Increase In Girth Research Articles

Penis Girth Augmentation Using SEPA Flap and Dermofat Grafts.

Men of various ages feel that an increase in penile size would give them and their sexual partners an increased confidence. There are a variety of methods for increasing penile girth, such as injection therapies and surgery. All of these methods have a high complication rate which must be emphasized to the patients. In this article, the techniques used for increasing penile girth using dermofat grafts and SEPA (superior external pudendal artery) flaps are highlighted along with their complications and their management thereof. Ten patients were operated for penile girth augmentation between June 2016 and March 2022. Of these, six patients had augmentation using dermofat grafts and four patients had SEPA flaps. Patients were chosen as per the Augmentation Phalloplasty Patient Selection and Satisfaction Inventory (APPSSI) score which was between 2 and 6 in the pre-operative period. The age range of the patients were between 25 and 57 years. The mid-penile girth in the flaccid state ranged from 8.8 to 12.3 cm. Post-operatively, after 6 months, the final girth increase varied from 1.9 to 2.6 cm. The complication rate was 50% and included skin loss, urinary obstruction, fat necrosis, and so on. The post-operative APPSSI score ranged from 2 to 12. Complications were more in uncircumcised patients and in those who desired excessive augmentation. Penis girth augmentation using SEPA flaps and dermofat grafts is indicated in patients who fulfill the criteria and give appreciable girth increase, but patients need to be aware of the potential complications of these surgeries.

(130) Increasing Penile Length and Girth in Healthy Men Using a Novel Protocol: The P-Long Study

Abstract Introduction Various therapies have been utilized to increase penile length and girth, with some exhibiting significant adverse event profiles, including fillers, fat transfers, suspensory ligament ligation, and silicon augmentation. Our team sought to evaluate a novel combination therapy to enhance penile characteristics using platelet-rich plasma (PRP) as a source of autologous growth factors, penile traction for lengthening, a vacuum erection device for girth enhancement, and nitric oxide precursor supplements to augment penile vascular smooth muscle function. Objective To evaluate the safety and efficacy of combination therapy with PRP, traction, vacuum device, and nitric oxide boosting nutritional supplements to increase penile length, girth, and function in healthy men. Methods A prospective, non-randomized study was designed (NCT04231422) to evaluate the efficacy of combination therapy in healthy men aged 20-55 with baseline normal erectile function and no penile pathology. Penile length and girth measurements were obtained using at-home photography of an erect penis with maximal tumescence. Measurements were obtained at baseline and at monthly intervals x 6 months. PRP (a modified P-Shot ® Procedure) was administered in the right and left corpora under ultrasound guidance once a month for six months using PureSpin double spin system (60cc blood drawn). Centrifuge technical data show an average platelet recovery of 84% and an average concentration of 6.6 times that of the whole blood sample. Using this data, the injection of 10cc of PRP, assuming a starting platelet count of 250K/microliter, would contain approximately 1.65 billion platelets. Subjective erectile function was assessed with a 5 point Likert Scale. RestoreX traction device was utilized for 20 minutes, twice daily, and a Dr Joel Kaplan vacuum erection device was applied with 5-10 mmHg pressure x 12 minutes (1 min x 2, 5 min x 2). Oral nitric oxide boosting supplementation was with AFFIRM, consisting of 3 gm L-Citrulline and 1 gm beet extract. Results A total of 32 men have been enrolled, with 16 having complete data available for review. The 6-month mean increase in the size of the erect penis was 0.85 inches in length (95% CI: 0.75 to 0.94, p-value < 0.01) (range 0.5-1.44) with a linear increase in size. The 6-month mean increase in circumference was 0.47 inches (95% CI: 0.37 to 0.57, p-value <0.01) (range 0.2-0.75). Mean age was 32 and mean baseline erect penile length was 5.70 and girth was 5.25. All 16 participants reported better penile rigidity with erections. No adverse events were reported. Conclusions Results from a pilot study using a novel combination therapy (P-Long Protocol) in healthy men demonstrated increases in penile length, girth, and subjective rigidity improvement compared to baseline with no adverse effects. External validation is warranted. The P-Long Protocol does not require any synthetic injectables or foreign bodies. It does not preclude additional augmentation procedures. The slope of the growth curve indicates possible continued growth with additional treatments. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: BTL Inc.

Maturity-Related Variations in Morphology, Body Composition, and Somatotype Features among Young Male Football Players.

