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Singh A, Cooper CA, Hou SW, Raheem OA. A Systematic Review of Partner Satisfaction After Penile Prosthesis with Special Emphasis on LGBTQ + Populations. Curr Urol Rep 2023; 24:105-115. [PMID: 36670232 DOI: 10.1007/s11934-022-01126-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2022] [Indexed: 01/22/2023]
Abstract
PURPOSE OF REVIEW Despite the current surgical advances and patients' satisfactions after penile prosthesis (PP) implantation, there has been paucity of data on reported partner satisfaction and their quality-of-life (QoL). Our objective was to summarize the current literature on partner satisfaction for both heterosexual and non-heterosexual populations, respectively. We specifically conducted a systematic review according to the Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards, and stratified studies into three tiers by methodological rigor. RECENT FINDINGS After an initial search of 172 articles, 33 studies met the inclusion criteria for the final review: 30 for heterosexual partner satisfaction, and 3 for LGBTQ patient satisfaction were included due to lack of published literature on partner satisfaction for LGBTQ patients. For heterosexual partner satisfaction, 10 studies were classified as Tier 1, 11 studies were classified as Tier 2, and 9 studies were classified as Tier 3. From an initial search of 13 records, three studies consisting of 272 patients met the inclusion criteria for our LGBTQ review. Across all the tiers, studies noted satisfaction rates between 50 and 90% and improved satisfaction and sexual QoL metrics compared to pre-surgery rates. That said, partner satisfaction rates were also consistently lower than patient satisfaction rates. Although the range of evidence quality varies, the available literature suggests significant improvements in and relatively high rates of partner satisfaction after PP implantation. Given the diversity of study designs and widespread use of non-validated or non-specific questionnaires in the current literature, future research should focus on prospective studies and/or data collection using validated, PP-specific questionnaires.
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Affiliation(s)
- Armaan Singh
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Caleb A Cooper
- Department of Surgery, Section of Urology, University of Chicago Medicine, Chicago, IL, USA
| | - Sean W Hou
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Omer A Raheem
- Department of Surgery, Section of Urology, University of Chicago Medicine, Chicago, IL, USA.
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Penile Implants: A Lesson from the First 50 Years. URO 2022. [DOI: 10.3390/uro3010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
This year marks the fiftieth anniversary of the first implant of an inflatable penile prosthesis (IPP). The authors of this paper want to celebrate the event with a narrative review of the current literature. The main scopes are antibiotic prophylaxis, patient satisfaction, and future developments. The implant of the first IPP in 1973, performed by Branteley Scott was a turning point in the history of penile prosthesis, revolutionizing the treatment of erectile dysfunction (ED). Since then, the idea of an inflatable device has not changed much. However, the innovations in design, materials, surgical techniques, and perioperative management led to a more natural, durable, and reliable device featuring fewer complications and greater patient satisfaction. Currently, IPP is associated with high patient satisfaction and excellent long-term outcomes, remaining the gold standard for men with refractory ED. Several strategies are under investigation to improve the technology of penile prosthesis, and we expect in the next future the introduction of new devices that are easier to activate, discreet, comfortable when deflated, and durable in time, mimicking a more physiological erection.
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Özbay E, Salar R, Oncel HF. Does two-piece PPI provide improvement in patient-partner quality of life? ACTA ACUST UNITED AC 2021; 93:237-240. [PMID: 34286563 DOI: 10.4081/aiua.2021.2.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 01/02/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The aim of this study is to retrospectively examine patient-partner satisfaction and changes in quality of life due to two-piece penile prosthesis implantation (PPI). There is no data about partner Quality of Life (QoL) related to two-piece PPI in the literature. MATERIAL AND METHODS SF 36 scale and modified Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS), which were filled before two-piece PPI and at the sixth postoperative month follow-up by male patients (n = 45) and female partners (n = 45), were evaluated. RESULTS We found patient-partner satisfaction rates as 80% and 86% respectively. The changes in all mean scores of SF 36 (mean total score, mean physical health score and mean mental health score) were statistically significant (p < 0.01). Again, the differences between all mean scores of SF 36 according to the level of patient-partner satisfaction were statistically significant (p < 0.01). CONCLUSIONS Two-piece PPI is an important option for ED treatment. It provides significant improvement in patient-partner QoL with high treatment satisfaction.
