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Prolonged ischemic priapism presents a treatment challenge given the difficulty in achieving detumescence and effects on sexual function. To evaluate current practice patterns, an open, web-based multi-institutional survey querying surgeons' experience with and perceived efficacy of tunneling maneuvers (corporoglanular tunneling and penoscrotal decompression), as well as impressions of erectile recovery, was administered to members of societies specializing in male genital surgery. Following distribution, 141 responses were received. Tunneling procedures were the favored first-line surgical intervention in the prolonged setting (99/139, 71.2% tunneling vs. 14/139, 10.1% implant, p

Objective: To define the appropriate penile straightening procedures corresponding to the specific penile curvature by comparing the penile length resulting from various straightening procedures in hypospadias repair. Methods: We retrospectively analyzed hypospadias patients between 2017 and 2019. Patients were divided into three groups based on the penile curvature after degloving: <30°, 30°–45°, and >45°. The penile straightening procedures include dorsal plication (DP), simple urethral plate (UP) transection, and UP transection with ventral lengthening (VL). The paired t‐test was conducted for the penile length after fully straightening in each group, simultaneously calculating the length changes (∆T). In addition, the penile length changes among these procedures were compared using Spearman analysis to show the correlation between the penile curvature and the length. Results: The penile length changed significantly after fully straightening in all groups. The length decreased mildly after DP, while increased in the other procedures. The penile curvature after degloving was positively correlated with the absolute change in the penile length (P < 0.001, r = 0.424) and the ratio of ∆T in the original length (P < 0.001, r = 0.433). Conclusion: For hypospadias, the 30° after degloving may serve as the cut‐off for the selection of the straightening method from the perspective of the penile length. For those with < 30°, methods such as DP or UP transection can either be selected. In patients with > 30°, DP should be used with caution because of the potential risk to shorten the penis. In contrast, UP transection effectively corrects the penile curvature and increases the penile length concurrently, which should be primarily recommended in those patients. [ABSTRACT FROM AUTHOR]

The glans clitoris has a corona; however, unlike the corona of the glans penis, the corona of the glans clitoris is practically "nonexistent" as evidenced by the noteworthy absence of its mention and depiction in anatomical and clinical sciences. Accordingly, the corona of the glans clitoris has been neglected in anatomical education and clinical practice. This report details the history regarding the anatomical terminology of the glans and identifies that descriptions of the glans penis, corona of the glans penis, and other penile structures have preceded descriptions of the homologous anatomy of the clitoris by at least a century. Today, recognition of the corona of the glans clitoris, as well as the coronal sulcus and neck of the clitoris should be commonplace. Henceforth, the corona of the glans clitoris and its related anatomy including the sulcus of the glans clitoris and neck of the clitoris should be incorporated into anatomical and clinical language, illustrations, textbooks, education, and practice. Likewise, efforts should be made to propagate knowledge regarding the corona of the glans clitoris, coronal sulcus, and neck of the clitoris to the general public. Giving names to the anatomical structures of the clitoris will undoubtedly increase the awareness of their existence which, in turn, will encourage their clinical assessment and result in decreased morbidity and mortality. Likewise, improved self-awareness of clitoral anatomy will promote self-care which is important in the prevention of disease and the promotion of optimal sexual health. [ABSTRACT FROM AUTHOR]

‘I would not have given it for a wilderness of monkeys’: so, says The Merchant of Venice’s Shylock, referencing the ring gifted to him by his late wife, Leah, now stolen by his errant daughter, Jessica. An odd pronouncement for a character often read as an exemplar of exchange values for whom everyone and everything has its price. Excepting, of course, Leah’s ‘turquoise’. The implied use value of which repositions Shakespeare’s most uncomfortable stereotype – Shylock as the Jewish usurer – as a critic, rather than comprador, of early modern Capital, thereby anticipating not only Marx but Freud. For at stake in The Merchant of Venice is nothing less than the surplus-jouissance of the Capitalist’s discourse itself, coincident with, but ultimately defined against the ‘jewish-ssance’ of Shylock. This article will draw upon the insights of psychoanalysis, as well as those of political economy to examine the status of value, love, and law in The Merchant of Venice, arguing that Shylock may be not only Capitalism’s fiercest critic, but its most misunderstood psychotherapist. [ABSTRACT FROM AUTHOR]

Erectile dysfunction (ED) refers to the inability of the penis to maintain a firm erection during sexual activity. Mucuna, or M. pruriens, contains levodopa, a compound showing promise in ED treatment. However, formulating Mucuna extract into tablet dosage forms is challenging due to its semisolid nature. This study aimed to develop sustained-release tablets containing Mucuna extract via semisolid extrusion 3D printing. Eudragit RS PO (Eudragit) served as a sustained-release polymer, with poly (vinyl alcohol) (PVA) as a co-polymer for forming the tablet matrices. This study had the following two main phases: screening, which identified the factors affecting the printability, and optimization, which focused on the factors influencing the levodopa release and its consistency. The results showed that both the polymeric solid percentage content (PSPC) in the semisolid slurry and the Eudragit-PVA ratio significantly affected the printability. All of the formulations were printable, and the PSPC and Eudragit-PVA ratios were incorporated into the optimized model. The desired formulation, achieving targeted levodopa release and consistency, had a PSPC of 58.8% and a Eudragit-PVA ratio of 2.87:1. In conclusion, semisolid extrusion 3D printing guided by the design of experiments (DoE) proved feasible for producing reliable 3D-printed tablets with consistent active ingredients and desired release rates. [ABSTRACT FROM AUTHOR]

Drymaeus nigroflavus is a newly described species found in the region of Itapebi, Bahia, Brazil, near the Jequitinhonha River. This species is characterized by its whitish shell adorned with dark, spiral bands that are uniform and spaced apart. Its genital system exhibits a very short penis and bursa copulatrix, as well as a spermoviduct with a wide, coiled uterus and a very narrow prostate, among other anatomical idiosyncrasies. [ABSTRACT FROM AUTHOR]

Reproductive problems in cattle are frequent and have an important impact on production. In addition, inflammatory, traumatic and other diseases may be followed by the development of tumours, which are a cause of culling of breeding males. The main types of tumours diagnosed in the bull penis are fibropapilloma and squamous cell carcinoma. The aim of this study was to characterize a case of a tumour in the glans penis of a bull from a dairy farm in Santa Fe, Argentina. The neoplastic tissue was stained with haematoxylin and eosin and then analysed by immunohistochemistry to reveal its characteristic phenotype. Results showed positivity to vimentin, neuron specific enolase, proliferating cell nuclear antigen, S100 and glial fibrillary acidic protein. This suggested that the tumour was a neoplasm of neural origin, classified as neurofibrosarcoma, a peripheral nerve sheath tumour, here reported in the penis of a bull for the first time. [ABSTRACT FROM AUTHOR]

