Background: Penile injection of foreign materials is an obsolete practice often performed by non-medical personnel in order to enlarge penile size. Methods: A systematic review of the literature from 1956 to 2022 was conducted in accordance with the general guidelines recommended by the Primary Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. We included full papers published from 1956 to 2022. We also described a case report of a 23 year old Bulgarian male affected by penile paraffinoma who underwent a 2-stages surgical technique. Results: A total of 152 cases have been reported, with a median age of 37.9 ranging from 18 to 64 years. Six different techniques have been described in the whole literature: bilateral scrotal flap, simple excision of the paraffinoma with primary closure, two-stage scrotum skin flap, medial prepuce-soprapubic advancement flap technique and penile reconstruction using split thickness skin graft (STSG) or full thickness skin graft (FTSG). An analysis of the distribution among early and late complications was then carried out. Conclusion: In our experience, among the variety of surgical techniques described, a two-stage penile reconstruction using scrotal skin results in excellent cosmetic and functional outcomes, with a low rate of complications.

This year marks the fiftieth anniversary of the first implant of an inflatable penile prosthesis (IPP). The authors of this paper want to celebrate the event with a narrative review of the current literature. The main scopes are antibiotic prophylaxis, patient satisfaction, and future developments. The implant of the first IPP in 1973, performed by Branteley Scott was a turning point in the history of penile prosthesis, revolutionizing the treatment of erectile dysfunction (ED). Since then, the idea of an inflatable device has not changed much. However, the innovations in design, materials, surgical techniques, and perioperative management led to a more natural, durable, and reliable device featuring fewer complications and greater patient satisfaction. Currently, IPP is associated with high patient satisfaction and excellent long-term outcomes, remaining the gold standard for men with refractory ED. Several strategies are under investigation to improve the technology of penile prosthesis, and we expect in the next future the introduction of new devices that are easier to activate, discreet, comfortable when deflated, and durable in time, mimicking a more physiological erection.

We performed a monocentric longitudinal study on sexually active male patients, from May 2021 to October 2021, with SARS-CoV-2 infection confirmed with a nasopharyngeal reverse transcriptase polymerase chain reaction (RT-PCR). The questionnaires were delivered by email. The study period was divided into the periods before getting tested (T1), during quarantine (T2), 1 month after a negative test (T3), and 3 months after a negative test (T4). All participants were invited to complete these questionnaires: 10- and 6-item questionnaires, a sexual distress schedule (SDS), and the international index of erectile function questionnaire of 15 items (IIEF-15). The primary endpoint was to evaluate the impact of quarantine on male sexual function (SF) during and after the SARS-CoV-2 infection. A total of 22 male patients met the inclusion criteria. The differences for both SDS and IIEF-15 scores, between T1–T2 (27 (IQR 24.0–32.2) vs. 37.5 (IQR 34.2–45.5), 45 (IQR 38.0–50.2) vs. 28.5 (IQR 19.5–38.0)), T2–T3 (37.5 (IQR 34.2–45.5) vs. 28 (IQR 24.0–31.0), and 28.5 (IQR 19.5–38.0) vs. 39.5 (IQR 35.5–44.2)) were statistically significant (p < 0.001), respectively. Moreover, between T1–T4, no statistically significant difference (p > 0.05) was recorded in both SDS (27 (IQR 24.0–32.2) vs. 26.5 (IQR 24–30.2)) and IIEF-15 (45 (IQR 38.0–50.2) vs. 28.5 (IQR 19.5–38.0)). In 20 patients (90.9%), SARS-CoV-2 had a huge impact on relationship and sexual life, but no patient attended a clinic for sexual difficulties. In conclusion quarantine has negatively influenced SF in infected patients; however, 3 months after the rRT-PCR negative test, a promising return to the preinfection SF values is observed.

Adult Acquired Buried Penis(AABP) is a debilitating condition often requiring surgical correction. This multicentre retrospective study, the largest of its kind in Europe to date, evaluated outcomes of 204 patients who underwent AABP repair between June 2011 and January 2025, with a median follow-up of 18.0 months(IQR 7.0–46.0). Surgical complexity was classified according to the Pariser system; 70.6% underwent high-complexity procedures(Pariser≥III). Body Mass Index ≥30 kg/m² was the leading etiological factor(45.1%), more prevalent in the high-complexity group( p < 0.001), followed by lichen sclerosus(23.0%), more prevalent in the low-complexity group( p = 0.011) and genital lymphoedema(20.1%). Main presenting complaints included sexual dysfunction(50.5%), aesthetic concerns(40.7%) and urinary problems(36.3%). Skin grafts were used in 44.6% of cases, more often in low-complexity procedures( p < 0.001). The overall complication rate was 27.0%, significantly higher in the high-complexity group(32.6% vs. 13.3%, p = 0.005), with high-complexity surgery independently predicting complications( p = 0.013). Recurrence occurred in 12.7%, with a recurrence-free survival rate of 91.5% and 83.7% at 12 and 24 months, respectively. Hematoma( p < 0.001) was associated with an increased risk of recurrence, whereas higher surgical complexity( p = 0.018) was associated with a reduced risk of recurrence. Postoperative gains included an increase in stretched penile length by 3.0 cm, improved urinary and sexual function( p < 0.001) and high satisfaction rates(86.8%). While high-complexity surgery leads to higher immediate complication rates, the comprehensive surgical approach, when tailored to the patient, offers durable results and significant improvements in function and quality of life.

Phalloplasty following penectomy for penile cancer presents a complex reconstructive challenge, requiring restoration of urinary and sexual function while addressing anatomical and psychological sequelae. Unlike gender-affirming phalloplasty, this procedure is complicated by previous surgery and potential anatomical deficits. However, limited data exist to guide reconstruction in this cohort. This narrative review summarises available evidence on phalloplasty post-penectomy. A systematic search identified six relevant studies, including 48 patients, with follow-up ranging from 1 to 150 months. The radial artery free flap (RAP) and anterolateral thigh flap (ALTP) are the preferred techniques, each with distinct advantages and limitations. While RAP offers superior tactile recovery, ALTP reduces donor site morbidity. Complication rates are high, particularly urethral strictures and fistulae, affecting up to 64.3% of cases. Despite these risks, functional outcomes, including standing micturition and sexual activity, are achievable and patient satisfaction remains high. Challenges include extrapolating data from transgender cohorts and managing psychosocial concerns. A multidisciplinary approach is essential for optimising patient selection, counselling, and long-term outcomes. Further research is needed to refine surgical techniques, improve complication management, and explore innovative reconstructive strategies.