The study aimed to investigate differences in anthropometry, body composition (BC), and somatotype in young football players of the same chronological age according to the maturity stage. Overall, 64 elite players (age: 14.28 ± 0.46 years) were evaluated for standing and sitting body height, girth measures, and BC using the bioelectric impedance scale and skinfold thickness. In total, two-thirds (73.44%, n = 47) of football players were classified as on-time maturers, 12.50% (n = 8) were early maturing, and 14.06% (n = 9) were late maturing. Standing and sitting height, leg length, fat-free mass, and muscle mass were significantly different (p < 0.001) across maturity groups. A significant decrease (p < 0.05) with maturity progression was seen for subscapular and suprailiac skinfolds along with a girth increase at all sites (p < 0.05). Early maturers were balanced ectomorphs, while on-time and late maturers featured mesomorph-ectomorph characteristics. The obtained results suggested that mature players have better BC presented as a lower fat percentage along with higher muscle mass, advantages in circumferences, and longitudinal dimensions of the body with highlighted mesomorph features. Maturity can have a substantial influence on body measures, thereby affecting sport-specific performance. Early maturers can use their anthropometric advantages and compensate for a lack of talent, consequently preventing even participation of physically undeveloped players in training. A better understanding of maturity, BC, and somatotypes can help in the selection of young talented players.

Compensatory mechanisms in response to induced hypothyroidism in the late gestation pig fetus†.

To understand the effect of fetal thyroid gland disruption on development in swine, we evaluated thyroid hormone levels, growth and developmental characteristics, and gene expression associated with thyroid hormone metabolism in late gestation fetuses exposed to methimazole (MMI). Pregnant gilts were given either oral MMI or equivalent sham from gestation day 85-106 (n= 4/group), followed by intensive phenotyping of all fetuses (n= 120). Samples of liver (LVR), kidney (KID), fetal placenta (PLC), and the corresponding maternal endometrium (END) were collected from a subset of fetuses (n= 32). Fetuses exposed to MMI in utero were confirmed hypothyroid, with a significant increase in thyroid gland size, goitrous thyroid histology, and dramatically suppressed thyroid hormone in serum. In dams, no differences in temporal measurements of average daily gain, thyroid hormone, or rectal temperatures relative to controls suggests that MMI had little effect on maternal physiology. However, fetuses from MMI-treated gilts exhibited significant increases in body mass, girth, and vital organ weights, but no differences in crown-rump length or bone measurements suggesting non-allometric growth. The PLC and END showed a compensatory decrease in expression of inactivating deiodinase (DIO3). Similar compensatory gene expression was observed in fetal KID and LVR with a downregulation of all deiodinases (DIO1, DIO2, DIO3). Minor alterations in the expression of thyroid hormone transporters (SLC16A2 and SLC16A10) were observed in PLC, KID, and LVR. Collectively, MMI crosses the PLC of the late gestation pig, resulting in congenital hypothyroidism, alterations in fetal growth, and compensatory responses within the maternal fetal interface.

Scrotal approach for tunica expansion procedure (TEP) for penile girth and length restoration during penile prosthesis implantation in patients with penile angulation due to Peyronie's disease and erectile dysfunction: technique and outcomes.

Peyronie's disease is often comorbid with erectile dysfunction and can cause significant penile shortening. We describe our modified tunica expansion procedure (TEP) technique of penile length preservation and girth enhancement with correction of penile angulation in patients with mild Peyronie's disease (<30 degree angulation, or hourglass deformity, no hinging) and erectile dysfunction presenting for inflatable penile prosthesis (IPP) surgery. A retrospective review of IPP placement from one high volume surgeon was performed. A total of 474 patients' charts from June 2017 to June 2021 were reviewed and those charts of patients undergoing modified TEP in the setting of Peyronie's disease were analyzed. Average increase in length and girth were measured and means with standard deviations calculated. The modified TEP is performed through a scrotal approach and involves complete eversion of the penis with dissection of Buck's fascia off the underlying tunica. Subsequently, staggered scorings of the underlying tunica are performed allowing for circumferential girth enhancement and length preservation. In men with Peyronie's disease, these scorings are preferentially concentrated on the side of the plaque to allow straightening without loss of length. A total of 32 patients with Peyronie's disease from the larger cohort underwent the modified TEP. Mean increase in length of distal corpora was 2.8 ± 0.8 cm (range 2.0-3.4 cm) (measured using Furlow before and after penile eversion with TEP), while mean increase in girth (measured at midphallus prior to prosthesis insertion and after IPP inflation) was 1.6 ± 0.4 cm (range 1.2-2.2 cm). There were no reported complications. A scrotal approach to TEP is an easy to perform technique that can be used to restore length and enhance girth in men with Peyronie's disease undergoing insertion of IPP. Additionally, it is a customizable approach that can also be used to correct mild penile angulation.