Penile lymphoma is a rare entity. Patients are often elderly, and present with an ulcerated painless mass on the shaft of the penis, strongly mimicking the more common diagnoses of infection, trauma or squamous cell carcinoma. Examination, radiological investigation and ultimately biopsy of the lesion is essential in making the diagnosis and guiding treatment. Herein, we present a case of diffuse large B cell lymphoma in the penis of an elderly gentleman, and review the salient histopathology regarding this uncommon entity. [ABSTRACT FROM AUTHOR]

Background Inguinal lymph node dissection plays an important role in the management of melanoma, penile and vulval cancer. Inguinal lymph node dissection is associated with various intraoperative and postoperative complications with significant heterogeneity in classification and reporting. This lack of standardization challenges efforts to study and report inguinal lymph node dissection outcomes. The aim of this study was to devise a system to standardize the classification and reporting of inguinal lymph node dissection perioperative complications by creating a worldwide collaborative, the complications and adverse events in lymphadenectomy of the inguinal area (CALI) group. Methods A modified 3-round Delphi consensus approach surveyed a worldwide group of experts in inguinal lymph node dissection for melanoma, penile and vulval cancer. The group of experts included general surgeons, urologists and oncologists (gynaecological and surgical). The survey assessed expert agreement on inguinal lymph node dissection perioperative complications. Panel interrater agreement and consistency were assessed as the overall percentage agreement and Cronbach's α. Results Forty-seven experienced consultants were enrolled: 26 (55.3%) urologists, 11 (23.4%) surgical oncologists, 6 (12.8%) general surgeons and 4 (8.5%) gynaecology oncologists. Based on their expertise, 31 (66%), 10 (21.3%) and 22 (46.8%) of the participants treat penile cancer, vulval cancer and melanoma using inguinal lymph node dissection respectively; 89.4% (42 of 47) agreed with the definitions and inclusion as part of the inguinal lymph node dissection intraoperative complication group, while 93.6% (44 of 47) agreed that postoperative complications should be subclassified into five macrocategories. Unanimous agreement (100%, 37 of 37) was achieved with the final standardized classification system for reporting inguinal lymph node dissection complications in melanoma, vulval cancer and penile cancer. Conclusion The complications and adverse events in lymphadenectomy of the inguinal area classification system has been developed as a tool to standardize the assessment and reporting of complications during inguinal lymph node dissection for the treatment of melanoma, vulval and penile cancer. [ABSTRACT FROM AUTHOR]

Background. Male circumcision (MC) is a practice involving the surgical excision of the foreskin to expose the glans and it is often performed for religious reasons. Ritual circumcision is frequently carried out by unqualified practitioners in inadequate settings, which can also lead to the death of the individual. Case Report. A 28-day-old infant was undergoing circumcision by a man that performed the circumcision using a razor blade. During the same day, the child experienced continuous bleeding from the wound and, finally, died after about 20 hours. At autopsy, a cutaneous sharp injury was revealed with ablation of the foreskin and part of the penile body. The lesion had irregular and jagged margins, with diffuse hemorrhagic infiltration. The glans and upper fascia of the penis appeared edematous and hyperemic and there were abundant hemorrhagic infiltrations in the frenulum area. The child's death was attributed to hemorrhagic shock in a child undergoing genital mutilation surgery. The finding of a significant hemorrhagic infiltration of the frenulum region indicated that the frenular artery had been severed. Conclusions. Around 35% of ritual male circumcisions are performed clandestinely in Italy, and typically by unqualified practitioners. In such events, the forensic investigation of the injuries inflicted on the victim allows for determining whether the procedure was performed appropriately or not, to verify the existence of a causal link between the procedure itself and the death of the individual. [ABSTRACT FROM AUTHOR]

A new monoterpene derivative namely dongsunol A (1) and sixteen known compounds (2–17) were isolated from the volva of Phallus dongsun. All compounds were isolated from this fungus for the first time. Their structures and absolute configurations were determined by nuclear magnetic resonance (NMR), HRESIMS spectral data, and electronic circular dichroism (ECD). The new monoterpene derivative (1) exhibited antibacterial activity with a MIC of 200 μg/mL. Other compounds have inhibitory effects on Staphylococcus aureus and Pseudomonas aeruginosa, while have displayed moderate NO inhibitory activity and antineoplastic activity on SMMC-7721 and SW480 in vitro. [ABSTRACT FROM AUTHOR]

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Background Methods Results Conclusions Level of evidence Extramammary Paget's disease (EMPD) is a rare intra‐epidermal adenocarcinoma, and reconstruction of the penoscrotal region remains a clinical challenge. The superficial circumflex iliac artery perforator (SCIP) flap has been successfully used as a free flap, while its application as a propeller flap in the reconstruction of penoscrotal EMPD defect is rarely reported. The objective was to evaluate the safety and efficacy of the SCIP propeller flap in the reconstruction of penoscrotal defects in EMPD.Between September 2010 and August 2022, consecutive patients diagnosed with penoscrotal EMPD were enrolled. All patients underwent penoscrotal EMPD excision and reconstruction with SCIP propeller flap combined with other flaps or skin grafts on individual defects. Demographic information, surgical parameters, postoperative complications, patient satisfaction, and recurrence rates were analyzed.Twenty‐four patients (mean age, 73 ± 8.8 years; mean BMI, 23.98 ± 3.62 kg/m2) with 33 SCIP propeller flaps (mean size 120.1 cm2; range, 24–208 cm2) were included, and the mean defect size was 67.4 cm2 (range, 12–255 cm2). The mean operative duration was 385.4 ± 146.8 min. Fifteen patients received autologous full‐thickness skin grafts, and four received other flaps simultaneously. All flaps survived without total or partial loss, and all donor sites achieved primary closure, though local hematoma (one case) and limited skin graft necrosis (two cases) were observed. All patients experienced complete wound healing and maintained penoscrotal morphology and function without recurrent lesions over a mean follow‐up of 59 months.The SCIP propeller flap seems a safe and effective reconstructive method for penoscrotal EMPD.IV. [ABSTRACT FROM AUTHOR]

