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Leong JY, Prebay ZJ, Ebbott D, Li M, Chung PH. Evaluating the management trends for priapism and assessing the risk of priapism after in-office intracavernosal injections: a cross-sectional analysis. Int J Impot Res 2024:10.1038/s41443-024-00861-2. [PMID: 38448610 DOI: 10.1038/s41443-024-00861-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 02/13/2024] [Accepted: 02/21/2024] [Indexed: 03/08/2024]
Abstract
We describe the management trends of patients suffering from any priapism and evaluate the risks of developing priapism after intracavernosal injections (ICI) performed in office. We queried TriNetX for two separate male adult cohorts - those presenting with any priapism based on International Classification of Disease code, N48.3 (priapism) and those who underwent ICI in office based on Current Procedural Terminology code, 54235 (injection of corpora cavernosa with pharmacologic agent[s]). We evaluated treatment options for these patients after any priapism and described demographic risks for developing priapism after ICI performed in office. There were 17,545 priapism encounters and 26,104 usages of ICI in the office. Most common treatment for any priapism was corporal irrigation/injection of medications (11.3%). Patients presenting with priapism after ICI were younger (age > 65 years, OR 0.44 [95% CI 0.38-0.51], p < 0.01) and had a higher prevalence of mood disorders (20% vs 14%), behavioral disorders (7% vs 2%) and sickle cell disease (6% vs <1%). They were less likely to have diabetes (14% vs 22%), hypertension (33% vs 40%), prostate cancer (13% vs 25%) or have taken sildenafil or tadalafil (29-30% vs 35-38%). For patients administering ICI, proper screening and counseling of priapism is important to reduce complications.
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Affiliation(s)
- Joon Yau Leong
- Department of Urology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Zachary J Prebay
- Department of Urology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - David Ebbott
- Department of Urology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Michael Li
- Center for Digital Health and Data Science, Thomas Jefferson University, Philadelphia, PA, USA
| | - Paul H Chung
- Department of Urology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA.
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Yassin M, Chen R, Ager M, Desouky E, Minhas S. Penile implants in low flow priapism. Int J Impot Res 2023; 35:651-663. [PMID: 37898653 DOI: 10.1038/s41443-023-00787-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 10/15/2023] [Accepted: 10/18/2023] [Indexed: 10/30/2023]
Abstract
Priapism is a persistent or prolonged erection, in the absence of sexual stimulation, that fails to subside. Prolonged ischaemic or low flow priapism is defined as a full or partial erection persisting for more than 4 h and unrelated to sexual interest or stimulation, characterised by little or no cavernous blood flow. Low flow priapism leads to progressive corporal fibrosis, which could, in turn, lead to long-lasting erectile dysfunction if left untreated. Penile prosthesis implantation is recognised as a management option in refractory and delayed low flow priapism for restoring erectile function with high patient satisfaction rates. However, the ensuing corporal fibrotic scarring poses a surgical challenge to clinicians, given the higher complication rates in this patient subset. Postoperative patient satisfaction has been closely linked to preoperative expectations and perceived loss of penile length. Therefore, thorough patient counselling concerning the risk and benefits of penile implants should be a priority for all clinicians. Moreover, there is a lack of consensus on the ideal prosthesis choice and procedural timing in refractory low flow priapism. In this review, we will examine the existing literature on penile implants in patients with priapism and discuss the options for managing complications associated with penile prosthesis surgery.
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Affiliation(s)
- Musaab Yassin
- Department of Urology, Churchill Hospital, Oxford University Hospitals NHS Trust, Oxford, UK.
- Department of Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK.
