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Penile Torsion


Presentation

  • Surgical management of congenital curvature without hypospadias can present a challenge to the pediatric urologist. The most widely used surgical techniques include penile degloving and dorsal plication.[ncbi.nlm.nih.gov]
  • ABSTRACT In the present case report, we describe a new technique for penile torsion correction that may be used in select patients. A 55-year-old male presented to our facility with a long history of erectile dysfunction.[urotoday.com]
Surgical Procedure
  • OBJECTIVES: To present the results of repairing congenital or acquired penile torsion by means of a simple surgical procedure that does not involve resection of corporeal tissue.[ncbi.nlm.nih.gov]
  • If you are experiencing intermittent torsion, then a surgical procedure performed electively can prevent further episodes and associated complications.[drelist.com]
  • Testicle Removal If a torsion goes on too long, doctors won't be able to save the affected testicle and it will be removed in a surgical procedure called an orchiectomy.[kidshealth.org]
  • Possible Complications of the Procedure ALL surgical procedures, regardless of complexity or time, can be associated with unforeseen problems. They may be immediate or even quite delayed in presentation.[deltamedix.com]
Gangrene
  • Postoperative complications included five cases of penile edema, one case of hematoma and one case of dorsal skin gangrene.[ncbi.nlm.nih.gov]
  • Postoperative complications included five cases of penile edema, one case of hematoma and one case of dorsal skin gangrene. Residual torsion of occurred in three cases.[infona.pl]
  • With Fournier’s gangrene, this infection affects the dartos, Scarpa’s and Colles’ fascias. Fournier’s gangrene progresses rapidly, and if treatment is delayed, bad things happen.[verywell.com]
  • (penis) (plastic) 607.89 penile 607.89 Induratio penis plastica 607.89 Irritation penis 607.89 Keratosis 701.1 penile 607.89 Mass penis 607.89 Phagedena (dry) (moist) (see also Gangrene) 785.4 penis 607.89 Sclerosis, sclerotic corpus cavernosum penis[icd9data.com]
  • The most common complications of local anesthesia include bruising and hematoma formation.[85] Local anesthesia containing epinephrine can cause vasoconstriction and penile ischemia (tissue deoxygenation),[87] and, in at least one reported case, gangrene[doctorsopposingcircumcision.org]
Multiple Congenital Anomalies
  • Benefits, and Psychological Effects of Surgery and Anesthesia, ‏ الصفحة 61 - Smith DW, Lemli L, Opitz JM: A newly recognized syndrome of multiple congenital anomalies. J Pediatr 1964;64:210-217. ‏[books.google.com]
Pulmonary Valve Stenosis
  • Valve Stenosis (heart valve disorder in which outflow of blood from the right ventricle of the heart is obstructed at the level of the pulmonic valve): 12 people, 85.71% Digeorge's Syndrome (genetic disorder characterized by hypocalcaemia, immunodeficiency[ehealthme.com]
Vascular Disease
  • 861 135 Handassisted laparoscopic surgery 867 136 Renal cryosurgery 871 137 Renal radiofrequency ablation 879 Reconstruction 883 139 Open pyeloplasty 887 140 Surgery of the horseshoe kidney 897 141 Repair of renal injuries 905 142 Surgery for renal vascular[books.google.com]
Mitral Valve Prolapse
  • Valve Prolapse (heart's mitral valve doesn't work well): 12 people, 85.71% Fallot's Tetralogy (birth heart defect of 5 chambers): 12 people, 85.71% Enlarged Heart: 12 people, 85.71% Double Outlet Right Ventricle: 12 people, 85.71% Pulmonary Valve Stenosis[ehealthme.com]
Heart Disease