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Affiliation(s)
- Engin Özbay
- SBU Istanbul Kanuni Sultan Süleyman Research and Training Hospital, Department of Urology.
| | - Remzi Salar
- SBU Sanlıurfa Mehmet Akif I˙nan Research and Training Hospital, Department of Urology.
| | - Halil Ferat Oncel
- SBU Sanlıurfa Mehmet Akif I˙nan Research and Training Hospital, Department of Urology.
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Polchert M, Dick B, Raheem O. Narrative review of penile prosthetic implant technology and surgical results, including transgender patients. Transl Androl Urol 2021; 10:2629-2647. [PMID: 34295749 PMCID: PMC8261434 DOI: 10.21037/tau-20-1279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 11/20/2020] [Indexed: 01/15/2023] Open
Abstract
Over the past 40 years, the technological and surgical advancements in penile prostheses have led to increased patient satisfaction rates and decreased complication and infection rates. In cis males with erectile dysfunction (ED), these technological improvements tremendously improve quality of life. In female to male transgender patients, prostheses provide the ability to engage in penetrative intercourse and to urinate standing. This review evaluates technological and surgical advancements in penile prosthetics in the context of documented patient satisfaction and complication rates from prosthesis surgeries. Retrospective studies of penile implant usage in female to male gender-affirming surgeries report that infection and complication rates are higher than those seen in cis males. There are newer prostheses developed specifically for female to male reassignment surgeries, but outcome data is limited. Continued research and development are needed to develop more efficacious penile implantation options for gender affirmation surgery.
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Affiliation(s)
- Michael Polchert
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Brian Dick
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Omer Raheem
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
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Fuentes JL, Yi YA, Davenport MT, Bergeson RL, Ward EE, Morey AF. Long-term sequelae of inflatable penile prosthesis: clinical characteristics of patients who develop distal cylinder tip extrusion. Transl Androl Urol 2020; 9:38-42. [PMID: 32055464 DOI: 10.21037/tau.2019.08.30] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background Impending distal cylinder tip extrusions (DCTE) make up approximately 5-33% of all inflatable penile prosthesis (IPP) reoperations. While there have been a few case reports of DCTE in patients with diabetes and trauma, the current literature regarding risk factors for DCTE is limited. In this study, we examined the long-term sequelae among a large cohort of IPP patients to identify clinical risk factors for impending DCTE. Methods A retrospective review was completed of our single surgeon IPP database of 797 IPP placement cases from the years 2007 to 2018. We identified those who had a surgical intervention for a confirmed DCTE. Infected prostheses were excluded. The primary clinical end point of this study was to identify the time to extrusion repair from original penile prosthesis placement. Secondary clinical end points included location of extrusion and presence of corporal fibrosis. Results Between the years 2007 to 2018, 26 cases (3%) of impending or complete cylinder extrusions were identified in our IPP database (n=797). The mean age at initial IPP placement was 58 years, compared to a mean of 66 years at the time of extrusion. The mean time from initial placement to extrusion repair surgery was 8.4 years (median 5.5 years). Most patients (15/26, 57.7%) had a history of prior IPP placement, five of whom had two or more prior prostheses. Location among the 26 extrusions varied-12 (46.2%) lateral, 9 (34.6%) distal urethra, 2 (7.7%) glanular, 2 (7.7%) mid-shaft, and 1 (3.8%) coronal sulcus. Concomitant pathologies identified include Peyronie's disease (7, 26.9%), idiopathic corporal fibrosis (7, 26.9%) and sickle cell disease with priapism induced erectile dysfunction (3, 11.5%). Conclusions The risk of IPP extrusion appears to be associated with increased time from initial prosthesis placement, prior history of IPP placement, and the presence of corporal fibrosis or deformity. Patients should be counseled to recognize this important long-term sequela of IPP surgery.