| | - Runzhi Chen
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Michael Ager
- Department of Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Elsayed Desouky
- Department of Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Suks Minhas
- Department of Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
- Division of Surgery, Department of Surgery and Cancer, Imperial College, London, UK
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Barham DW, Chang C, Hammad M, Pyrgidis N, Swerdloff D, Gross K, Hatzichristodoulou G, Hsieh TC, Hotaling JM, Jenkins LC, Jones JM, Modgil V, Osmonov D, Pearce I, Perito P, Sadeghi-Nejad H, Suarez-Sarmiento A, Sempels M, Service CA, Simhan J, Yafi FA, Gross MS. Delayed placement of an inflatable penile prosthesis is associated with a high complication rate in men with a history of ischemic priapism. J Sex Med 2023; 20:1052-1056. [PMID: 37279440 DOI: 10.1093/jsxmed/qdad075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/03/2023] [Accepted: 05/05/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND Corporal fibrosis is known to result from prolonged priapism; however, the impact of the timing of penile prosthesis placement after priapism on complication rates is poorly understood. AIM We sought to evaluate the impact of timing of inflatable penile prosthesis (IPP) placement on complications in men with a history of ischemic priapism. METHODS We performed a multicenter, retrospective cohort study of patients with a history of priapism undergoing IPP placement by 10 experienced implantation surgeons. We defined early placement as ≤6 months from priapism to IPP. We identified a 1:1 propensity-matched group of men without a history of priapism and compared complication rates between men who had early placement, late placement, and no history of priapism. OUTCOMES Our primary outcome was postoperative noninfectious complications, and secondary outcomes included intraoperative complications and postoperative infection. RESULTS A total of 124 men were included in the study with a mean age of 50.3 ± 12.7 years. A total of 62 had a history of priapism and 62 were matched control subjects. The median duration of priapism was 37 (range, 3-168) hours and the median time from ischemic priapism to IPP placement was 15 months (range, 3 days to 23 years). Fifteen (24%) men underwent early (≤6 months) IPP placement at a median time of 2 months (range, 3 days to 6 months) following the ischemic priapism event. The remaining 47 (76%) underwent placement >6 months following priapism at a median time of 31.5 months (range, 7 months to 23 years). The complication rate in the delayed placement group was 40.5% compared with 0% in the early placement group and control group. Cylinder-related complications such as migration or leak accounted for 8 (57%) of 14 of the postoperative noninfectious complications. Full-sized cylinders were used in all patients who had a cylinder related complication. CLINICAL IMPLICATIONS Priapism patients should be referred to prosthetic experts early to decrease complication rates in those needing an IPP. STRENGTHS AND LIMITATIONS This is a multicenter study from experienced prosthetic urologists but is limited by the retrospective nature and small number of patients in the early placement group. CONCLUSION IPP complication rates are high in men with a history of ischemic priapism, especially when implantation is delayed beyond 6 months.
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Affiliation(s)
- David W Barham
- Department of Urology, University of California, Irvine, Orange, CA 92868, United States
| | - Chrystal Chang
- Department of Urology/Urologic Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, United States
| | - Muhammed Hammad
- Department of Urology, University of California, Irvine, Orange, CA 92868, United States
| | - Nikolaos Pyrgidis
- Department of Urology, University Hospital, LMU Munich 80539, Germany
| | - Daniel Swerdloff
- Department of Urology/Urologic Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, United States
| | - Kelli Gross
- Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT 90491, United States
| | | | - Tung-Chin Hsieh
- Department of Urology, University of California San Diego, La Jolla, CA 92103, United States
| | - James M Hotaling
- Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT 90491, United States
| | - Lawrence C Jenkins
- Department of Urology, University of California, Irvine, Orange, CA 92868, United States
| | - James M Jones
- Department of Urology, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03766, United States
| | - Vaibhav Modgil
- Manchester Andrology Centre, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Daniar Osmonov
- Department of Urology, University Hospital Schleswig Holstein, Kiel, Germany
| | - Ian Pearce
- Manchester Andrology Centre, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Paul Perito
- Perito Urology, Coral Gables, FL, United States
| | | | | | - Maxime Sempels
- Department of Urology, University Hospital of Liège, Liège, Belgium
| | - C Austin Service
- Department of Urology, University of California San Diego, La Jolla, CA 92103, United States
| | - Jay Simhan
- Department of Urology/Urologic Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, United States
| | - Faysal A Yafi
- Department of Urology, University of California, Irvine, Orange, CA 92868, United States
| | - Martin S Gross
- Department of Urology, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03766, United States
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A population-based analysis of predictors of penile surgical intervention among inpatients with acute priapism. Int J Impot Res 2022; 35:107-113. [PMID: 35260809 DOI: 10.1038/s41443-021-00518-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 11/26/2021] [Accepted: 12/09/2021] [Indexed: 11/09/2022]
Abstract
While consensus exists regarding risk factors for priapism, predictors of operative intervention are less well established. We assessed patient and hospital-level predictors associated with penile surgical intervention (PSI) for patients admitted with acute priapism, as well as length of stay (LOS) and total hospital charges using the National Inpatient Sample (2010-2015). Inpatients with acute priapism were stratified by PSI, defined as penile shunts, incisions, and placement of penile prostheses, exclusive of irrigation procedures. Survey-weighted logistic regression models were utilized to assess predictors of PSI. Negative binomial regression and generalized linear models with logarithmic transformation were used to compare PSI to LOS and total hospital charges, respectively. Among 14,529 weighted hospitalizations, 4,953 underwent PSI. Non-Medicare insurances, substance abuse, and ≥3 Elixhauser comorbidities had increased odds of PSI. Conversely, Black patients, sickle cell disease, alcohol abuse, neurologic diseases, malignancies, and teaching hospitals had lower odds. PSI coincided with shorter median LOS (adjusted IRR: 0.62; p < 0.001) and lower ratio of the mean hospital charges (adjusted Ratio: 0.49; p < 0.001). Additional subgroup analysis revealed penile incisions and shunts primarily associated with reduced LOS (adjusted IRR: 0.66; p < 0.001) and total hospital charges (adjusted Ratio: 0.49; p < 0.001). Further work is required to understand predictors of poor outcomes in these populations.