Introduction: Division of the suspensory ligament of the penis has emerged as a popular surgical approach for penile lengthening, but accurate preoperative predictions of lengthening outcomes remain elusive. This study aimed to identify readily measurable anatomical parameters associated with post-ligamentolysis penile length gain, facilitating more reliable preoperative estimations. Methods: An experimental cross-sectional study was performed on 16 adult cadavers. Data collected before dissection included: age at death, ethnicity, height, length of the penis before dissection and width of the suspensory ligament of penis. Following the complete dissection of the suspensory ligament of penis, the depth of the pubic symphysis and the penile length after the procedure were measured. The absolute and relative length differences pre- and post-ligamentolysis were calculated. Correlation coefficients were used to study relations between these variables. Results: Penile length increased uniformly after complete division of the suspensory ligament (average gain: 26.38 mm, SD = 14.83 mm; range 4–60 mm). Pearson correlation revealed a significant negative correlation between pre-ligamentolysis penile length and post-ligamentolysis increase (r = − 0.601; p = 0.014), suggesting greater gains in individuals with shorter pre-ligamentolysis lengths. Age, ligament width, and pubic arch depth showed no significant correlations. Ethnicity did not impact post-ligamentolysis length increase (t = − 0.135; p = 0.894). Conclusions: This study highlights the potential to predict penile length gain post-ligamentolysis through measurable anatomical parameters. The ability to anticipate the outcome of this procedure could empower surgeons to provide informed counseling, potentially elevating patient satisfaction. An experimental cross-sectional study was performed to investigate the outcomes of penile lengthening surgery Penile lengthening was achieved in all subjects via complete dissection of the suspensory ligament of the penis Penile length increase may be predicted preoperatively using easily measurable anatomical parameters No Level Assigned: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 [ABSTRACT FROM AUTHOR]

The Temminck's pangolin (Smutsia temminckii) is one of eight pangolin species worldwide and the only pangolin present in southern Africa. Historically, pangolins have not been able to reproduce successfully in captivity and this may be in part due to the lack of knowledge and understanding with regards to the pangolin reproductive system (anatomy, physiology, biology) in all eight species. This original study describes the gross anatomy of the male Temminck's pangolin from three adult individuals investigated. The male Temminck's pangolin presented a short, conical penis with ascrotal (internal) testes, similar to many other myrmecophagous mammals such as the aardvark (Orycteropus sp.) and anteaters (suborder: Vermilingua). However, the orientation of the penis of the Temminck's pangolin differed in that it was oriented cranioventrally, in contrast to the caudal orientation of the giant anteater. The testes were found to be bilaterally flattened with an elongate oval shape, similar to the aardvark. The specific characteristics of the reproductive tract of the male Temminck's pangolins are thought to be adaptations to their peculiar lifestyle as the male portrays characteristics that indicate adaptation to a lower basal metabolic rate and body temperature as well as to their defensive mechanism of rolling up into a ball. Our study suggests the male Temminck's pangolin reproductive anatomy is most similar and comparable to the Xenarthrans and the aardvark that display the same fossorial activities as pangolins, and the male morphology is not comparable to the phylogenetically closely‐related Carnivora. [ABSTRACT FROM AUTHOR]

Simple Summary: A new genus of empidine dance fly, namely Rhamphempis, is described with five new species included. The new genus is recorded from French Guiana and the United States of America. The peculiar disjunct geographic distribution of Rhamphempis is discussed. The genus Rhamphempis gen. nov. (Diptera: Empididae: Empidinae: Empidini) is described and includes the following five new species from French Guiana and the USA: Rhamphempis concava sp. nov. (France: French Guiana, Roura); R. distincta sp. nov. (France: French Guiana, Roura); R. mirifica sp. nov. (France: French Guiana, Régina); R. montreuili sp. nov. (Type species, France: French Guiana, Mitaraka, Roura, St-Georges-de-l'Oyapock); and R. septentrionalis sp. nov. (USA: Maryland, College Park). The genus differs from other empidine genera by the following combination of characters: scape and postpedicel lengthened, proboscis long, strongly sclerotised with labella as long as prementum bearing annulations, wing with R2+3 somewhat shortened, more or less recurved at pterostigma, R4+5 unforked, base of abdomen yellowish in male, brownish to blackish in female, male pregenital segments strongly modified and postabdomen more or less downcurved, presence of large surstylus, very fine and long phallus. The genus is fully illustrated and keyed along with a discussion of its peculiar disjunct geographic distribution and its phylogenetic relationship within the tribe Empidini. [ABSTRACT FROM AUTHOR]

Background: Peyronie's disease (PD) is a localized fibrosis of tunica albuginea, which causes the anatomical and functional changes to the penis. Corporoplasty with grafting is indicated in severe (>60°) and complex curvature. Buccal mucosa is the most favored autologous graft material nowadays. The ventrolateral aspect of lingual mucosa has similar histological features to the rest of the oral cavity. Methods: This study aimed to test the efficacy, safety, durability, and reproducibility of corporoplasty with lingual mucosal graft (LMG) in the surgical treatment of PD in terms of surgical outcome, sexual function, and donor site complications. This prospective study included 19 patients of PD with severe and complex curvature, who underwent corporoplasty with LMG. Surgical and functional outcomes were assessed at follow-up planned at 2 weeks, 3 months, 6 months, 1 year, and 2 years. Results: The mean operative time was 126.31 ± 21.45 min. Additional Nesbit's plication to correct the residual deformity was required in 26% (5 / 19) of patients. Straightening of the penis (curvature <10°) was achieved in 89% (17 / 19) of patients. Increase in the penile length (>1 cm) postoperatively was achieved in 63% (12 / 19) of patients and a shortening of penis occurred in 5% (1 / 19) of patients. Newer onset erectile dysfunction developed in 11% (2 / 19) of patients, and patient and partner satisfaction rates were 89% (17 / 19) and 84% (16 / 19), respectively, in a mean follow-up of 20.66 ± 5.37 months. Donor site complications were minimal and no patient had any salivary changes or speech disturbances. Conclusion: LMG provided excellent short-term results in terms of deformity correction, improved sexual function, and minimal donor site morbidity. The method is simple and reproducible, and multicenter studies with larger number of cases with longer follow-up are required to confirm these favorable results. [ABSTRACT FROM AUTHOR]

