Sexual Function after Partial Penectomy: A Prospectively Study From China

The Purpose of this study was to evaluate the sexual function after partial penectomy for penile carcinoma patients. 

Between January 2010 and May 2013, patients treated with partial penectomy at our institution were prospectively enrolled in this study. Sexual function (IIEF-15), age, body mass index, penile length in the flaccid state after partial penectomy (PL), treatment, having a partner and psychological factors (SAS scores and SDS scores) were assessed. Univariate and multivariate linear regression analyses were performed. 43 patients were included in our study. 

The median age was 56 years, and the median PL was 4 cm. The preoperative IIEF-15, SAS, SDS scores were significantly different from the postoperative scores. There was no statistically significant difference between the patients treated with partial penectomy and partial penectomy+ lymphadenectomy on IIEF-15 scores. Age was negatively associated with erectile function, sexual desire, and overall satisfaction; PL was positively associated with intercourse satisfaction; SAS score was negatively associated with erectile function, orgasmic function, sexual desire, and intercourse satisfaction. 

Our preliminary findings suggest that the sexual function after partial penectomy was significantly reduced. The sexual function was negatively affected by age and anxiety but positively affected by PL.

Full article at:  http://goo.gl/PO8ZMV

By:  Cui Yu,1 Chen Hequn,1 Liu Longfei,1 Chen Minfeng,1 Chen Zhi,1 Zeng Feng,1 Chen Jinbo,1 Qi Lin,1 and Zu Xiongbinga,1

¹Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan 410000, China

^aEmail: moc.621@yxbxuz

Sci Rep. 2016; 6: 21862.

Published online 2016 Feb 23. doi:  10.1038/srep21862

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Penile Cancer Treatment Costs in England

BACKGROUND:

Penile cancer is a rare malignancy in Western countries, with an incidence rate of around 1 per 100,000. Due to its rarity, most treatment recommendations are based on small trials and case series reports. Furthermore, data on the resource implications are scarce. The objective of this study was to estimate the annual economic burden of treating penile cancer in England between 2006 and 2011 and the cost of treating a single case based on a modified version of the European Association of Urology penile cancer treatment guidelines.

METHODS:

A retrospective (non-comparative) case series was performed using data extracted from Hospital Episode Statistics. Patient admission data for invasive penile cancer or carcinoma in situ of the penis was extracted by ICD-10 code and matched to data from the 2010/11 National Tariff to calculate the mean number of patients and associated annual cost. A mathematical model was simultaneously developed to estimate mean treatment costs per patient based on interventions and their associated outcomes, advised under a modified version of the European Association of Urologists Treatment Guidelines.

RESULTS:

Approximately 640 patients per year received some form of inpatient care between 2006 and 2011, amounting to an average of 1,292 spells of care; with an average of 48 patients being treated in an outpatient setting. Mean annual costs per invasive penile cancer inpatient and outpatient were £3,737 and £1,051 respectively, with total mean annual costs amounting to £2,442,020 (excluding high cost drugs). The mean cost per case, including follow-up, was estimated to be £7,421 to £8,063. Results were sensitive to the setting in which care was delivered.

CONCLUSIONS:

The treatment of penile cancer consumes similar levels of resource to other urological cancers. This should be factored in to decisions concerning new treatment modalities as well as choices around resource allocation in specialist treatment centres and the value of preventative measures.

Below:  Invasive penile cancer cost distribution per care type. *Excludes chemotherapy and radiotherapy. Note: 2010 figures are based on preliminary data

Full article at:   http://goo.gl/3OjGm3

By:  Keeping ST1, Tempest MJ2, Stephens SJ3, Carroll SM4, Sangar VK5.

• 1Sanofi Pasteur MSD, Mallards Reach, Bridge Avenue, Maidenhead, Berks, SL6 1QP, UK. skeeping@spmsd.com.
• 2Pharmerit Ltd, Enterprise House, Innovation Way, York, YO10 5NQ, UK. mtempest@pharmerit.com.
• 3Pharmerit Ltd, Enterprise House, Innovation Way, York, YO10 5NQ, UK. sstephens@pharmerit.com.
• 4Pharmerit Ltd, Enterprise House, Innovation Way, York, YO10 5NQ, UK. scarroll@spmsd.com.
• 5The Christie NHS Foundation Trust, University Hospital of South Manchester, Wilmslow Road, Manchester, M20 4BX, UK. vijay.sangar@nhs.net.
• BMC Public Health. 2015 Dec 29;15(1):1305. doi: 10.1186/s12889-015-2669-2. 