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Update on the Penuma® an FDA-cleared penile implant for aesthetic enhancement of the flaccid penis. Int J Impot Res 2022; 34:369-374. [PMID: 34987181 DOI: 10.1038/s41443-021-00510-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 11/10/2021] [Accepted: 11/22/2021] [Indexed: 11/09/2022]
Abstract
The Penuma® implant is a medical-grade silicone implant surgically inserted subcutaneously to provide cosmetic improvement of the penile aesthetic. The principal author was invited to provide an update on the usage of the Penuma® implant for penile aesthetics. He collected as yet unpublished data, which is undergoing synchronous submission to Urologic meetings and peer-reviewed publications by a variety of authors for this communication. The objective of this article is to provide updated information regarding the Penuma® aesthetic penile implant. A new scrotal method of implantation named "concealed" is emerging. Through physician comparison of various factors prior to and after the scrotal method intervention, early findings suggest this approach seems to have less visible scar, is quicker and is followed by less seroma formation. As the device is now surgically implanted by surgeons other than its inventor, new developments have appeared authenticating the original published paper in 2018. Patients were contacted via phone and were asked five questions regarding satisfaction with the responses recorded. This new multicenter study shows findings of high patient and partner satisfaction coupled with acceptable adverse outcomes similar to the single-surgeon study. A new penile rehabilitation program has been developed with the aim for the penis appearance to be restored to its pre-operative state if the Penuma® is removed. 12 patients who underwent penile implant removal were followed for 6 months while participating in the penile rehabilitation program. The discipline worked in patients who desired removal for dissatisfaction and is currently under evaluation in patients who require device removal for medical reasons, e.g., infection or suture-related issues. Through new developments, the acceptance of Penuma® in the prosthetic community seems to be further solidified.
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Capece M, Falcone M, Cai T, Palmieri A, Cocci A, La Rocca R. Penile Prosthesis Implantation in Refractory Ischaemic Priapism: Patient Selection and Special Considerations. Res Rep Urol 2022; 14:1-6. [PMID: 35059330 PMCID: PMC8765601 DOI: 10.2147/rru.s278807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/08/2021] [Indexed: 11/23/2022] Open
Affiliation(s)
- Marco Capece
- Department of Urology, AOU Federico II, University Hospital, Naples, Italy
| | - Marco Falcone
- Department of Neurourology, A.O.U. Città della Salute e della Scienza di Torino - Unità Spinale Unipolare, Turin, Italy
| | | | - Alessandro Palmieri
- Department of Urology, AOU Federico II, University Hospital, Naples, Italy
- Correspondence: Alessandro Palmieri Department of Neuroscience, Reproductive Science and Odontostomatology, University Federico II of Naples, via S.Pansini 5, Naples, 80131, ItalyTel +39 081 746 2611Fax +39 081 746 4311 Email
| | - Andrea Cocci
- Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florence, Italy
| | - Roberto La Rocca
- Department of Urology, AOU Federico II, University Hospital, Naples, Italy
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Shaeer O, Raheem AA, Elfeky H, Seif A, Abdel-Raheem TM, Elsegeiny A, Soliman MS, Basalious EB, Shaeer K. Urethral instillation of chlorhexidine gel is an effective method of sterilisation. Arab J Urol 2021; 19:419-422. [PMID: 34552794 PMCID: PMC8451623 DOI: 10.1080/2090598x.2021.1956832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/09/2021] [Indexed: 11/23/2022] Open
Abstract
Objective: To examine the effectiveness of preoperative urethral sterilisation with chlorhexidine gel in rendering the urethra as sterile as the skin of the genital area, with the skin sterilised as per the International Society for Sexual Medicine guidelines for penile prosthesis implantation. Patients and methods: A total of 111 male patients undergoing sterile andrological surgical procedures were divided into a control group (N = 61) and a chlorhexidine gel group (N = 50). Patients in the chlorhexidine group received urethral instillation with 6 mL of chlorhexidine preoperatively and on table. Patients from both groups received on-table skin preparation using povidone iodine and chlorhexidine povidone iodine. At the end of surgery, swabs were obtained from urethra and the penile skin. Skin and urethral swabs were compared for bacterial colonisation by culture and sensitivity. Results: Of the 111 patients, 16 had urethral colonisation and 10 had skin contamination, and they were all in the control group. The most common organism detected in both the urethral and skin samples was coagulase-negative Staphylococcus aureus. Urethral colonisation was significantly greater in the control group compared to the chlorhexidine group, at 16/61 vs 0/50 (P = 0.001). Similarly, skin colonisation was significantly greater in the control group compared to the chlorhexidine group, at 10/61 vs 0/50, (P = 0.002). Conclusion: Chlorhexidine gel is a powerful sterilising agent that will render the urethra sterile.
