51 research outputs found
Simultaneous implant of inflatable penile prosthesis and artificial urinary sphincter: a single high-volume center experience
No full textErectile dysfunction and stress urinary incontinence are both an important sequel after local therapy for prostate cancer, such as radical prostatectomy and radiotherapy. The implant of an inflatable penile prosthesis or an artificial urinary sphincter is an option if other treatments fail in both cases. There is a lack of literature regarding a simultaneous dual implantation. The aim of this study is to describe per- and postoperative morbidity and functional results. We included 25 patients operated between January 2018 and August 2022. Data were collected retrospectively. Standardized questionnaires for evaluating satisfaction were administered. There was a median operative time of 45 min (IQR 41.25-58). No intra-operative complications were seen. Four patients needed revision surgery, all of them regarding the sphincter prosthesis. One of these patients had additional revision surgery due to leakage of the penile implant reservoir. There were no infectious complications. There was a median follow-up time of 29 months (IQR 9.5-43). There was a satisfaction rate of 88% with patients and 92% with partners. Postoperative pads per day were reduced to zero or one in 96% of patients. We conclude that the dual implantation of an inflatable penile prosthesis and an artificial urinary sphincter was a safe and effective treatment in our series for patients with conservative treatment-refractory stress urinary incontinence and erectile dysfunction.All contributors to the article are mentioned in the author list
Majority of erectile dysfunction patients would have preferred earlier implantation of their penile prosthesis: validation of the recently changed EAU guidelines
No full textUntil 2019, the European Association of Urology guidelines recommended the implantation of a penile prosthesis as a third-line therapy, which has since then changed to "if other treatments fail or depending on the patient's preference". Primary endpoint was to assess whether patients with a penile prosthesis and their partner would have preferred earlier implantation. Secondary endpoints were the reason why patient and partner wanted earlier implantation, how much earlier they wanted it, satisfaction of patient and partner and if patient and partner would have recommended the intervention. We selected patients with a virgin inflatable penile prosthesis operated between April 2013 and December 2019. We included 155 patients and 65 partners. Telephonic interview was conducted in a structured manner. Further data were collected retrospectively. The preference for earlier implantation was reported in 59.4% of patients and 46.2% of partners. Of them, respectively 53.2% and 46.6% would have wanted the prosthesis more than 5 years earlier. Satisfaction was seen in 83.2% of patients and 73.8% of partners. Respectively 82.6% and 78.4% of patients and partners would recommend the procedure. Our results indicate that a more patient-oriented approach with good counseling is desirable and that the "three-level" concept must be abandoned.All contributors to the article are mentioned in the author list. We would like to thank our surgical team for their great work resulting in our high quality of care
Maldi-TOF analysis of hydroxy-containing polytetrahydrofuran chains (Poster by L. Van Renterghem)
No full textMaldi-Tof analysis of hydroxy-containing polytetrahydrofuran chains (Poster by L. Van Renterghem)
No full textClimacturia: a comprehensive review assessing pathophysiology, prevalence, impact, and treatment options regarding the “leak of pleasure”
No full textAim of this review is to summarize and evaluate the current literature on the pathophysiology, prevalence, sociosexual impact, and potential treatment options of climacturia. Climacturia, defined as orgasm-associated urinary incontinence and characterized by great prevalence variability, ranging between 15.7 and 93% was, so far, a relatively neglected post-radical prostatectomy functional side-effect. Recent studies have shown that it can significantly impact the quality of life of couples after prostate cancer treatment. A knowledge gap characterizes the pathophysiologic pathways while treatment is based on empirically chosen treatment options (condom use, presexual intercourse urination) or on therapeutic modalities proposed by low-quality studies (pelvic floor muscle training, penile applied devices). Evidence regarding efficacy of surgical techniques (artificial urinary sphincter, male sling, or dual implantation of penile prosthesis with a sling) for climacturia treatment are limited but with an increasing trend of relevant published data in the last 5 years. The mini-jupette sling plus inflatable penile prosthesis placement is a promising surgical technique that has been studied in a multi-institutional cohort with encouraging results regarding climacturia, erectile dysfunction, and mild-incontinence control. However, future studies with longer follow-up and larger sample sizes are certainly needed to confirm the long-term safety and benefits of this intervention.Mykoniatis, I (reprint author), Ctr Hosp Univ Liege, Serv dUrol, Hasselt, Belgium; Jessa Hosp, Dept Urol, Hasselt, Belgium.
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Immediate salvage with inflatable penile prosthesis in an infected field is associated with a high success rate
No full textThe Author(s), under exclusive licence to Springer Nature Limited 202
Multiscale investigation of quasi-brittle fracture characteristics in a 9Cr-1Mo ferritic-martensitic steel embrittled by liquid lead-bismuth under low cycle fatigue
No full textLiquid metal embrittlement (LME) induced quasi-brittle fracture characteristics of a 9Cr–1Mo ferritic–martensitic steel (T91) after fatigue cracking in lead–bismuth eutectic (LBE) have been investigated at various length scales. The results show that the LME fracture morphology is primarily
characterized by quasi-brittle translath flat regions partially covered by nanodimples, shallow secondary
cracks propagating along the martensitic lath boundaries as well as tear ridges covered by micro dimples.
