu Lin, Tsen-Fang Tsai
Verapamil is one of the conservative treatment choice for plantar fibromatosis [35], possibly through the property of enhanced secretion of MMP1 in fibroblasts and collagenase secretion [36]. Several articles reported its efficacy for Peyronie’s disease [37,38], 57% plaque volume decreased after intralesional verapamil injection [38], and lesion size and penis curvature decreased 30% after intralesional verapamil for a total of 6 weeks (10 mg/cm2, every 2 weeks) [39]. However, some studies reported no significant improvement after intralesional verapamil or nicardipine [40,41]. Treatment success was reported after topical verapamil 15% gel was applied twice daily for 9 months, which decreased the size in Peyronie’s to 85% [37]. However, another study suggested that topical verapamil is not recommended for the treatment for Peyronie’s disease, due to its inability to infiltrate the tunica albuginea [42]. Whether topical verapamil is effective for treatment of Peyronie’s disease is still controversial.
Peyronie’s disease: new paradigm for the treatment of a unique cause of erectile dysfunction
Published in Postgraduate Medicine, 2020
Peyronie’s Disease (PD) is an often debilitating condition caused by fibrosis of the tunica albuginea (TA) of the penis resulting in difficulty with coitus in many patients. Over the past decade, the knowledge of the etiology, genetics, and treatment of PD has changed the approach to this condition that causes angst, depression, and disability in many men affected. Peyronie’s Disease was first reported by Fallopius and Vesalius in correspondence in 1561 [1]. Earlier reports exist, but the first series of patients was reported by Francois Gigot de la Peyronie in 1743. Peyronie, often referred to as the father of French surgery, was the first surgeon to be physician to the royal court of France. He reported a series of five men with what he termed induratio penis plastica that consisted of ‘rosary beads’ in the penile shaft caused by irritation of the penis and best treated by bathing in the baths of Berege in Southern France. Little was known of the optimal treatment paradigm over the centuries and most men were told that there was no solution to their problem.