Penile prosthesis implantation: A single center 25 years of experience

OBJECTIVES

We analyzed the long-term results of malleable and inflatable penile prosthesis: the rates of complications, revision surgery and patient satisfaction.

MATERIALS AND METHODS

Between January 1996 and December 2020, a total of 138 patients underwent implantation of a malleable or inflatable types penile prosthesis. The data of the patients were derived from the patient files and digital recording system. The patients were contacted face-to-face interaction if possible. If it is not possible, phone connection was made.

RESULTS

The median age of patients was 56 (21-83) years. Fourteen (10.2%) 1-piece, 46 (33.3%) 2-piece and 78 (56.5%) 3-piece penile prosthesis were implanted. The mostly used perioperative antibiotic was teicoplanin+amikacin in 107 patients. Total complication rate was 30% (n=42). Prosthesis infection constituted 9% (n=13) of these complications. The total satisfaction rate was 89.1%. There was no correlation between the complications and antibiotic regimen or prosthesis type (P=0.488, P=0.454, respectively). The rate of infection showed a slight increase in 3-piece penile prosthesis without any statistically significance (P=0.633). The patients with complications expressed more dissatisfaction compared to those without complications (P=0.001).

CONCLUSIONS

In our series, penile prosthesis implantation seems to be a recommended treatment method with high patient satisfaction in the treatment of refractory erectile dysfunction.

LEVEL OF EVIDENCE

4.

Lymph node density in retroperitoneal lymph node dissection as a novel marker for predicting recurrence in patients with germ cell testicular cancer: A case-control study and long-term clinical experience of a tertiary referral hospital

INTRODUCTION AND OBJECTIVES

In this retrospective study, we aimed to evaluate lymph node (LN) density in retroperitoneal lymph node dissection (RPLND) to analyze whether residual mass after chemotherapy might behave as predicting factor for recurrence in patients with germ cell testicular cancer (GCTC).

MATERIALS AND METHODS

The data of 185 patients that were operated between 12/2004 and 02/2017 because of GCTC were reviewed retrospectively. LN density was calculated. The patients were compared statistically in terms of demographic features, tumor characteristics, serum tumor marker levels, treatment strategies, and pathological results according to GCTC subtypes. Correlation analysis was performed to determine the parameters related to recurrent disease.

RESULTS

The median follow-up was 79 (31-179) months and the median age of the patients was 23 (16-71). The median tumor size was 4 (1-18) cm. Five (2.7%) patients had metastatic disease at initial diagnosis. Seminoma, non-seminomatous-GCT and mix type-GCTC was detected in 62 (33.5%), 60 (32.4%) and 63 (34.1%) patients, respectively. Following inguinal orchiectomy, 48 (25.9%) patients underwent follow-up, 126 (68.1%) patients underwent chemotherapy and 11 (5.9%) patients underwent radiotherapy. A total of 21 (11.4%) patients underwent post-chemotherapy RPLND. Early and late recurrence was seen in 3 (1.6%) and 2 (1.1%) of the patients, respectively. A mild to moderate, negative, but significant correlation was found between the recurrence and the number of LNs containing metastatic deposits and LN density (r= -0.490, P=.024 and r= -0.450, P=.041, respectively).

CONCLUSIONS

There was a negative correlation between the number of LNs containing metastatic deposits and LN density and recurrent disease.

Four novel cycloartane glycosides from Astragalus oleifolius

Four novel cycloartane-type triterpene glycosides, macrophyllosaponins A-D (1-4) were isolated from the roots of Astragalus oleifolius. By means of chemical (acetylation, alkaline hydrolysis) and spectroscopic methods (IR, 1D- and 2D-NMR, FABMS), their structures were established as 3-O-alpha-L-rhamnopyranosyl-24-O-(4"-O-acetyl)-beta-D-xylopyranosyl-1 alpha,3 beta,7 beta,24(S), 25-pentahydroxycycloartane (1), 3-O-alpha-L-rhamnopyranosyl-24-O-beta-D-xylopyranosyl-1 alpha,3 beta, 7 beta,24(S), 25-pentahydroxycycloartane (2), 3-O-alpha-L-rhamnopyranosyl-25-O-beta-D-glucoyranosyl-1 alpha, 3 beta,7 beta,24(S),25-pentahydroxycycloartane (3), and 3-O-alpha-L-rhamnopyranosyl-24-O-(2-O-beta-D-xylopyranosyl) -beta-D-xylopyranosyl-1 alpha,3 beta,7 beta,24(S), 25-pentahydroxycycloartane (4).

Karsoside and scropolioside D, two new iridoid glycosides from Scrophularia ilwensis

Two new iridoid glycosides, karsoside [1] and scropolioside D [2], were isolated from the aerial parts of Scrophularia ilwensis. Their structures were elucidated on the basis of chemical and spectral data as 6'-O-(beta-D-xylopyranosyl)-methylcatalpol and 6-O-[(2",4"-di-O-acetyl-3"-O-trans-cinnamoyl)-alpha-L-rhamnopyranosyl]- catalpol, respectively. Additionally, four known iridoids (aucubin, harpagide, 8-O-acetylharpagide, and ajugol), a phenylpropanoid glycoside (angoroside C), and two flavonoids (quercetin-3-O-rutinoside and kaempferol-3-O-rutinoside) were isolated and identified.