  • disease): 12 people, 85.71% Respiratory Acidosis (respiratory failure or ventilatory failure, causes the ph of blood and other bodily fluids to decrease): 12 people, 85.71% Convulsion (muscles contract and relax rapidly and repeatedly, resulting in an[ehealthme.com]
Osteoporosis
  • 0.0 % 50-59: 0.0 % 60 : 25 % Top conditions involved for these people *: Depression: 13 people, 92.86% Ulcerative Colitis (inflammatory bowel disease (ibd). it causes swelling, ulcerations, and loss of function of the large intestine): 1 person, 7.14% Osteoporosis[ehealthme.com]
  • […] dysfunction (the inability to achieve or maintain an erection) Infertility Decreased sex drive Decrease in beard and growth of body hair Decrease in size or firmness of the testicles Decrease in muscle mass and increase in body fat Lose of bone mass ( osteoporosis[webmd.com]
Flushing
  • Flush your toilets, Dangler, and swirl away all those silly thoughts...clockwise, of course! 12-17-2015 #6 Actually this happend to me, the only exercise i can think of that made me get this was "bundled stretches". So i quit doing them.[pegym.com]
Convulsions
  • […] disorder characterized by hypocalcaemia, immunodeficiency, and congenital heart disease): 12 people, 85.71% Respiratory Acidosis (respiratory failure or ventilatory failure, causes the ph of blood and other bodily fluids to decrease): 12 people, 85.71% Convulsion[ehealthme.com]
Headache
  • […] person, 7.14% Osteoporosis (bones weak and more likely to break): 1 person, 7.14% Multiple Sclerosis (a nervous system disease that affects your brain and spinal cord. it damages the myelin sheath): 1 person, 7.14% Kidney Transplant: 1 person, 7.14% Headache[ehealthme.com]
Forgetful
  • I guess because they're babies we forget how resilient they are. Thanks for the well wishes. j johnsoncindy100 @chrissytina16 Wow, your brother had some major surgery.[whattoexpect.com]
Chordee
  • Ventral chordee ranged from 45 to 100 , with a median of 50 . A ratio of 1:9.6 was found for chordee without hypospadias compared to the total hypospadias cases, with an incidence of 9.5%.[ncbi.nlm.nih.gov]
Painful Erection
  • N48.3 Priapism Painful erection N48.4 Impotence of organic origin Use additional code, if desired, to identify cause.[apps.who.int]
  • Penis disorders include Erectile dysfunction - inability to get or keep an erection Priapism - a painful erection that does not go away Peyronie's disease - bending of the penis during an erection due to a hard lump called a plaque Balanitis - inflammation[icdlist.com]
  • erection No pain when penis is in non-erect state Pathophysiology of Peyronie's Disease fibrous plaque involving tunica albuginea Dupuytren's contracture Peyronie's Disease treatment and management - Observation; spontaneous remission occurs in about[brainscape.com]
  • The ventral curvature associated with chordee can lead to painful erections, especially with severe chordee. Impaired copulation and thus inadequate insemination is a further consequence of significant chordee.[clinicalgate.com]
  • Removal of the foreskin not only results in a smaller penis, it may restrict growth, and/or cause painful erections during childhood, at puberty, and as an adult.[yourwholebaby.org]
Penile Pain
  • Numerous diseases, conditions and injuries may occur to the area that may lead to testicular and penile pain or discomfort.[livestrong.com]
  • In this position, the foreskin naturally retracts and edema or swelling collects in the penis, and penile pain ensues.[verywell.com]
Renal Injury
  • injuries 905 142 Surgery for renal vascular disease 911 143 Renal transplant recipient 919 144 Open donor nephrectomycadaver donor nephrectomy 933 145 Percutaneous endopyelotomy 939 146 Percutaneous endopyeloplasty 943 147 Laparoscopic renal biopsy 949[books.google.com]

