1,720,982 research outputs found
Penile girth enhancement procedures for aesthetic purposes
No full textThe present study aimed to describe and critically discuss the current evidence regarding the penile girth enhancement procedures for aesthetic purposes. We designed a narrative review of the literature. A comprehensive search in the MEDLINE database was performed. Original articles in English-language, published until March 2021, were selected. A total of 29 studies were included (3 reporting non-invasive approaches, 11 injection therapies, and 15 surgical procedures). The vast majority of articles (26, 89.7%) were not randomized controlled trials, with overall low quality and limited level of evidence. Only 1 (33.3%) paper regarding non-invasive approaches reported a minimal (+0.03 cm) but a significant increase of penile girth (p = 0.034). A low rate (11.2-14.4%) of mild, temporary adverse events and poor-to-moderate patient satisfaction were found. Eight (72.7%) articles concerning injection therapies showed a significant increase in penile girth (p < 0.05). A low rate of mild complications, generally at the injection site, and a high patient satisfaction rate (75-100%) were highlighted. Nine (60%) papers on surgical treatments found a significant increase in penile girth (p < 0.05), while the other 6 (40%) studies reported a generic improvement in penile circumference. Skin necrosis or ulcers, wound infections, or need for reoperation were reported in 8 (53.3%) studies. A high patient satisfaction rate (60-100%) was reported. Our review highlighted the overall positive results of injection procedures, the poor outcomes associated with non-invasive techniques, and the good efficacy and satisfaction with a non-negligible risk of complications in patients undergoing surgical treatments. However, the adverse events are probably largely under-reported and these procedures should still be considered under investigation due to the limited evidence available and the lack of guidelines
Simultaneous Penile Lengthening and Penile Prosthesis Implantation in Patients with Peyronie's Disease, Refractory Erectile Dysfunction, and Severe Penile Shortening
No full textIntroduction. Due to loss of length, patients who had penile prosthesis implantation for Peyronie's disease (PD) show a statistically significant reduction in their levels of satisfaction when compared with the general implant population. Aim. The aim of this study is to report our experience of penile lengthening with circumferential graft during penile prosthesis implantation in patients with PD and severe penile shortening. Methods. Between March 2006 and February 2008, 23 patients with PD, refractory erectile dysfunction, and severe penile shortening underwent penile lengthening with circumferential graft and concomitant implantation of an inflatable penile prosthesis. Main Outcome Measures. Surgical outcome and complications have been recorded during postoperative follow-up. Patients' satisfaction has been assessed 6 months postoperatively with the administration of the modified Erectile Dysfunction Index of Treatment Satisfaction (EDITS) questionnaire. Results. After an average follow-up of 22 months (range 6-36), 20 patients attended all the postoperative follow-up visits and returned the EDITS questionnaire. An average length gain of 2.8 cm (range 2.2-4.5) was recorded, and all patients were able to cycle the device and engage in penetrative sexual intercourse. Patient recorded complications included diminished glans sensitivity in four (20%) and persistent dorsal curvature of less than 15° in three (15%). Overall, 18 patients (90%) were satisfied with the cosmetic and functional result of surgery. Conclusion. Penile lengthening with circumferential graft during penile prosthesis implantation in patients with PD represents a safe and reproducible technique that yields higher satisfaction rates than penile prosthesis implantation alone in patients with severe penile shortening. Sansalone S, Garaffa G, Djinovic R, Egydio P, Vespasiani G, Miano R, Loreto C, and Ralph DJ. Simultaneous penile lengthening and penile prosthesis implantation in patients with Peyronie's disease, refractory erectile dysfunction, and severe penile shortening. J Sex Med **;**:**-**