Objective To assess the efficacy of thickened condoms in the treatment of premature ejaculation. Methods Total of 100 premature eeaculation patients treated at the Department of Urology, First Affiliated Hospital of Zhejiang University School of Medicine, from August to December 2021 were selected as the premature eeaculation group and 30 normal men as the normal group. Safety, comfort, penile dorsal nerve conduction velocity, eeaculation latency, penile sensitivity, erectile function, and serum reproductive hormone levels were evaluated after using both regula and thickened condoms in both groups. Results Compared to regular condoms, premature ejaculation patients using thickened condoms reported lower comfort (80/100 vs. 60/100; P<0.05), slower penile dorsal nerve conduction velocity (30.5 ± 2.7) m/s vs. (21.04 ± 1.9) m/s; P <0. 05, increased penile vibration threshold (29 ±2.5) vs. (47 ±2.0); P<0.05), longer eeaculation latency (>3 min) (16/100 vs. 78/100; P <0. 05), and prolonged total erectile time (>10 min) (76/100 vs. 88/100; P<0.05). Moreover, mean hardness of the coronary sulcus (≤50%) (78/100) vs. (89/100); P<0.05) and serum androgen levels (78 ±12) ng/dL vs. (89 ± 100) ng/dL; P < 0. 05 were significantly increased. For normal men using thickened condoms, penile vibration threshold significantly increased (50 ± 2.1) vs. (59 ± 1.8); P < 0.05, with no significant changes in ejaculation latency or penile erection time (P <0.05). Conclusion Thickened condoms effectively prolong ejaculation latency in premature ejaculation patients, enhance glans penis sensitivity, improve penile erection strength, and extend erection time, thereby enhancing sexual intercourse quality and offering a therapeutic effect on premature ejaculation. However, thickened condoms do not significantly alter ejaculation latency in normal men, suggesting caution against their use for this purpose. [ABSTRACT FROM AUTHOR]

The human penile and clitoral development begins from a morphologically indifferent genital tubercle. Under the influence of androgen, the genital tubercle forms the penis by forming a tubular urethra within the penile shaft. Without the effect of the androgen, the genital tubercle differentiates into the clitoris, and a lack of formation of the urethra within the clitoris is observed. Even though there are similarities during the development of the glans penis and glans clitoris, the complex canalization occurring along the penile shaft eventually leads to a morphological difference between the penis and clitoris. Based on the morphological differences, the main goal of this study was to define the vascular and neuronal anatomy of the developing penis and clitoris between 8 and 12 weeks of gestation using laser scanning confocal microscopy. Our results demonstrated there is a co‐expression of CD31, which is an endothelial cell marker, and PGP9.5, which is a neuronal marker in the penis where the fusion is actively occurring at the ventral shaft. We also identified a unique anatomical structure for the first time, the clitoral ridge, which is a fetal structure running along the clitoral shaft in the vestibular groove. Contrary to previous anatomical findings which indicate that the neurovascular distribution in the developing penis and clitoris is similar, in this study, laser scanning confocal microscopy enabled us to demonstrate finer differences in the neurovascular anatomy between the penis and clitoris. [ABSTRACT FROM AUTHOR]

Male harvestmen penial armature has a remarkable morphology; however, it is poorly known regarding its functions. We examined the male genitalia of virgin and mated males of the gonyleptid Pachyloides thorellii under Scanning Electron Microscope looking for evidence that the penis could remove sperm from the female ovipositor lumen during mating. Micrographs show sperm agglutinations over and within the microsetae fields in six out of the 12 mated males studied. For the mating experiments we used only virgin females, therefore the sperm found in the penis was in all cases their own sperm. This self-sperm removal could be the extraction of sperm excess in cooperation (or not) with the females. This is the first study to show for the Order Opiliones direct evidence that a male penis contains structures that can effectively remove sperm from the female ovipositor. Further behavioral and morphological studies are needed to confirm the conditions of occurrence and participation of each sex in sperm removal processes in this species. [ABSTRACT FROM AUTHOR]

Genitourinary tuberculosis (GUTB), especially penile tuberculosis (PTB), is a disease often overlooked by urological specialists, especially in Europe, where the pathology is less frequent. In this report, we described a case of penile tuberculosis (PTB) characterized by ulcers on the penis. After the patient was administered three months of anti-tuberculosis treatment (isoniazid 0.3 g/qd, rifampicin 0.6 g/qw, and ethambutol 0.75 g/qd), the ulcer disappeared. The patient was followed up for seven months and showed no recurrence. [ABSTRACT FROM AUTHOR]

Inflatable Penile Prostheses (IPP) implantation is a surgical treatment for patients desiring definitive treatment for erectile dysfunction. While this procedure has proven to be effective, it also carries its own set of unique risks that need to be carefully considered. The article reviews the current understanding of complications associated with penile prosthetic surgery and provides strategies to mitigate these adverse events. This article covers various aspects of IPP implantation, including the risks of infection, bleeding, injury to nearby structures, glans ischemia, and device malfunction. It also discusses the importance of careful preoperative screening to identify risk factors and the implementation of infection reduction strategies such as antimicrobial prophylaxis, skin prep, and operative techniques. In addition, it emphasizes the need for postoperative vigilance and prompt management of any complications that may arise. Overall, the article provides a comprehensive overview of the risks and strategies for mitigating complications associated with IPP implantation. Our recommendations are given based on the current consensus in the field and highlight the importance of careful planning, attention to detail, and effective communication between healthcare providers and patients. Despite the potential risks, this review underscores the fact that complications following penile prosthesis implantation are relatively rare.

ABSTRACT Purpose: To answer the question of whether it is possible to achieve complete corporal covering of the urethral closure using incomplete penile disassembly in classic bladder exstrophy. We hypothesize that mobilization of the corpora under Buck's fascia, their dorsal translocation through the incisions in Buck's fascia and suturing corporal convex sides above the urethra would allow extend corporal covering of the urethra, reducing the risk of urethra-cutaneous fistula formation. Materials and Methods: A prospective follow-up on all boys who underwent the modified Cantwell-Ransley primary penile reconstruction was conducted. Inclusion criteria comprised bladder exstrophy closure in our institution, ensuring a postoperative follow-up period of no less than 24 months. The key innovation of the technique lies in a deep dissection of the dependent corpora under Buck's fascia, followed by their dorsal relocation through extended dorsal incisions in Buck's fascia, and limited external corporal rotation 90 degrees only at the base of the penis. Results: Between November 2019 and March 2022, 18 boys aged 11 to 35 months met the inclusion criteria and underwent the modified penile reconstruction. Surgical procedures and postoperative period did not include any major complications. Total corporal covering of the urethral sutures was achieved in 15 of 18 patients. No urethra-cutaneous fistulas were observed within 2 years of follow-up. All individuals demonstrated spontaneous erections, and the absence of dorsal curvature was documented. Conclusion: The modified technique of incomplete penile disassembly applied in a homogenous group of patients with classic bladder exstrophy allows penile shaft elongation, improved aesthetic outcomes, preserved erections, and eliminates dorsal curvature. The technique demonstrated feasibility and reliability while maintaining positive effects on tissue circulation. The absence of urethra-cutaneous fistulae is attributed to the complete corporal covering of the urethral sutures and supports the initial hypothesis.

