RESUMO
This is an observational transversal cohort study in which we aim to analyze the Brazilian penis length and compare the penis size of the men self-declared as white (SDW) or black (SDB) skin color. Subjects were asked for self-declare according to their skin color, after that they have been invited to participate in a semi-structured interview so as to have their perception evaluated regarding their penis size and their self-esteem as well. Eventually, their penis length was measured with an anthropometric ruler. The men´s mean penis length who declared themselves as black skin color was 16.5 ± 1.7 cm (penis length in real fully-stretched flaccid length) and the men´s mean penis length who declared themselves as white skin color was 15.8 ± 1.6 cm (p < 0.001).The majority of either SDB (94.0%) or SDW (89.4%) are satisfied with their penis size (p = 0.464). We have shown that the man´s mean penis length who identifies himself as black is just a little bit bigger than the one who identifies himself as white. However, there were no significant difference between groups regarding self-assessment of genital body image.
Assuntos
Pênis/anatomia & histologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antropometria , População Negra/estatística & dados numéricos , Imagem Corporal , Brasil , Estudos de Coortes , Humanos , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , População Branca/estatística & dados numéricos , Adulto JovemRESUMO
OBJECTIVE: The 2nd to 4th digit length (2D:4D) is inversely related to androgen exposure during the fetal period, which may represent a risk factor for several steroid-related diseases. We aimed to evaluate the relationship between 2D:4D ratio and the risk of developing prostate cancer (PCa). SUBJECTS AND METHODS: We assessed the 2D:4D ratio of 474 men >40 years old, stratified into three groups: group 1 (n = 222) patients with PCa, group 2 (n = 82) subjects with high risk of PCa, and group 3 (n = 170) men with low risk of PCa. Subjects were submitted to a digital picture of the ventral surface of the right hand and 2nd and 4th fingers measurements were determined by the distance from the proximal crease to the tip using computer-assisted analysis. RESULTS: The mean serum prostate-specific antigen level was 7.5 ng/ml in the high-risk group and 0.92 ng/ml in the low-risk group (p < 0.05). The mean 2D:4D ratios were 0.96 ± 0.04, 0.97 ± 0.04 and 0.96 ± 0.04 for the PCa, high-risk and low-risk groups, respectively, and no difference was found among the three groups (p = 0.12). CONCLUSION: Anthropometry of the hand using the 2D:4D ratio is not a predictor of PCa.
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Androgênios/uso terapêutico , Dedos/anatomia & histologia , Neoplasias da Próstata/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Antropometria , Biópsia , Estudos de Casos e Controles , Humanos , Masculino , Pessoa de Meia-Idade , Antígeno Prostático Específico/metabolismo , Fatores de Risco , Resultado do TratamentoRESUMO
OBJECTIVE: To describe the penile length after radical prostatectomy (RP) in a long-term follow-up. MATERIALS AND METHODS: We evaluated prospectively the penile length of 105 patients with localized prostate cancer treated by open RP. Participants using therapy for penile rehabilitation were excluded from statistical analysis. Measurements of the stretched penis were taken preoperatively and at 3, 6, 12, 24, 36, 48, and 60 months postoperatively. The International Index of Erectile Function-Erectile Function (IIEF-EF) questionnaire was used to evaluate erectile function. The penile anthropometric measure used was the stretched length of the flaccid penis, from the pubopenile skin angle to the end of the glans, after the prepubic fat was depressed under maximum manual traction. RESULTS: The mean stretched penile length 3 months after RP decreased an average of 1 cm from baseline (P <.001). This mean difference persisted until 24 months. At 36 months, the penile length differed 0.6 cm. At 48 months (-0.3 cm) and 60 months (+0.4 cm), the mean differences in penile length before and after RP were not significant (P = .080 and P = .065, respectively). Erectile function was a predictor for early return of penile length. CONCLUSION: Nearly 1 cm of penile shortening after RP may be expected up to 12 months. However, a trend toward recovery of penile length occurs after 24 months of follow-up and is completely re-established after 48 months. The preserved erectile function after RP is a predictor for penile length recovery.