Cryopreserved Penile Tunica Albuginea for Allotransplantation: A Morphological and Ultrastructural Investigation
Full text linkIntroduction. Peyronie's disease, a connective tissue disorder of penile tunica albuginea (TA) associated with penile deformity, curvature, pain, and erectile dysfunction, is best managed surgically, but suitable graft biomaterials are not available. Aim. To establish whether cryopreservation affects human TA in view of its use in allotransplants. Methods. The effects on TA samples of the two most widely used tissue cryopreservation methods were investigated using an ad hoc panel of histochemical, immunohistochemical, and ultrastructural tests. Apoptotic cells were evaluated using the terminal deoxynucleotidyl transferase method of end labeling (TUNEL) assay. Main Outcome Measures. Assessment of tissue integrity and arrangement of collagen and elastic fibers in thawed TA. Results. Both cryofixation methods provided TA tissue suitable for use as graft material. Significant ultrastructural changes, namely, a greater diameter of collagen fibrils, were detected in sections preserved in liquid nitrogen; nonetheless, such increase never exceeded the normal range. The comprehensive panel of assays used proved suitable to characterize the thawed tissue. Conclusion. Human TA is suitable for cryopreservation; freezing at -80°C provides better results than preservation in liquid nitrogen. Loreto C, Orlandi A, Ferlosio A, Djinovic R, Basic D, Bettocchi C, Rutigliano M, Barbagli G, Vespasiani G, Caltabiano R, Musumeci G, and Sansalone S. Cryopreserved penile tunica albuginea for allotransplantation: A morphological and ultrastructural investigation. J Sex Med **;**:**-**
Penile prosthesis in the treatment of erectile dysfunction: Updates in 2020
No full textPenile erection implants are considered to be the «Gold Standard» for the treatment of erectile dysfunction with an organic component that escapes pharmacological and mechanical treatment. The place of preoperative information is fundamental. It is a simple and minimally invasive surgery. Penile Erection Implants are becoming more and more a full-fledged treatment line, which can be offered at the same time as other Erectile Dysfunction treatments. In this article, we will discuss the presentation of the different implants available, the elements underlying their indication, the place of preoperative information, the mains steps of the surgical procedure, the outcomes and satisfaction rates. © 2020 Editions Medecine et Hygiene. All rights reserved
Retrospective descriptive analysis of 1,176 patients with failed hypospadias repair.
No full textAbstract
PURPOSE: To our knowledge epidemiological data on the incidence of failed hypospadias repair and the number of patients seeking further surgical treatment remain unknown. We report an observational, descriptive survey of patients who were evaluated and treated for urethral stricture disease and/or penile defects after primary hypospadias repair.
MATERIALS AND METHODS: We performed a retrospective observational chart analysis of patients evaluated and treated for urethral stricture disease and/or penile defects at 2 tertiary European centers from January 1998 to December 2007. In each case we investigated the primary abnormal meatal site, the number of operations needed to repair primary hypospadias and complications of this primary repair. Patients were offered surgical repair for previous failed hypospadias treatment. After surgery evaluation was scheduled at 3, 6 and 9 months. Success was defined as a functional urethra without fistula, stricture or residual chordee and a cosmetically acceptable glanular meatus after the completion of all secondary procedures.
RESULTS: A total of 1,176 patients with a mean age of 31 years were evaluated and treated. To treat failed hypospadias repair 760 (64.6%) and 416 patients (35.4%) underwent 1-stage and staged repair, respectively. Mean followup was 60.4 months. Of 1,176 cases 1,036 (88.1%) were classified as successful and 140 (11.9%) were considered failures.
CONCLUSIONS: Failed hypospadias repair may be corrected by multiple and complex surgeries. Its effects are experienced during the lifetime of the patient and parents.
