Gambaran Histologi dan Histomorfometri Penis Kuda Gayo

Penis kuda adalah alat kopulasi utama pada kuda. Penelitian ini bertujuan untuk mengetahui gambaran histologi danhistomorfometri penis pada kuda gayo. Sampel penelitian menggunakan penis dari 3 ekor kuda gayo jantan berumur 5-10 tahun yang dipotong di Rumah Potong Hewan Dolok Sanggul, Humbang Hasundutan, Sumatera Utara. Prosesmikroteknik dilakukan terhadap sampel menggunakan pewarnaan hematoksilin-eosin (HE). Pengamatan strukturhistologi menggunakan mikroskop dan dilakukan pengukuran ketebalan lapisan epitel uretra, ketebalan tunikaalbugenia di corpora cavernosa dan corpus spongiosum radix, corpus, dan glans penis menggunakan program aplikasitoupview. Hasilnya dibahas secara deskriptif. Hasil penelitian menunjukkan gambaran histologi penis kuda gayo terdiriatas dua jaringan erektil yaitu corpora cavernosa dan corpus spongiosum serta satu uretra. Sinusoid cavernosal daricorpus cavernosum mengandung banyak trabekula yang terdiri atas jaringan ikat fibroelastis, serat otot polos danfibroblas. Corpus spongiosum memiliki trabekula yang lebih tipis dengan ruang kavernosa yang lebih besar. Corpuscavernosum dan corpus spongiosum ditutup oleh tunika albuginea. Uretra terdiri atas berbagai epitel, seperti epitelberlapis transisional, epitel kolumnar berlapis dan epitel skuamosa. Pengukuran histomorfometri menunjukkan bahwaketebalan tunika albugenia radix dan corpus penis kuda gayo berturut-turut adalah 2.181,10 ± 48,50 µm, dan 2.366,51 ±131,48 µm., sedangkan ketebalan lapisan epitel uretra adalah 50,02 ± 6,95 µm. Kesimpulannya adalah penis kuda gayoterdiri atas radix, corpus dan glans penis. Radix dan corpus penis kuda gayo terdiri atas jaringan ikat, otot polos dansinusoid cavernosal; glans penis terdapat sinus uretra.

To Compare the Recurrence Rate of Strictures after Internal Optical Urethrotomy with Intralesional Injection of Mitomycin C versus without Mitomycin C Injection in Patients Presenting with Anterior Urethral Stricture

Background: The urethral strictures occurred due to narrowing of urethra. These may occur after an injury or ureteral or excretory system diseases, due to the injury to urothelium or corpus spongiosum that lead to the development of scar tissues. Mitomycin C can be used as chemotherapeutic agent because of its quality of being anti-tumour actions. Aim: To compare the recurrence rate of strictures after internal optical urethrotomy with intralesional injection of Mitomycin C versus without Mitomycin C injection in patients presenting with anterior urethral stricture. Study Design: Randomized controlled trial. Place and Duration of Study: Department of Urology, Lahore General Hospital, Lahore from 5th September 2016 to 5th March 2017. Methodology: Sixty male patients age 18-70 years, diagnosed with anterior (penile and bulbar) urethral stricture up to 2.0cm were included. Patients were randomly divided into two groups; Group A patients were treated with internal optical urethrotomy alone and Group B patients treated with internal optical urethrotomy with intralesional injection of Mitomycin C. After the procedure, an 18F or 20F indwelling catheter left for 7 days. After 6 months, surgical site evaluated and if stricture again developed, then recurrence labeled. Results: The mean age was 39.32±11.38 years, mean duration of stricture was 6.85±3.32 months and the mean stricture size was 1.21±0.45 cm. The recurrence occurred in 18 (30%) patients. Significant difference was noted for recurrence in both groups (p-value<0.05). Conclusion: The recurrence rate with anterior urethral stricture is significantly lower in with Mitomycin C as compared to without Mitomycin C. Keywords: Recurrence, Urethral stricture, Mitomycin C

