Congenital penile curvature treatments in adults: a systematic review of techniques and outcomes
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How to improve functional outcome of inflatable penile implant surgery? a narrative review
The implantation of a three-piece inflatable penile prosthesis (IPP) has been shown to be a safe and successful treatment with a high satisfaction rate among individuals with erectile dysfunction. This narrative review aims to explore ways to improve the functional outcomes of IPP implantation. We conducted an English-language narrative review using all relevant articles sourced from PubMed. Over the years, modifications in IPP surgery have focused on increasing the longevity of prostheses and improving functional outcomes. These modifications include advancements in surgical methods, implant types, intracorporeal tubing length, the use of rear tip extenders, and reservoir placement. IPP implantation continues to significantly improve quality of life, making it essential for surgeons to stay updated on the latest developments and research to ensure the best outcomes for their patients. Optimal functional outcomes are achieved by an experienced surgical team and the use of a safe, rapid, minimally invasive surgical technique with the latest technology and equipment.
Twist–torsion coupling in beating axonemes
Motile cilia and flagella produce regular bending waves that enable single-cell navigation due to non-planar waveforms with characteristic torsion. However, it is not known how torsion, a geometric property of the three-dimensional waveform, relates to mechanical twist deformations of the axoneme, the conserved cytoskeletal core of cilia and flagella. Here we show that axoneme twisting and torsion are coupled and that twist waves propagate along the beating axoneme of Chlamydomonas reinhardtii algae. We resolve the three-dimensional shapes of the axonemal waveform with nanometre precision at millisecond timescales using defocused dark-field microscopy and beat-cycle averaging, observing regular hetero-chiral torsion waves propagating base to tip. To investigate whether the observed torsion results from axonemal twist, we attach gold nanoparticles to axonemes and measure their cross-section rotation during beating. We find that, locally, the axonemal cross-section co-rotates with the bending plane, evidencing twist–torsion coupling. Our results demonstrate the link between shape and mechanical deformation in beating axonemes and can inform models of the dynamics of motor proteins inside the axoneme responsible for shaping the beat of motile cilia.
Intraoperative frozen section examination for penile cancer surgery: a systematic review
Penile cancer (PeCa) is rare but aggressive and life changing. Penile-preserving surgery (PPS) allows length preservation for sexual activity and normal voiding. Intraoperative frozen section examination (FSE) of resection margins helps to decide on how much penile tissue is excised. Oncological outcomes and diagnostic accuracy of FSE to date, however, are not well documented. The objective of this systematic review was to evaluate the efficacy of FSE in the treatment of PeCa and its impact on oncological outcomes. A systematic review was conducted with reference to the PRISMA statement. Studies published from 2009 to 2024 were identified through a search conducted between 1975 and 2024. The search yielded 7 studies involving 574 patients. Intraoperative FSE had a high percentage of accuracy, with a mean accuracy of 95.4% and a range of 92.9–99.4%. The mean values of sensitivity, specificity, positive predictive value, and negative predictive values were 71.4%, 99.9%, 98.8%, and 96.5%, respectively. Functional outcomes with PPS were encouraging, especially in terms of sexual function. The average local recurrence rate was 7.9%. There is a paucity of data on PeCa FSE in the literature. However, it appears that FSE is accurate and can be helpful in guiding surgeons intraoperatively when performing PPS.
General movement assessments in neonates born with congenital gastrointestinal anomalies: a single site, retrospective study
We aimed to characterize general movements in neonates with congenital gastrointestinal anomalies and to compare them to general movements in extremely low birth weight (ELBW) infants.
The role of the urologist in managing high flow priapism
High-flow priapism (arterial) is a prolonged erection caused by irregular cavernous arterial flow, often resulting from blunt perineal or penile trauma, or iatrogenic needle injury. This condition leads to the formation of an arteriolacunar fistula, causing unregulated arterial blood flow into the sinusoidal spaces of the penis. Unlike low-flow priapism, high-flow priapism typically presents with a partially erect, non-painful penis. The diagnosis is confirmed through characteristic findings on color Doppler ultrasound, which reveals turbulent high-velocity flow pinpointing the fistula’s location. Blood gas analysis typically reflects arterial values, helping to differentiate high-flow priapism from its low-flow counterpart. Although high-flow priapism was historically considered non-urgent, recent evidence suggests that delayed treatment may increase the risk of erectile dysfunction. Therefore, prompt intervention by urologists is crucial. The primary goal is to close the fistula, and the treatment plan should be individualized based on the severity and duration of the condition. Urologists play a critical role in managing this condition, offering a range of therapeutic options. These include conservative approaches, such as observation and compression, medical therapy, arterial embolization, and, in some cases, surgical intervention. The choice of treatment depends on the patient’s condition, the fistula’s location, and the resources available. By ensuring timely and appropriate management, urologists can minimize complications and preserve erectile function.
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