Surgery

ESC CardioMed ◽  
2018 ◽  
pp. 1035-1039
Author(s):  
Odunayo Kalejaiye ◽  
Amr Abdel Raheem ◽  
David Ralph
Keyword(s):  
Erectile Dysfunction ◽  
Gold Standard ◽  
Penile Prosthesis ◽  
Vacuum Therapy ◽  
Risk Of Infection ◽  
Penile Prostheses ◽  
Activity Frequency ◽  
High Satisfaction ◽  
Satisfaction Rates ◽  
Very High

Penile prostheses are associated with very high satisfaction rates which have been reproduced consistently in the literature with rates of over 80%; the risk of infection, mechanical failure, and erosion are quoted as 2–16%, less than 6%, and less than 6%, respectively. When compared with Viagra®, vacuum therapy, or injection therapy, a penile prosthesis resulted in significantly higher satisfaction and sexual activity frequency. Penile prostheses should therefore be considered the gold standard treatment for the management of erectile dysfunction refractory to conservative measures. This chapter explores the surgical principles surrounding the surgical management of erectile dysfunction.

scholarly journals Contemporary Patient Satisfaction Rates for Three-Piece Inflatable Penile Prostheses

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Raymond M. Bernal ◽  
Gerard D. Henry
Keyword(s):  
Patient Satisfaction ◽  
Erectile Dysfunction ◽  
Penile Prosthesis ◽  
Surgical Approaches ◽  
Patient Dissatisfaction ◽  
Inflatable Penile Prosthesis ◽  
Penile Prostheses ◽  
The Many ◽  
Data Collation ◽  
Satisfaction Rates

Among the many treatments for erectile dysfunction, implantation of a penile prosthesis has been associated with high patient satisfaction rates. Specifically, the placement of a three-piece inflatable penile prosthesis (IPP) confers the highest rates of satisfaction. We reviewed the literature over the past 20 years regarding satisfaction rates for penile prostheses, with a focus on patients who had undergone an initial IPP implantation for erectile dysfunction. In all, 194 articles were reviewed, and of these, nine met inclusion criteria for analysis and data collation. We determined contemporary satisfaction rates to reflect patients’ experiences with newer products and surgical approaches. Of importance, we noted that varied metrics were used to determine patient satisfaction, and overall satisfaction could not be precisely determined. Nevertheless, we found that patients in general were quite satisfied with their three-piece IPPs and restoration of sexual function. We also identified reasons for patient dissatisfaction and reviewed the literature to find ways by which satisfaction could be improved. Given the various means by which patient satisfaction was determined, future efforts should include standardized and validated questionnaires.

scholarly journals An update on the best approaches to prevent complications in penile prosthesis recipients

2019 ◽  
Vol 11 ◽  
pp. 175628721881807 ◽  
Author(s):  
Sarah C. Krzastek ◽  
Ryan Smith
Keyword(s):  
Erectile Dysfunction ◽  
Patient Selection ◽  
Penile Prosthesis ◽  
Inflatable Penile Prosthesis ◽  
Device Implantation ◽  
Penile Prostheses ◽  
Operative Complications ◽  
Partner Satisfaction

Placement of inflatable penile prosthesis is a procedure frequently performed for medication-refractory erectile dysfunction. Device implantation is not without risks, and as the frequency of device implantation increases, so do associated complications. The aim of this work is to review the most frequent operative complications associated with implantation of inflatable penile prostheses, and to review the best approaches to prevent these most common complications. Complications can broadly be categorized as infectious, noninfectious tissue-related, device-related, or related to patient and partner satisfaction. With understanding of these complications and ways to avoid them, as well as with appropriate patient selection and counseling, the inflatable penile prosthesis is an excellent option for the treatment of erectile dysfunction.

scholarly journals Use of inflatable penile prostheses AMS CX with momentary squeeze in a patient with Peyronie’s disease after removal of two previously implanted penile prostheses

2014 ◽  
Vol 86 (1) ◽  
pp. 46
Author(s):  
Patrizio Vicini ◽  
Ferdinando De Marco ◽  
Gabriele Antonini ◽  
Ettore De Berardinis ◽  
Riccardo Giovannone ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Tunica Albuginea ◽  
Penile Prosthesis ◽  
Longitudinal Axis ◽  
Peyronie’S Disease ◽  
Neurovascular Bundle ◽  
Complex Case ◽  
Sexual Life ◽  
Penile Prostheses ◽  
Peyronie's Disease

