Re: Penile Fracture: Outcomes of Early Surgical Intervention

Re: Penile Fracture: Outcomes of Early Surgical Intervention

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Trauma, and Genital and Urethral Reconstruction Re: Penile Fracture: Outcomes of Early Surgical Intervention D. E. Swanson, A. S. Polackwich, B. T. Helfand, P. Masson, J. Hwong, D. D. Dugi, III, A. C. Martinez Acevedo, J. C. Hedges and K. T. McVary Department of Urology, Oregon Health and Science University, Portland, Oregon, Division of Urology, Department of Surgery, NorthShore University Health, Glenview, Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago and Division of Urology, Southern Illinois University of Medicine, Springfield, Illinois, and Department of Urology, Brigham and Women’s Hospital, Boston, Massachusetts Urology 2014; 84: 1117e1121.

Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.05.021 available at http://jurology.com/ Editorial Comment: This is a contemporary report of 30 penile fracture cases from 2 institutions, in which immediate repair was performed. Urethral involvement was surprisingly common (18%). Although the authors observed a high rate of erectile dysfunction and penile deformity (35%), it is noteworthy that these are patient reported outcomes assessed early in the recovery period. Interestingly the authors pose the question of whether outcomes of a circumcision approach differ from those of a directed penoscrotal approach. We have converted to a penoscrotal approach using a disposable self-retaining retractor and a supporting strap under the proximal shaft in the same manner as commonly used for inflatable penile prosthesis insertion. By avoiding mobilization of the entire foreskin, we believe this directed strategy decreases time and surgical trauma, particularly in cases with focal physical findings. Allen F. Morey, MD

Re: Dorsal Plication without Degloving is Safe and Effective for Correcting Ventral Penile Deformities P. H. Chung, T. J. Tausch, J. Simhan, J. F. Scott and A. F. Morey Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas Urology 2014; 84: 1228e1233.

Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.05.022 available at http://jurology.com/ Editorial Comment: The potential advantages of plication procedures over grafting procedures are magnified in Peyronie cases with ventral deformities. Grafting entails degloving and urethral mobilization to allow ventral corporeal incision and grafting. By comparison, dorsal plication involves only a 2 mm trough to be created in a “hopscotch” pattern along either side of the dorsal veindjust wide enough to place parallel plication suturesdwithout degloving. The results of this minimally invasive procedure in 17 men provide further evidence supporting the safety and efficacy of plication. Average correction was 45 degrees, with a trivial mean measured loss of penile length of 0.6 cm. Patient reported satisfaction was greater than 90%. Further study is needed (including validated questionnaires) to confirm this promising initial experience. Allen F. Morey, MD

0022-5347/15/1942-0001/0 THE JOURNAL OF UROLOGY® Ó 2015 by AMERICAN UROLOGICAL ASSOCIATION EDUCATION

AND

RESEARCH, INC.

http://dx.doi.org/10.1016/j.juro.2015.05.021 Vol. 194, 1-2, August 2015 Printed in U.S.A.

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Re: Sports-Related Testicular Injuries and the Use of Protective Equipment among Young Male Athletes J. M. Bieniek and J. M. Sumfest Department of Urology, Geisinger Medical Center, Danville, Pennsylvania Urology 2014; 84: 1485e1489.

Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.05.023 available at http://jurology.com/ Editorial Comment: A questionnaire was administered at a series of Pennsylvania high schools and colleges to evaluate the prevalence of testicular injuries and use of protective equipment in young male athletes. Surveys were completed by 731 young men, of whom 18% reported having experienced testicular injuries. The sports most commonly implicated were lacrosse (48%), wrestling (32%), soccer (25%) and baseball (21%). Although more than 80% of lacrosse players reported having seen a teammate experience a testicular injury, only 51% wore protective cups. We can and must do better. Allen F. Morey, MD

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