Penis Reconstructions ‘Life-Altering’ for Men, Studies Show

By Amy Norton
HealthDay Reporter

SATURDAY, May 7, 2016 (HealthDay News) — Men who undergo surgery to create a new penis seem to fare well in the long term, two new studies show.

The surgery, known as phalloplasty, is most often done for transgender men who want to undergo a surgical transition. But it’s also an option for men who’ve lost their penis to cancer or trauma — including soldiers who’ve been wounded on the battlefield.

The new studies, to be presented Saturday at the American Urological Association’s annual meeting in San Diego, included both groups of patients. And the studies suggest that by and large, both types of patients do well in the long run.

“A lot of people may not know there are surgeons who have this capability,” said Dr. Gregory Bales, a urologist and surgeon at the University of Chicago who was not involved in the studies.

But the procedure can be “life-altering,” both for transgender men and for those who’ve lost their penis in an accident or other trauma, said Bales, a spokesman for the AUA who will moderate these meeting presentations.

In one of the studies, British researchers at University College London followed 10 men who’d undergone phalloplasty after a traumatic loss of the penis — most often from a blast injury or traffic accident.

In each case, the surgeons used skin and other tissue from the man’s forearm to construct a new penis. That approach — known as radial artery-based forearm phalloplasty — is probably the most commonly used method, according to Bales.

It also tends to be the most successful, said Dr. Nim Andrew Christopher, a consultant uro-andrologist who worked on the study.

That’s in part, he said, because the forearm has little fat, little hair and a large nerve and blood vessel that can be harvested along with the skin and some soft tissue — to create a penis that has the look and sensation of a natural one.

From there, the organ is carefully attached to blood vessels and nerves in the groin.

Some of the men in Christopher’s study also needed a complete reconstruction of the urethra — the tube that carries urine and semen through the penis.

“It’s not a surgery for the fainthearted,” Christopher said. “It takes multiple procedures, and we don’t always get it just right the first time.”

Two patients in the study developed blood clots, and one developed a blockage in the new urethra — all successfully treated, according to the researchers.

And in the long run (a little over four years, on average), all of the patients said they were happy with the size, appearance and sensation of the new penis. All of the men were also able to urinate normally.

“It’s as good as the real thing,” Christopher said.

For a man to have sex after the surgery, he needs to have an inflatable device implanted in the new penis.

“Just creating the penis is a bit like making a hood ornament,” Bales explained. “It will have no ability for penetrative intercourse without the implant.”

Six men in Christopher’s study opted for an implant; three ended up needing a revision surgery because of an infection or because the implant had a “mechanical failure.”

The saline-filled devices can break, Bales explained, or can sometimes “erode” through the skin. And ultimately, he said, any man with a penile implant will need another procedure, because the devices “don’t last forever.”

The second study looked at 93 patients who had undergone phalloplasty at one Virginia hospital between 1983 and 2015. The group included 44 transgender patients and 49 men who’d had the procedure after a trauma, or to treat a congenital defect.

After an average of 4.5 years, 39 percent of transgender men and 48 percent of other men rated their urinary function as “excellent.” Most — 70 percent — were happy with the sensation from the new organ, and one-quarter said they were sexually active.

Transgender men were more likely to develop a blockage in the urethra: 56 percent, versus 30 percent of other men. According to Bales, that is probably because the urethra is constructed “from scratch” for transgender patients.

There can be other issues, too. The surgery leaves a scar on the forearm, and patients may be left with numbness or weakness in the arm, Bales said.

There are also practical obstacles to getting the procedure. In the United States, there are probably only 30 to 40 surgeons who perform the operation, Bales estimated. So many patients may have to travel to get it.

Insurance coverage varies, but plans may pay for the procedure — if, for example, a transgender patient has been diagnosed with gender dysphoria, Bales said.

“The cost of the entire endeavor is dependent to some extent on complications and the number of surgeries,” Bales said. “But it is safe to say that it is well over $100,000.”

Research presented at meetings is considered preliminary until it has been subjected to the peer review of a medical journal.

More information

The Canadian Cancer Society has more on penis reconstruction.

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Does a Deep Voice Draw Women?