Penile skin zipper entrapment is an emergent medical condition in which the penile skin, scrotal skin, or foreskin gets caught within the teeth of a zipper or the slider itself. This can lead to complications such as urethral involvement, skin loss, or tissue necrosis. We propose a novel technique to aid in the release of entrapped skin utilizing wire cutters directed at the inferior portion of the zipper pull. To describe a novel technique to free entrapped penile skin and compare its performance to the well-established median bar technique in a simulated setting. A randomized cross-over design was used to compare techniques on successful release, time to release and tissue injury using an animal model of raw chicken skin entrapped in a zipper. Statistical significance was assessed at p < 0.05. Twenty-two participants were included. There was no statistically significant difference between the novel technique and the median bar technique regarding successful release (100% vs 95.5%, respectively), median time to release (29.1 vs 26.4 seconds, respectively), or frequency of tissue injury (22.7% vs 27.3%). Performance using our novel technique for removal of penile skin from a zipper is similar to the median bar release technique regarding. Our novel technique may be a valid treatment option for the release of entrapped penile skin in a zipper mechanism in the emergency department setting. [ABSTRACT FROM AUTHOR]

Throughout world history, moles and birthmarks have occupied a special place as omens. Little is known of the cultural beliefs concerning the determinants of coercive control. In this ethnographic study of coercive control in Cambodia, the focus is on popular beliefs that moles are omens portending that men shall control women. Lachrymal moles (under the eye) signify women weeping as a result of misery. Penile moles portend men attracting, controlling, even abusing women. They have implications for reinterpreting an "insider" view of hegemonic masculinity and for culturally responsive interventions against gender-based violence. [ABSTRACT FROM AUTHOR]

ABSTRACT Purpose: Penile fracture (PF) affects 1,14 to 10,48 men in every 100.000 men in East Asia, and the primary aetiology is sexual intercourse, but the knowledge regarding the most dangerous sexual position is not well explained. This study compares three sexual positions: man on top position (MTP), woman on top position (WTP), and doggy style position (DSP), leading to PF potential. Materials and methods: A search of sexual position-related PF in Google Scholar, PubMed, Cochrane, and PMC Europe was performed. Criteria inclusion was the full text of relevant articles which describ the number of sexual positions. It was analyzed by odds ratio, random model effect, and the OR and 95%CI were calculated. Results: Twelve relevant papers involving 490 patients comprised 169 MTP, 120 WTP, 158 DSP, and 43 no intercourse cases. Meta-analysis of all sexual positions was a MTP P= 0,04, WTP P=0,49, and DSP P=0,0005. Conclusions: The man-dominant positions (MTP and DSP) were significantly potential for PF, which speculated that when a man is dominant and very excited, intercourse may become highly vigorous and impact trauma. This study found that man's dominant position consists of DSP and the MTP significantly lead to PF.

Neoplasm of the penis is relatively rare in most regions representing 0-2% of cancers worldwide. While the penis can be affected by sarcomas, basal cell carcinomas or even melanoma, Penile Squamous Cell Carcinoma (PSCC) represents approximately 95% of all penile neoplasms. Despite its rarity and most common presentation at later decades of life most individuals diagnosed with PSCC are faced with significant decrease in quality of life. The prevalence and incidence vary among different regions and populations, but a common trend is for diagnosis to occur late (stage 4). Underdeveloped countries are traditionally reported to have higher incidence rates; however, rates may vary significantly between urban and rural areas even in developed countries. Age adjusted rates are on the rise in some countries that used to have incidence rates of 1:100 000 or less. The list of associated risk factors is long and includes among others, lack of neonatal circumcision, poor genital hygiene, socioeconomic status, history of human papillomavirus (HPV) infection and penile intraepithelial neoplasia (PeIN). Many risk factors are widely debated among experts however HPV and PeIN are indisputable risk factors, and both also form part of the classification system for PSCC. Both conditions may have occurred in the past or be present at the time of diagnosis and identifying them plays a major role in management strategies. For such a rare condition PSCC can present in many different forms clinically making diagnosis no easy feat. Diagnosis of PSCC is done through clinical examination, including lymph node palpation, followed by a biopsy, which is essential for the classification. Lymph node involvement is a common finding at first presentation and investigation of spread to deep nodes is important and can be done with the aid of PET-CT. Treatment options for PSCC include surgery, chemotherapy, and radiation therapy. Surgical removal of the tumor is considered the most effective however can lead to severe decrease of quality of life. Chemotherapy is used in the case of fixed or bulky lymph nodes, where surgery is not indicated, and for distant metastasis. Radiation therapy is particularly effective in the case of HPV-positive PSCC. [ABSTRACT FROM AUTHOR]

Background: Primary testicular lymphoma (PTL) is relatively rare. The contralateral testis is a common site of PTL relapse; therefore, once complete remission is achieved, radiation therapy (RT) is administered to the contralateral testis to prevent relapse. Case presentation: A 76-year-old man was diagnosed with PTL and received RT as described above. However, despite achieving and maintaining complete remission, a mass diagnosed as diffuse large B-cell lymphoma by tissue biopsy developed in the glans penis 6.5 years after prophylactic RT. We investigated whether the glans penile lymphoma was PTL relapse or a new malignancy by genomic analysis using next-generation sequencing of DNA extracted from two histopathological specimens. Conclusions: We found the same variant allele fraction in four somatic genes (MYD88, IL7R, BLNK, and FLT3) at similar frequencies, indicating that the glans penile lymphoma had the same origin as the PTL. To the best of our knowledge, this is the first case report of PTL relapse in the glans penis. [ABSTRACT FROM AUTHOR]