PMID: 19913825 [PubMed - indexed for MEDLINE
Penile prosthesis in the treatment of erectile dysfunction: Updates in 2020
No full textPenile erection implants are considered to be the «Gold Standard» for the treatment of erectile dysfunction with an organic component that escapes pharmacological and mechanical treatment. The place of preoperative information is fundamental. It is a simple and minimally invasive surgery. Penile Erection Implants are becoming more and more a full-fledged treatment line, which can be offered at the same time as other Erectile Dysfunction treatments. In this article, we will discuss the presentation of the different implants available, the elements underlying their indication, the place of preoperative information, the mains steps of the surgical procedure, the outcomes and satisfaction rates. © 2020 Editions Medecine et Hygiene. All rights reserved
Simultaneous Total Corporal Reconstruction and Implantation of a Penile Prosthesis in Patients with Erectile Dysfunction and Severe Fibrosis of the Corpora Cavernosa
No full textImplantation of a penile prosthesis in severely scarred corporal bodies represents a great challenge as fibrosis can compromise dilatation and subsequent closure of the corpora cavernosa and limit size, type, and function of the device.Introduction. Implantation of a penile prosthesis in severely scarred corporal bodies represents a great challenge as fibrosis can compromise dilatation and subsequent closure of the corpora cavernosa and limit size, type, and function of the device. Aim. The aim of this study is to report our experience of simultaneous corporeal reconstruction and penile prosthesis implantation in patients with severe penile contracture consequence of diffuse fibrosis. Methods. Between March 2006 and February 2010, 18 patients with severe penile contracture and coporeal fibrosis underwent simultaneous corporeal reconstruction and placement of a penile prosthesis. Main Outcome Measures. Surgical outcome and complications have been recorded during postoperative follow-up. Patients' satisfaction has been assessed 6 months postoperatively with the administration of the modified Erectile Dysfunction Index of Treatment Satisfaction questionnaire. Results. Although the dilatation of the corpora was extremely difficult due to the severe fibrosis, a penile prosthesis has been implanted in all patients. A malleable penile prosthesis has been inserted in four patients and a three-piece inflatable device in the remainder. After an average follow-up of 26 months (range 6-36), revision surgery was required in four patients (elective exchange to three-piece inflatable device in three patients and upsizing of the implant in one patient). Although all patients were able to achieve penetrative sexual intercourse, four patients were partially dissatisfied because of significant penile shortening. Conclusion. In expert hands, simultaneous penile prosthesis implantation and corporal reconstruction of severely scarred corpora yield satisfactory results. Patients must be warned that complication rate in presence of severe fibrosis is significantly higher than in virgin cases and that downsized cylinders might be required due to the contracture of the tunica albuginea. Sansalone S, Garaffa G, Djinovic R, Antonini G, Vespasiani G, Ieria FP, Cimino S, Loreto C, and Ralph DJ. Simultaneous total corporal reconstruction and implantation of a penile prosthesis in patients with erectile dysfunction and severe fibrosis of the corpora cavernosa. J Sex Med **;**:**-**
Recurrent hypospadias surgery
No full textTo evaluate the results of various reconstructive surgical procedures in patients with failed hypospadias repair
Surgical Repair of Late Complications in Patients Having Undergone Primary Hypospadias Repair during Childhood: A New Perspective
Full text linkBackground. The repair of complications in patients who had undergone hypospadias repair is still an open problem. Patients and Methods. We conducted a retrospective study of patients treated for late complications after hypospadias repair. Study inclusion criteria were patients presenting urethral, corpora cavernosa deformity, and/or penile defects due to previous hypospadias repair. Exclusion criteria were precancerous or malignant lesions and incomplete data on personal medical charts. Preoperative evaluation included clinical history, physical examination, urine culture, residual urine measurement, uroflowmetry, urethrography, urethral sonography, and urethroscopy. The patients were classified into four different groups. Success was defined as a normal functional urethra, with apical meatus, no residual penile curvature or esthetic deformity of the genitalia. Results. A total of 1,176 patients were entered in our survey. Out of the 1,176 patients, 301 patients (25.5%) underwent urethroplasty (group 1), 60 (5.2%) corporoplasty (group 2), 166 (14.1%) urethroplasty and corporoplasty (group 3), and 649 (55.2%) complex genitalia resurfacing (group 4). Mean followup was 60.4 months. Out of the 1,176 cases, 1,036 (88.1%) were considered successful and 140 (11.9%) failures. Conclusion. The majority of patients (55.2%) with failed hypospadias repair require surgical reconstruction to fully resurfacing the glans and penile shaft
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