FRIDAY, May 6, 2016 (HealthDay News) — Deep voices in men may not be meant to make women swoon, but rather to scare away potential rivals, a new study suggests.

In a series of experiments with humans and primates such as gorillas, chimpanzees and orangutans, researchers found that a deep male voice was seen as dominant by other males, but had a smaller effect on attracting females.

“We find that masculine traits in humans are not the same as, say, in peacocks, where the beautiful tail attracts a mate,” said study leader David Puts, an associate professor of anthropology at Penn State University.

“For example, beards make men more dominant-looking, scarier and seemingly more dangerous, but most women prefer clean-shaven men,” he said in a university news release.

Masculine traits such as a deep voice can be formidable and imply physical aggression, and may provide competitive advantages in fighting or threatening other men more than helping attract a female mate, Puts said.

The researchers also found that differences in voices between males and females were greater in people than in other primates.

In the human experiments, the researchers first looked at 258 female and 175 male college students who read a passage that was recorded without any background sounds. Then 558 women and 568 men rated the recordings.

Each male recording was rated by 15 men for dominance and 15 women for short- and long-term romantic attractiveness. There was a greater correlation with dominance than with attractiveness, the researchers said.

In a separate experiment, researchers recorded 53 women and groups of 62 and 58 men, and tested saliva for the stress hormone cortisol and testosterone. In women, there was no connection between vocal pitch and either cortisol or testosterone.

But in both groups of men, high testosterone and low cortisol levels corresponded with deeper voices, said Puts.

The study was published recently in the journal Proceedings of the Royal Society B.

More information

The American Academy of Otolaryngology-Head and Neck Surgery explains how the voice works.

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Is Daily Blood Thinner Needed for Irregular Heartbeat?

By Alan Mozes
HealthDay Reporter

FRIDAY, May 6, 2016 (HealthDay News) — A smartphone app might offer an alternative for certain patients with an irregular heartbeat who must take risky blood-thinning medication every day to lower their risk for stroke.

New research suggests some people with atrial fibrillation might do just as well by diligently monitoring their pulse, perhaps recording their heartbeat via a smartphone EKG, and only taking such drugs on an as-needed basis.

Atrial fibrillation is a serious condition characterized by an abnormal or irregular heart rhythm. Uncontrolled, it can lead to blood clotting and stroke.

Blood-thinning drugs, called anticoagulants, are the usual treatment. For years, the blood thinner warfarin (Coumadin) has been the top go-to drug for such patients.

“The problem is that long-term use of anticoagulants is associated with an increased risk of bleeding,” explained study co-author Dr. Francis Marchlinski. He is director of cardiac electrophysiology at the University of Pennsylvania Health System.

“So if you don’t need them continuously, it’s reasonable to try to avoid them as much as possible. Minor bleeding events can become a major event, or even life-threatening,” Marchlinski added.

The new investigation focused on a newer class of blood thinners known as novel anticoagulants (NOACs). These include rivaroxaban (Xarelto), apixaban (Eliquis), and dabigatran (Pradaxa).

These drugs work faster than warfarin and can apply to a broader pool of patients, including those with “non-valvular” atrial fibrillation (abnormal heart rhythm unrelated to a heart-valve problem), researchers say.

Compared to warfarin, ongoing use of NOAC meds is less commonly associated with major bleeding, but bleeding resulting from NOAC use is considered more difficult to treat, the researchers explained.

This approach isn’t appropriate for all atrial fibrillation patients, however.

“This potential strategy for intermittent use is only intended for patients with electrocardiogram-demonstrated control of atrial fibrillation, who have undergone an extended period of monitoring, and who are avid pulse-takers that can recognize their atrial fibrillation if it occurs,” cautioned Marchlinski, a professor of medicine at Penn’s Perelman School of Medicine. “In other words, it’s a very select group of highly motivated patients.”

Marchlinski and his colleagues are scheduled to present their findings Friday in San Francisco at the annual meeting of the Heart Rhythm Society.

To assess the potential of an “as-needed” approach to anticoagulant use for atrial fibrillation, the team focused on 100 patients, aged 56 to 72, previously on a daily regimen of NOAC medications.

When the study was launched, none had shown signs of atrial fibrillation trouble for an “extended period of time.” All checked their pulse twice daily, including nine who monitored their heart rhythm using a smartphone-enabled device.

