1,720,978 research outputs found
Diagnostic and Therapeutic Workup of Erectile Dysfunction: Results From a Delphi Consensus of Andrology Experts
No full textIntroduction: Erectile dysfunction is a highly prevalent condition. Existing guidelines provide recommendations for diagnosis and treatment, but they are often disregarded in clinical practice in favor of a “patient-tailored” approach. Objectives: We planned a Delphi consensus method to bridge the gap between evidence-based medicine and the real-life approach in daily practice. Materials and Methods: The Advisory Board prepared 15 statements on debated topics in andrology, each including 4–6 items designed as a 5-point Likert scale. After a validation phase, the questionnaire was sent by e-mail to a panel of experts for a first round of voting; members of the panel were later invited to a second round of voting, preceded by discussion of the “hot topics” identified in the first round. Results: The first round of the Delphi consensus involved 101 experts; 71 (70%) also took part in the second round of voting. The Advisory Board deemed 22 items to be worthy of debate, and these underwent the second round of voting. “Real-life” results from the survey proved quite different from evidence-based recommendations. Conclusion: Although guidelines suggest the best approach for a “standard” patient, real-life settings require flexibility. Diagnostic and therapeutic approaches should be tailored to the patients’ needs. Phosphodiesterase type 5 inhibitors are recognized as the first-line therapy in both settings, including the newly introduced sildenafil orodispersible film. Indications from the panel might help close the gap between recommendations from guidelines and real-life practice in relation to the diagnosis and treatment of erectile dysfunction. Isidori AM, Giammusso B, Corona G, et al. Diagnostic and Therapeutic Workup of Erectile Dysfunction: Results From a Delphi Consensus of Andrology Experts. Sex Med 2019;7:292–302
Distal hypospadias repair using the needle point bipolar cutting–coagulation forceps
No full textIntroduction: To determine the outcome of distal hypospadias repairs performed using bipolar diathermy (BD) for all the dissection. Methods: Retrospective review of 310 patients undergoing distal hypospadias (264 subcoronal/distal penile and 46 coronal/glanular) over a 11-year period. Median age at surgery was 2.0 years (range 9 months–15 years). Caudal anesthesia was performed in all patients. All children underwent an in situ tubularization of the urethral plate, which was combined with midline incision of the plate in 30 (10%). Preputial reconstruction was performed in 303 (98%) patients. BD forceps was used for coagulation and for all the dissection including skin incision, elevation of glans wings, separation of the corpus spongiosum from the corpora cavernosa, and urethral plate incision, when deemed appropriate. The authors assessed surgical complications and cosmetic results. The latter using the hypospadias objective score (HOSE), with a score ≥ 14 considered as acceptable. Results: The average operative time was 70 min. There was no postoperative bleeding or hematomas that required surgical intervention. There were no wound infections or necrosis. Complications occurred in 37 patients (11.9%). Urethral fistula formation was the commonest (n = 18.6%). Postoperative persistent preputial swelling occurred in 3.5% of cases. Two hundred twelve patients (90.6%) had a HOSE score ≥ 14, and no patient required revision surgery for skin problems after a median follow-up of 8.1 (range 1.2–13.1) years. Discussion: The study is limited by its retrospective nature and by the fact that a number of other pre-operative, intra-operative, and postoperative variables can affect outcome. Conclusions: Bipolar diathermy can be safely used for distal hypospadias repairs. It allowed careful control of intra-operative bleeding and also clear visualization of tissue planes. Complication rate overall compares favorably with the literature, and cosmetic results were satisfactory. [Table presented
Distal hypospadias repair using the needle point bipolar cutting-coagulation forceps