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Affiliation(s)
- Jorge L Fuentes
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Yooni A Yi
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Michael T Davenport
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Rachel L Bergeson
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ellen E Ward
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Allen F Morey
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Verze P, Capece M, Califano G, La Rocca R. Two-piece inflatable and semi-rigid penile implants: an effective alternative? Int J Impot Res 2019; 32:24-29. [PMID: 31685942 DOI: 10.1038/s41443-019-0213-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 09/26/2019] [Accepted: 10/23/2019] [Indexed: 11/09/2022]
Abstract
Penile prostheses (PPs) are an excellent treatment to be considered for patients suffering from erectile dysfunction (ED), refractory to oral medications, or unwilling to consider intracavernosal injections or other therapeutic strategies. Nowadays the market is dominated by three-piece inflatable penile prosthesis (IPP), which are considered the best option available. However, in some specific cases three-piece IPP may be superseded by semi-rigid penile prosthesis (SRPP) and two-piece IPP. Despite the advantages of these implants, the literature is quite scarce, not robust and rarely takes into consideration the partner's satisfaction. This clearly affects the strength of our conviction. Most of the studies confirm that SRPPs and two-piece IPPs can be considered a valid alternative in patients with hand dexterity issues, refractory ischaemic priapism, neophallus and in cases of complex anatomies. In addition, the ease of placement and the high confidence level of surgeons make them a powerful tool in the armamentarium of urologists.
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Affiliation(s)
- Paolo Verze
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy.
| | - Marco Capece
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Gianluigi Califano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Roberto La Rocca
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
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Predictors of Satisfaction in Men After Penile Implant Surgery. J Sex Med 2018; 15:1180-1186. [PMID: 30017718 DOI: 10.1016/j.jsxm.2018.05.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 05/15/2018] [Accepted: 05/23/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Despite the high satisfaction with penile implant (PI) surgery reported in the literature, a significant proportion of patients remain dissatisfied. AIM To evaluate satisfaction after PI surgery, using a single question and a scoring system. Furthermore, we attempted to define factors that predicted high patient satisfaction. METHODS The study population consisted of all patients undergoing PI surgery between 2009 and 2015. Comorbidity, demographic, and implant information were recorded. Complications recorded included: minor (requiring no re-operation) such as penile or scrotal hematoma, superficial wound breakdown; major (requiring hospitalization or re-operation) such as device infection, erosion, and mechanical malfunction. Patient satisfaction was defined using a single question posed to the patient 6 months after surgery using a 5-point Likert scale (5 being the most satisfied). Descriptive statistics were used to define complication rates and multivariable analysis (MVA) was performed to define predictors of high satisfaction (score ≥ 4), including presence and degree of complications, Peyronie's disease (PD), diabetes mellitus (DM), number of vascular comorbidities, body mass index (BMI) > 30, and patient age. MAIN OUTCOME MEASURE Patients with a major complication, with or without an additional minor complication, had a higher likelihood of being dissatisfied (25%) compared to patients with no complication or only minor complication 1.9% (no complications) and 3.7% (only minor complications), P < .001. RESULTS 902 patients were analysed. Mean age was 56.6 ± 10.6 years. Mean BMI was 30 ± 5. Comorbidity profile was diabetes 75%, dyslipidaemia 44%, hypertension 33%, cigarette smoking 32%, and PD 34%. 76% had a malleable implant (MPP) and 24% an inflatable implant (IPP). 31% had a minor complication and 9% a major complication. 93% had high satisfaction (score ≥4). Patients with any complication had a reduced rate of high satisfaction (97.5% vs 87.7%; P < .001) and even more pronounced with a major complication (96.7% vs 64.2%; P < .001). On MVA, only the absence of a major complication was a significant predictor of high satisfaction (OR 20, 95% CI 9-50, P < .001). CONCLUSION A high percentage of men are satisfied after penile implant surgery. Only the presence of a major complication is linked to a lower likelihood of achieving high satisfaction. Habous M, Tal R, Tealab A, et al. Predictors of Satisfaction in Men After Penile Implant Surgery. J Sex Med 2018;15:1180-1186.