Such devices have become increasingly accessible and accurate in recent years, the study authors said.

In close consultation with their physicians, the patients were given NOAC drugs to have on hand. The study participants were told to avoid taking them unless they suspected or were sure they were experiencing an atrial fibrillation-related event lasting between one to two hours. Patient-controlled twice daily pulse-monitoring was mandatory.

Over the following 18 months, about one-quarter of the patients had to take their NOAC blood-thinning medication at least once. Only six patients ultimately ended up returning to a daily regimen of NOAC, the study found.

Also, none of the patients experienced either a stroke or transient ischemic attack (mini-stroke). And only one experienced what was described as “a minor bleeding event.”

Still, the researchers cautioned that the current study is an investigational “pilot study,” and said more research will be needed to confirm the findings.

Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, seconded that point.

“As this was a relatively small study of a select group of patients with a modest follow-up period and without a control group, larger studies with longer-term follow-up are needed before this strategy should be further considered,” Fonarow said.

Moreover, data and conclusions presented at meetings are usually considered preliminary until published in a peer-reviewed medical journal.

More information

There’s more on atrial fibrillation at the American Heart Association.

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Heart Failure Risk Seems to Rise in Winter

By Alan Mozes
HealthDay Reporter

FRIDAY, May 6, 2016 (HealthDay News) — When there’s a real chill in the air, your risk of being hospitalized for heart failure rises, a new study suggests.

Cold weather also seems to boost the risk of hospitalization for both heart failure and atrial fibrillation, a condition characterized by an irregular heart rhythm.

“In the past, seasonal differences have been noted for heart attacks and strokes,” said study co-author Dr. Abhishek Deshmukh, a cardiac electrophysiologist with the Mayo Clinic in Rochester, Minn.

“We looked at seasonal differences in patients getting hospitalized for heart failure and atrial fibrillation from a large national hospitalizations database,” he added. “We found that during cooler months, especially in February, the rates of hospitalizations are the highest.

“It is striking that people get more sick with cardiac diseases during cooler months,” Deshmukh said. “Whether it is the cooler air, after-effect of holiday season or other environmental triggers needs further studies.”

Deshmukh and his colleagues were to present their findings Friday at a meeting of the Heart Rhythm Society, in San Francisco.

More than five million Americans experience heart failure every year and as many as 6 million may have atrial fibrillation, according to the U.S. Centers for Disease Control and Prevention.

The study focused on hospitalizations that occurred between 2002 and 2012 due to heart failure. That information included more than 12 million patients, a third of whom also had atrial fibrillation.

Averaging the frequency of hospitalizations across the 10-year period, the researchers found that both those with heart failure and those with heart failure and atrial fibrillation were “notably” more likely to be hospitalized during winter months compared with summer months.

The lowest month for such hospitalizations was July, the study authors said. But in the months after, hospitalizations climbed, reaching their highest rate in February. From that month forward, however, the figures started to decline, until again reaching a low point the following July.

Though Deshmukh said it’s unclear what exactly drives these seasonal differences, he identified a number of “plausible reasons.” They include: seasonally provoked changes in bodily fluid balances, changing levels of naturally occurring hormones, a rise in infection risk, and shifting air pollution environments.

The cooler ambient air of winter may itself serve as a potential trigger, he added, given that cooler air can provoke an increase in blood pressure.

That point was seconded by Dr. Gregg Fonarow, a cardiology professor at the University of California, Los Angeles.

“Blood pressure is higher in winter, which can worsen heart failure,” he said. “Also during winter months, there are higher rates of respiratory tract infections, which increase heart failure risk.”

An increase of salt intake in winter months may also be problematic, he noted.

Deshmukh said he believes that increasing “awareness of this ‘winter effect’ may lead to more attention to symptoms.”

Still, is there anything patients can do to proactively cut down the likelihood of cold weather heart trouble?

Unfortunately, no, said Deshmukh, who added that more research is needed to explore what steps patients can take to modify or diminish the wintertime risk.

Meeting results are typically viewed as preliminary until published in a peer-reviewed journal.

More information

There’s more on heart failure at the American Heart Association.