EFFECT OF CRUDE OIL POLLUTION OF SOIL ON THE VEGETATIVE GROWTH OF PLANTAIN (Musa paradisiaca¬)

Plant growth is affected by genetic, climatic and edaphic factors among others. Soil pollution may adversely affect biota by limiting growth and survival of plants. The research was carried out to investigate the potential effect of crude oil pollution of soil on the growth of two cultivars of Musa paradisiaca. Crude oil was added to agricultural soil on which plantain suckers were planted. Growth was then periodically assessed in terms of height, stem girth and total leaf area. Plant height was significantly reduced in the two cultivars grown on polluted soil in comparison with controls grown on unpolluted soil. There was also an insignificant decrease in stem girth in plants grown on polluted soil. Total leaf area increased for French plantain planted on crude oil contaminated soil more than control. For False Horn plantain however, the control had greater leaf area than those on polluted soil. The rates of increase in height, stem girth and leaf area were not uniform with time for the two cultivars. French plantain survived the stress caused by soil pollution better than False Horn plantain, although, both plantain cultivars on polluted soil still grew appreciably in comparison with controls. They may therefore be useful in remediating soils polluted by crude oil spillage.

Circumferential acquired macropenis: proposal of a geometrically-based reduction corporoplasty

Circumferential acquired macropenis is a rare syndrome of symmetric corpora cavernosa girth increase, that encompasses two distinct etiologies: post-priapistic cases, with penile girth increase both in flaccidity and erection, and idiopathic cases, with girth increase in erection only, and a thinned albuginea in the affected area (paper accepted for publication - Sexual Medicine). We propose an “ad hoc” geometrically-based reduction corporoplasty. Case: man that developed over two years a critical girth penile increase up to 21 cm, causing partner dyspareunia. DICC ruled out vascular problems; its cavernosographic phase showed a symmetric, sharp dilatation of the two corpora at the shaft middle 2/3 (see Figure). Surgical technique: following neurovascular bundle elevation, proximal and distal normal, “target” circumferences, according to perception of normal thickness albuginea, are measured. Bilateral paraurethral defined reference intervals are marked along the dilated aspect of the albuginea; circumferential measurements at such reference sections are performed. The differences between the measured circumferences and the target circumferences are then calculated. Each resulting difference is divided by two, to identify the final measurements to bilaterally define the ellipses of albuginea to be excised. Following their removal, albugineal margins are closed with a continuous water-tight suture. In all the affected aneurysmal area the thinned albuginea is reinforced by a patch of bovine pericardium (Synovis Supple Peri-Guard®), fashioned according to the target erect shaft dimensions, and anchored with cardinal stitches at the paraurethral albuginea, and in the dorsal midline.Bucks’ fascia is re-approximated, and standard circumcision performed. At 20 months follow-up the patient is maintaining a normalized penile shape, he has a regular sexual activity, with dyspareunia resolution and full patient-partner satisfaction. Circumferential acquired macropenis prevents affected men from effective sexual penetration. We present its correction by a geometrically-based reduction corporoplasty, with satisfactory results at 20 months follow-up. Authors do not have any conflict of interest.

Penile augmentation by division of the suspensory ligament of the penis and autologous fat injection

To evaluate the outcome of penile augmentation (PA) surgery at one center. A retrospective review of 471 patients who underwent division of the suspensory ligament of the penis, with insertion of silicon buffer, and autologous fat injection at one unit. The following data were collected: the penile length and girth before and after the surgery, patient satisfaction and the complication rate. 471 patients were included this review over a 4 year period. The mean patient age was 35 (26-62) years; mean follow-up period was 4 (1-9) months; mean pre-operative flaccid length and girth was 9.4 (6-14) cm and 8.9 (7-11.5) cm respectively; and the mean increase in flaccid penile length and girth was 4.2 (2-8) cm and 3.9 (2.5- 7.5) cm respectively. In terms of patient-reported treatment outcome: 80% of the patients satisfied with the procedure, the main source of the dissatisfaction in the remaining patients was fat loss which occured in 94 (20%) patients and was managed by fat top up. No serious complications were encountered: 15 patients developed phimosis which resolved spontaneously except in 2 patients who needed a circumcision; 8 patients experienced the formation of a hard fat lump which was managed by needling and hyalase injections in an outpatient setting; 5 patients experienced infection of the silicon buffer which required surgical removal; 3 patients experienced discomfort from the silicon buffer which required surgical removal;7 patients had migration of some fat into the scrotum and 3 of them required surgical removal of the fat lump. None of the patients complained of downward angulation of the penis, sensory changes or erectile dysfunction. Surgical Penile enlargement is a safe, effective procedure associated with a high patient-satisfaction rates. None

