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Frontiers in Endocrinology 2023Erectile dysfunction is a common disease of the male reproductive system, which seriously affects the life quality of patients and their partners. At present, erectile... (Review)
Review
Erectile dysfunction is a common disease of the male reproductive system, which seriously affects the life quality of patients and their partners. At present, erectile dysfunction is considered as a social-psychological-physiological disease with complex etiology and various treatment methods. Oral PDE5I is the first-line treatment for erectile dysfunction with the advantages of high safety, good effect and non-invasiveness. But intracavernosal injection, hormonal replacement therapy, vacuum erection device, penile prosthesis implantation can also be alternative treatments for patients have organic erectile dysfunction or tolerance to PDE5I. With the rapid development of technologies, some new methods, such as low-intensity extracorporeal shock wave and stem cell injection therapy can even repair the organic damage of the corpora cavernosa. These are important directions for the treatment of male erectile dysfunction in the future. In this mini-review, we will introduce these therapies in detail.
Topics: Male; Humans; Erectile Dysfunction; Phosphodiesterase 5 Inhibitors; Treatment Outcome
PubMed: 36923224
DOI: 10.3389/fendo.2023.1148834 -
Cureus Jan 2023The inflatable penile prosthesis (IPP) is a three-piece device indicated to treat erectile dysfunction. Although it is considered a safe procedure, it can result in...
The inflatable penile prosthesis (IPP) is a three-piece device indicated to treat erectile dysfunction. Although it is considered a safe procedure, it can result in complications, such as reservoir herniation. Literature is scarce regarding reservoir incarcerated herniation as a complication of IPP and its management. Surgery is required to reduce symptomatic hernias and properly secure the reservoir to avoid recurrence. An untreated incarcerated hernia may lead to strangulation and necrosis of abdominal organs, as well as implant malfunction. We present a rare case of a left-sided incarcerated inguinal hernia containing fat and a penile reservoir of a previous penile prosthesis implant in a 79-year-old man, as well as the technique used to correct it.
PubMed: 36860239
DOI: 10.7759/cureus.34315 -
Cureus Jan 2023Online health information (OHI) has become widely accessible and affects patient decisions regarding their healthcare. The purpose of this study was to assess the...
BACKGROUND
Online health information (OHI) has become widely accessible and affects patient decisions regarding their healthcare. The purpose of this study was to assess the readability, quality, and accuracy of information available to patients online about penile prosthesis implants (PPIs).
METHODS
We performed a Google search using the keywords "penile implant" and "penile prosthesis." The first 30 search results for both terms were analyzed, and advertisements, news articles, duplicates, and videos were excluded. Websites were categorized as institutional, commercial, and personal/patient support. Readability of each website was determined using the Flesch-Kincaid grade level (FKGL) readability formula within the readable tool. Quality was measured by Health On the Net (HON) certification status and the DISCERN scoring method. For website accuracy, a score of 1-4 (1=0-25%, 2=25-50%, 3=50-75%, and 4=75-100%) was assigned.
RESULTS
Forty-four websites met the criteria (23 institutional, 12 commercial, and 9 personal/patient support). The mean total FKGL score was 9.55. No statistical difference was detected between mean FKGL for each website category (p=0.69). Only eight websites (18%) scored ≤8th-grade reading level (average US adult level), while 36 (82%) were >8th-grade level. Mean total DISCERN sum score was 39.74/75, with no statistical difference in mean DISCERN score between website types (p=0.08). Over half (55%) of the websites were defined as "very poor" or "poor" quality by DISCERN scoring. Mean total overall quality rating was 2.67/5. HON certification was verified for only nine websites (20%). Twenty-five percent of websites were classified as 0-25% accurate, 23% were 25-50% accurate, 30% were 50-75% accurate, and 23% were 75-100% accurate.
CONCLUSION
Most information on the Internet about PPIs is reasonably accurate; however, the majority of websites are deficient in quality and unreadable to the average patient, irrespective of website type.
PubMed: 36852349
DOI: 10.7759/cureus.34240 -
Research and Reports in Urology 2023We present the first case of a patient born with congenital fusiform megalourethra who underwent the successful placement of an inflatable penile prosthesis (IPP) and...