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Statins Might Protect People With Narrowed Leg Arteries

FRIDAY, May 6, 2016 (HealthDay News) — Cholesterol-lowering statins may spare people with narrowed leg arteries from the possibility of amputation and even death, a new study suggests.

The higher the dose of these drugs, the lower the risk of both outcomes, the researchers found.

“PAD, a narrowing of the peripheral arteries to the legs, stomach, arms and head, is the next cardiovascular epidemic,” said study author Dr. Shipra Arya. She is an assistant professor in the division of vascular surgery at Emory University School of Medicine in Atlanta.

For the study, the researchers analyzed health information on more than 200,000 veterans with peripheral artery disease (PAD) from the Veterans Affairs’ database.

They identified those who were taking statins around the time they were diagnosed with PAD. The researchers also recorded the veterans’ dosage of these drugs.

During an average follow-up period of 5.2 years, the veterans were divided into three groups: those taking high doses of statins, those taking moderate to low doses of the drugs, and those who did not take statins.

The study revealed that those with PAD who took high doses of statins had a 33 percent lower risk for amputation and a 29 percent lower risk of death than those who didn’t take these drugs.

Meanwhile, the patients on a moderate or low dose of statins had a 22 percent lower risk of amputation and death.

The findings suggest, but don’t prove, that “patients who have been diagnosed with PAD should be considered for placement on high-dose statins upon diagnosis if they can tolerate it, along with other medical management, including smoking cessation, anti-platelet [anti-clotting] therapy and a walking program,” Arya said in a news release from the American Heart Association.

The findings were to be presented Friday at an American Heart Association meeting in Nashville. Research presented at meetings is considered preliminary until published in a peer-reviewed journal.

More information

The U.S. National Library of Medicine provides more information on statins.

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Young LGBT Adults Are Target of FDA Stop-Smoking Campaign

FRIDAY, May 6, 2016 (HealthDay News) — Hoping to reduce tobacco use by young lesbian, gay, bisexual and transgender adults, the U.S. Food and Drug Administration has launched an LGBT stop-smoking campaign.

“We know LGBT young adults in this country are nearly twice as likely to use tobacco as other young adults,” said Mitch Zeller, director of the FDA’s Center for Tobacco Products.

“We want LGBT young adults to know that there is no safe amount of smoking. Even an occasional cigarette can have serious health implications and lead to addiction,” he said in an agency news release.

The campaign specifically targets 18- to 24-year-old LGBT smokers. At least 800,000 of the more than 2 million LGBT young adults in the United States are occasional or social smokers, according to the FDA.

A key reason for high tobacco use among this group of young adults is the real and perceived social stigma, discrimination and anxiety they experience when they “come out,” the FDA stated.

Many find a sense of community in LGBT bars and clubs where tobacco use is common, and some leading LGBT public figures openly promote tobacco use, the agency explained.

The new campaign “is designed to challenge the perception that tobacco use is a necessary part of LGBT culture,” said Richard Wolitski. He is acting director of the Office for HIV/AIDS and Infectious Disease Policy of the U.S. Department of Health and Human Services.

“The campaign shows LGBT young adults they can be the person they want to be and still live tobacco-free,” Wolitski explained.

Entitled “This Free Life,” the campaign was scheduled to launch in 12 regions nationwide this week with print, digital and out-of-home ads. Local outreach efforts will also highlight tobacco-free attitudes and lifestyles within the LGBT community.

The $35.7 million campaign is funded by user fees collected from the tobacco industry, not taxpayer dollars.

More information

The U.S. Centers for Disease Control and Prevention has more on LGBT health.

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Aspirin May Help Protect Against Bile Duct Cancer: Study

FRIDAY, May 6, 2016 (HealthDay News) — Regular aspirin use may lower the risk of bile duct cancer, a new study suggests.

The study included nearly 2,400 bile duct cancer patients and a control group of more than 4,700 people without the cancer. About 25 percent of the bile duct cancer patients and 45 percent of those in the control group took aspirin.

Overall, people who took aspirin were roughly three times less likely to develop bile duct cancer than those who did not take aspirin, according to the study published online April 26 in the journal Hepatology.

The findings do not prove that aspirin caused the risk of bile duct cancer to drop.