Ovarian hyperstimulation syndrome following the use of GnRH agonist trigger of final oocyte maturation and freeze–all strategy

Rationale: The current literature has a surprising controversy regarding the use of low-dose human chorionic gonadotropin (hCG) for luteal support as an explanation for the development of ovarian hyperstimulation syndrome, and this is because of the gap in the listing of the predisposing factors that put women at an increased risk of ovarian hyperstimulation syndrome. Patient concerns: A case of 25-year-old woman presented with abdominal pain, distention, dyspnea, and nausea with a 6.5 kg increase in weight from baseline. Ultrasonographic examination showed bilaterally enlarged multicystic ovaries after gonadotropin-releasing hormone (GnRH) agonist triggering and cycle segmentation with no hCG rescue administration. Diagnosis: Moderate/severe ovarian hyperstimulation syndrome. Interventions: The woman was admitted to the hospital for medical management of moderate/severe ovarian hyperstimulation syndrome, and pain management was advanced to patient-controlled anesthesia with the start of low molecular weight heparin. On day 2, albumin therapy followed by a furosemide chase was started due to an increase in abdominal girth. On day 1, Cabergoline was maintained, and on day 2 the GnRH antagonist Cetrorelix was started. Outcomes: The woman’s clinical condition improved, and a clinical pregnancy was eventually achieved during the first cryo-warmed blastocyst cycle. Lessons: Ovarian hyperstimulation syndrome can still happen even after the use of GnRH agonist and avoidance of hCG support. Segmentation of in vitro fertilization with complete avoidance of hCG for luteal support remains the best approach.

Appendicular mass with pseudomyxoma peritonei: a case report

Pseudomyxoma peritonei is an infrequently occurring clinical entity having an annual incidence of less than two per million. It is originated from the rupture of a tumour filled with mucinous substance. The intra-abdominal viscera are usually covered with a jelly-like substance. This syndrome originates most frequently from tumours of the appendix or ovaries. Genetic history is expected to play a role in the appendicular mucocele. The disease advances due to the presence of microbial agents expressed in carcinomas associated with gelatinous ascites. It typically has an insidious onset with a non-exclusive presentation like an increase in abdominal girth and associated abdominal pain with locoregional dissemination initially and dissemination to multiple sites later. The main sign is pelvic ascites. Diagnosis is made by combining radiological imaging with histopathology. Ultrasound aids in identifying the pelvic mass, peritoneal implants, calcifications, effusion, septa, the associated tumours (e.g., ovaries), the involvement of mesentery, and finalizing the surgical strategy. Usually, this condition is adequately treated by combining surgical excision and/or hyperthermic intra-peritoneal chemotherapy (HIPEC), which may be omitted by selecting the patient carefully.

Visible abdominal distension in functional gut disorders: Objective evaluation.

Visible abdominal distension has been attributed to: (A) distorted perception, (B) intestinal gas accumulation, or (C) abdominophrenic dyssynergia (diaphragmatic push and anterior wall relaxation). A pool of consecutive patients with functional gut disorders and visible abdominal distension included in previous studies (n= 139) was analyzed. Patients (61 functional bloating, 74 constipation-predominant irritable bowel syndrome and 4 with alternating bowel habit) were evaluated twice, under basal conditions and during a self-reported episode of visible abdominal distension; static abdominal CT images were taken in 104 patients, and dynamic EMG recordings of the abdominal walls in 76, with diaphragmatic activity valid for analysis in 35. (A) Objective evidence of abdominal distension was obtained by tape measure (increase in girth in 138 of 139 patients), by CT imaging (increased abdominal perimeter in 96 of 104 patients) and by abdominal EMG (reduced activity, i.e., relaxation, in 73 of 76 patients). (B) Intestinal gas volume was within ±300 ml from the basal value in 99 patients, and above in 5 patients, who nevertheless exhibited a diaphragmatic descent. (C) Diaphragmatic contraction was detected in 34 of 35 patients by EMG (increased activity) and in 82 of 103 patients by CT (diaphragmatic descent). In most patients complaining of episodes of visible abdominal distention: (A) the subjective claim is substantiated by objective evidence; (B) an increase in intestinal gas does not justify visible abdominal distention; (C) abdominophrenic dyssynergia is consistently evidenced by dynamic EMG recording, but static CT imaging has less sensitivity.