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Pênis/anatomia & histologia , Prostatectomia , Neoplasias da Próstata/cirurgia , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Ereção Peniana , Período Pós-Operatório , Estudos Prospectivos , Recuperação de Função FisiológicaRESUMO
INTRODUCTION: Penile curvature is one of the most common male conditions, affecting nearly 10% of men, and can impair sexual intercourse. Tunica albuginea (hTA) plays a key role in penile curvature, and reconstructive procedures may be necessary for its substitution. Although several grafts have been proposed for hTA repair, the ideal graft is not yet available. AIM: The aim of this article is to evaluate a new human tunica albuginea acellular matrix (hTAAM) as potential graft for penile reconstructive procedures. METHODS: Twelve penises were obtained during sex reassignment surgeries from male-to-female transsexual patients. After dissection, hTAs were assigned into two groups according to the decellularization methods: polyethylene glycol (PEG) 1000 method following ultraviolet-C radiation, and Triton X-100 modified method. MAIN OUTCOME MEASURES: Structural analyses were assessed by hematoxilin and eosin, Masson's trichrome, Weigert's, and picrosirius-polarization staining methods. Total protein, total glycosaminoglycan (GAG), and nucleic acid (DNA and RNA) concentrations were assessed by specific biochemical analyses. Uniaxial strength tests were performed to evaluate biomechanical properties. RESULTS: All hTAAMs presented no nuclear or cellular remnants. Total protein concentration was significantly higher in PEG 1000 hTAAM. Despite GAG concentration decreased significantly in hTAAM, Triton X-100 hTAAM retained the highest GAG concentration (1.0 ± 0.42 µg HexUr/mg dry tissue, P > 0.05). All decellularization methods were efficacious to remove nucleic acids. The maximal break point presented no difference between hTA and hTAAM groups (P > 0.05). CONCLUSIONS: PEG 1000 and Triton X-100 decellularization methods provide equally successful hTAAMs, preserving original structural and biochemical properties.
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Doenças do Pênis/cirurgia , Pênis/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Transplantes , Tecido Conjuntivo/cirurgia , Humanos , Masculino , Octoxinol , Pênis/anatomia & histologia , PolietilenoglicóisRESUMO
INTRODUCTION: Randomized clinical trials (RCT) remain the gold standard in providing scientific evidence in medical practice in spite of the significant placebo effect in the treatment of several disorders. Although the first-line therapy for erectile dysfunction (ED) is oral phosphodiesterase type-5 inhibitor (iPDE5), the placebo effect in RCT of iPDE5 for ED occurs at a rate as high as 50%. AIMS: To evaluate the role of therapeutic illusion in the oral treatment for ED. METHODS: A prospective, controlled, single-blind, parallel-group study was performed at single-center. One hundred and twenty-three patients with ED were randomly assigned into three groups and received different letters: Group 1 (G1) was informed to be receiving a substance for ED treatment; Group 2 (G2) was informed that they could be receiving an active drug or placebo; Group 3 (G3) was conscious to be using placebo. Starch capsules were dispensed to all patients. Median follow up was 12 weeks. MAIN OUTCOME MEASURES: ED improvement was assessed after 8 weeks of the intervention by the erectile function domain of the International Index of Erectile Function (IIEF) and the Quality of Erection Questionnaire. ED severity was classified by the IIEF erectile function (IIEF-EF) domain score into five categories: no ED (score of 26-30), mild (22-25), mild to moderate (17-21), moderate (11-16), and severe (6-10). Improvement in IIEF-EF domain was considered as a change in category of severity. RESULTS: ED severity improved in all three groups (G1 = 31.7%, P = 0.039; G2 = 36.8%, P = 0.028; G3 = 36.8%, P = 0.002) and no difference was found among groups (P = 0.857). Improvement of quality of erection score was only significant in G2 (P = 0.005) and G3 (P < 0.001). CONCLUSIONS: Written-suggested therapeutic illusion for patients with ED has no major influence in the outcomes. However, treatment of ED with oral placebo capsules demonstrates clinical effects, improving erectile function and quality of erection.
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Disfunção Erétil/terapia , Efeito Placebo , Humanos , Ilusões , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Índice de Gravidade de Doença , Método Simples-Cego , Inquéritos e Questionários , Resultado do TratamentoRESUMO
PURPOSE: Meticulous excision of the stricture and any associated spongiofibrosis is critical to the success of urethral reconstruction. However, normal urethral limits are determined during surgical reconstruction based on macroscopic appearance only. We evaluated structural changes of the presumed healthy urethral ends. MATERIALS AND METHODS: Samples were obtained from 29 patients with a mean age of 40 years who underwent end-to-end anastomotic urethroplasty. Suprapubic catheter drainage was performed for at least 30 days in 15 patients. After the urethral stricture was excised biopsy was performed of the proximal and distal healthy ends. Structural characterization was evaluated by staining histological sections with Masson's trichrome, Sirius red and Weigert's resorcin-fuchsin method. The control group consisted of 10 cadaver bulbar urethras. RESULTS: All samples of presumed normal urethral ends showed histological changes. Chronic and acute inflammatory reactions were the most common findings. In the proximal urethral end intense cellularity was found in 18 patients (62.1%). Fibroblast and inflammatory cells were most common and related to the lack of suprapubic cystostomy (p = 0.001). Between proximal urethral edges with and without a suprapubic urinary catheter the elastic fiber distribution and the ratio of collagen types III and I showed a significant change (p = 0.045 and <0.001, respectively). CONCLUSIONS: The supposedly healthy urethral ends of end-to-end anastomotic urethroplasty show structural changes. Urethral obstruction and its relief by suprapubic urinary drainage can affect extracellular matrix turnover regulation. Therefore, these changes can lead to urethral remodeling in the proximal bulbar urethra.