No full textIntroduction: To determine the outcome of distal hypospadias repairs performed using bipolar diathermy (BD) for all the dissection. Methods: Retrospective review of 310 patients undergoing distal hypospadias (264 subcoronal/distal penile and 46 coronal/glanular) over a 11-year period. Median age at surgery was 2.0 years (range 9 months-15 years). Caudal anesthesia was performed in all patients. All children underwent an in situ tubularization of the urethral plate, which was combined with midline incision of the plate in 30 (10%). Preputial reconstruction was performed in 303 (98%) patients. BD forceps was used for coagulation and for all the dissection including skin incision, elevation of glans wings, separation of the corpus spongiosum from the corpora cavernosa, and urethral plate incision, when deemed appropriate. The authors assessed surgical complications and cosmetic results. The latter using the hypospadias objective score (HOSE), with a score ≥ 14 considered as acceptable. Results: The average operative time was 70 min. There was no postoperative bleeding or hematomas that required surgical intervention. There were no wound infections or necrosis. Complications occurred in 37 patients (11.9%). Urethral fistula formation was the commonest (n = 18). Postoperative persistent preputial swelling occurred in 3.5% of cases. Two hundred twelve patients (90.6%) had a HOSE score ≥ 14, and no patient required revision surgery for skin problems after a median follow-up of 8.1 (range 1.2-13.1) years. Discussion: The study is limited by its retrospective nature and by the fact that a number of other pre-operative, intra-operative, and postoperative variables can affect outcome. Conclusions: Bipolar diathermy can be safely used for distal hypospadias repairs. It allowed careful control of intra-operative bleeding and also clear visualization of tissue planes. Complication rate overall compares favorably with the literature, and cosmetic results were satisfactory
Author Correction: Diagnostic and therapeutic workup of male infertility: results from a Delphi consensus panel (International Journal of Impotence Research, (2021), 10.1038/s41443-021-00511-x)
No full textThe following acknowledgments have been added: Authors want to acknowledge all collaborators who completed the questionnaire during the first and second round of voting: Paolo Turchi, Gianmartin Cito, Ilaria Natali, Alessandro Natali, Antonio Corvasce, Lucilla Divenuto, Stefano Impedovo, Michele Tedeschi, Francesco Paolo Turri, Antonio Vavallo, Antonio Vitarelli, Francesco Sebastiani, Davide Arcaniolo, Francesco Bottone, Francesco Chiancone, Lorenzo Cirigliano, Michelangelo Sorrentino, Giuseppina Peluso, Ottavio Sicuro, Pietro Paolo Cozza, Manuela Andreozzi, Marco Bitelli, Giorgio Franco, Vincenzo Gentile, Giuseppe La Pera, Andrea Ortensi, Pietro Salacone, Federica Sanna, Giovanni Tuffo, Paola Asero, Danilo Di Trapani, Vincenzo Favilla, Ignazio Gattuccio, Emilio Italiano, Bruno Giammusso, Filippo Montalto, Paolo Panella, Salvatore Privitera, Pietro Russo, Giuseppe Sidoti, Andrea Fabiani, Giorgio Gentile, Alessandro Franceschelli, Carlo Maretti, Edoardo Pescatori, Pasquale Scarano, Massimo Polito, Luigi Quaresima, Andrea Salonia, Gaetano Donatelli, Antonio Avolio, Daniele Tiscione, Andrea Galantini, Matteo Titta, Giorgio Piubello, Luca Boeri, Massimo Iafrate, Filippo Migliorni, Giovanni Liguori, Gioacchino De Giorgi, Emanuele Baldassarre, Giorgio Del Noce, Michele Manica, Carla Pasquale, Maurizio Ruggieri, Paolo Capogrosso, Fabrizio Ildefonso Scroppo, Elisabetta Micelli, Michele Rizzo
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Penile prosthesis: what should we do about complications?
No full textEven in the era of phoshodiesterase type 5 inhibitors, penile implants are considered the definitive solution for the treatment of organic erectile disfunction. The advent of new surgical tools and new infection-resistant materials has significantly reduced the risk of intra and post-operative complications and the need for revision surgery. Various companies have also improved their mechanical systems in order to reduce the risk of failures, and their products are now so good they may last lifelong. In this article, we evaluate the intraoperative and postoperative complications recorded in our experience and in literature reports, and make some suggestions as to how to prevent or correct them
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