These diverse LME fracture features likely indicate a LME mechanism involving multiple physical processes,such as weakening induced interatomic decohesion at the crack tip and plastic shearing induced nano/micro voiding in the plastic zone.sponsorship: The work is financially supported by the MYRRHA project, SCK.CEN, Belgium and partly funded by the European Atomic Energy Community's (Euratom) Seventh Framework Programme FP7/2007-2013 under grant agreement No. 604862 (MatISSE project) and in the framework of the EERA (European Energy Research Alliance) Joint Programme on Nuclear Materials. Dr. Tom Van der Donck (KU Leuven) is acknowledged for the EBSD measurements. The authors are grateful to Dr. Van Renterghem Wouter (SCK.CEN) for fruitful discussion of the TEM results. Xing Gong sincerely acknowledges valuable suggestions from Dr. S.P. Lynch (Defence Science and Technology Organisation and Monash University, Melbourne, Australia). (MYRRHA project, SCK.CEN, Belgium, European Atomic Energy Community's (Euratom) Seventh Framework Programme FP7|604862)status: Publishe
Assessment of Combination Therapies vs Monotherapy for Erectile Dysfunction A Systematic Review and Meta-analysis
No full textIMPORTANCE Combining 2 first-line treatments for erectile dysfunction (ED) or initiating other modalities in addition to a first-line therapy may produce beneficial outcomes. OBJECTIVE To assess whether different ED combination therapies were associated with improved outcomes compared with first-line ED monotherapy in various subgroups of patients with ED. DATA SOURCES Studies were identified through a systematic search in MEDLINE, Cochrane Library, and Scopus from inception of these databases to October 10, 2020. STUDY SELECTION Randomized clinical trials or prospective interventional studies of the outcomes of combination therapy vs recommended monotherapy in men with ED were identified. Only comparative human studies, which evaluated the change from baseline of self-reported erectile function using validated questionnaires, that were published in any language were included. DATA EXTRACTION AND SYNTHESIS Data extraction and synthesis were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. MAIN OUTCOMES AND MEASURES A meta-analysis was conducted that included randomized clinical trials that compared outcomes of combination therapy with phosphodiesterase type 5 (PDE5) inhibitors plus another agent vs PDE5 inhibitor monotherapy. Separate analyses were performed for the mean International Index of Erectile Function (IIEF) score change from baseline and the number of adverse events (AEs) by different treatment modalities and subgroups of patients. RESULTS A total of 44 studies included 3853 men with a mean (SD) age of 55.8 (11.9) years. Combination therapy compared with monotherapy was associated with a mean IIEF score improvement of 1.76 points (95% CI, 1.27-2.24; I-2 = 77%; 95% PI, -0.56 to 4.08). Adding daily tadalafil, low-intensity shockwave therapy, vacuum erectile device, folic acid, metformin hydrochloride, or angiotensin-converting enzyme inhibitors was associated with a significant IIEF score improvement, but each measure was based on only 1 study. Specifically, the weighted mean difference (WMD) in IIEF score was 1.70 (95% CI, 0.79-2.61) for the addition of daily tadalafil, 3.50 (95% CI, 0.22-6.78) for the addition of low-intensity shockwave therapy, 8.40 (95% CI, 4.90-11.90) for the addition of a vacuum erectile device, 3.46 (95% CI, 2.16-4.76) for the addition of folic acid, 4.90 (95% CI, 2.82-6.98) for the addition of metformin hydrochloride and 2.07 (95% CI, 1.37-2.77) for the addition of angiotensin-converting enzyme inhibitors. The addition of alpha-blockers to PDE5 inhibitors was not associated with improvement in IIEF score (WMD, 0.80; 95% CI, -0.06 to 1.65; I-2 = 72%). Compared with monotherapy, combination therapy was associated with improved IIEF score in patients with hypogonadism (WMD, 1.61; 95% CI, 0.99-2.23; I-2 = 0%), monotherapy-resistant ED (WMD, 4.38; 95% CI, 2.37-6.40; I-2 = 52%), or prostatectomy-induced ED (WMD, 5.47; 95% CI, 3.11-7.83; I-2 = 53%). The treatment-related AEs did not differ between combination therapy and monotherapy (odds ratio, 1.10; 95% CI, 0.66-1.85; I-2 = 78%). Despite multiple subgroup and sensitivity analyses, the levels of heterogeneity remained high. CONCLUSIONS AND RELEVANCE This study found that combination therapy of PDE5 inhibitors and antioxidants was associated with improved ED without increasing the AEs. Treatment with PDE5 inhibitors and daily tadalafil, shockwaves, or a vacuum device was associated with additional improvement, but this result was based on limited data.This study was cofunded by the European Union and Greece through the Operational Programme Competitiveness, Entrepreneurship and Innovation under the Research-Create-Innovate project code T1EDK-00540.Mykoniatis, I (corresponding author), Aristotle Univ Thessaloniki, Sch Hlth Sci, Fac Med, Dept Urol, Ethnikis Aminis 41, Thessaloniki 54436, Greece.