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Cancer of the Penis Associated with HIV: A Report of Three Cases Presenting at the CHU Cocody, Ivory Coast

We describe three cases of advanced penile cancer associated with HIV infection.

Advanced penile cancer associated with VIH infection were discovered in three patients aged respectively 47, 56 and 40. The prognosis was extremely poor. Two patients died without receiving any treatment and one patient was lost to follow-up after refusing all treatment proposed.

There appears to be a link between HIV infection and penile cancer with concomitant HIV infection worsening the prognosis of the disease.

Cancer of the penis is extremely rare. In Europe and the USA, the incidence of this form of cancer is estimated as 1.0 per 100,000 men [1]. The incidence varies between different countries worldwide with a higher incidence in Hispanic individuals, in Brazil and in Uganda [2]. Circumcision in the perinatal period or before puberty has a preventative role, but not circumcision carried out in adulthood. Early circumcision decreases the risk 3–5-fold [3], probably by improving local hygiene. Cancer of the penis is usually a disease of older men and its incidence increases with age. The peak in frequency occurs between 60 and 70 years of age [1], [2], [4]. In 95 % of cases penile tumours are squamous cell carcinomas [5]. Penile cancer may present as a flat or ulcerated exophytic papillary lesion, with the latter having a worse prognosis. The most common locations are the glans (48 % of cases) and the foreskin (25 % of cases). Penile cancer patients with advanced disease have a poor prognosis. Grades 2 and 3 disease, T3 stage and positive lymph nodes are adverse prognostic factors for cancer-specific survival in penile squamous cell carcinoma [6], [7]. In a study of eight patients with metastatic penile cancer, the longest and shortest survival times (from diagnosis of the primary cancer to death) were 16 years and 9 months, respectively [8]. Other, rarer histological forms of penile cancer such as melanoma and sarcoma may also occur [9].

There is a higher risk of penile cancer in patients with AIDS although it is not possible to conclude formally about a causal link with immunosuppression [10]. An increasing number of cases of penile cancer associated with HIV are being reported in the literature [1], [10], [11]. The aim of this report is to describe three cases of penile cancer associated with HIV that presented at the Urology Department of the CHU Cocody and to review the literature...

Below:  Cancer of the penis (patient 1), view 3

Below:  Cancer of the penis (patient 2)

Below:  Paraphimosis seen in patient 3 on admission, view 2

Full article at: http://goo.gl/832GHc

By:  P. G. Konan^*, C. C. Vodi, A. H. Dekou, A. Fofana, E. E. Gowé and K. Manzan

Service d’Urologie, CHU de Cocody, Abidjan, Ivory Coast, Africa

 

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Metastatic Tumors of the Penis: A Report of 8 Cases and Review of the Literature

The purpose of this study was to report the clinical characteristics, treatments, and outcomes of secondary penile cancers and review the literature of this rare condition.

The records of 8 patients with metastatic penile cancer treated at our hospital from 2006 to 2013 were analyzed. A search of medical databases was conducted.

Patient symptoms included penile mass (n = 7, 5 had concomitant pain) and acute urine retention (n = 1). The primary cancers included bladder, lung, gastric, liver, and prostate malignancies and 1 case of pulmonary epithelioid hemangioendothelioma. The longest time from diagnosis of the primary cancer to metastatic penile cancer was 16 years and the shortest was 7 months. Six patients were treated with phallectomy, 1 with resection of the mass, and 1 with only a biopsy because of advanced metastatic disease. Five patients are deceased at the time of this report, and the longest and shortest survival times (from the diagnosis of primary cancer to the death) were 16 years and 9 months, respectively. The literature review identified 17 cases reported since 2011, bringing the total number of reported cases to 480. Genitourinary cancer, primarily bladder and prostate, account for approximately 70 of the primary cancer sites and gastrointestinal cancers account for approximately 21%. Approximately half of the patients had died of their disease within 1 year of the diagnosis of penile metastasis.

