Until now, no reliable method is recognised in treating buried penis. This study explored a new method of penile length augmentation using acellular dermal matrix filler in infrapubic space combined with liposuction and penile suspensory release. Patients with “small‐sized penis” received penile length augmentation procedure including suprapubic liposuction, penile suspensory ligament release and insertion of folded acellular dermal matrix between corpora cavernosa and pubis symphysis. Their penile length from tip to skin was measured pre‐operatively and post‐operatively. The post‐operative complications and patients' satisfaction were also recorded. Fifteen adult male patients were included with the mean age of 33.2 ± 4.6 years old and BMI of 28.9 ± 5.3 kg/m2. The average amount of liposuction was 430 ± 90.0 ml. The average penile length measured pre‐operatively and post‐operatively (on table and 3 months afterwards) was 3.0 ± 1.3 cm, 7.3 ± 2.1 cm and 5.4 ± 1.8 cm. The penile length has significantly increased by 4.3 ± 1.6 cm (on table) and 2.4 ± 0.8 cm (3 months post‐operatively; p < 0.05). The post‐operative complications included oedema of penis, ecchymosis of lower abdomen and poor wound healing. No patient was dissatisfied with the appearance and function. The new method using acellular dermal matrix combined with liposuction and penile suspensory ligament release is safe and effective. The method could be applied to selected patients with buried penis.
Hyaluronic acid injection is becoming a popular way for penile augmentation. However, only few studies and follow-ups have investigated the various complications of hyaluronic acid injection and their corresponding management. In this study, a total of 230 patients who had penile augmentation with hyaluronic acid injection from January 2018 to December 2019 were examined on follow-up for penile girth, complications, and their corresponding management. At 1-month, 3-month, and 6-month postoperative follow-ups, the penile circumference had increased by 2.66 ± 1.24 cm, 2.28 ± 1.02 cm, and 1.80 ± 0.83 cm, respectively. During the entire 6-month follow-up, 4.3% had complications such as subcutaneous bleeding, subcutaneous nodules, and infection. There were no systemic or local allergic reactions among all the patients. All complications were treated accordingly, and no further deterioration or severe sequelae were observed. Although complications of hyaluronic acid injections are mild and rare, these may affect the patient's satisfaction postoperatively. Preoperative redundant prepuce may increase the incidence of penile edema or postoperative gel migration. Standardization of the surgery protocol and elucidation of the effects of other injection parameters are still lacking. Nevertheless, it still highlights the importance of preoperative preparation and surgical technique.
In recent years, nursing has come to be considered a high-risk and high-pressure profession, given the fast-paced working environment and constant need to handle emergencies, especially for nurses working in hemodialysis centers. Nearly every day, nurses are confronted with life and death situations and are required to provide skilled, high quality care for their patients, in fast-paced and demanding environments. Thus, nurses are susceptible to both psychological stress and other mental health problems, making them more vulnerable to burnout when compared against other healthcare professions. An anonymous online questionnaire was completed by a group of participating nurses, using the web-based survey platform WeChat. Registered nurses working in hemodialysis centers were randomly selected from 5 comprehensive tertiary level hospitals in Sichuan Province, China. The data collection instrument comprised two parts: demographic data and a nurse burnout questionnaire—the Maslach Burnout Inventory. Overall, 70 nurses were invited to participate, with 65 returning completed questionnaires, giving a response rate of 92.9%. In this survey, the burnout level was set at28.15 ± 12.39 for emotional exhaustion (EE), 10.23 ± 5.47 for depersonalization (DP), and 37.19 ± 8.31 for personal accomplishment (PA)—EE and DP levels are found to be high at the level of burnout. Job burnout was found to exist widely among the nurses of hemodialysis centers, which may then result in adverse effects on their physical and mental health. Active interventions can significantly reduce job burnout and also help maintain the stability of nursing workforce levels.
To study the prevalence of burnout and job satisfaction in Chinese pediatrics residents. Prospective participants were invited via a WeChat group to participate from October 1, 2018 to January 31, 2019. The Maslach Burnout Inventory-Human Services Survey was used to measure physician burnout, and the Minnesota Satisfaction Questionnaire was used to measure job satisfaction. A total of 380 residents (81.1% response rate) from 35 pediatric residency programs completed the cross-sectional web-based survey. Of the responders, 233 (61.3%) exhibited high levels of career burnout. Residents 24 to 29 years of age were less likely to report burnout than residents ≥30 years of age (50.9% vs74.7%; P < .05). In addition, residents with an annual income less than 80,000 RMB seem to have higher burnout levels (66.2%). Residents who reported that they felt sleep deprived had significantly higher rates of burnout than those who did not (P < .01). Logistic regression showed that age ≥30 years (odds ratio [OR] 3.74 [1.57–7.66], P < .01) and sleep deprivation (OR 4.11 [2.19–7.35], P < .01) were the 2 independent risk factors associated with burnout. Burnout is highly prevalent among Chinese pediatrics residents who also reported poor job satisfaction.
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