Query: Childs penis images

title: Correlative 3D imaging of Pipistrellus penis micromorphology: Validating quantitative microCT images with undecalcified serial ground section histomorphology
abstract: Detailed knowledge of histomorphology is a prerequisite for the understanding of function, variation, and development. In bats, as in other mammals, penis and baculum morphology are important in species discrimination and phylogenetic studies. In this study, nondestructive 3D microtomographic (microCT, uCT) images of bacula and iodine stained penes of Pipistrellus pipistrellus were correlated with light microscopic images from undecalcified surface stained ground sections of three of these penes of P. pipistrellus (1 juvenile) The results were then compared with uCT images of bacula of P. pygmaeus, P. hanaki, and P. nathusii. The Y shaped baculum in all studied Pipistrellus species has a proximal base with two club shaped branches, a long slender shaft, and a forked distal tip. The branches contain a medullary cavity of variable size, which tapers into a central canal of variable length in the proximal baculum shaft. Both are surrounded by a lamellar and a woven bone layer and contain fatty marrow and blood vessels. The distal shaft consists of woven bone only, without a vascular canal. The proximal ends of the branches are connected with the tunica albuginea of the corpora cavernosa via entheses. In the penis shaft, the corpus spongiosum surrounded urethra lies in a ventral grove of the corpora cavernosa, and continues in the glans under the baculum. The glans penis predominantly comprises an enlarged corpus spongiosum, which surrounds urethra and baculum. In the 12 studied juvenile and subadult P. pipistrellus specimens the proximal branches of the baculum were shorter and without marrow cavity, while shaft and distal tip appeared already fully developed. The present combination with light microscopic images from one species enabled a more reliable interpretation of histomorphological structures in the uCT images from all four Pipistrellus species.  2015.

title: Images in clinical medicine. Atypical ulcerations of the penis.
abstract: A 73 year old man presented with a 3 month history of painful ulcers of the penis. He had a history of urinary incontinence after undergoing surgery for prostate cancer 6 years earlier; his cancer was being treated with diethylstilbestrol.

title: 'It's just a penis' the politics of publishing photos in research about sexuality
abstract: This paper explores some of the challenges of publishing photographs generated as part of sexuality research. It aims to initiate discussion of these issues to enable sexuality researchers to consider and navigate the use of images in their work. Examples highlighting these difficulties are employed from a photo method project which examined young people, sexuality and schooling. It is argued that existing child sex panics rendered these images risky and intensified their scrutiny by gatekeeping forces. The discussion contributes to a broader conversation within the field of sexualities about the constitution of sexuality research as dirty work. Specifically, the paper investigates how some publishing and editing practices might be conceptualised as constituting techniques that construct sexuality research as dirty work. By not publishing photos which form part of sexuality research, the knowledge it is possible for sexuality researchers to generate and circulate is subsequently curtailed.

title: Penis Transplantation: First US Experience
abstract: We describe the first successful penis transplant in the United States in a patient with a history of subtotal penectomy for penile cancer.  Penis transplantation represents a new paradigm in restoring anatomic appearance, urine conduit, and sexual function after genitourinary tissue loss. To date, only 2 penis transplants have been performed worldwide.  After institutional review board approval, extensive medical, surgical, and radiological evaluations of the patient were performed. His candidacy was reviewed by a multidisciplinary team of surgeons, physicians, psychiatrists, social workers, and nurse coordinators. After appropriate donor identification and recipient induction with antithymocyte globulin, allograft procurement and recipient preparation took place concurrently. Anastomoses of the urethra, corpora, cavernosal and dorsal arteries, dorsal vein, and dorsal nerves were performed, and also inclusion of a donor skin pedicle as the composite allograft. Maintenance immunosuppression consisted of mycophenolate mofetil, tacrolimus, and methylprednisolone.  Intraoperative, the allograft had excellent capillary refill and strong Doppler signals after revascularization. Operative reinterventions on postoperative days (PODs) 2 and 13 were required for hematoma evacuation and skin eschar debridement. At 3 weeks, no anastomotic leaks were detected on urethrogram, and the catheter was removed. Steroid resistant rejection developed on POD 28 (Banff I) progressed by POD 32 (Banff III) and required a repeat course of methylprednisolone and antithymocyte globulin. At 7 months, the patient has recovered partial sensation of the penile shaft and has spontaneous penile tumescence. Our patient reports increased overall health satisfaction, dramatic improvement of self image, and optimism for the future.  We have shown that it is feasible to perform penile transplantation with excellent results. Furthermore, this experience demonstrates that penile transplantation can be successfully performed with conventional immunosuppression. We propose that our successful penile transplantation pilot experience represents a proof of concept for an evolution in reconstructive transplantation.