We present the first case of a patient born with congenital fusiform megalourethra who underwent the successful placement of an inflatable penile prosthesis (IPP) and mesh phalloplasty due to primary erectile dysfunction (ED). After an extensive psychosexual assessment and a preoperative MRI scan, an IPP was successfully implanted. The procedure was carried out through a penoscrotal approach, which offered excellent exposure to the crura and the proximal ends of the corpora cavernosa. Following the incision and the dilatation of both corpora cavernosa, the penile cylinders were inserted and a mesh phalloplasty was performed, to replace the erectile tissues lacking in the distal corpora cavernosa. After reservoir and pump placement, the device was tested, and no mechanical issues were recorded. The postoperative course was uneventful, and, at the 2-year follow-up, the patient reported highly satisfactory results, with valid functional erections.
PubMed: 36814907
DOI: 10.2147/RRU.S387042 -
Urology Case Reports Jan 2023Stress urinary incontinence and erectile dysfunction often coexist in men surgically treated for prostate cancer. Despite many men having both an artificial urinary...
Stress urinary incontinence and erectile dysfunction often coexist in men surgically treated for prostate cancer. Despite many men having both an artificial urinary sphincter and inflatable penile prosthesis to treat these conditions, there is limited information in the literature to guide surgeons when it comes to placing both devices. We recommend obtaining direct exposure of proximal crura to allow for complete dilation of corporal spaces for proper prosthetic placement. Further dissection via penoscrotal incision or perineal counter-incision can be utilized. Surgeons should consider dorsal lithotomy position at time of IPP placement to allow for perineal exposure.
PubMed: 36743325
DOI: 10.1016/j.eucr.2022.102310 -
International Journal of Impotence... Nov 2023
Review
Topics: Humans; Male; Penile Prosthesis; Penile Implantation; Erectile Dysfunction
PubMed: 36650316
DOI: 10.1038/s41443-023-00663-y -
Frontiers in Endocrinology 2022Diabetic erectile dysfunction (DMED) refers to erectile dysfunction secondary to diabetes. Erectile dysfunction is characterized by a persistent inability to achieve and...
INTRODUCTION
Diabetic erectile dysfunction (DMED) refers to erectile dysfunction secondary to diabetes. Erectile dysfunction is characterized by a persistent inability to achieve and maintain an erection sufficient to permit satisfactory sexual activity.
METHODS
Based on the Web of Science core collection database, we firstly analyzed the quantity and quality of publications in the field of DMED, secondly profiled the publishing groups in terms of country, institution, author's publication and cooperation network, and finally sorted out and summarized the hot topics of research.
RESULTS
From 2001 to 2022, a total of 1,403 articles relating to this topic were published in 359 journals. They represent the global research status, potential hotspots, and future research directions. The number of DMED-related publications and citations has steadily increased over the few past decades. Academic institutions from Europe and the United States have played a leading role in DMED research. The country, institution, journal, and author with the most publications were the United States (294), INHA University (39), the Journal of Sexual Medicine (156), and Ryu, Ji-Kan (29), respectively. The most common keywords were erectile dysfunction (796), men (256), diabetes (254), diabetes mellitus (239), prevalence (180), corpus cavernosum (171), dysfunction (155), mellitus (154), nitric-oxide synthase (153), and expression (140). The main keyword-based research topics and hotspots in the DMED field were oral sildenafil, smooth muscle relaxation, nitric oxide synthase, gene therapy, metabolic syndrome, cavernous nerve injury, stem cell, and penile prosthesis.
DISCUSSION
The terms oral sildenafil, smooth muscle relaxation, nitric oxide synthase, gene therapy, metabolic syndrome, cavernous nerve injury, stem cell, and penile prosthesis will be at the forefront of DMED-related research.
Topics: Male; Rats; Animals; Humans; Erectile Dysfunction; Sildenafil Citrate; Metabolic Syndrome; Rats, Sprague-Dawley; Diabetes Mellitus, Experimental; Bibliometrics
PubMed: 36568113
DOI: 10.3389/fendo.2022.1091999 -
Therapeutic Advances in Urology 2022One of the most challenging aspects of inflatable penile prosthesis (IPP) surgery is reservoir placement. The traditional space of Retzius (SOR) is not suitable for all...