Workup

Colitis
  • 0.0 % Age of people who have Penile torsion when taking Prednisone *: 0-1: 25 % 2-9: 0.0 % 10-19: 0.0 % 20-29: 0.0 % 30-39: 0.0 % 40-49: 0.0 % 50-59: 0.0 % 60 : 25 % Top conditions involved for these people *: Depression: 13 people, 92.86% Ulcerative Colitis[ehealthme.com]

Treatment

  • OBJECTIVE: To report our experience in the treatment of penile torsion with a special reference to the Fisher technique. PATIENTS AND METHODS: We reviewed 30 cases of congenital penile torsion treated from 2009 to 2015 in a single center.[ncbi.nlm.nih.gov]
  • In men who don’t seek treatment, removal of the testicle is the likely outcome.[drelist.com]
  • Any older and there is the risk of psychological problems resulting from the boy having some memory of his treatment. Implications regarding circumcision The corrective surgery may require donor tissue.[circlist.com]
  • We saw a pediatric urologist in the hospital, who explained what the condition was and the treatment for it, and recommended that we bring him in for a follow-up when he's 2-3 months old.[community.babycenter.com]

Etiology

  • This paper will review the current theories for the etiology of penile curvature, discuss the spectrum of severity of congenital chordee and penile torsion, and present varying surgical techniques for the correction of penile curvature in the absence[ncbi.nlm.nih.gov]
  • In 1981, Corriere [7] described Buck's fascia involvement in the etiology of congenital penile torsion. In 2006, Zhou et al [8], denied that abnormal skin attachment was a main factor in any case.[urotoday.com]
  • الصفحة 122 - Study of the incidence of hypospadias in Rochester, Minnesota, 1940-1970, and a casecontrol comparison of possible etiologic factors. Mayo. Clin. Proc. ‏ الصفحة 338 - In: Gillenwater JY, Grayhack JT, Howards SS, Duckett JW, eds.[books.google.com]
  • Although the etiology of these malformations is probably multifactorial, the existence of an inbred strain of rats that are characterized by a high incidence of ectopic scrotum suggests a genetic component to this anomaly.[emedicine.medscape.com]
  • Although the developmental etiology for torsion is indeterminate, skin tethering and corporal disproportion, along with abnormal dartos fascial development have been named as possible contributing factors.[pediatricurologybook.com]

Epidemiology

  • Congenital torsion was present in 11.993% of the epidemiologic study group. It was categorized as mild in 80%, moderate in 15%, and severe in 5% of the cases. Only 2.2% of the patients were bothered by the condition.[urotoday.com]
  • “Necrotizing Fasciitis: A Rare Disease Especially for the Healthy” from the CDC: Sorenson MD, et al. “ Fournier’s Gangrene: Population Based Epidemiology and Outcomes .” The Journal of Urology 2009.[verywell.com]
  • The Task Force included AAP representatives from specialty areas, including anesthesiology/pain management, bioethics, child health care financing, epidemiology, fetus and newborn medicine, infectious diseases (including pediatric AIDS), and urology.[pediatrics.aappublications.org]
  • Circumcisions for medical reasons in the Brazilian public health system: epidemiology and trends. Einstein (Sao Paulo). 2012;10(3):342-6. 176.Earp BD, Allareddy V, Allareddy V, Rotta AT.[doctorsopposingcircumcision.org]
Sex distribution
Age distribution

Pathophysiology

  • In this chapter, we will only consider congenital penile torsion/curvature/chordee. 12.3 Pathophysiology The pathophysiologic mechanisms leading to penile torsion still need to be unveiled.[abdominalkey.com]
  • […] paraphimosis Usually treated by firmly squeezing glans for 5 minutes to reduce the tissue edema; then skin drawn forward over the glans Antibiotics Signs of Peyronie's Disease Curvature of penis and painful erection No pain when penis is in non-erect state Pathophysiology[brainscape.com]
  • […] capacity, compressing emissary veins and thus further decreasing venous outflow; as a result, intracavernous pressure increases and is further increased by contraction of the ischiocavernous and bulbospongiosus muscles, resulting in full rigidity [9] Pathophysiologic[emedicine.medscape.com]
  • Clinical presentation and pathophysiology of meatal stenosis following circumcision. Br J Urol. 1995;75(1):91-3. 125. Van Howe RS. Variability in penile appearance and penile findings: a prospective study. Br J Urol. 1997;80:776-82. 126.[doctorsopposingcircumcision.org]

Prevention

  • During surgery, whether done immediately or later, urologists usually secure both testes to prevent future episodes of torsion. NOTE: This is the Consumer Version.[merckmanuals.com]
  • If you are experiencing intermittent torsion, then a surgical procedure performed electively can prevent further episodes and associated complications.[drelist.com]
  • Prevention Having testicles that can rotate in the scrotum is a trait inherited by some males. If you have this trait, the only way to prevent testicular torsion is surgery to attach both testicles to the inside of the scrotum.[drugs.com]
  • Is there anything I can do to prevent testicular torsion? Unfortunately, there isn’t anything you can do to prevent testicular torsion from happening.[youngmenshealthsite.org]

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