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Affiliation(s)
- Osama Shaeer
- Andrology Department, Kasr El Aini Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Amr Abdel- Raheem
- Andrology Department, Kasr El Aini Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Haitham Elfeky
- Andrology Department, Kasr El Aini Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmad Seif
- Andrology Department, Kasr El Aini Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Tarek M. Abdel-Raheem
- Medical Physiology Department, Kasr El Aini Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Amgad Elsegeiny
- Andrology Department, Kasr El Aini Faculty of Medicine, Cairo University, Cairo, Egypt
| | - May Sherif Soliman
- Clinical and Chemical Pathology Department, Kasr El Aini Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Emad B. Basalious
- Pharmaceutics and Industrial Pharmacy Department, Cairo University Cairo, Cairo, Egypt
| | - Kamal Shaeer
- Andrology Department, Kasr El Aini Faculty of Medicine, Cairo University, Cairo, Egypt
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Attar FS, Mohammad MA, Almoamin HHA. Long-term outcome of sexual function in sickle cell disease men with ischemic priapism: A systematic review. JOURNAL OF CLINICAL UROLOGY 2021. [DOI: 10.1177/20514158211014051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: The purpose of this study was to have an accurate estimate about the sexual function of sickle cell disease adult men with previous history of recurrent attacks of ischemic priapism in childhood. We assessed the studies for their precise documentation for the erectile function in this group of patients. Materials and methods: We performed a systematic review of the literature by querying PubMed, Medline, and Cochrane. We included original studies on adult patients with sickle cell disease and history of ischemic priapism. Results: We identified 15,057 publications, of which 10 met the study inclusion criteria. The incidence of erectile dysfunction was reported up to 69.20% in one study. Conclusion: More extended prospective studies are required as multicenter studies to find the exact incidence of erectile dysfunction in men with sickle cell disease and priapism. Level of evidence: Level of evidence is not applicable for this systematic review.
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Affiliation(s)
- Firas S Attar
- College of Medicine, Departement of Surgery, University of Basrah, Basrah, Iraq
| | - Majed A Mohammad
- College of Medicine, Departement of Surgery, University of Basrah, Basrah, Iraq
| | - Haithem HA Almoamin
- Al-Zahraa College of Medicine, Department of Surgery, University of Basrah, Basrah, Iraq
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Fernandez-Crespo RE, Buscaino K, Parker J, Carrion R. Current Status for Semirigid Penile Prosthetic Devices. Curr Urol Rep 2021; 22:7. [PMID: 33420928 DOI: 10.1007/s11934-020-01028-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE OF REVIEW The goal of this paper was to evaluate the current use of semirigid penile prosthesis (SRPP), surgical techniques for insertion of SRPP, and how to prevent and approach surgical complications. RECENT FINDINGS SRPP is a valid option for those who are refractory to medical therapy for erectile dysfunction (ED) and even more appropriate for specific subsets of patient populations. It is important for urologists to know which patient population SRPP is preferred for. Several studies have shown good patient outcomes and patient satisfaction with those who underwent SRPP.
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Affiliation(s)
- Raul E Fernandez-Crespo
- Tampa General Hospital, 1 Tampa General Circle, Tampa, FL, 33606, USA. .,University of South Florida, Morsani College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA.
