Peyronie’s disease affects?
Correct Answer: Penis
Description: Ans. b (Penis). (Ref. Bailey & Love, Surgery, 25th ed., 1373)PEYRONIE'S DISEASE# Relatively common cause of deformity of erect penis.# Hard plaque of fibrosis that may be calcified can be palpable in tunica of corpora cavernosa.# Etiology: unknown, past trauma, association with Dupuytren's contracture.# Medical treatments are often ineffective. The disease is typically self-limiting.# Rx: Surgery (Nesbitt's operation) indicated to correct deformity that causes sexual dysfunction. Nesbitt's operation is straightening of penis by placing non-absorbable sutures in corpus cavernosum opposite the plaque.6Chordee.# Chordee (French = corded) is a fixed bowing of the penis due to hypospadias or, rarely, chronic urethritis.# Erection is deformed and sexual intercourse may be impossible.# Treatment is usually surgical.Persistent priapism.# The penis remains erect and becomes painful.# This is a pathological erection and the glans penis and the corpus spongiosum are not involved.# Etiology:- Blood disorders such as sickle cell disease or leukaemia.- Following therapeutic injection of papaverine- An abnormally prolonged bout of otherwise normal sexual activity.- Malignant disease in the corpora cavernosa or the pelvis (A tiny proportion).- Spinal cord disease.# Treatment.- An underlying cause should be excluded. Prolonged priapism is associated with erectile dysfunction, especially if surgical decompression by shunt formation is performed.- If aspiration of the sludged blood in the corpora cavernosa fails to cause detumescence, and injection of metaraminol or 1:100 000 adrenaline solution is ineffective, it may be necessary to decompress the penis by an anastomosis between the corpus spongiosum and one of the corpora cavernosa. The outlook for normal erectile function is poor.Precancerous penile conditions:# Chronic balanoposthitis# Leukoplakia of the glans# Long-standing genital warts# Paget's disease of the penis (syn. erythroplasia of Queyrat): is 'a persistent rawness of the glans like a longstanding balanitis followed by cancer of the substance of the penis'. Treatment is by circumcision, observation and excision if the lesion does not resolve.Buschke-Lowenstein tumour# is uncommon. It is a verrucous carcinoma. It is locally destructive and invasive but appears not to spread to lymph nodes or to metastasise. Treatment is by surgical excision.Circumcision soon after birth confers almost complete immunity against carcinoma of the penis. Later circumcision does not seem to have the same effect and Muslims circumcised between the ages of 4 and 9 years are still liable to the disease. Never use monopolar diathermy when performing circumcision.
Category:
Surgery
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