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P-05-017 Penile trauma: apropos of two cases
S223
P-05 Late Breaking Posters - MSD
(43%) have a median cancer specific survival of 18 months instead 39 patients with non urological metastasis (57%) have a median cancer specific survival of 11months Ten patients presented with malignant priapism (5 from urological metastasis and 5 from non urological metastasis). Median survival after the diagnosis of penile metastasis was 10 months (range 6-18 months). Patients with priapism from urological tumor have a median cancer specific survival of 30 months the patients with priapism from non urological tumor have median cancer specific survival of 15 months. Kaplan-Meier analysis demonstrated that patients presenting with priapism and those with metastases from non-urologic tumors have a significantly worse prognosis (age adjusted Log Rank: p ¼ 0.037 for priapism vs no priapism and p ¼ 0.045 for urologic vs non urologic) Conclusion: This systematic analysis shows that prognostic differences exist based on the presentation of penile metastasis. Survival is substantial and treatment should therefore take into account definitive symptom improvement and quality of life. Policy of full disclosure: None.
Figure 1. P-05-017 PENILE TRAUMA: APROPOS OF TWO CASES Multescu, R.1; Satalan, R.2; Georgescu, D.2; Geavlete, P.2 1 Urology, Bucharest, Romania; 2“Saint John” Hospital, Bucharest, Romania Objective: A frequent cause of hospitalization after penile trauma is corpus cavernosum albuginea ruptures, but other devices such as weapons or working machineries may also be involved. This paper aims to present characteristics of particular cases of penile traumatic disorders. Methods: There were 25 patients with penile trauma treated in our department between January 2014 -December 2015. Corpus cavernous rupture occurred during intercourse or masturbation in 21 patients, while 4 patients had penile wounds. We present the characteristics of two such cases. Results: TN, aged 42 years, presented with avulsion of the penile and scrotum skin on their ventral side, due to a work accident (the trousers were attached to the blade of a circular saw). Minimal bleeding at the moment of the presentation. We performed suture of the skin after surgical removal of the devascularized margins. Necrosis of a small skin triangle
J Sex Med 2016;13:S216eS226
(approximately 1 square centimeter) occurred during evolution, which was surgically removed. SF, 24 years old, had a knife lesion on the right side of the penis which was treated and sutured in another center as a superficial skin wound. 12 hours later the patient was referred to our department with giant hematoma on the left hemiscrotum. Exploration of the initial wound described skin puncture on the right side, section of the corpus spongiosum (the dorsal half) and small puncture of the left corpus cavernosum (on the ventral side), with blood accumulation in the left hemiscrotum. We performed evacuation of the hematoma, suture of the corpus cavernosum and urethra, blood transfusion. Evolution was simple. Conclusion: Penile trauma may generate extensive or difficult to assess lesions. Their potential to generate excessive bleeding imposes attentive initial assessment. Policy of full disclosure: None. P-05-018 ONE-STAGE PEDICLED ANTEROLATERAL THIGH FLAP PHALLOPLASTY COMBINED WITH FREE RADIAL FOREARM FLAP URETHRAL RECONSTRUCTION IN TRANSGENDER MEN: SURGICAL TECHNIQUE AND OUTCOME IN NINETEEN PATIENTS van Der Sluis, W.1; Smit, J.M.2; Pigot, G.2; Buncamper, M.2; Bouman, M.-B.2 1 VU University Medical Center, Plastic Surgery, Amsterdam, Netherlands; 2VU University Medical Center, Amsterdam, Netherlands Objective: Free radial forearm flap (FRFF) or pedicled anterolateral thigh flap (ALTF) phalloplasty is frequently performed as penile (re)construction. In this study, we aim to describe the onestage pedicled ALTF phalloplasty combined with FRFF urethral reconstruction in transgender men ineligible to undergo FRFF or pedicled anterolateral thigh flap alone and assess its surgical outcome. Methods: All transgender men who underwent pedicled ALTF phalloplasty combined with a FRFF as urethral reconstruction in one stage were identified from a departmental database. The surgical procedure was described. Patient demographics, surgical characteristics, intra- and postoperative complications, hospitalization length and re-operations were recorded. Results: Between January 2008 and December 2015, nineteen transgender men (median age 37, range 21-57) underwent a pedicled ALTF phalloplasty combined with a FRFF urethral reconstruction in one stage with a median clinical follow-up of 35 months (3-95). The median operative time was 470 minutes (376-693), the mean hospitalization length 9.2 ± 3.3 days. Median clinical follow-up was 35 (3-95) months. Short-term complications comprised total FRFF failure in two, total failure of the ALTF flap in one, and partial necrosis of the ALTF flap in 1 patient. Long-term urinary complications occurred in 10 (53%) patients, of which nine concerned urethral strictures.