Miroculis (Ommaethus) Savage and Peters, 1983 (Ephemeroptera, Leptophlebiidae) is reviewed based on fresh material from Southeastern Brazil and on type specimens. Miroculis (Ommaethus) cipoensis sp. n. is described based on male and female imagos from Serra do Cipó, Minas Gerais State, Brazil. It can be distinguished from other species of the subgenus based on the following characteristics: forewings with membrane brown and dark brown mark around cross veins; hind wing uniformly brown; forceps segment I light brown, segment II and III lighter; penis lobe long (at least ⅔ of forceps segment I) and apically rounded and curved on apical ¼; length of body between 5.0 and 6.3 mm. Photographs of fresh material belonging to M. (O.) froehlichi Savage and Peters, 1983 and M. (O.) mourei Savage and Peters, 1983 are provided, clarifying the boundaries between the existing species of the subgenus. Based on that, M. (O.) misionensis Domínguez, 2007 is considered a junior synonym of M. (O.) mourei. A key to the male imagos of the subgenus is presented, as well as a distributional map with updated records of the species. [ABSTRACT FROM AUTHOR]

Background: The erectile dysfunction (ED), which is the inability to achieve and/or sustain a penile erection sufficient to result in a satisfying sexual performance, represents a very common complaint. for men over forty years old. The aim of the study was to evaluate if Flat Magnetic Stimulation (FMS) technology could help individuals with symptomatic erectile dysfunction. Methods: Twenty patients with erectile dysfunction, underwent eight sessions of about 30 minutes each in a twice a week frequency with the study device. During treatments, every potential side effect was assessed. The International Index of Erectile Function (IIEF) was compiled by all patients at the beginning, after the eighth treatment and at 1 month from the end of the last treatment. The questionnaire scores were presented as median values along with the interquartile range (IQR) and we set the significance threshold at 0.01. Results: After the treatment and at 1-month follow-up, the increase in questionnaire scores was statistically significant compared to the baseline, thus supporting the clinical usefulness of this treatment. In particular, the result of the study indicates a statistically significant difference between IIEF score before treatment (Median = 34) and IIEF score after the end of treatment (Median = 45) and between IIEF score before treatment and IIEF score at 1-month follow-up (Median = 54). Conclusions: The study findings showed that FMS represents a promising treatment option to individuals affected by symptomatic erectile dysfunction. [ABSTRACT FROM AUTHOR]

Introduction: Traditional anatomy-based penile venous surgery is deemed inadequate. Based on revolutionary insights into penile vasculature, penile venous stripping (PVS) shows promise in treating adolescent erectile dysfunction (AED). We aimed to report on this novel approach. Methods: We conducted a retrospective analysis of 223 individuals under 30 diagnosed with veno-occlusive dysfunction (VOD) between 2009 and 2023. Among them, 83 were diagnosed with AED and divided into the PVS (n = 37) and no-surgery (NS, n = 46) groups. All participants had been dissatisfied with conventional therapeutic options. Dual pharmaco-cavernosography was the primary diagnostic modality. PVS involved stripping the deep dorsal vein and two cavernosal veins after securing each emissary's vein with a 6-0 nylon suture. Erection restoration was accessed using the abridged five-item version of the International Index of Erectile Function (IIEF-5) score system and the erection hardness scale (EHS). Statistical analysis was performed using IBM SPSS 21.0. Results: There were significant differences (both p < 0.001) between the preoperative and postoperative IIEF-5 scores in the PVS and NS groups (9.8 ± 3.0 vs. 20.4 ± 2.2; 9.9 ± 2.5 vs. 9.5 ± 2.1), as well as in the EHS scores (1.7 ± 0.7 vs. 3.5 ± 0.6 and 1.8 ± 0.5 vs. 1.3 ± 0.4). The satisfaction rate was 87.9% (29/33) in the PVS group and 16.7% (17/41) in the NS group. Conclusions: AED can be effectively treated using physiological methods, although larger patient cohorts are needed for validation. [ABSTRACT FROM AUTHOR]

Fathering a child does not just confer a new identity on a Nigerian man, it encapsulates the essence of his existence. Although male infertility negatively impacts sterile men’s masculinity, it is rarely studied as such. This study focuses on the struggles of the nonvirile man in a culture where his existence is deeply rooted in virility. Using Corpus Linguistics and Critical Discourse Analysis. I examine how the pronoun “I” and its Ngram realizations are used to express the male character’s personal struggles with infertility in Ayobami Adebayo’s Stay with Me. I conclude that an erect phallus is crucial to a male’s positive self-appraisal and self-actualization in Nigeria. [ABSTRACT FROM AUTHOR]

This document is a compilation of editorial comments on various studies and articles related to urologic oncology, male infertility, and prostate cancer. The studies discussed cover a range of topics including bladder cancer treatment options, advancements in urothelial carcinoma therapy, factors influencing aggressive treatment for bladder cancer, lifestyle changes to improve male fertility, the impact of varicocele repair on sperm health, dietary interventions for obese men, the effects of COVID-19 on semen quality, and molecular features of bladder cancer stages. These studies offer valuable insights into the management and treatment of urologic conditions and male infertility. The document also includes editorial comments on topics such as the role of dioxin and polychlorinated biphenyls in prostate cancer, metabolic responses to androgen receptor inhibition, the correlation between weight-adjusted waist index and kidney stones, the use of single-use endoscopes in urological procedures, oxidative stress in renal stone formers, and the contribution of the transporter AGT1/rBAT in cystinuria progression. These comments provide additional perspectives and suggest further reading for those interested in these topics. [Extracted from the article]

Vasculogenic erectile dysfunction (ED) is the most common form of ED affecting the male population. Once the first line investigation for erectile dysfunction, penile Doppler ultrasound examinations have reduced in number following the introduction of oral phosphodiesterase inhibitors as a treatment method. As such, skilled professionals versed in the performance of these examinations are dwindling. This skill deficit is compounded by the lack of standardisation that exists in the performance and interpretation of penile haemodynamics relative to impotence of vascular origin. Despite the success of pharmacological agents in the treatment of vasculogenic dysfunction, penile Doppler examinations are still relevant in the assessment of ED in non‐responders, and those patients in which pelvic surgery or trauma has altered the normal erectile mechanism. Growing evidence in the literature also suggests that vasculogenic ED may be an early indicator of systemic vascular disease and therefore prognostic of future cardiovascular events. Considering this, the relevance of Doppler assessment of penile haemodynamics with ultrasound should not be underestimated. This article will introduce the sonographer to advanced vascular anatomy of the penis, pathophysiology of erectile function and the principles of normal and pathological penile haemodynamic patterns. It also aims to suggest a standardised protocol for the performance of penile Doppler ultrasound relative to primary vasculogenic ED and reduce the amount of variability that exits between operators. As such the sonographer can make a significant contribution to patient management pathways. [ABSTRACT FROM AUTHOR]