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Lerner T, Soares JM, Cavalcanti AL, Gay EP, Dos Santos AR, Cury J, Srougi M, Baracat EC. Penile prosthesis implantation: A solution or a dilemma for the couple. Rev Assoc Med Bras (1992) 2017; 63:475-476. [PMID: 28876419 DOI: 10.1590/1806-9282.63.06.475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Théo Lerner
- Division of Gynecology, Department of Obstetrics and Gynecology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, SP, Brazil
| | - José Maria Soares
- Division of Gynecology, Department of Obstetrics and Gynecology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, SP, Brazil
| | - Ana Lúcia Cavalcanti
- Division of Gynecology, Department of Obstetrics and Gynecology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, SP, Brazil
| | - Elsa Pereyra Gay
- Division of Gynecology, Department of Obstetrics and Gynecology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, SP, Brazil
| | | | - José Cury
- Division of Urology, HC-FMUSP, São Paulo, SP, Brazil
| | - Miguel Srougi
- Division of Urology, HC-FMUSP, São Paulo, SP, Brazil
| | - Edmund C Baracat
- Division of Gynecology, Department of Obstetrics and Gynecology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, SP, Brazil
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Akdemir F, Okulu E, Kayıgil Ö. Long-term outcomes of AMS Spectra® penile prosthesis implantation and satisfaction rates. Int J Impot Res 2017; 29:184-188. [DOI: 10.1038/ijir.2017.16] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 01/30/2017] [Accepted: 03/20/2017] [Indexed: 11/10/2022]
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Critical Analysis of Satisfaction Assessment After Penile Prosthesis Surgery. Sex Med Rev 2017; 5:244-251. [DOI: 10.1016/j.sxmr.2017.01.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 12/24/2016] [Accepted: 01/01/2017] [Indexed: 01/09/2023]
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Casabé AR, Sarotto N, Gutierrez C, Bechara AJ. Satisfaction assessment with malleable prosthetic implant of Spectra (AMS) and Genesis (Coloplast) models. Int J Impot Res 2016; 28:228-233. [DOI: 10.1038/ijir.2016.33] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 07/12/2016] [Accepted: 07/23/2016] [Indexed: 01/23/2023]
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12
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Challenges to Practicing Sexual Medicine in the Middle East. Sex Med Rev 2016; 4:221-228. [DOI: 10.1016/j.sxmr.2016.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 03/26/2016] [Accepted: 04/01/2016] [Indexed: 11/19/2022]
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Bozkurt IH, Arslan B, Yonguc T, Kozacıoglu Z, Degirmenci T, Gunlusoy B, Minareci S. Patient and partner outcome of inflatable and semi-rigid penile prosthesis in a single institution. Int Braz J Urol 2015. [PMID: 26200547 PMCID: PMC4752147 DOI: 10.1590/s1677-5538.ibju.2014.0241] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Penile prostheses are subject to a continuous development and have gained better mechanical reliability and safety during the last decades. In this study, we aimed to investigate the outcomes and satisfaction rates of inflatable penile prosthesis (IPP) and semirigid penile prosthesis (SPP) implantation. MATERIALS AND METHODS From August 2001 to June 2012, 257 men with erectile dysfunction (ED) underwent penile prosthesis implantation (PPI) at our institution. Of the 257 patients, 118 underwent implantation of IPP and 139 underwent SPP implantation. The pre-operative and post-operative erectile status of the patients were assessed by international index of erectile function (IIEF) questionnaire. The satisfaction of patients and partners were evaluated by a telephone interview using the erectile dysfunction inventory of treatment satisfaction (EDITS) questionnaire and EDITS partner survey. RESULTS The overall major complication rate was higher in IPP group. PPI led to a significant improvement in IIEF scores in both groups. For IPP and SPP groups the average EDITS scores were 78±11and 57±8, respectively, and that for the partners were 72±10 and 49±7, respectively (p<0.05). CONCLUSION Although the IPP implantation have better satisfaction rates, the SPP implantation is still a viable treatment option in the surgical treatment of ED because of low cost and high durability with acceptable satisfaction rates.