However, “chronic persistent inflammation is one of the key elements that promotes cancer of the bile ducts, and well-known risk factors for bile duct cancer have all been shown to increase the risk for bile duct cancer by inducing chronic inflammation of the ducts,” study co-leader Dr. Jonggi Choi said in a journal news release.

“Aspirin is an anti-inflammatory agent and may reduce the risk of bile duct cancer by reducing inflammation… Previous studies have shown that aspirin also blocks additional biological pathways that promote cancer development,” added Choi, who did the research while at the Mayo Clinic College of Medicine in Rochester, Minn.

The bile ducts move the fluid bile from the liver to the small intestine, where it helps digest fats in food. Bile duct cancer is a rare disease, affecting less than 3,000 people in the United States each year, according to the American Cancer Society.

The findings suggest that further research on the potential for aspirin to prevent bile duct cancer is warranted, the study authors said.

“The next steps should include population-based studies examining the associations of aspirin use with risk of bile duct cancer and also clinical trials, particularly in populations at high-risk for bile duct cancer, to confirm the benefit of aspirin for bile duct cancer prevention,” said study co-leader Dr. Lewis Roberts, also of the Mayo Clinic College of Medicine.

More information

The American Cancer Society has more on bile duct cancer.

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Tom Brady Wants to Sell You a $200 Cookbook

Photo: Getty Images

Tom Brady and Gisele Bundchen’s strict diet has become legendary, with most of us wondering how in the world anyone can stick with such dietary restrictions. Well, the football icon is ready to share his healthy living secrets…but they’ll come at a price. Brady’s upcoming cookbook can be yours to the tune of $200.

[RELATED: When Tom Brady Breaks His Diet, This Is What He Splurges On]

Why the steep price tag when you can get a standard cookbook for well under 40 bucks? For starters the tome will feature a natural maple cover laster-etched with Brady’s TB12 logo, according to Boston.com, plus off the ability to insert new recipes you find that perhaps fit with the quarterback’s food philosophies.

And if you’re worried that the cookbook will simply feature recipes for carrot sticks and sautéed kale, think again. Brady is including some of his favorite healthified (yes, I just made that word up) recipes including sweet potato gnocchi and carrot cake, which are two items I’d gladly welcome into my meal plan every single day.

[RELATED: Gisele Bundchen’s Personal Chef Opens Up About Her Strict Diet]

What you shouldn’t expect to find in the cookbook? Any of the ingredients Brady and Bundchen have sworn off, like coffee, caffeine, olive oil, dairy, fungus, white flour, white sugar, nightshade veggies, and MSG.

I have to admit, while it won’t be easy to part with 200 smackers for a cookbook, I’m incredibly curious to see what else it contains. Obviously I won’t expect it to turn me into an elite athlete or supermodel, but if it’s good enough for Tom and Gisele it’s definitely worth a try, don’t you think?

This article originally appeared on InStyle.com/MIMI.

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E-Cigarettes to Be Regulated as Tobacco Products

Photo: Getty Images

E-cigarettes will be regulated as tobacco products, federal authorities announced on Thursday.

In a long-awaited ruling, the U.S. Food and Drug Administration (FDA) finalized rules that give the agency authority to regulate all tobacco products including e-cigarettes, cigars, hookah tobacco and pipe tobacco, as well as other products. Until now, e-cigarettes were not regulated by the FDA and there was no national law to prohibit the sale of e-cigarettes,hookah tobacco or cigars to people under 18.

“The actions being taken today will help the FDA prevent misleading claims by tobacco product manufacturers, evaluate the ingredients of tobacco products and how they are made, as well as communicate their potential risks,” the agency said in a statement.

The new rule means the agency will have to approve all products that made it to market as of Feb. 15, 2007—a point at which the e-cigarette market was virtually non-existent. “What we know is absence of federal restriction means that enforcement is uneven and at times nonexistent,” HHS Secretary Sylvia Burwell said during a news conference.

