What does Prof. Alessandro Natali?

These are the uro-andrological clinical fields in which Prof. A. Natali practices his profession both from the medical and surgical point of view

CLINICAL FIELDS

Surgery of external male genitalia

There can be various pathological situations that affect the male external genitalia. The most frequent and requiring surgical therapies are the short frenulum, phimosis and congenital curved penis.

SHORT FRENULUM

The frenulum in the penis is a thin strip of skin that joins the glans to the foreskin. This tissue, rich in blood vessels and nerve endings, during sexual intercourse, being particularly stressed, can undergo partial lacerations, with consequent noticeable bleeding.

In some individuals, even after puberty, the frenulum remains short and prevents the foreskin from discovering the glans entirely or causes a sensation of discomfort during erection, in such cases it is possible to perform an outpatient operation of frenulotomy or plastic of the frenulum in which an incision is made on the frenulum under local anesthesia, which heals within a week or two.

PHIMOSIS

The foreskin is the flap of sliding skin that covers the glans.The phimosis is the presence of a foreskin that prevents the glans from being completely uncovered. The phimosis can be of various levels or degrees depending on the severity, generally treated with circumcision. When the foreskin completely blocks the exit of the glans, thus preventing sexual intercourse, we speak of tight or complete phimosis, which in the most serious forms can even prevent the urine from escaping.

More often the phimosis is partial, the glans can only partially escape and pain is felt during intercourse. If you force the glans out, the foreskin can get stuck under the glans causing a dangerous throttling that requires surgery, in this case we talk about paraphimosis.
Circumcision surgery is usually performed under local anesthesia and in an outpatient setting

CONGENITAL CURVED PENIS

Congenital Curved Penis (CCP) is a congenital anomaly, which is generally revealed after complete puberal development, when the penis has increased its size. It has an incidence that is around 7% of the male population.

The aetiology of this congenital malformation has not yet been well clarified, it seems that hormonal factors may also come into play at the time of development. The malformation consists of an asymmetrical development of two cavernous bodies, with curvature in erection of the penis, more frequently ventral or lateral, less frequently dorsal.

The diagnosis of this disease is based on the execution by the patient of an autophotography of the erect penis, to calculate the degree of curvature. Then a dynamic penile ecocolordoppler with a microinjection inside the cavernous bodies of a substance, "Alprostadil" which, obtaining an erection, allows, besides a further evaluation of the curvature, also to ascertain if we are facing a curvature of the penis not congenital, but acquired by fibrosis of the corpora cavernosa. If CCP has an erection curvature greater than thirty degrees, with mechanical difficulties of penetration, it is possible to perform surgery with reconstructive plastic interventions to restore a normal functional physinomy of the organ.

Of course this type of surgery must, be carried out by experienced andrological surgeons.

 

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