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Affiliation(s)
| | - Burak Arslan
- Department of Urology Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Tarik Yonguc
- Department of Urology Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Zafer Kozacıoglu
- Department of Urology Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Tansu Degirmenci
- Department of Urology Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Bulent Gunlusoy
- Department of Urology Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Suleyman Minareci
- Department of Urology Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
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Lledó‐García E, Jara‐Rascón J, Moncada Iribarren I, Piñero‐Sánchez J, Aragón‐Chamizo J, Hernández‐Fernández C. Penile Prosthesis First and Replacement Surgeries: Analysis of Patient and Partner Satisfaction. J Sex Med 2015; 12:1646-53. [DOI: 10.1111/jsm.12932] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Bozkurt IH, Arslan B, Kozacioglu Z, Yonguc T, Degirmenci T, Gunlusoy B, Minareci S. Does the etiology affect the outcome and satisfaction rates of penile prosthesis implantation surgery? Kaohsiung J Med Sci 2014; 30:570-3. [DOI: 10.1016/j.kjms.2014.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Revised: 03/08/2014] [Accepted: 03/03/2014] [Indexed: 10/25/2022] Open
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Current Management of Penile Implant Infections, Device Reliability, and Optimizing Cosmetic Outcome. Curr Urol Rep 2014; 15:413. [DOI: 10.1007/s11934-014-0413-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Falcone M, Rolle L, Ceruti C, Timpano M, Sedigh O, Preto M, Gonella A, Frea B. Prospective analysis of the surgical outcomes and patients' satisfaction rate after the AMS Spectra penile prosthesis implantation. Urology 2013; 82:373-6. [PMID: 23791218 DOI: 10.1016/j.urology.2013.04.027] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Revised: 04/15/2013] [Accepted: 04/19/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the outcomes, the patients', and their partners' satisfaction concerning the AMS Spectra penile prosthesis implantation. METHODS Twenty-two unresponsive or dissatisfied patients with phosphodiesterase 5 inhibitor oral therapy or prostaglandin intracavernous injection underwent a Spectra penile prosthesis implantation. No major intraoperative or postoperative complications were observed. The preoperative erectile dysfunction (ED) was rated by the International Index of Erectile Function (IIEF) questionnaire. The patients and their partners were submitted to the IIEF and Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaires through telephonic interviews at the third, sixth, and 12th months after the penile surgery. RESULTS This study demonstrates that 86.4% of the patients and 52.6% of their partners are satisfied by the AMS Spectra penile prosthesis. The preoperative average IIEF score was equal to 28.5 (range 13-39). The postoperative IIEF rates were 47.7 (43-53), 51.8 (48-58), and 53.9 (50-58) at the third, sixth, and 12th months, respectively. The patient average EDITS score amounted to 39.5 (31-48), 43.4 (36-50), and 45.2 (38-50) at the third, sixth, and 12th months, respectively. The increase between the preoperative and postoperative IIEF parameters resulted to be statistically significant (P <.05) as well as the increase in EDITS at the third, sixth, and 12th months postoperatively. CONCLUSION The AMS Spectra is a reliable device to treat ED as shown by the high grade of the patients' satisfaction. Moreover, the AMS Spectra is highly convenient in terms of cost savings in comparison to an inflatable device. In selected patients, this prosthesis should be considered as an effective solution to treat severe ED.
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Affiliation(s)
- Marco Falcone
- Urologic Clinic, "Città della Salute e della Scienza" - Molinette Hospital, Corso Bramante 88, Torino, Italy.
