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Pathology Carcinoma of the penis is most typically a squamous cell carcinoma arising in the skin of the glans penis or the prepuce. It may be flat and infiltrating or warty in appearance. The former often starts as leukoplakia or PeIN; the latter results from ...

Penile intraepithelial neoplasia (carcinoma in situ of the penis, Bowen’s disease, erythroplasia of Queyrat) PeIN is typically seen as a red cutaneous patch on the penis. When it occurs on the glans penis, it is known as erythroplasia of Queyrat; when it occu...

Periurethral abscess Periurethral abscesses were once common with high morbid ity but are now rare. Clinical presentation is varied but may include fever, dysuria, urethral discharge and swelling of the penis or scrotum. In untreated cases urethral fistulation...

Phimosis in adults Scarring in adults occurs as a result of balanitis (inflammation of the glans penis), posthitis (inflammation of the foreskin) or LS. In LS ( Figures 85.14 and 85.15 ) the normal pliant foreskin becomes thickened, typically whitish in appea...

Phimosis in boys In true phimosis the prepuce does not retract ( Figure 85.13 This may result in ballooning of the foreskin during micturition and may also result in infection (balanoposthitis).

Reiter’s disease (synonym: sexually

Short frenulum Phimosis should not be confused with the condition where the frenulum is short. It causes pain when the foreskin is retracted. Another possible presentation is tearing of the frenulum during sexual activity . Treatment is by frenuloplasty , wh...

Strangulation of the penis Strangulation of the penis is caused by rings placed on the penis, usually for sexual pleasure. It can cause venous engorge - ment, which prevents their removal. The ring must be cut o ff with a ring cutter. -

T H E P E N I S Anatomy The penis is a sexual organ and composed of three tubular structures. The two dorsal structures, the corpora cavernosa, provide erectile function and are anchored posteriorly onto the pubic rami. The ventral tubular structure is the ...

THE MALE URETHRA Anatomy The male urethra is a fibromuscular tube that extends from the bladder neck to the meatus. Functionally the urethra allows transport of urine from the bladder and semen from the ejaculatory ducts through the penis. The male urethra is ...

Treatment Management is divided into treatment of the primary tumour and treatment of the inguinal nodes. Patients with small lesions surgery , such as limited excision, Mohs’ surgery or laser ablation. Mohs’ micrographic surgery is based on sequential tissu...

Tropical sexually transmitted infections Lymphogranuloma venereum Lymphogranuloma venereum is a sexually transmitted disease caused by C. trachomatis (chlamydia A) types L1–L3 and is primarily an infection of the lymphatics and lymph nodes. It can a ff ect bot...

Urethral discharge The commonest cause of urethral discharge in men is urethritis; the two commonest causes of urethritis are non-specific urethritis (NSU) and gonococcal urethritis. Other related symptoms include dysuria and urethral pruritus while epididymi...

acquired reactive arthritis) Reiter’s disease is an autoimmune disease characterised by the triad of urethritis, conjunctivitis and polyarthritis. Common triggers include chlamydial urethritis, less commonly gonococ - cal urethritis and diarrhoea secondary to...

genital warts) Genital warts are caused by infection with HPV and are sexu - ally transmitted. Infection is very common, with only a small - proportion of infected patients actually having visible warts. Most commonly due to HPV types 6 and 11, these viruses ...

Absent testis ‘Vanishing’ testis describes a condition in which a testis devel ops but disappears before birth. The most likely cause for this is prenatal torsion. True agenesis of the testis is rarer. Laparos copy is useful in distinguishing these causes of ...

CYSTS ASSOCIATED WITH THE EPIDIDYMIS There are several types of cyst associated with the epididymis, including epididymal cysts and spermatoceles.

Carcinoma of the scrotum ‘Chimney sweep’s cancer’ was the first reported occupational cancer (described by Percival Pott in 1775). It is a rare cancer that has also been seen in other workers who come into contact with oil and coal products. Animal studies sugg...