Men's Experiences and Psychological Outcomes of Nonsurgical Medical Penile Girth Augmentation: A Preliminary Prospective Study.

The popularity of penile augmentation procedures is increasing, but investigation into men's experiences with these procedures and their impact on psychological well-being is lacking. The aim of this study was to investigate men's experiences with nonsurgical medical penile girth augmentation and assess, based on valid psychological measures, the impacts these procedures have on psychological well-being. Men seeking to undergo a girth augmentation (n = 19) completed an online questionnaire prior to their procedure and 6 months later that contained standardized measures assessing impacts of the procedure, penile size self-discrepancy, body dysmorphic disorder, psychological distress, self-esteem, and body image-related quality of life. Girth size was also measured preprocedure and 6 months postprocedure for a subsample of men. Almost half of the men reported positive impacts of "increased self-confidence" and "increased sexual pleasure" after their procedure. Despite an average girth increase of 3.29 cm, the men still perceived that their penile girth and length was less than what they should be or less than the ideal size after their augmentation procedure. However, this perceived discrepancy was significantly smaller than before their procedures. Prior to the procedure, the men who met diagnostic criteria for body dysmorphic disorder according to self-reported questionnaire (11%, n = 2/19) and clinical interview (7%, n = 1/15) lost this diagnosis at 6 months. There were no changes in psychological distress, self-esteem, or body image-related quality of life from pre- to postprocedure. Men report positive impacts on their lives after penile girth augmentation, but impacts on broader psychological well-being are mixed.

Evaluating Starter Feeding on Ruminal Function in Yak Calves: Combined 16S rRNA Sequencing and Metabolomics.

For young ruminants, starter feeding can effectively facilitate the growth and development of rumen in ruminants, but the development of rumen is an important physiological challenge as it remains unclear for the mechanism of starter feeding stimulating. In this study, we performed an analysis of ruminal microbiota and their metabolites in yak calves to explore how the ruminal microbiota and their metabolites stimulate the ruminal function. This study associated 16S rRNA sequencing with liquid chromatography-mass spectrometry (LC-MS)-based metabolomics to evaluate the effects of starter feeding on ruminal microbiota diversity and metabolites in yak calves. We designed the experiment using 20 yak calves that were assigned equally into 2 groups, based on feeding milk replacer; the control (RA) group was fed with alfalfa hay while the treatment (RAS) group was fed with alfalfa hay and starter. After the experiment, we investigated the ruminal microbiota and metabolites through 16S rRNA sequencing and LC-MS-based metabolomics. During the preweaning period, the RAS group significantly promoted the growth performance and ruminal development in yak calves, including increases in body weight, chest girth, and development of rumen (P < 0.05). The RAS group increased the relative abundance of Bacteroidota, Proteobacteria, Chloroflexi, Synergistota, and Spirochaetota and decreased the abundance of Firmicutes, Desulfobacterota, Actinobacteriota, and Actinobacteriota at the phylum level (P < 0.05). At the genus level, the ruminal content of the RAS group was significantly enriched for Rikenellaceae_RC9_gut_group and Ruminococcus, while depleted for Prevotella, Christensenellaceae_R-7_group, and NK4A214_group (P < 0.05). A total of 37 metabolites were identified between the RA group and the RAS group, of which 15 metabolites were upregulated and 22 metabolites were downregulated compared with the RA group. Metabolic pathway analyses indicated that upregulated the metabolites of the RAS group yak calves were related to carbohydrate metabolism, ubiquinone, and other terpenoid-quinone biosynthesis, while the downregulated metabolic pathway was relevant to xenobiotic biodegradation, metabolism, and nucleotide metabolism. In summary, starter feeding before weaning significantly increased the dry matter intake and body weight of yak calves, changed the diversity and abundance of ruminal microbiota, and positively regulated the good development of ruminal morphology and function, providing an important basis for high-quality cultivation and the nutritional level of nutrition of yak calves in the Qinghai Tibet plateau. This study is based on the availability of 16S rRNA sequencing and LC-MS-based metabolomics in clarifying the function of starter feeding in the yak calves.