Objective: Peyronie's disease (PD) is a fibrotic wound-healing condition of the tunica albuginea that results in penile deformity, curvature, hinging, narrowing and shortening, penile pain, and in some cases, erectile dysfunction (ED). Surgery remains the gold standard treatment option, ensuring the faster and trustworthy treatment. For those patients who have erectile dysfunction and PD, penile prosthesis placement with straightening procedure is the best method to solve both diseases. The aim of this article is to present the use of hydraulic penile prostheses AMS CX with Momentary Squeeze associated with a complete isolation of the neurovascular bundle in a complex case after removal of two previously implanted prostheses in a man suffering from Peyronie’s disease and erectile dysfunction. Material and method: A 50 year-old patient underwent two previous prosthetic implants in another hospital. The first implantation was performed using an infrapubic approach followed by placement of a three-component hydraulic penile prosthesis. After six months the prosthesis was removed using an infra-pubic approach and two soft prosthesis Virilis II were implanted during the same surgery. One year after the second operation we implanted a hydraulic penile prosthesis AMS CX with Mo - mentary Squeeze after complete isolation of the neurovascular bundle, fixing the two crural tips at the same level of albuginea of the two corpora cavernosa. Result: Twelve months after surgery the penis was completely straight without penile shortening and the patient was fully satisfied with his sexual life. Conclusion: The procedure enabled a perfect alignment of the cylinders along the longitudinal axis and penile prosthetic symmetry to obtain a good penile rigidity and a perfect penile straightening.

scholarly journals Recent advancements in penile prosthetics

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 193 ◽  
Author(s):  
Mathew Q Fakhoury ◽  
Joshua Halpern ◽  
Nelson Bennett
Keyword(s):  
Erectile Dysfunction ◽  
Surgical Technique ◽  
Penile Prosthesis ◽  
Treatment Modalities ◽  
Implant Design ◽  
Definitive Treatment ◽  
Inflatable Penile Prosthesis ◽  
Operative Care ◽  
Partner Satisfaction ◽  
Satisfaction Rates

Since the original inflatable penile prosthesis in the 1970s, several enhancements to penile prosthesis implant design, implant surgical technique, and post-operative care have been developed to increase overall patient (and partner) satisfaction rates. We, in this communication, seek to discuss these advancements and the overall impact in combating erectile dysfunction. As we continue to pursue avenues of effective and definitive treatment modalities for erectile dysfunction refractory to medical therapy, rates of infection and mechanical failure will hopefully continue to decline in the perioperative setting.

scholarly journals Dual Implantation of Artificial Urinary Sphincter and Inflatable Penile Prostheses for Concurrent Male Urinary Incontinence and Erectile Dysfunction

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Tariq F. Al-Shaiji
Keyword(s):  
Urinary Incontinence ◽  
Erectile Dysfunction ◽  
Surgical Techniques ◽  
Cost Savings ◽  
Penile Prosthesis ◽  
Artificial Urinary Sphincter ◽  
Inflatable Penile Prosthesis ◽  
Penile Prostheses ◽  
Urinary Sphincter ◽  
Negative Effect

Erectile dysfunction and urinary incontinence secondary to sphincter dysfunction are common conditions affecting many men worldwide with a negative effect on quality of life. They are encountered in a number of etiologies most commonly following radical prostatectomy in which they coexist in the same patient. Implantations of an artificial urinary sphincter and inflatable penile prosthesis have proven to be effective in the treatment of both conditions should conservative and minimally invasive measures fail. The recent literature has shown that dual implantation of these devices is feasible and safe with a durable clinical outcome. Once indicated, this can be done in a synchronous or nonsynchronous manner; however, the emerging of the single transverse scrotal incision as well as advancement in the prostheses has made synchronous dual implantation more favourable and appealing option. It provides time and cost savings with an evidence of high patient satisfaction. Synchronous dual implantation should be offered initially when indicated. This paper discusses the surgical techniques of artificial urinary sphincter and inflatable penile prosthesis dual implantation in the management of concurrent moderate-to-severe urinary incontinence and medically refractive erectile dysfunction, in addition to highlighting the existing literature pertaining to this approach.

scholarly journals Long term patient satisfaction and quality of life with AMS700CX inflatable penile prosthesis

2013 ◽  
Vol 85 (3) ◽  
pp. 133 ◽  
Author(s):  
Antonio Vitarelli ◽  
Lucia Divenuto ◽  
Francesca Fortunato ◽  
Antonio Falco ◽  
Vincenzo Pagliarulo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Erectile Dysfunction ◽  
Penile Prosthesis ◽  
Standard Reference Materials ◽  
Prosthesis Implantation ◽  
Satisfaction Rate ◽  
Inflatable Penile Prosthesis ◽  
Satisfaction Rates

