SciCombinator

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Concept: Andrology

172

In recent years, penile traction therapy (PTT) has gained considerable interest as a novel nonsurgical treatment option for men with Peyronie’s disease (PD) and short penises. The current published literature suggests that selected cases of PD may benefit from a conservative approach with PTT, resulting in increased penile length and reduction of penile deformity. It appears to be safe and well tolerated but requires a great deal of patient compliance and determination. This article reviews the current literature pertaining to the use of PTT in men with PD, short penises and in the setting of pre- and postprosthesis corporal fibrosis.

Concepts: Andrology, Literature, Erectile dysfunction, Penis, Peyronie's disease, Art, Micropenis, Penis enlargement

144

While the nonpalpable testis represents only a small portion of all cryptorchid testes, it remains a clinical challenge for pediatric urologists. Many controversies about the best evaluation and management exist. This narrative review serves as an update on what is known about the nonpalpable testis: etiology, pre-operative evaluation, the best surgical management, novel techniques, and ongoing controversies.

Concepts: Medicine, Andrology, Testicle, Testicular cancer, Novel, Orchiopexy, Cryptorchidism

141

The PIWI-interacting RNA (piRNA) pathway has an essential role in transposon silencing, meiosis progression, spermatogenesis, and germline maintenance. HIWI genes are critical for piRNA biogenesis and function. Therefore, polymorphisms in HIWI genes contribute to spermatogenesis defects and can be considered as risk factors for male infertility. The aim of the present study was to investigate the association between the HIWI2 gene rs508485 polymorphism and non-obstructive azoospermia.

Concepts: Gene, Genetics, Allele, RNA, Chromosome, Andrology, Transposon, Piwi-interacting RNA

139

To assess the correlation between penile hypersensitivity and premature ejaculation (PE), a total of 420 consecutive subjects attending our andrologic clinic for suspected PE were enrolled. The entire cohort was asked to complete the self-report intravaginal ejaculation latency time (IELT) by stopwatch. According to the IELT, the subjects were classified into 3 groups. Vibratory thresholds were recorded at the glans penis and penile shaft using a biothesiometer. We found that vibratory thresholds in the glans penis and penile shaft were significantly lower in both mild and severe PE group than in the control group (3.81 ± 0.57 and 3.54 ± 0.43 vs 4.73 ± 0.77 for glans penis p = 0.000; 3.64 ± 0.52 and 3.37 ± 0.50 vs 4.62 ± 0.69 for penile shaft p = 0.002). The vibratory threshold decreased as the disease aggravated. In the mild and severe PE groups, a significant positive correlation was detected between the mean values of IELT and the vibratory thresholds. Furthermore, in the receiver operating characteristics curve analysis, the area under the curve of the glans penis and penile shaft vibratory thresholds predicting severe PE were 0.852 and 0.893 respectively. Our study established a dose-dependent association between penile vibratory threshold and PE. Therefore, the vibratory threshold can serve as a potential marker for predicting the severity of PE.

Concepts: Andrology, Receiver operating characteristic, Orgasm, Ejaculation, Penis, Premature ejaculation, Glans penis, Intravaginal ejaculation latency time

136

To provide an overview of current approaches to penile reconstructive surgery in Peyronie disease (PD), and to discuss the challenges in restoring normal penile size and function.

Concepts: Andrology, Erectile dysfunction, Reconstructive surgery, Penis, Peyronie's disease, Human penis size, Micropenis, Penis enlargement

43

Precise spatiotemporal control of physiological processes by optogenetic devices inspired by synthetic biology may provide novel treatment opportunities for gene- and cell-based therapies. An erectile optogenetic stimulator (EROS), a synthetic designer guanylate cyclase producing a blue-light-inducible surge of the second messenger cyclic guanosine monophosphate (cGMP) in mammalian cells, enabled blue-light-dependent penile erection associated with occasional ejaculation after illumination of EROS-transfected corpus cavernosum in male rats. Photostimulated short-circuiting of complex psychological, neural, vascular, and endocrine factors to stimulate penile erection in the absence of sexual arousal may foster novel advances in the treatment of erectile dysfunction.