INTRODUCTION
One of the most challenging aspects of inflatable penile prosthesis (IPP) surgery is reservoir placement. The traditional space of Retzius (SOR) is not suitable for all patients. For example, radical cystectomy or prostatectomy may alter the anatomical SOR. Hence, traditional placement of the reservoir in this space increases the risk of bowel or vascular injury. Also, patients with bilateral inguinal hernias repaired with mesh, or those with previous reservoirs that have been retained, are not eligible for a Retzius reservoir. Our study reports on the use of midline sub-rectus muscle placement of a penile prosthesis reservoir in these patients as an alternative to high submuscular placement commonly used.
METHODS
A retrospective chart review of male patients who underwent IPP surgery between June 2017 and 2021 was conducted. Patients were divided into two groups based on the location of the reservoir: SOR Midline Submuscular Reservoir (MSMR). Complication rates were compared, including herniated reservoirs, infections, bowel injuries, and vascular injuries.
RESULTS
Our cohort included 461 patients who underwent IPP surgery between June 2017 and 2021 in one tertiary center. SOR was used in 89% of patients and MSMR in 11% of patients ( = 413 and 48, respectively). Median follow-up for all patients was 28 months. The mean age was 67 ± 8 years. There was no statistically significant difference between the two groups regarding age or comorbidities (BMI, diabetes mellitus, hypertension, hyperlipidemia, and coronary artery disease). The complication rate was low in both the SOR and MSMR groups, with device malfunction being the most common (2% 4%, respectively; = 0.32). The infection rate was 0.5% in the SOR group with no infections in the MSMR group (NS). There was only one case of herniation requiring surgical revision in the SOR group and no cases of bowel or vascular injury.
CONCLUSION
Placement of a penile prosthesis reservoir within a midline rectus submuscular space is a safe and effective technique when the SOR is compromised by previous surgery or bilateral inguinal canals are not accessible.
PubMed: 36504599
DOI: 10.1177/17562872221139109 -
BMC Medical Imaging Dec 2022In this study, the role and efficiency of computerized tomography angiography (CTA) in the postoperative management of patients with penile revascularization were...
BACKGROUND
In this study, the role and efficiency of computerized tomography angiography (CTA) in the postoperative management of patients with penile revascularization were evaluated.
METHODS
Between 2014 and 2018, penile revascularization surgery was performed in 78 patients who presented with the complaint of erectile dysfunction (ED). The mean age of the patients was 47.17 ± 13.26 (23-69) years. Patients with a regular sexual partner and relationship, who hadn't benefitted from medical treatment and who had ED complaints for at least three months were included in the study. The cases were divided into three groups according to their age (20-40, 41-60, and > 61 years). All the cases were evaluated preoperatively using the five and 15-item International Index of Erectile Dsysfunction (IIEF-5 and IIEF-15) questionnaire, cavernosometry, corpus cavernosum electromyography, and penil color doppler ultrasonography. At the postoperative third month, IIEF 5-15 questionnaire was repeated and anastomotic patency was evaluated by performing CTA scanning.
RESULTS
CTA performed at the postoperative third month revealed anastomosis patency in 56. In 22 cases, the anastomosis area could not be observed. Among the patients with anastomosis patency, the rate of the IIEF-5 increase in the postoperative period was between 35.0 and 80.8%, while in those patients without anostomotic patency, the increase rate of IIEF-5 were between 12.5 and 23.3%. Increases in the IIEF-5 and IIEF-15 questionnaire scores were found to be significantly higher in the group in which anastomotic patency was observed on CTA compared to remaining patients.
CONCLUSION
The CTA results and changes in the IIEF rates after penile revascularization had a high correlation. Anastomotic patency with CTA can guide the timing of more invasive procedures such as penile prosthesis implantation.
Topics: Adult; Humans; Male; Middle Aged; Erectile Dysfunction; Prospective Studies; Tomography
PubMed: 36482377
DOI: 10.1186/s12880-022-00941-z -
Urology Case Reports Nov 2022Penile abscess with involvement of the corpus cavernosum is a relatively rare condition and is typically associated with cavernosography, intracavernosal injections,...
Penile abscess with involvement of the corpus cavernosum is a relatively rare condition and is typically associated with cavernosography, intracavernosal injections, penile prosthesis, open trauma, priapism, and seeding from a distant infection. Less commonly, it can be seen following penile fracture, particularly in patients with identified risk factors of uncontrolled diabetes mellitus or other immunosuppression. We report a case of a healthy 24-year-old man with a penile abscess discovered during repair of a one-month-old, imaging confirmed, neglected penile fracture.
PubMed: 36406007
DOI: 10.1016/j.eucr.2022.102273