This study aimed to elucidate the influence of various culture medium components, including carbon sources, nitrogen sources, inorganic salts, suspension agents, and temperature, on the mycelial growth characteristics of Phallus dongsun. Employing single-factor experiments and response surface methodology within glass Petri dishes, the research identified that carrot powder, soybean powder, and ZnSO4 notably enhanced the proliferation of aerial mycelium, significantly augmenting the growth rate of P. dongsun mycelium. The resultant mycelium was observed to be dense, robust, and fluffy in texture. In particular, ZnSO4 markedly accelerated the mycelium growth rate. Furthermore, xanthan gum was found to effectively modulate the medium's viscosity, ensuring a stable suspension and facilitating nutrient equilibrium. The optimal cultivation temperature was determined to be 25°C, with mycelial growth ceasing below 5°C and mycelium perishing at temperatures exceeding 35°C. The optimal medium composition was established as follows: wheat starch 5 g/l, carrot powder 5 g/l, soybean powder 7.50 g/l, glucose 10 g/l, ZnSO4 0.71 g/l, NH4Cl 0.68 g/l, xanthan gum 0.5 g/l, and agar 20 g/l. Under these optimized conditions, the mycelium of P. dongsun exhibited a rapid growth rate (1.04 ± 0.14 mm/day), characterized by a thick, dense, and well-developed structure. This investigation provides a theoretical foundation for the conservation, strain selection, and breeding of P. dongsun. [ABSTRACT FROM AUTHOR]

Copyright of Zeitschrift für Sexualforschung is the property of Georg Thieme Verlag Stuttgart and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Phenotypic plasticity of the penis and cirri of acorn barnacles is well documented for intertidal species. We investigated whether these phenomena also occur in the epizoic sea-turtle barnacle, Chelonibia testudinaria (Linnaeus, 1758). We compared the morphologies of the penis and cirri, and fertilization rates for adult, hermaphroditic barnacles on different regions of the carapace of sea turtles, and at different levels of crowding on the carapace. Barnacles were more abundant in the posterior position of loggerhead sea turtles, Caretta caretta (Linnaeus, 1758), followed by the central, central costal, and anterior positions. Barnacles in clustered groups were fertilized 68% more often than solitary individuals. Penis size increased with barnacle size and among individual sea turtles. Cirrus length and width also varied with barnacle size, among individual sea turtles, and among positions. Larger barnacles had longer and wider feeding cirri, and cirri were longer and wider in the central and posterior positions of the carapace than in the anterior and central costal positions. The phenotypic plasticity of the morphologies of the penis and cirrus is far less dramatic in Ch. testudinaria than in intertidal species. This may be explained by the epizoic barnacles not being permanently fixed and able to move to preferred positions on the host shell. [ABSTRACT FROM AUTHOR]

Background The endothelial glycocalyx is an important barrier that protects the structure and function of endothelial cells. Androgen deficiency is a common factor that causes structural and functional impairment of endothelial cells. Aim To investigate changes in the endothelial glycocalyx in the penile corpus cavernosum of the rat with low androgen status and its relationship with erection function. Methods Eighteen 10-week-old Sprague-Dawley male rats were randomly divided into 3 groups (n = 6 each): sham operation, castration, and castration + testosterone replacement. The maximum intracavernosal pressure/mean arterial pressure of the penis was measured after modeling for 4 weeks. The expression levels of endothelial nitric oxide synthase (eNOS), phospho-eNOS, syndecan 1, heparanase, and nitric oxide in penile cavernous tissue and the serum levels of heparan sulfate, hyaluronic acid, tumor necrosis factor α, and interleukin 6 were determined. Transmission electron microscopy was used to observe the ultrastructure of the endothelial glycocalyx in penile tissue. Outcomes The thickness of the endothelial glycocalyx in the penile corpus cavernosum of castrated rats was significantly lower than that of the control group. Results In the castrated rats, the endothelial glycocalyx thickness, syndecan 1 level, ratio of phospho-eNOS to eNOS, nitric oxide level, and maximum intracavernosal pressure/mean arterial pressure (3 V, 5 V) were significantly lower than those in the sham group (P  < .05). The expression of heparanase and the serum levels of tumor necrosis factor α and interleukin 6 were significantly higher in the castrated group than in the sham group (P  < .05). Clinical Translation Upregulating the expression of the endothelial glycocalyx in the penile corpus cavernosum may be a new method for treating erectile dysfunction caused by low androgen levels. Strengths and Limitations This study confirms that low androgen status promotes the breakdown of the endothelial glycocalyx. However, further research is needed to determine whether androgens are related to the synthesis of the endothelial glycocalyx. Conclusion Low androgen status may suppress the level of nitric oxide in the cavernous tissue of the penis via impairment of the endothelial glycocalyx, resulting in inhibited erection function in rats. [ABSTRACT FROM AUTHOR]

Copyright of Basic & Clinical Andrology is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: Since there are various benign and malignant diseases of the penis, different imaging methods can be used for diagnosis. Abdominal computed tomography (CT) is not a frequently used imaging method in diagnosing penile pathologies. In an abdominal CT scan performed with the standard technique, the slices are obtained by scanning from the diaphragm's dome to the symphysis pubis's lower edge. Although the whole penis is not always captured, almost all abdomen scans include a portion of the penis. Penile pathologies can be detected with careful evaluation by CT. Methods: In this study, we aim to investigate incidental penile pathologies detected in abdominal CT performed for other reasons and whether abdominal CT contributes to showing penile pathologies. Therefore, abdominal CTs of 3,698 male patients were re-evaluated for penile pathologies. Results: The mean age was 52.2 years. Of the CT scans, 38% were obtained due to trauma, 16% were taken for oncological causes, 16% for abdominal pain and acute abdominal pathologies, 10% for urological reasons, 20% for other causes. Penile pathology was detected in 33 (0.83%) of 3968 patients. The patients were divided into four groups according to the pathologies observed in the penis: Traumatic, inflammatory, tumoral, and other findings. Conclusion: Although CT is not routinely used to diagnose penile pathologies, it may be necessary if the whole penis is included in the examination. [ABSTRACT FROM AUTHOR]

Pigmented epithelioid melanocytoma is rare cutaneous melanocytic proliferation, characterized by heavily pigmented melanocytes, with a potential for regional node metastasis, but with an overall favorable clinical course. Here, we describe an uncommon case of pigmented epithelioid melanocytoma involving the penis in an adolescent patient. [ABSTRACT FROM AUTHOR]