Respons Pertumbuhan Bibit Kelapa Sawit dengan Pemberian Kompos Pelepah, Tandan Kosong Kelapa Sawit, dan Air Cucian Beras

In oil palm plantations, compost application for plants aims to support a sustainable cropping system. The study aimed to determine the effect of oil palm midrib compost, oil palm empty fruit bunches and rice washing water on the growth of oil palm seedlings in the main nursery. The experiment was conducted at the Ciparanje Experimental Garden, Faculty of Agriculture, Padjadjaran University, from February 2020 to August 2020. The experiment was conducted using an experimental method using a randomised block design consisting of twelve treatments with three replications. The treatments included the application of inorganic fertilisers, oil palm midrib compost, oil palm empty fruit bunch compost and rice washing water either singly or in a combination of the three. Observations were made on the variables of increase in plant height, increase in stem girth, increase in the number of palm midribs, and leaf chlorophyll content. The F (Fisher) test analysed observational data at a 95% confidence level, followed by Duncan's multiple range test at a 95% confidence level. Data analysis using the SASM-Agri application. A mixture of 1.600 g of oil palm midrib compost, 100 g of oil palm empty fruit bunch compost with 500 ml of rice washing water can be used as a reference for the composition of organic fertiliser for oil palm seedlings, especially its effect on the increase of stem girth and leaf chlorophyll content.

PD28-12 MODIFIED TEP: A NOVEL WAY TO OPTIMIZE PENILE GIRTH AND LENGTH ENHANCEMENT POST IPP

You have accessJournal of UrologyCME1 May 2022PD28-12 MODIFIED TEP: A NOVEL WAY TO OPTIMIZE PENILE GIRTH AND LENGTH ENHANCEMENT POST IPP Shirin Razdan, Ariel Zisman, and Robert Valenzuela Shirin RazdanShirin Razdan More articles by this author , Ariel ZismanAriel Zisman More articles by this author , and Robert ValenzuelaRobert Valenzuela More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002576.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Three piece penile prosthesis (IPP) surgery is the gold standard surgical treatment of erectile dysfunction. As this procedure is associated with penile shortening in inexperienced hands, many techniques created by experienced surgeons exist in the literature to optimize penile length and ensure proper cylinder sizing. Here we present our data on a modification of the existing tunica expansion procedure (TEP) for penile length restoration. METHODS: A retrospective review of IPP placement from one high volume surgeon was performed. A total of 474 patients’ charts from June 2017 to June 2021 were reviewed and those charts of patients undergoing modified TEP were analyzed. The modification entails alternating between vertical and horizontal scoring of the tunica albuginea, with vertical scoring contributing to increased penile length and horizontal scoring contributing to increased penile girth. Endpoints were average increase in prosthesis length as well as average increase in girth. RESULTS: A total of 23 patients from the larger cohort underwent modified TEP. All patients underwent IPP placement via scrotal approach. In patients undergoing vertical modification of TEP (n=15), average increase in length of distal corpora was 2.8cm. This was measured using Furlow before and after penile degloving with TEP. In patients undergoing horizontal TEP (n=8), average increase in girth was 1.6cm. This was measured at midphallus pre-procedure and after full inflation of prosthesis. There were no reported complications for these 23 cases. CONCLUSIONS: In men undergoing IPP placement, modification of the already existing TEP can allow for measurable increase in penile length and girth of almost 3 and 2cm respectively. This is an important technique within the arsenal of the prosthetic urologist to ensure cosmesis post IPP placement is optimized. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e503 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shirin Razdan More articles by this author Ariel Zisman More articles by this author Robert Valenzuela More articles by this author Expand All Advertisement PDF DownloadLoading ...