The risks of e-cigarettes has been a public health debate for some time and the FDA initially announced its proposal to increase its jurisdiction in 2014. The HHS and FDA said on Tuesday that surveys show 1 in 4 high school students and 1 in 13 middle schoolers report being tobacco users. 16% of high schoolers also reported using cigarettes in 2015, a 900% increase from 1.5% in 2011. While e-cigarettes do not contain the same carcinogens as traditional cigarettes, they do contain nicotine, which is addictive. Early research has also cast doubt on the safety of some of the chemicals used inE-cigarettes when inhaled into the lungs.

Small and medium sized e-cigarette companies have responded to the news with concerns that undergoing the new approval process will be costly. “This gigantic price tag is affordable to Big Tobacco companies, but small and medium-sized businesses will be crushed,” said Gregory Conley, President of the American Vaping Association. “If the FDA’s rule is not changed by Congress or the courts, thousands of small businesses will close in two to three years.”

Burwell addressed these concerns during a news conference with reporters, saying the agencies understand the concerns small businesses will have, and that the FDA will allow them to have more time to comply.

The FDA says after 90 days they will begin enforcing portion of the rule that says the products cannot be sold to people under 18. This rule also requires ID to purchase tobaccos products and bans sales in vending machines as well as free samples

“The health of the nation will continue to suffer the consequences of any further delay in implementing a law intended to protect public health,”Chris Hansen, president of the American Cancer Society Cancer Action Network, said in a statement.

This article originally appeared on Time.com.

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7 Ways to Prevent Thigh Rub

Photo: Getty Images

Unless you’re one of the five people on Earth who have a thigh gap, you’re probably familiar with what the rest of us mortals call “thigh rub”—that annoying chafing that you get when your thighs cozy up together as you walk or run.

Basically, here’s what happens: When your thighs rub together, it creates friction that damages the outer layer of skin, causing pain and inflammation, says Melissa Piliang, MD, a dermatologist at the Cleveland Clinic. And when you sweat, moisture sits on the skin and breaks down the outer layer of skin even more. Ouch.

Enter Amy Schumer—comedienne, star of Trainwreck, and bestie to J.Law—with perhaps the greatest thigh rub hack ever:

At Monday’s Met Gala, Schumer, 34, stunned in an Alexander Wang gown, and her Instagram account featured plenty of behind-the-scenes photos of her prepping for the big event. But it was this video of Schumer applying deodorant to her inner thighs—“No chafe #nothighgapnoproblem”— that racked up more than 121,000 likes. Obviously, many of us can relate.

Deoderant is “good in a pinch,” confirms Dr. Piliang. As a general rule, anything that absorbs moisture can help with chafing, she says. But deodorant can also be drying, so if you use it too often, your skin might become even more irritated.

With summer right around the corner, we asked the experts for a few more options to help stop the chafe.

RELATED: Is Wearing Workout Leggings All Day Bad for My Vagina?

Lip balm 

Since lip balms are slick, they can help keep your thighs from rubbing against each other and creating friction, says Carolyn Bangert, MD, a dermatologist at McGovern Medical School at University of Texas Health Science Center at Houston.

Petroleum jelly

This is another option that can act as a lubricant and prevent friction, says Dr. Bangert. Bonus: Petroleum jelly can also be used to soothe already-chafed skin. (The only downside? It can be a little greasy.)

Body Glide

An anti-chafing balm that helps prevent the skin irritation caused by friction, Body Glide is an alternative for people who don’t want to deal with messier products. Plus, it also protects against blisters, which makes it especially useful for weekend warriors and athletes alike.

RELATED:7 Bike Shorts That Will Save Your Crotch

Spanx

They’re a good option when you’re wearing a dress: The fabric acts as a barrier against the skin, which helps prevent friction and wick away sweat, says Dr. Piliang.

Baby Powder

Since baby powders are good at absorbing moisture, they’re also helpful for preventing chafing. (Though you might want to go with a cornstarch-based product instead of one that contains talc.) And like petroleum jelly, baby powder can also be used on chafed skin to soothe the irritation.

RELATED: 12 Baby Products Dermatologists Recommend to Adults

Bandelettes

On first glance, these look too pretty to be useful. But in fact, Bandelettes are specifically designed to ward off chafing. Plus, they’re also recommended by fashion editors and bloggers alike. They’re non-slip, made of silicone, and are cute enough to wear with (or, ahem, without) your favorite skirt.

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