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El-Sakka AI. Erectile dysfunction in Arab countries. Part II: Diagnosis and treatment. Arab J Urol 2012; 10:104-9. [PMID: 26558011 PMCID: PMC4442901 DOI: 10.1016/j.aju.2012.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2012] [Revised: 02/14/2012] [Accepted: 02/14/2012] [Indexed: 11/29/2022] Open
Abstract
Objective To review local published data on the diagnosis and treatment of erectile dysfunction (ED) in Arab countries. Methods MEDLINE was searched for English-language articles published from 2000 to 2011, using the search terms ‘Arab countries’, ‘sexual dysfunction’, ‘diagnosis’ and ‘treatment’. Results In all, 86 articles were found to be relevant to this review; only a few had a high level of evidence and the remaining studies used an uncontrolled design. Several local studies were consistent with previous reports showing that a customised diagnostic pathway, with full consideration of the patient’s goals, is adopted by most clinicians to treat ED. For an effective treatment, the evaluation methods should answer important questions about the aetiology and severity of ED, as well as the patient’s and partner’s goals and expectations. As ED is known to be associated with many common medical comorbidities and medications, careful questioning can yield information about peripheral vascular disease, coronary artery disease, diabetes, hypertension, dyslipidaemia, and tobacco and alcohol use. The presence of psychological, neurological or chronic debilitating diseases can direct further evaluation. Conclusion The methods used for the diagnosis and treatment of ED need more investigation, especially in Arab countries. Only a few studies addressed the results of different methods of investigating and treating ED among Arab men.
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Henry GD, Brinkman MJ, Mead SF, Delk JR, Cleves MA, Jennermann C, Wilson SK, Kramer AC. A survey of patients with inflatable penile prostheses: assessment of timing and frequency of intercourse and analysis of implant durability. J Sex Med 2012; 9:1715-21. [PMID: 22568579 DOI: 10.1111/j.1743-6109.2012.02729.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
INTRODUCTION This study was conducted to determine how long after inflatable penile prosthesis (IPP) surgery patients attempt sexual intercourse and the frequency of subsequent relations. We also examined survival-related factors for the AMS 700 CX, Mentor Alpha 1, and Mentor Alpha Narrow Base. AIMS The aim was to survey men who received IPPs and collect information about their return to sexual function and frequency of use, and to assess the resilience of their devices. METHODS Phase I involved retrospective chart review of 1,298 virgin IPP surgeries performed by one surgical team from January 1992 to December 1998. Phase II included 330 subjects selected by stratified, systematic, random sampling from phase I patients. Data were collected by computer-assisted telephone interview, using a 27-question survey. All patients had been instructed to wait 4 weeks before using the implant and were taught how to inflate/deflate their prostheses at the 4-week postsurgical visits. MAIN OUTCOME MEASURES The survey examines the length of time after surgery for men to resume sexual function. In the same study, information was garnered about mechanical durability of the device. RESULTS Among phase I subjects, the 5-year survival rate was 83% (N = 1,069) for IPP revision for any reason. Of the 330 phase II subjects, 248 (75%) were successfully contacted; 199 (80%) responded to the full survey and 49 (20%) responded to selected parts of the survey. Sexual intercourse was resumed postoperatively at 1-4 weeks for 41% (78/190), at 5-6 weeks for 31% (59/190), at 7-8 weeks for 16% (30/190), and at >8 weeks for 12% (23/190) of the patients. More than 60% of patients reported using their IPP at least once weekly. CONCLUSION The three-piece IPP has excellent 5-year survival rates. Most patients return to sexual activity relatively quickly, with high frequency of usage of their prostheses.