HF01-17 PENILE STRETCHING PRACTICES THROUGH TIME AND CULTURE

You have accessJournal of UrologyCME1 May 2022HF01-17 PENILE STRETCHING PRACTICES THROUGH TIME AND CULTURE John Sigalos, Sriram Eleswarapu, and Jesse Mills John SigalosJohn Sigalos More articles by this author , Sriram EleswarapuSriram Eleswarapu More articles by this author , and Jesse MillsJesse Mills More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002541.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The medical literature suggests there is benefit to penile stretching and traction therapy in Peyronie’s disease, after prostatectomy to prevent shortening, erectile dysfunction prior to placement of an inflatable prosthesis, and for men concerned about penile length. We seek to present the historical practices regarding penile stretching and traction therapies. METHODS: Literature review via PubMed, Google scholar, and archive.org for books, journal articles, texts, and historical discussion detailing the practice of penile stretching and traction practices throughout history. RESULTS: Margaret Mead in her studies of Polynesian males described a woven device of plant fiber that was used to help men to stretch their penises. Working in a similar fashion to a Chinese finger trap, the penis is inserted into one end of the device while a weighted object is hung from the other end. The Cholomec tribe from Peru and some African tribes have used the direct hanging of weights on to their penises in attempts to increase penile length. This method of traction does not increase girth. Direct use of weights hanging from the penis has been shown to decrease girth and cause tissue damage. Certain Holy Men from the Sadhu tribes in India have practiced penile stretching via hanging stones from their penises using grass or lianas. Egyptian pharaohs as well may have used weights to increase penile length. The most prominently featured technique of penile stretching is the Arabic jelqing method. Jelqing is still practiced by some to this day, and it involves a regimented milking or massaging of the semi-erect penis from base to tip repeatedly. The man then stops jelqing prior to ejaculation so that the process can be restarted. Jelqing has not been rigorously studied in the medical literature, however one British physician reported on use of jelqing for penile length gain in the 1970s. Richards' study reported on 30 men, who followed a regular program of jelqing three months. According to Richards, 87 percent of the participants experienced increases in penile length with an average 1 inch increase in the length of their penises and a 1 inch increase in girth. A similar milking and exercise method has been used by Sudanese practioners to achieve increased penile size. CONCLUSIONS: There is a long-standing use of penile stretching and traction practices across many cultures and historical time points. Only recently has the medical literature begun to elucidate best practices and objective benefits that men have been seeking for many years. Source of Funding: John Sigalos has received funding from H H LEE Research Program via LB Research and Education Foundation in support of this work © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e217 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information John Sigalos More articles by this author Sriram Eleswarapu More articles by this author Jesse Mills More articles by this author Expand All Advertisement PDF DownloadLoading ...

Seasonal patterns of increases in stem girth, vessel development, and hydraulic function in deciduous tree species.

The onset of spring growth and vessel formation were examined within three deciduous woody plant species, Acer rubrum, Populus balsamifera ssp. trichocarpa and Quercus rubra. We were broadly interested in the lag between the onset of girth expansion and the formation of mature and hydraulically conductive vessels within the new xylem. Dendrometers were installed on 20 trees (6-7 per species), and expansion of both bole and distal stems was monitored throughout the growing season in a common garden. For each species, four to six distal stems were harvested every other week for anatomical examination of vessel formation. Additionally, for Populus and Quercus, hydraulic conductivity measurements and active xylem staining were completed on all stem samples. For all three species, the timing of girth expansion was similar. Expansion of distal branches occurred 12-37 d earlier than that of the bole. Vessel formation initiated several weeks prior to leaf-out, but no new earlywood vessels were mature at the time of bud break for Acer and Populus and only a few were present in Quercus. Initial stem girth expansion occurred 2 to &gt;6 weeks before the maturation of the first current-year vessels, and there was an additional delay of up to 4 weeks before mature vessels became hydraulically functional. Hydraulic conductivity was strongly correlated with the number and diameter of stained vessels. Bud break and leaf expansion relied predominantly on water supplied by vessels formed during prior seasons. Early-season activity is likely affected by the function of older xylem vessels and the environmental factors that influence their structure and function. Understanding the functional lifespan of vessels and the varying contributions of new and older vessels to conductivity are critical to understanding of the phenology and vascular function of long-lived woody plants in response to changing climates.