Objective: Penile prosthesis implantation is the solution of choice in patients who have failed or present contraindication to the use of all conservative treatment for erectile dysfunction (ED). Overall, satisfaction rates are high, with more than 80% of patients and partners fully satisfied with cosmetic and functional result of surgery. Chronic postoperative pain, penile shortening, soft or hyposensitive glans, pencil like penis syndrome and difficulty to cycle the device represent the most common causes of patient’s dissatisfaction. Satisfaction rates are better assessed with the use of validated questionnaires such as the International Index of Erectile Function (IIEF) and the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) The aim of our study was to analyze the long-term mechanical reliability of the AMS 700CX/CXM inflatable penile prosthesis and the patient’s satisfaction rate using IIEF and EDITS questionaire as standard reference. Materials and methods: A retrospective case notes review of all patients who have undergone implantation of a three pieces inflatable penile prosthesis AMS 700 CX and CXR between October 1997 and December 2010. Overall, 80 patients have undergone implantation of 3 pieces inflatable penile prosthesis AMS 700 CX InhibiZone. Patients have been administered the IIEF-5 and EDITS questionnaires in combination with a non validated 9 domain questionnaire that assesses penile rigidity, sensation, orgasmic function, frequency of intercourse, impact of surgery on the quality of life, satisfaction rate. Results: Overall 10 years survival estimate according to the Kaplan Meier method of AMS 700 CX touch pump and AMS 700 CX momentary squeeze pump are respectively 77.6% and 82.5%. The median postoperative IIEF5 and EDITS score were respectively 21.46 and 73.11, which show a high level of satisfaction. 59 patients (90.8%) were able to cycle the device and were engaging in penetrative sexual intercourse. Conclusions: Penile prosthesis implantation yields excellent results in terms of cosmetic and functional outcome and therefore has a significant impact on patients’ satisfaction, sex life and overall quality of life. Overall, long term reliability has been significantly improved and complication rates are low in the hands of experienced surgeons.

scholarly journals Three-component hydraulic penile prosthesis malfunction due to penile fibrolipoma secondary to augmentative phalloplasty: A case report

2016 ◽  
Vol 87 (4) ◽  
pp. 339
Author(s):  
Gabriele Antonini ◽  
Patrizio Vicini ◽  
Ettore De Berardinis ◽  
Arianna Pacchiarotti ◽  
Vincenzo Gentile ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Case Report ◽  
Sexual Intercourse ◽  
Penile Prosthesis ◽  
Penile Prostheses

Fibrolipomas are an infrequent type of lipomas. We describe a case of a man suffering from subcutaneous penile fibrolipoma, who twelve months earlier has been submitted to augmentative phalloplasty due to aesthetic dysmorphophobia. The same patient three years earlier has been submitted to three-component hydraulic penile prostheses implantation due to erectile dysfunction. After six months from removing of the mass, the penile elongation and penile enlargement were stable, the prostheses were correctly functioning and the patient was satisfied with his sexual intercourse and life. The diagnostics and surgical characteristics of this case are reported.

scholarly journals Outcomes of low-flow priapism and role of integrated penile prosthesis management

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Mamdouh M. Elhawy ◽  
A. M. Fawzy
Keyword(s):  
Erectile Dysfunction ◽  
Erectile Function ◽  
Penile Prosthesis ◽  
Low Flow ◽  
Penile Prostheses ◽  
Immediate Placement ◽  
Penile Implant ◽  
History Of ◽  
Short And Long Term ◽  
Good Treatment Option

Abstract Background The natural history of priapism and predictors of erectile dysfunction (ED) remain vague due to defective reporting, different management techniques and variable follow-up durations. Acquiring more information concerning the prognosis of erectile function after priapism can help to assess the burden of post-priapism ED. Also, it may guide the decision-making process regarding penile prosthesis insertion in refractory and late post-priapism ED. In this study, we tried to evaluate the state of erectile function after recovery and how far penile implant surgery could be integrated in the early and late management of priapism-related ED. Methods We included 72 patients with low-flow priapism who were managed via a stepwise approach starting from aspiration through percutaneous distal shunt up to distal shunt. Immediate placement of a penile prosthesis was completed in eight refractory patients, including three that were inserted even before an open distal corporoglanular shunt. Results Nearly two-thirds (70.3%) of recovered priapism patients developed ED, but penile prostheses were inserted only in 35.5% of ED cases. There were no differences in the short- and long-term complications of immediate versus delayed prosthesis placement except for difficulty with the insertion of the penile prosthesis in delayed procedures. Conclusions Immediate placement of a penile prosthesis is a good treatment option in the setting of refractory priapism with comparable outcomes to those of patients with post-priapism ED who received prostheses. Immediate penile prosthesis insertion was further justified by the high incidence of post-priapism erectile dysfunction.

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