1. Congenital penile curvature We had 308 cases. The average age was 28.0years (7-56 years). Chief complain were curvature, disturbance of intercourse, erectile dysfunction and penile pain. Treatment methods for congenital penile curvature were plication(240 cases), no treatment(61 cases),and symptomatic therapyï¼ˆ7 cases). We have done our shaving method to prevent relapse.Then, inverted plication suture was performed using non – absorbable 2-0 Ticron.
2. Peyronie’s disease We had 555cases. The average age was 51.4years. Chief complains were curvature, palpable fibrosis, pain, ED etc. 283 cases (34%) was improved by medication. We had two operation methods, plication and grafting after conservative treatment for 1 year. We have two methods of saphenous vein graft, vein graft after plaque excision or vein graft after Hourglass-shaped incision. We performed dermal graft for large defect and lateral defect.
1. Congenital penile curvature We had 240 plication cases. Satisfaction rate was 95.7% (230cases), slight curvature remain was 3.7% (9cases) and complain short penis was 0.6% (1case). Temporary sensory disturbance improved within six months.
2. Peyronie’s disease 113 cases were performed saphenous vein graft. 11 cases were performed dermal graft. 64 cases were performed plication. Satisfaction rate of Grafting was 93.2%. Slight curvature remain was 6.8%. Complain short penis was 2.1%. Complication rate with ED was 1 %.
1) Plication method for congenital curvature is very safe and the high degree of satisfaction.
2) Vein graft is better than plication method for PD with penis shortening.
3) Vein is the best as material for grafting, because the grafted vein is thin and soft.
4) The hourglass-shaped incision method is most suitable for cases of a wide plaque.
5) We need dermal graft for large defect due to calcification of tunica and lateral defect.
The age-related reduction in blood serum testosterone (T) level is well known as hypogonadism. Laboratory biochemical reports in healthy male youth has been reported to contain total-T ranging 250 - 800 mg/L. 60% are tightly bound to SHBG (sex-hormone-binding-globulin), 38% to albumin and in small fraction (2%) only is unbound and known as “free-T”. Consequently, only albumin-bound and free-T constitute the bio-available form of T, which are accessible to target tissues and carry out the actions of essential sex hormone, which also care for sexual function such as libido and mechanism of penile erection. This bioavailability of T concentration is influenced by SHBG levels. Aging men experience increase in aromatase activity and an elevation in SHBG production. The net result is an increase in the ratio of estrogen to T and decrease in total-T and Free-T. Free-T is essential for De-Hydro-Testosterone (DHT) production needed to cross the blood-brain- barrier to stimulate the TARGET aggressive-centre in the brain which provokes libido. Our former studies have shown that Tribulus terrestris L extracts containing the active agent PROTODIOSCIN can be converted to bioidentical DHEA, which may activate the conversion of albumin-bound-T to active Free-T and total-T presence of 5-alpha-dehydrogenase. Experiment with Protodioscin on Hypogonadic men with ED
This presentation, "Responding to the needs of consumers with complex trauma histories a consumer perspective" focuses on the needs of adult survivors of child abuse, highlighting the frequent