Concepts: Sexual intercourse, Andrology, Erectile dysfunction, Ejaculation, Penis, Cyclic guanosine monophosphate, Erection, Sexual arousal

33

A walnut supplement for a Western-style diet in men was shown to improve sperm motility, vitality, and morphology. To gain further insights into factors underlying this improvement, we administered a parallel walnut-enriched diet to mice [including those with a defect in sperm motility due to deletion of Plasma Membrane Ca(2+)-ATPase 4 (Pmca4(-/-) )] to determine if there is a similar improvement that is accompanied by reduced sperm membrane peroxidative damage. Although sperm vitality and acrosome reaction rate were unaffected, the diet led to a significant improvement in motility (P < 0.05) and morphology (P < 0.04) in wild-type sperm and in morphology (P < 0.01) in Pmca4(-/-) , confirming the diet's efficacy, which appeared to be more modest in mice than in humans. In both strains of mice, the diet resulted in a significant decrease in sperm lipid peroxidation (oxidative stress) levels, but did not rescue the significantly increased apoptotic levels seen in the testis and epididymis of Pmca4 nulls. Our findings support the effectiveness of walnuts on sperm quality, associated with reduced peroxidative damage; and suggest that oxidative stress is involved in the mechanism(s) underlying male reproductive defects in Pmca4(-/-) .

Concepts: Human, Reproduction, Antioxidant, Sperm, Andrology, Testicle, Reproductive system, Semen

30

Aneurysmal dilatation of the corpora cavernosa can occur because of recurrent priapism in the setting of sickle cell disease.

Concepts: Andrology, Erectile dysfunction, Sickle-cell disease, Sickle, Erection, Corpus cavernosum penis, Priapism

29

Introduction.  Vaseline self-injection into the penis is currently a popular procedure in prisons. Since such injections are illegal, severe complications of the procedure can often remain hidden. Aim.  To identify the incidence, motivation, and morbidity of Vaseline self-injection into the penis among inmates. Methods.  A total of 4,735 inmates at the largest Hungarian prisons were asked to complete a questionnaire relating to their sexual life, whether they had self-injected Vaseline into their penis, the motivation leading them to resort to Vaseline self-injection, any complications observed and the level of satisfaction attained. Main Outcome Measures.  A 17-point questionnaire on the circumstances, motivations, and complications of Vaseline self-injection among prisoners. Results.  Of the 1,905 responders, 15.7% admitted Vaseline self-injection. Only around one-fifth of the Vaseline injected subjects had not been satisfied with the original size of their penis and their sexual life up to the time of the injection, a proportion similar to that among Vaseline nonusers. While the satisfaction with the sexual life became significantly worse after the Vaseline injection, the satisfaction with the penis size did not change and an erectile dysfunction developed de novo in 21.4% of cases. The most common motivation for self-injection was a recommendation by another inmate; it was rarely recommended by a sexual partner. Complications had developed among 25.4% of the Vaseline users and 50.3% of them were not satisfied with the result of the Vaseline injection. Of the Vaseline users, 22.4% regretted the self-injection, while the rate among those who had developed complications was 53%. Conclusions.  The self-injection of Vaseline into the penile skin proved to be somewhat of a trend among these inmates. The complications depended mainly on the amount of Vaseline injected, the poor hygienic circumstances, and the personal tolerability. Increased awareness is needed for the prevention of this social, psychological, and physical problem. Rosecker Á, Bordás N, Pajor L, and Bajory Z. Hungarian “jailhouse rock”: Incidence and morbidity of Vaseline self-injection of the penis. J Sex Med **;**:**-**.

Concepts: Sexual intercourse, Andrology, English-language films, Erectile dysfunction, Penis, Erection, Human penis size, Penis enlargement

28

What’s known on the subject? and What does the study add? The association between Peyronie’s disease (PD) and erectile dysfunction (ED) is reported to be 20-70%. Frequently, men who suffer from both ED and PD do not respond to erectogenic medication. In such cases, a simple straightening operation does not provide any benefit to the patient, as inadequate rigidity still impedes sexual intercourse. For these patients, surgical correction of the curvature should be performed with simultaneous penile prosthesis implantation. Penile prosthesis implantation guarantees a functional straight penis. Almost all patients report adequate rigidity for sexual intercourse postoperatively; however, in up to 50% of cases, patients are dissatisfied with the postoperative penile length. In cases of penile prosthesis implantation for PD, a simultaneous penile lengthening procedure should be performed to increase postoperative satisfaction rates. We report our experience using a novel method for restoration of penile length and girth in patients with PD by grafting. Our study shows that penile prosthesis implantation with concomitant penile lengthening and girth restoration based on circumferential tunica albuginea incision is highly effective for extensive penile shaft reconstruction to correct severe penile shortening and narrowing, resulting in maximum penile length gain and girth restoration, regardless of plaque characteristics.

Concepts: Sexual intercourse, Andrology, Erectile dysfunction, Penis, Peyronie's disease, Penile prosthesis, Erection, Human penis size