The prognosis of metastatic penile cancer is poor. Most primary cancers are in the urologic or gastrointestinal systems. Surgery and adjunctive therapy may improve symptoms, but fail to prolong survival.

Below:  Penile metastasis from lung squamous cell carcinoma. (A) Longitudinal section of the corpora cavernosum of the penis after phallectomy. The cancer invaded the full-length penis (from balanus to root, red circle), and superficial skin ulceration was also observed. (B) Histological examination with hematoxylin and eosin stain (magnification ×200) showed squamous cell carcinoma of the corpora cavernosum of the penis, moderately to poorly differentiated cells, with massive necrosis and cancer thrombus in the vasculature (red arrows).

Below:  Representative histopathological images of penile metastases with different primary tumors. All images are hematoxylin and eosin stained, ×200 magnification. (A) Epithelioid hemangioendothelioma, primary lung. (B) Advanced urothelial cancer, primary bladder. (C) Advanced urothelial cancer, primary bladder. (D) Angiosarcoma, primary liver. (E) Adenocarcinoma, primary prostate. (F) Poorly differentiated adenocarcinoma, primary stomach. (G) Invasive papillary urothelial carcinoma, primary bladder.

Full article at: http://goo.gl/IJt9B6

By: Ke Zhang, MD, MS, Jun Da, MD, MS, Hai-jun Yao, MD, MS, Da-chao Zheng, MD, MS, Zhi-kang Cai, MD, Yue-qing Jiang, MD, Ming-xi Xu, MD, MS, and Zhong Wang, MD, PhD

Department of Urology and Andrology (KZ, JD, HY, DZ, ZC, YJ, MX, ZW), Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Correspondence: Zhong Wang; Ming-Xi Xu, Department of Urology and Andrology, Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, 639 Zhizaoju Road, Shanghai 200011, China (e-mail: moc.anis@0102gnawgnohz).

  

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HPV Prevalence in Multiple Anatomical Sites among Men Who Have Sex with Men in Peru

Human Papilloma Virus (HPV) infection is the most common sexually transmitted viral infection worldwide. HPV is highly prevalent in sexually active men who have sex with men (MSM) and has been associated with anal cancer, penile cancer, and oropharyngeal cancer.

From March to September 2011, we conducted a cross-sectional study of HPV prevalence among MSM above age 18 years. Participants were recruited using respondent driven sampling at Clinica Cayetano Heredia. All participants provided anal, genital, and oral samples for HPV DNA testing, and blood for HIV and HPV antibody testing.

A total of 200 MSM were recruited in the study. The mean age was 34 years (range 18–59 years, SD = 9.4) and101 participants were HIV negative (99 HIV positive). HPV 6/11/16/18 or quadrivalent HPV vaccine (HPV4) genotype seroprevalence among HIV negative and positive MSM was 64.3% (55%-75.9%) and 93.8% (87.6%-99.2%) respectively (p<0.001). HIV positivity was associated with a higher prevalence of HPV4 and HPV 16/18 DNA at external genital sites and the anal canal. HPV4 DNA prevalence at external genital sites among HIV negative and positive MSM was 14.9% and 28.7% (p = 0.02) respectively, at anal canal was 50.9% and 79.0% (p = 0.001), and at the oral cavity was 9.9% and 8.5% (p = 0.6).

HPV4 seroprevalence was high in our study among both HIV positives and negatives, with HPV DNA prevalence much lower, and the anal canal being the anatomical site with the highest HPV DNA prevalence. HPV prevention interventions are needed among MSM at high-risk for HIV infection.

Below:  Representation of the seeds and their referred participants

Full article at: http://goo.gl/CpyYCy

By: 

Magaly M. Blas, Luis Menacho, Isaac E. Alva, Cesar Carcamo

Epidemiology, STD and HIV Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru

Brandon Brown

Center for Healthy Communities, UCR School of Medicine, Riverside, California, United States of America

Alfonso Silva-Santisteban

Unit of Health, Sexuality and Human Development, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru

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