Characteristics of HPVRelated Precursor Lesions

Intraepithelial Lesion Penis

Characteristics of HPV-related precursor lesions are presented in Fig. 1.1. Genital Bowen's disease, erythroplasia of Queyrat (EQ), and Bowenoid papulosis (BP) are clinical presentations of high-grade PIN. Bowen's disease and EQ are usually found in elderly men, being present on the follicle bearing skin and the mucosa of the penis (i.e., glans or prepuce), respectively. Bowen's disease presents as a single, scaly plaque, located on keratinized genital skin. EQ usually presents as one or more...

Ultrasound and MR Appearance of Lymph Nodes

Liquefaction Lymph Node Ultrasound

Normal lymph nodes are usually ovoid in shape, with a fatty hilum and an organized vascular pattern radiating from the hilum57 (Fig. 4.14). Some features, such as focal areas of necrosis, are highly specific for malignancy, and in general malignant nodes tend toward roundness and may lose their fatty hilum58 (Fig. 4.15). One recent study of the use of ultrasound in 44 patients, the majority of whom had penile cancer, showed that in 42 44 patients with metastasis at least one of the following...

The Radial Artery Forearm Flap Phalloplasty

Radial Phalloplasty

This is often considered the gold standard phalloplasty as it allows the formation of a cylindrical and sensate phallus with a urethra that reaches the tip and which is less prone to complications. The disadvantage is that it leaves a considerable donor site defect on the arm which some patients find unacceptable. The nondominant forearm is used in all patients having checked the vascular competency of the superficial and deep palmar arteries with an Allen test followed by a duplex ultrasound...

Antero Lateral Thigh Flap Phalloplasty

Flap Phalloplasty

The anterolateral thigh flap is another good option for phallic reconstruction.33 This is a musculocutaneous (perforator) rather than a fasciocutaneous based-flap and is based on the perforator vessels through vastus lateralis and rectus femoris from the descending branch of the lateral circumflex femoral artery (Chap. 7). The ALT flap is very reliable from a vascular point of view and is commonly used in reconstructive surgery. Rubino et al. described the ALT flap in order to create a...

Abdominal Pubic Phalloplasty

Pubic Phalloplasty

This technique is commonly used for phallus reconstruction in transsexuals but can be modified for use in penile cancer patients although no published data are available for this group.29 The advantages of this technique are that there is no donor site defect on the arm and that the operating time is shorter. The phallus however is relatively insensate, hairy, and prone to urethral complications.29 The phallus is fashioned from a flap of anterior abdominal wall skin, 12 cm wide and 12-14 cm...

Genital Lichen Sclerosus Et Atrophicus LS

Lichen Sclerosus Years Old

Balanitis Xerotica Obliterans (BXO) is now better defined as the male genital variant of lichen sclerosus et atrophicus (LS). It was initially described as a chronic, progressive, scleroatrophic inflammatory process of unknown etiology affecting the glans penis, prepuce, and in advanced cases, the anterior urethra and meatus, either individually or in any combination. It occurs almost exclusively in uncircumcised men. Lesions classically appear as pale, atrophic plaques, which may coalesce and...

The Use of Chemotherapy and Chemoradiation

Penis Needle

Combination therapy in the form of chemotherapy and radiotherapy is utilized in an attempt to improve the long-term outcomes for patients diagnosed with urethral Fig. 8.7 Interstitial brachytherapy of the penile urethra using hypodermic needle and plastic template. The penis is kept away from the testicles using a sponge (From Gerbaulet et al.34. Reprinted with permission) Fig. 8.7 Interstitial brachytherapy of the penile urethra using hypodermic needle and plastic template. The penis is kept...