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Paranhos M, Andrade E, Antunes AA, Barbieri ALN, Claro JA, Srougi M. Penile prosthesis implantation in an academic institution in Latin America. Int Braz J Urol 2010; 36:591-601. [DOI: 10.1590/s1677-55382010000500009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2009] [Indexed: 11/22/2022] Open
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Fathy A, Shamloul R, AbdelRahim A, Zeidan A, El-Dakhly R, Ghanem H. Experience with Tube (Promedon) malleable penile implant. Urol Int 2007; 79:244-7. [PMID: 17940357 DOI: 10.1159/000107957] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2007] [Accepted: 02/15/2007] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The main advantages of semirigid penile prosthesis are simple implantation, ease of use, very low risk of mechanical failure and more financial suitability for patients in developing countries. AIM To evaluate reliability and safety of Tube(R) (Promedon, Cordoba, Argentina) penile prosthesis in the surgical treatment of erectile dysfunction. PATIENTS AND METHODS This retrospective case series was conducted on 83 patients who underwent Tube penile implant surgeries between 2001 and 2006. The choice of Promedon penile implant was determined by the patient himself. Strict infection control measures were applied. Patients were followed up for stability of vital signs and discharged within 72 h. RESULTS Successful sexual intercourse was possible for 75 (90.4%) of cases. Common postoperative complaintswere: prosthesis too short in 27 cases (32.5%), not happy with the appearance of the penis in 8 cases (9.6%), non-specific pain which subsided spontaneously in 20 cases (24%), in which no further intervention was done apart from reassurance. 79 (95.2%) patients were on regular follow-up for the first year and the rest dropped out. None of the patients experienced prosthetic infection postoperatively. Crural cross-perforation (4%) was managed intraoperatively. Hematomas (1.6%) were managed conservatively. Retarded ejaculation (10%) and penile hypothesia (0.8%) resolved spontaneously within 6 months in all cases. CONCLUSION The Promedon malleable penile prosthesis is reliable and safe in the surgical treatment of erectile dysfunction.
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Affiliation(s)
- Ahmad Fathy
- Andrology and Sexology Department, Cairo University Hospital, Beni-Sueif, Egypt
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Salama N, Kishimoto T, Kanayama HO, Kagawa S. Unusual trivial trauma may end with extrusion of a well-functioning penile prosthesis: a case report. J Med Case Rep 2007; 1:34. [PMID: 17594510 PMCID: PMC1913532 DOI: 10.1186/1752-1947-1-34] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2007] [Accepted: 06/27/2007] [Indexed: 11/24/2022] Open
Abstract
Background Diabetes mellitus (DM) is the most common indication for insertion of a penile prosthesis and is a risk factor for infection of such prostheses. Case presentation Two patients presented with infected prostheses following unusual trivial penile trauma. Both patients underwent exploration and removal of the prostheses with uneventful recovery. Conclusion Appropriate sizing of the prosthesis should be taken into account to ensure good concealment and avoid easy exposure of the penis to unexpected trauma. Use of the newly designed antibiotic-coated prostheses appears preferable. As soon as signs of prosthesis infection appeared, extrusion of the device should be expedited.
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Affiliation(s)
- Nader Salama
- Departments of Urology, Alexandria School of Medicine, Alexandria, Egypt
- Tokushima School of Medicine, Tokushima City, Japan
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Moncada I, Martinez-Salamanca JI, Allona A, Hernandez C. Current role of penile implants for erectile dysfunction. Curr Opin Urol 2004; 14:375-80. [PMID: 15626882 DOI: 10.1097/00042307-200411000-00014] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to appraise new developments and publications in the field of penile prosthetic surgery. Urologists dealing with erectile dysfunction need to recognize the value of penile prosthetic surgery as a very efficacious treatment for this common condition. This type of surgery is needed in a considerable proportion of patients with erectile dysfunction so this review is timely and relevant. RECENT FINDINGS The main themes in the literature covered include risk factors for infection of penile prostheses, its prevention with the use of hydrophilic and antibiotic-coated prostheses, particularly in re-operations, and its management with the new rescue procedures. Surgical tips for prosthetic surgery are also reviewed as well as clinical outcomes and factors influencing them. SUMMARY Of all the invasive treatments currently available, placement of a penile prosthesis is one of the most successful, giving high levels of satisfaction. With the aid of new technical advances, the risk of infection--the most feared complication--can be minimized so prosthetic surgery may play a major role in the treatment of erectile dysfunction.
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Affiliation(s)
- Ignacio Moncada
- Gregorio Marañón General Hospital, c/Caleruega 97, Madrid 28033, Spain.
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Montorsi F, Dehò F, Salonia A, Briganti A, Bua L, Fantini GV, Gallina A, Saccà A, Mirone V, Rigatti P. Penile implants in the era of oral drug treatment for erectile dysfunction. BJU Int 2004; 94:745-51. [PMID: 15329092 DOI: 10.1111/j.1464-410x.2004.05025.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Francesco Montorsi
- Department of Urology, University Vita Salute San Raffaele, Milan, Italy.
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