Background: Although premature ejaculation (PE) is the most common male sexual dysfunction, the underlying mechanisms are not fully understood. Aim: The study sought to evaluate the possible associations among glans penis volume and tissue stiffness measured using penile ultrasonography and penile shear wave elastography (SWE) with PE. Methods: Men 18 to 65 years of age with normal International Index of Erectile Function scores (>25) and who were diagnosed with PE between June 2021 and June 2022 were enrolled. The Premature Ejaculation Diagnostic Tool score and intravaginal ejaculation latency times were recorded. Healthy volunteers constituted the control group. The study group was divided into lifelong PE (LLPE) and acquired PE (AqPE) subgroups. In all groups, the glans penis volume was measured via penile ultrasonography and tissue stiffness of the glans penis, penile frenulum, postcircumcision mucosal cuff, and penile shaft were measured via SWE. The findings of the groups were compared using appropriate statistical methods. Outcomes: The outcomes included ultrasonographic and elastographic measurements of the glans penis. Results: Data on 140 men, including 70 PE patients and 70 healthy volunteers, were evaluated. Of the patients, 20 had LLPE and 50 had AqPE. The median glans penis volume was significantly greater in the LLPE group (14.1 [range, 6.6-19] mm3) compared with the AqPE group (11.7 [range, 5.1-27] mm3) and control group (11.4 [range, 6.1-32] mm3) (P =.03). According to the Youden index, the best cutoff value for glans penis volume in LLPE compared with non-LLPE (AqPE + control) was 12.65 mm3 (area under the curve, 0.684; 95% confidence interval, 0.556-0.812; P =.009). The risk of having LLPE in those with a glans penis volume ≥12.65 mm3 was 3.326 (95% confidence interval, 1.234-8.965) times higher than the non-LLPE group (P =.014). There were no significant differences between the groups in the SWE evaluation of glans penis, penile frenulum, mucosal cuff, and penile shaft tissue stiffness. Clinical Implications: The high incidence of PE in those with high glans penis volume may make glans penis volume a predictor for the development of LLPE. Strengths and Limitations: This was the first study to show that PE is more common in individuals with a high glans penis volume. It was also the first to perform a penile elastographic evaluation in patients with PE. The most important limitation was that we did not evaluate glans penile nerve function with a test, but rather we made an indirect inference about the density of free nerve endings based on increased glans penile volume. Conclusion: Glans penis volume was a significant predictor for LLPE. However, there are no associations between PE and the glans penis, postcircumcision mucosal cuff, penile frenulum, or penile shaft tissue stiffness and development. [ABSTRACT FROM AUTHOR]

Background: Cavernous nerve (CN) injury, caused by prostatectomy and diabetes, initiates a remodeling process (smooth muscle apoptosis and increased collagen) in the corpora cavernosa of the penis of patients and animal models that is an underlying cause of erectile dysfunction (ED), and the Sonic hedgehog (SHH) pathway plays an essential role in the response of the penis to denervation, as collagen increases with SHH inhibition and decreases with SHH treatment. Aim: We examined if part of the mechanism of how SHH prevents penile remodeling and increased collagen with CN injury involves bone morphogenetic protein 4 (BMP4) and gremlin1 (GREM1) and examined the relationship between SHH, BMP4, GREM1, and collagen in penis of ED patients and rat models of CN injury, SHH inhibition, and SHH, BMP4, and GREM1 treatment. Methods: Corpora cavernosa of Peyronie's disease (control), prostatectomy, and diabetic ED patients were obtained (N = 30). Adult Sprague Dawley rats (n = 90) underwent (1) CN crush (1-7 days) or sham surgery; (2) CN injury and BMP4, GREM1, or mouse serum albumin (control) treatment via Affi-Gel beads or peptide amphiphile (PA) for 14 days; (3) 5E1 SHH inhibitor, IgG, or phosphate-buffered saline (control) treatment for 2 to 4 days; or (4) CN crush with mouse serum albumin or SHH for 9 days. Outcomes: Immunohistochemical and Western analysis for BMP4 and GREM1, and collagen analysis by hydroxyproline and trichrome stain were performed. Results: BMP4 and GREM1 proteins were identified in corpora cavernosa smooth muscle of prostatectomy, diabetic, and Peyronie's patients, and in rat smooth muscle, sympathetic nerve fibers, perineurium, blood vessels, and urethra. Collagen decreased 25.4% in rats with CN injury and BMP4 treatment (P = .02) and increased 61.3% with CN injury and GREM1 treatment (P = .005). Trichrome stain showed increased collagen in rats treated with GREM1. Western analysis identified increased BMP4 and GREM1 in corpora cavernosa of prostatectomy and diabetic patients, and after CN injury (1-2 days) in our rat model. Localization of BMP4 and GREM1 changed with SHH inhibition. SHH treatment increased the monomer form of BMP4 and GREM1, altering their range of signaling. Clinical implications: A better understanding of penile remodeling and how fibrosis occurs with loss of innervation is essential for development of novel ED therapies. Strengths and limitations: The relationship between SHH, BMP4, GREM1, and collagen is complex in the penis. Conclusion: BMP4 and GREM1 are downstream targets of SHH that impact collagen and may be useful in collaboration with SHH to prevent penile remodeling and ED. [ABSTRACT FROM AUTHOR]

The Ancient Greeks were great innovators in all academic fields, including medicine. Hippocrates of Kos, the Father of Medicine, established many terms for the genitourinary (GU) system, such as nephros, urethra, urogenital, and adenocarcinoma. According to Hesiod's Theogony, Aphrodite, the goddess of love and beauty, was born off the coast of Kythera, from the foam produced by Uranus's genitals, after his son Cronus had thrown them into to the sea. In this review, we present the etymology of the GU vocabulary, review the Ancient Greeks' understanding of the GU system and the origins of Greek myths related to the male genitals. [ABSTRACT FROM AUTHOR]

This article delves into the psychoanalytic concept of the "good and bad breast" and extends it to the penis. It examines how early experiences of growth and fragmentation shape the positive and negative aspects of the penis. The article also explores the role of the phallic parent and the internal struggles faced by infants. The author suggests that a nurturing environment can help individuals integrate these experiences, leading to emotional and verbal self-discovery. Additionally, the text explores the different forms of aggression and their impact on emotional well-being, proposing that understanding and integrating both positive and negative aspects of aggression can foster a more constructive and creative life. A clinical example is provided to illustrate these ideas. [Extracted from the article]