title: Androgen and estrogen receptor expression in the developing human penis and clitoris.
abstract: To better understand how the human fetal penis and clitoris grows and remodels, we undertook an investigation to define active areas of cellular proliferation and programmed cell death spatially and temporally during development of human fetal external genitalia from the indifferent stage (8 weeks) to 18 weeks of gestation. Fifty normal human fetal penile and clitoral specimens were examined using macroscopic imaging, scanning electron microscopy and immunohistochemical localization for the cellular proliferation and apoptotic markers, Ki67 and Caspase 3. A number of hot spots of cellular proliferation characterized by Ki67 localization are present in the penis and clitoris especially early in development, most notably in the corporal body, glans, remodeling glanular urethra, the urethral plate, the roof of the urethral groove and the fully formed penile urethra. The 12 fold increase in penile length over 10 weeks of growth from 8 to 18 weeks of gestation based on Ki67 labelling appears to be driven by cellular proliferation in the corporal body and glans. Throughout all ages in both the developing penis and clitoris Ki67 labeling was consistently elevated in the ventral epidermis and ventral mesenchyme relative to the dorsal counterparts. This finding is consistent with the intense morphogenetic activity/remodeling in the ventral half of the genital tubercle in both sexes involving formation of the urethral/vestibular plates, canalization of the urethral/vestibular plates and fusion of the urethral folds to form the penile urethra. Areas of reduced or absent Ki67 staining include the urethral fold epithelium that fuses to form the penile tubular urethra. In contrast, the urethral fold mesenchyme is positive for Ki67. Apoptosis was rarely noted in the developing penis and clitoris; the only area of minimal Caspase 3 localization was in the epithelium of the ventral epithelial glanular channel remodeling.

title: Hookworm related cutaneous larva migrans of the penis successfully treated with topical ivermectin
abstract: Hookworm related cutaneous larva migrans is an infestation of the skin caused by nematodes. Involvement of genitals is extremely rare. We report the case of a child with this infestation on the penis who cleared rapidly with topical ivermectin.

title: Acquired Buried Penis in Adults: A Review of Surgical Management.
abstract: Acquired buried penis (ABP) is a urologic condition that has significant morbidity and negative effect on quality of life, including but not limited to sexual function, hygiene, micturition, and self image. This disease process is characterized by a wide degree of variability and severity that requires a patient specific approach and significant flexibility on the surgeon's behalf.  To review and present the current evaluation and surgical management of this rare and complex patient population.  A structured review of the English language literature from 1970 to June 2018 was performed using the PubMed and MEDLINE medical databases. Queried terms included "buried penis," "concealed penis," "hidden penis," "adult buried penis," "cicatricial penis," "trapped penis," "inconspicuous penis," "scrotoplasty and obesity," "penile release," "penile skin graft," "penile reconstruction," and "pubic lift." Papers were individually reviewed for their utility and applicability to the management of adult ABP. Manuscripts focusing on pediatric patients were excluded. MAIN OUTCOME MEASURE Current surgical management options for adult ABP are heterogenous but focus on preserving shaft length while improving cosmesis and voiding function.  Surgical versatility remains critical for successful outcomes. However, recent advances in surgical techniques for correction of adult ABP focus on the use of skin grafting to cover the shaft, along with lipectomy and/or scrotoplasty to further aid penile exposure. Collaboration with multiple surgical services is often required to achieve optimal outcomes.  ABP is a complex urologic condition with equally complex surgical treatment options. Care must be taken when planning a surgical intervention, and support from plastic or general surgery may be required. However, with careful selection, surgical correction frequently leads to significant improvement in function and quality of life. Smith Harrison LI, Piotrowski J, Machen GL, et al. Acquired Buried Penis in Adults: A Review of Surgical Management.