| | - Kristina Buscaino
- Tampa General Hospital, 1 Tampa General Circle, Tampa, FL, 33606, USA.,University of South Florida, Morsani College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Justin Parker
- Tampa General Hospital, 1 Tampa General Circle, Tampa, FL, 33606, USA.,University of South Florida, Morsani College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Rafael Carrion
- Tampa General Hospital, 1 Tampa General Circle, Tampa, FL, 33606, USA.,University of South Florida, Morsani College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA
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Mishra K, Loeb A, Bukavina L, Baumgarten A, Beilan J, Mendez M, DiGiorgio L, Fu L, Carrion R. Management of Priapism: A Contemporary Review. Sex Med Rev 2020; 8:131-139. [DOI: 10.1016/j.sxmr.2019.01.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 12/27/2018] [Accepted: 01/18/2019] [Indexed: 10/27/2022]
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Özbay E, Aydın A, Salar R, Durmuş E, Karlıdağ İ, Öncel HF, Sönmez MG. Sexual experiences between partners after penile prosthesis: Who is more satisfied? Andrologia 2019; 52:e13461. [PMID: 31696574 DOI: 10.1111/and.13461] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 09/09/2019] [Accepted: 09/28/2019] [Indexed: 11/29/2022] Open
Abstract
Penile prosthesis implantation (PPI) is the final stage treatment in erectile dysfunction (ED). In this study, we planned to investigate the effect of PPI application on sexual functionality in the patients and their partners. After taking permission and consent for the study, from 20 male patients who were applied penile prosthesis due to ED between March 2013 and June 2018 and their partners, the couples were included in the study. Patients and partners filled in Arizona Sexual Experiences Scale (ASEX) form before PPI. After starting to use prosthesis, 20 patients and 19 partners were asked to fill in modified EDITS and ASEX form in the follow-ups in the sixth month. Average age was 54.35 years for the patients and 43.84 for the partners. Although post-PPI sexual satisfaction ratio was detected higher in female partners compared with the male patients, this difference was not statistically significant (p = .71). A significant recovery was also observed in total scale score, physiological stimulation, orgasm capacity and satisfaction scores in both groups after PPI. Penile prosthesis implantation is an operation providing high satisfaction for both the partner and the patient and is still one of the best options of ED.
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Affiliation(s)
- Engin Özbay
- Department of Urology, Şanlıurfa M. Akif İnan Training and Research Hospital, Şanlıurfa, Turkey
| | - Arif Aydın
- Department of Urology, NEÜ Meram Medicine Faculty, Konya, Turkey
| | - Remzi Salar
- Department of Urology, Şanlıurfa M. Akif İnan Training and Research Hospital, Şanlıurfa, Turkey
| | | | - İsmail Karlıdağ
- Department of Urology, Şanlıurfa M. Akif İnan Training and Research Hospital, Şanlıurfa, Turkey
| | - Halil Ferat Öncel
- Department of Urology, Şanlıurfa M. Akif İnan Training and Research Hospital, Şanlıurfa, Turkey
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12
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A Systematic Review on Ischemic Priapism and Immediate Implantation: Do We Need More Data? Sex Med Rev 2019; 7:530-534. [DOI: 10.1016/j.sxmr.2018.10.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 10/14/2018] [Accepted: 10/15/2018] [Indexed: 11/17/2022]
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13
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Carlos EC, Sexton SJ, Lentz AC. Urethral Injury and the Penile Prosthesis. Sex Med Rev 2018; 7:360-368. [PMID: 30078620 DOI: 10.1016/j.sxmr.2018.06.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 06/07/2018] [Accepted: 06/16/2018] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The relative infrequency of urethral injuries during penile prosthesis implantation has caused the event to be understudied relative to the morbidity and cost associated with their management. AIM To draw attention to both acute intraoperative and delayed urethral injuries via cylinder erosion by compiling and evaluating the available literature on their cause, diagnosis, and management. METHODS A literature review was performed through PubMed from 1985 to 2018 regarding urethral injuries in the setting of penile prosthesis implantation. Comorbidities and anatomic factors that predispose a patient to a urethral injury were also queried. MAIN OUTCOME MEASURES The goal is to identify at-risk populations and assess options for managing distal, mid-pendulous, and proximal acute urethral injuries that occur in the setting of penile prosthesis implantation. We also examine strategies to manage prosthesis erosion into the urethra. RESULTS Although urethral injuries are rare, certain patient populations are at higher risk for the event. Injuries at various locations along the urethra present unique challenging and morbid clinical scenarios. However, there are a variety of management options available that allow a patient to ultimately void normally and have a successfully implanted penile prosthesis. CONCLUSION Overall, penile prostheses offer many patients an improved sexual quality of life. In the setting of prosthesis implantation both acute and delayed urethral injuries are rare, but their associated morbidity can undercut the benefits of the device. Our understanding of these injuries has matured, and we now possess management strategies that can mitigate the morbidity and frustration that accompany this complication. Carlos EC, Sexton SJ, Lentz AC. Urethral injury and the penile prosthesis. Sex Med Rev 2019;7:360-368.
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Affiliation(s)
- Evan C Carlos
- Duke University, Division of Urology, Durham, NC, USA.
| | | | - Aaron C Lentz
- Duke University, Division of Urology, Durham, NC, USA
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