Reconstruction of soft tissue penile defects due to trauma using inguinal flaps

Background: We present a case of using the external pudendal artery (EPA) flap to cover the soft tissue defects of the penis following multiple trauma with penis shrinkage, corpus spongiosum and urethral injuries. Case report: A 54-year-old male patient was admitted to the hospital with multiple injuries: complex trauma with extensive scrotal and perineal skin loss, soft tissue defects of the penis with corpus spongiosum and urethral injuries, complex and open forearm fracture. The patient underwent emergency surgery to remove scrotal skin, Burry the testis in the subcutaneous pouches in the thigh, Foley sonde was placed over the bladder above the pubic bone and amputate the right hand.After that, the patient was operated on using foreskin flaps to cover corpus spongiosum defects and reconstruct the urethra. However, after about 10 days, the foreskin flap was infected and then necrotic resulting in the soft tissue defects of the penis exposing the urethral.Therefore we decided to perform surgery using the external pudendal artery (EPA) flap to solve that problem. We put sonde foley to shallow urethra and let urine pass out. The cosmetic and functional results of this foreskin-flap have been good. There was no infection, the length of the penis was maintained. The urinary stream has been normal with no urine leakage after surgery. Conclusion: The external pudendal artery flap is a good option for the treatment of patients with penile soft tissue defects. Due to its simplicity, short operation time, easy dissection, good aesthetic outcome. Therefore the external pudendal artery flap is an optimal choice for the treatment of cases of genital soft tissue defects (scrota and penis).

The Unique Penile Morphology of the Short-Beaked Echidna, Tachyglossus aculeatus

Monotremes diverged from therian mammal ancestors approximately 184 million years ago and have a number of novel reproductive characteristics. One in particular is their penile morphology. There are differences between echidna and platypus phalluses, but both are somewhat similar in structure to the reptilian phallus. The echidna penis consists of 4 rosette glans, each of which contains a termination of the quadrifurcate urethra, but it appears that only 2 of the 4 glans become erect at any one time. Despite this, only a few historical references describe the structure of the echidna penis and none provides an explanation for the mechanisms of unilateral ejaculation. This study confirmed that the echidna penis contains many of the same overall structures and morphology as other mammalian penises and a number of features homologous with reptiles. The corpus cavernosum is well supplied with blood, extends up to the base of the glans penis and is primarily responsible for erection. However, the echidna possesses 2 distinct corpora spongiosa separated by a septum, each of which surround the urethra only distal to the initial urethral bifurcation in the glans penis. Together with the bifurcation of the main penile artery, this provides a mechanism by which blood flow could be directed to only one corpus spongiosum at a time to maintain an open urethra that supplies 2 of the 4 glans to facilitate unilateral ejaculation.

Quantification of penile fat infiltration using the mDIXON quant sequence: a pilot study on the correlation with penis hardness and erectile dysfunction

Objective: The purpose of this study was to determine fat/water signal ratios using the mDIXON Quant sequence, quantitatively assess fat infiltration in the penis, and explore its possible relationship with penile hardness and erectile dysfunction. Methods: Routine pelvic magnetic resonance imaging with the mDIXON Quant sequence was performed in 62 subjects, including 22 people in the normal group, 20 people in the normal erectile hardness group, and 20 people in the ED group. The fat/water signal ratio in the penis was measured using the mDIXON Quant sequence. Shear wave elastography was used to evaluate the hardness of the corpus cavernosa of the penis. Results: The fat/water signal ratio of the corpus spongiosum was significantly lower than that of the corpus cavernosa in the normal group (p = 0.03) and ED group (p < 0.01). There was no significant difference in the fat/water signal ratios between the normal group and the normal erectile hardness group. Fat infiltration was significantly lower, and erectile hardness was significantly higher in the normal erectile hardness group than in the erectile dysfunction group, and the fat infiltration in the left and right corpus cavernosa was inversely proportional to the erectile hardness of the penis. Conclusion: This study suggests that mDIXON Quant can be used as a noninvasive, quantitative, and objective method for evaluating penile fat infiltration. This method could help diagnose penile fat infiltration in patients with erectile dysfunction and varying BMIs. Our results could also allow for a more accurate diagnosis and monitoring of erectile hardness function by quantitatively measuring penile fat infiltration. Advances in knowledge: (1) The proton density fat fraction (PDFF) technology is a new tool for the objective, quantitative and noninvasive evaluation of penile fat infiltration. (2) The quantitative measurement of fat infiltration in the corpora cavernosa might help diagnose and monitor penile erection hardness and its function more accurately.

Traumatic penile fracture with bilateral corporeal rupture

A 24-year-old man with no urological history presented to the emergency room for rapid onset severe penile pain, tenderness, swelling, and ecchymosis during vaginal sexual intercourse. Clinical examination was suggestive of penile fracture with a high suspicion of bilateral corporeal involvement. Urethrography excluded an injury to the corpus spongiosum. Surgical exploration confirmed the bilateral laceration of the corpora and tunica albuginea which was repaired with absorbable sutures. Penile fractures are true urological emergencies whose surgical treatment must not be delayed to prevent long-term sequelae. Bilateral corporal rupture represents only 2-10% percent of penile fractures and usually involves the urethra, especially when the lacerations are situated ventrally.