title: Congenital absence of the penis (aphallia)
abstract: Absence of the penis, known as aphallia, is a very rare congenital anomaly. It is believed to be a result of either the absence of the genital tubercle or its failure to fully develop and is associated with the level of hormones and chromosomal rearrangements. The failure of the genital tubercle influences the development of the penis and partly depends upon testosterone secreted by Leydig cells of the testis. Chromosomal polymorphisms may affect the functions of protection and regulation, potentially leading to susceptibility to congenital diseases. Herein, an extremely rare case of a congenital absence of the penis is described.  A 3 month old was brought to the OPD by his parents with complaints of absence of penis since birth and urine being passed rectally. When he was born, he was registered as a boy because his chromosomes were 46XY but with 9qh+ Local examination revealed the total absence of the penis. The scrotum was well developed. The testes were palpable bilaterally. The anal opening was located normally. No urethral orifice could be identified. However, his parents had not yet decided whether to accept treatment. The child has been lost to follow up.  Congenital absence of the penis (aphallia) (46 XY normal male karyotype)  We explained the nature of the abnormality and management options to the parents. However, it was much regretted that the patient was too young to make a decision and that his parents had not made a decision yet. They left without any further contact.  Because the parents left our hospital without any contact, it has not been possible to develop a follow up plan.  In consideration of the rarity and devastating psychosocial consequences of this case, we accordingly call for active cooperation with doctors to minimize the negative impact of this malformation. Early assignment of gender avoids confusion and contradiction. Parental confidence solidifies the child's own confidence in his or her gender.

title: Novel Application of Micro Computerized Tomography for Morphologic Characterization of the Murine Penis.
abstract: The murine penis model has enriched our understanding of anomalous penile development. The morphologic characterization of the murine penis using conventional serial sectioning methods is labor intensive and prone to errors.  To develop a novel application of micro computerized tomography (micro CT) with iodine staining for rapid, non destructive morphologic study of murine penis structure.  Penises were dissected from 10 adult wild type mice and imaged using micro CT with iodine staining. Images were acquired at 5 mm spatial resolution on a Bruker SkyScan 1272 micro CT system. After images were acquired, the specimens were washed of any remaining iodine and embedded in paraffin for conventional histologic examination. Histologic and micro CT measurements for all specimens were made by 2 independent observers.  Measurements of penile structures were made on virtual micro CT sections and histologic slides.  The Lin concordance correlation coefficient demonstrated almost perfect strength of agreement for interobserver variability for histologic section (0.9995, 95% CI 0.9990 0.9997) and micro CT section (0.9982, 95% CI 0.9963 0.9991) measurements. Bland Altman analysis for agreement between the 2 modalities of measurement demonstrated mean differences of 0.029, 0.022, and 0.068 mm for male urogenital mating protuberance, baculum, and penile glans length, respectively. There did not appear to be a bias for overestimation or underestimation of measured lengths and limits of agreement were narrow.  The enhanced ability offered by micro CT to phenotype the murine penis has the potential to improve translational studies examining the molecular pathways contributing to anomalous penile development.  The present study describes the first reported use of micro CT with iodine staining for imaging the murine penis. Producing repeated histologic sections of identical orientation was limited by inherent imperfections in mounting and tissue sectioning, but this was compensated for by using micro CT reconstructions to identify matching virtual sections.  This study demonstrates the successful use of micro CT with iodine staining, which has the potential for submicron spatial resolution, as a non destructive method of characterizing murine penile morphology. O'Neill M, Huang GO, Lamb DJ. Novel Application of Micro Computerized Tomography for Morphologic Characterization of the Murine Penis.  2017;14:1533 1539.

title: MR Imaging of the Penis and Urethra.
abstract: MR imaging has been increasingly used as a problem solving adjunct after an initial ultrasound examination for a variety of penile disorders, and is the best cross sectional imaging modality for the assessment of urethra and periurethral disease. Critical advantages of MR imaging for penile and urethra imaging include high soft tissue contrast resolution providing detailed anatomic evaluation, which is important for the demonstration and assessment of critical structures such as tunica albuginea or walls of the urethra, larger field of view for better evaluation of extent of disease, and demonstration of proteinaceous material and varying ages of the blood products.