Effects of Poultry Manure Application on the Early Seedling Development of Treculia Africana (Breadfruit)

This study was carried out to ascertain the effects of different rates of poultry manure on early seedling development of Treculia africana. The experiment was carried out at Nnamdi Azikwe University Awka. Randomized Complete Block Design was used for the study. A total number of 18 perforated poly bags (48cm×40cm) containing 10kg of soil were laid out in the screen house in a Randomized Completely Block Design (RCBD) with 6 treatments in 3 replicates. The levels of treatment were, 0.0g, 17g, 34g, 51g, 68g, and 85g of poultry manure per 10kg of soil which were sun-dried to conserve the nutrient properties and for easy handling, weighed properly and incorporated into the soil 2 weeks prior to sowing. Growth parameters such as changes in length, girth, leaf area and number of leaves were measured on bi-weekly bases and recorded accordingly. The physicochemical properties of the soil sample and poultry manure is shown in Table 1. The table revealed that the soil sample contained higher composition of sand than silt and clay. The poultry manure contained higher pH, organic carbon, available phosphorus, potassium ion and calcium ion than the soil samples. The effect of different rates of poultry manure on percentage germination of Treculia africana was shown in Table 2. The result of the effect of different rates of poultry manure on the germination of T. africana revealed that rate of 68g/10kg gave the highest percentage germination of (85.17±0.208 %), 85g/10kg gave the highest increase in stem girth from 1.02±0.026cm in week 2. the number of leaves of T. africana indicated that the rate of 85g/10kg gave the highest increase in the number of leaves from 3.50±0.015 in weeks 2 to 5.01±0.010in weeks 8, while 85g/10kggave the highest increase in leaf area from 26.65±2.904cm2 in weeks 2 to 47.80±0.046cm2 in weeks 8. Due to the ecosystem pollutions caused by use of inorganic materials, this study has demonstrated the potential of poultry manure in enhancing the early seedling growth of T. africana in fairly low nutrient soil. There was an increase growth rate of the seedlings with increasing rates of poultry manure. All the parameters of T. africana seedling responded positively to various rate of poultry manure with the seedlings with 85g/10kg rate of the poultry giving the best performance while the control plants gave the lowest performance.

When the metastatic tumor presents as a primary tumor: Gastric signet-ring cell carcinoma presenting as advanced cervical cancer with ovarian metastasis

Ovarian cancer is the second most common malignancy of the lower part of the female genital tract. Primary signet-ring cell carcinoma (SRCC) of the ovary is rare and is most commonly metastatic from a primary lesion. Discerning between primary and metastatic SRCC of the ovary or cervix may be difficult. SRCC of the cervix is also a rare type of cervical carcinoma, and just like in the ovary, it is usually metastatic from a primary gastric tumor. Presented here is a case of a 37-year-old nulligravid, who presented with an increase in abdominal girth with associated abdominal pain. The initial impression was ovarian new growth, probably malignant, and cervical mass, probably malignant. On laparotomy, intraoperative impression was cervical with ovarian malignant tumor, primary unknown versus double primary. Histopathology revealed metastatic adenocarcinoma, right ovary, cervical stroma, omentum, and umbilical mass with anterior abdominal mass. Peritoneal fluid was positive for malignant cells. Clinical correlation, further workup, and immunohistochemical stains for CK7, CK19, CK20, and CDX2 were recommended. All immunohistochemical results tested positive in tumor cells and were noted to be consistent with metastatic carcinoma of gastric versus pancreatic primary. Further workup was done, and the biopsy from the esophagogastroduodenoscopy revealed poorly differentiated adenocarcinoma with signet-ring features, antral mucosa.

Circumferential Acquired Macropenis: Definition, Literature Review and Proposal of Geometrically-Based Reduction Corporoplasty.

IntroductionOver the years, scattered cases of acquired penile girth increase have been published with different terms, the common clinical feature being a mechanically hampered penetration.AimTo search for all published cases of acquired penile girth increase, and to propose a geometrically-based reduction corporoplasty.MethodsA case of acquired penile bilateral albuginea herniation prompted us to a PubMed, EMBASE and Google Scholar literature review from 1970 to 2021, in search for similar conditions.Main Outcome MeasureWe identified 7 cases of acquired penile girth increase; the geometric approach used to surgically correct bilateral corporal herniation proved successful in our case.ResultsIn 5 of the 7 cases of acquired penile girth increase, priapistic episodes were deemed the causal factor; in the remaining 2 and in ours, a clear etiology could not be identified.Conclusion“Circumferential acquired macropenis” describes the unusual syndrome of acquired penile girth increase, that encompasses 2 distinct etiologies: post-priapistic cases, characterized by penile girth increase both in flaccidity and erection, and idiopathic cases, characterized by girth increase in erection only, and at surgery by a thinned albuginea in the affected area.Pescatori ES, Drei B, Rabito S Circumferential Acquired Macropenis: Definition, Literature Review and Proposal of Geometrically-Based Reduction Corporoplasty. Sex Med 2022;10:100460.