P-05 Late Breaking Posters - MSD
(43%) have a median cancer specific survival of 18 months instead 39 patients with non urological metastasis (57%) have a median cancer specific survival of 11months Ten patients presented with malignant priapism (5 from urological metastasis and 5 from non urological metastasis). Median survival after the diagnosis of penile metastasis was 10 months (range 6-18 months). Patients with priapism from urological tumor have a median cancer specific survival of 30 months the patients with priapism from non urological tumor have median cancer specific survival of 15 months. Kaplan-Meier analysis demonstrated that patients presenting with priapism and those with metastases from non-urologic tumors have a significantly worse prognosis (age adjusted Log Rank: p ¼ 0.037 for priapism vs no priapism and p ¼ 0.045 for urologic vs non urologic) Conclusion: This systematic analysis shows that prognostic differences exist based on the presentation of penile metastasis. Survival is substantial and treatment should therefore take into account definitive symptom improvement and quality of life. Policy of full disclosure: None.
Figure 1. P-05-017 PENILE TRAUMA: APROPOS OF TWO CASES Multescu, R.1; Satalan, R.2; Georgescu, D.2; Geavlete, P.2 1 Urology, Bucharest, Romania; 2“Saint John” Hospital, Bucharest, Romania Objective: A frequent cause of hospitalization after penile trauma is corpus cavernosum albuginea ruptures, but other devices such as weapons or working machineries may also be involved. This paper aims to present characteristics of particular cases of penile traumatic disorders. Methods: There were 25 patients with penile trauma treated in our department between January 2014 -December 2015. Corpus cavernous rupture occurred during intercourse or masturbation in 21 patients, while 4 patients had penile wounds. We present the characteristics of two such cases. Results: TN, aged 42 years, presented with avulsion of the penile and scrotum skin on their ventral side, due to a work accident (the trousers were attached to the blade of a circular saw). Minimal bleeding at the moment of the presentation. We performed suture of the skin after surgical removal of the devascularized margins. Necrosis of a small skin triangle
J Sex Med 2016;13:S216eS226
(approximately 1 square centimeter) occurred during evolution, which was surgically removed. SF, 24 years old, had a knife lesion on the right side of the penis which was treated and sutured in another center as a superficial skin wound. 12 hours later the patient was referred to our department with giant hematoma on the left hemiscrotum. Exploration of the initial wound described skin puncture on the right side, section of the corpus spongiosum (the dorsal half) and small puncture of the left corpus cavernosum (on the ventral side), with blood accumulation in the left hemiscrotum. We performed evacuation of the hematoma, suture of the corpus cavernosum and urethra, blood transfusion. Evolution was simple. Conclusion: Penile trauma may generate extensive or difficult to assess lesions. Their potential to generate excessive bleeding imposes attentive initial assessment. Policy of full disclosure: None. P-05-018 ONE-STAGE PEDICLED ANTEROLATERAL THIGH FLAP PHALLOPLASTY COMBINED WITH FREE RADIAL FOREARM FLAP URETHRAL RECONSTRUCTION IN TRANSGENDER MEN: SURGICAL TECHNIQUE AND OUTCOME IN NINETEEN PATIENTS van Der Sluis, W.1; Smit, J.M.2; Pigot, G.2; Buncamper, M.2; Bouman, M.-B.2 1 VU University Medical Center, Plastic Surgery, Amsterdam, Netherlands; 2VU University Medical Center, Amsterdam, Netherlands Objective: Free radial forearm flap (FRFF) or pedicled anterolateral thigh flap (ALTF) phalloplasty is frequently performed as penile (re)construction. In this study, we aim to describe the onestage pedicled ALTF phalloplasty combined with FRFF urethral reconstruction in transgender men ineligible to undergo FRFF or pedicled anterolateral thigh flap alone and assess its surgical outcome. Methods: All transgender men who underwent pedicled ALTF phalloplasty combined with a FRFF as urethral reconstruction in one stage were identified from a departmental database. The surgical procedure was described. Patient demographics, surgical characteristics, intra- and postoperative complications, hospitalization length and re-operations were recorded. Results: Between January 2008 and December 2015, nineteen transgender men (median age 37, range 21-57) underwent a pedicled ALTF phalloplasty combined with a FRFF urethral reconstruction in one stage with a median clinical follow-up of 35 months (3-95). The median operative time was 470 minutes (376-693), the mean hospitalization length 9.2 ± 3.3 days. Median clinical follow-up was 35 (3-95) months. Short-term complications comprised total FRFF failure in two, total failure of the ALTF flap in one, and partial necrosis of the ALTF flap in 1 patient. Long-term urinary complications occurred in 10 (53%) patients, of which nine concerned urethral strictures.