An unusual complication of penile prosthesis following urethroplasty

Three-Piece Inflatable Penile Prosthesis Implantation for the Treatment of Severe Erectile Dysfunction Following a Complex Pelvic Fracture: A Case Report

Pelvic fracture is one of the common causes of erectile dysfunction (ED). The pathophysiology of ED following pelvic injury is quite complicated and comprises vascular, neurogenic, corporal, as well as psychogenic causes. Penile prosthesis implantation is the third-line treatment of ED due to any reason including pelvic trauma that poorly responds to other standard treatments. In this study, we reported a case of a 33-year-old man with severe erectile dysfunction and urethral stricture following a complex pelvic fracture due to a traffic accident who was successfully implanted with a three-piece inflatable penile prosthesis at People's Hospital 115. At the sixth month of follow-up, this device has been working effectively, the patient had the ability to attain full erection for sexual intercourse. Both the patient and the partner are satisfied with their sexual lives. ED is a long-term consequence of pelvic fracture. The high proportion of young patients with a demand for erection rehabilitation and complex pathophysiology make the treatments even more challenging. Penile implant surgery is a potential treatment for refractory ED patients suffering from pelvic trauma.

Erectile and Ejaculatory Dysfunction After Urethroplasty

PURPOSE OF THE REVIEW

The goal of this paper was to evaluate the impact on erectile and ejaculatory function after anterior and posterior urethroplasty.

RECENT FINDINGS

With a rise in the use of urethroplasty, its impact on sexual function has come into question. For anterior urethroplasties, some degree of erectile dysfunction is common, but this tends to be transient, with most patients having a resolution of any de novo dysfunction by 12 months. Patients with posterior urethral strictures have a very high rate of erectile dysfunction prior to surgery and may show improvement after urethroplasty. Ejaculatory function tends to improve in patients due to alleviation of obstruction while some patients notice degradation in force of ejaculation. While urethroplasty has a minimal permanent effect on sexual function for most patients, there are some patients who notice improvement and others worsening. Patients should be counseled on these risks prior to urethroplasty.

Erectile dysfunction in urethral stricture and pelvic fracture urethral injury patients: diagnosis, treatment, and outcomes

Urethral stricture disease, pelvic fracture urethral injury (PFUI), and their various treatment options are associated with erectile dysfunction (ED). The etiology of urethral stricture disease is multifactorial and includes trauma, inflammatory, and iatrogenic causes. Posterior urethral injuries are commonly associated with pelvic fractures. There is a spectrum in the severity of both conditions and this directly impacts the treatment options offered by the surgeon. Many published studies focus on the treatment outcomes and the relatively high recurrence rates after surgical repair. This communication reviews the current knowledge of the association between ED and urethral stricture disease, as well as PFUI. The incidence, pathophysiology, and clinical ramifications of both conditions on sexual function are discussed. The treatment options for ED in those patients are reviewed and summarized.

[Urethral injuries secondary to implantation of penile prosthesis. Analysis of the causes, prevention and treatment]

Urethral injuries due to penile prosthesis implant represent a rare complication of the intervention to position penile prosthesis, but unfortunately scientific literature about this is poor. This rare complication may occur during surgery and in the postoperative period, both early and late. It recognizes a variety of causes that may include anatomical or functional conditions, for example cavernosal fibrosis or outcomes of inflammations or previous urethral lesions and pathological sensibility due to diabetic neuropathy or other forms of neuropathy including those from spinal cord injury or myelopathy. This review evaluates the possible predisposing conditions, the clinical presentations, and the devices in the surgical procedures to use to minimize the risk of onset of this lesions and the measures to take if they occur.