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L'accès à l'information et les méthodes de travail d'un lettré bagdadien du Ve/XIe siècle
No full textThis article focuses on information sources and work methods of Arab medieval historians, through examining the original example of a Hanbali Baghdadian scholar, Ibn al-Bannā' (d. 471 h./1079 CE). This author left some personal notes probably meant to be later used for historiographical writing. In most case, Ibn al-Bannā' had been the witness of the actor of the events he reports; in others, travelers (merchants and scholars) were the source of information. They were using oral as much as written transmission, the written documents being mainly merchant letters brought by caravans. Then the news were collected and afterwards spread in Baghdad by some riche Hanbali merchants and patrons. Public rumor was also spreading important political or military news. Information collected by Ibn al-Bannā' was mainly local, concerning Baghdad, Iraq, or rarely the neighboring areas (Syria, Palestine, Ġazīra, Iran, Arabia) but never other parts of the world. Finally, the author's sociability networks appear as essential in collecting information.Il s'agit ici de s'interroger sur les sources d'information et les méthodes de travail des chroniqueurs arabes de l'époque médiévale, à travers un exemple original, celui du lettré hanbalite bagdadien Ibn al-Bannā' (m. 471 h./1079 apr. J.-C.), qui laissa des notes personnelles sans doute destinées à une compilation historiographique postérieure. Dans de nombreux cas, Ibn al-Bannā' était lui-même le témoin ou l'acteur des événements rapportés ; dans d'autres, les informations reçues, communautaires (internes au groupe hanbalite) ou non, étaient transmise par des voyageurs, marchands et lettrés essentiellement. Outre la transmission orale, les lettres de commerçants comptaient parmi les plus importants vecteurs de l'information. Elles étaient transportées par les caravanes marchandes, puis les nouvelles dont elles étaient porteuses étaient collectées et redistribuées à Bagdad par de riches commerçants et mécènes hanbalites. La rumeur publique colportait également des nouvelles politiques ou militaires souvent importantes. L'information recueillie par Ibn al-Bannā' était essentiellement locale, badgdadienne ou irakienne, ou plus rarement concernait les régions voisines (Syrie-Palestine, Ğazīra, Iran, Arabie) à l'exclusion du reste du monde. En définitive, les réseaux de sociabilité de l'auteur apparaissent comme essentiels dans son travail de collecte de l'information
L'accès à l'information et les méthodes de travail d'un lettré bagdadien du Ve/XIe siècle
No full textThis article focuses on information sources and work methods of Arab medieval historians, through examining the original example of a Hanbali Baghdadian scholar, Ibn al-Bannā' (d. 471 h./1079 CE). This author left some personal notes probably meant to be later used for historiographical writing. In most case, Ibn al-Bannā' had been the witness of the actor of the events he reports; in others, travelers (merchants and scholars) were the source of information. They were using oral as much as written transmission, the written documents being mainly merchant letters brought by caravans. Then the news were collected and afterwards spread in Baghdad by some riche Hanbali merchants and patrons. Public rumor was also spreading important political or military news. Information collected by Ibn al-Bannā' was mainly local, concerning Baghdad, Iraq, or rarely the neighboring areas (Syria, Palestine, Ġazīra, Iran, Arabia) but never other parts of the world. Finally, the author's sociability networks appear as essential in collecting information.Il s'agit ici de s'interroger sur les sources d'information et les méthodes de travail des chroniqueurs arabes de l'époque médiévale, à travers un exemple original, celui du lettré hanbalite bagdadien Ibn al-Bannā' (m. 471 h./1079 apr. J.-C.), qui laissa des notes personnelles sans doute destinées à une compilation historiographique postérieure. Dans de nombreux cas, Ibn al-Bannā' était lui-même le témoin ou l'acteur des événements rapportés ; dans d'autres, les informations reçues, communautaires (internes au groupe hanbalite) ou non, étaient transmise par des voyageurs, marchands et lettrés essentiellement. Outre la transmission orale, les lettres de commerçants comptaient parmi les plus importants vecteurs de l'information. Elles étaient transportées par les caravanes marchandes, puis les nouvelles dont elles étaient porteuses étaient collectées et redistribuées à Bagdad par de riches commerçants et mécènes hanbalites. La rumeur publique colportait également des nouvelles politiques ou militaires souvent importantes. L'information recueillie par Ibn al-Bannā' était essentiellement locale, badgdadienne ou irakienne, ou plus rarement concernait les régions voisines (Syrie-Palestine, Ğazīra, Iran, Arabie) à l'exclusion du reste du monde. En définitive, les réseaux de sociabilité de l'auteur apparaissent comme essentiels dans son travail de collecte de l'information
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