scholarly journals Management of proximal penile prosthetic cylindrical complications: a novel direct crural approach

2020 ◽  
Vol 30 (1) ◽  
Author(s):  
Ahmed S. Zugail ◽  
Maher Abdessater ◽  
Abdulmajeed Althobity ◽  
Johnny Boustany ◽  
Mabel Nuernberg ◽  
...  
Keyword(s):  
Operative Time ◽  
Traditional Approach ◽  
Tunica Albuginea ◽  
Penile Prosthesis ◽  
Proximal Part ◽  
Lithotomy Position ◽  
Longitudinal Incision ◽  
Operative Complications ◽  
Operative Recovery

Abstract Introduction Patients with proximal penile prosthetic cylindrical complications (PPPCC) can be treated with a direct crural technique without using the original traditional approach. In this article we present our novel direct crural approach for management of patients with PPPCC. Materials and methods Between 2014 and 2019, data were retrospectively collected from 13 patients who underwent surgical revision using our novel direct crural approach for PPPCC. The procedure commences with identification of the affected zone. The patient is in a low lithotomy position. A 2-centimeter longitudinal incision is made directly over the affected site. Dissection is carried down through Colles’ fascia, followed by a longitudinal incision through the tunica albuginea at the proximal part of the affected cylinder. Via the incision we can deliver out the cylinder and manage its problem. Results Mean operative time was 40 min. No intra or post-operative complications were reported. All patients (Mean age = 57) were discharged on the same day. Postoperative follow-up found correction of all existing deformities at month 1, 3 and 6. All patients were satisfied and reported less pain and faster recovery than the first procedure. Conclusion Our technique, which can be used for all types of penile prosthesis, is both feasible and safe. It may simplify PPPCC revision by avoiding adhesions below the original incision, without jeopardizing the already implanted materials or the urethra. It may also improve patients’ safety and satisfaction, by reducing iatrogenic injury and post-operative recovery time.

Abdominal sacrohysteropexy UV prolapse and preservation of reproduction.

2021 ◽  
Vol 28 (05) ◽  
pp. 652-655
Author(s):  
Robina Ali ◽  
Riffat Ehsan ◽  
Ghazala Niaz ◽  
Fatima Abid
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Uterovaginal Prolapse ◽  
Prolapse Recurrence ◽  
Gynecology And Obstetrics ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
Operative Recovery ◽  
Post Operative Complications

Objectives: The purpose of this study was to assess the safety of sacrohystcopxy by determining intraoperative and post-operative complications and its effectiveness by pelvic organ prolapse recurrence on follow up. Study Design: Prospective study. Setting: Department of Gynecology and Obstetrics Unit-II DHQ Hospital PMC, Faisalabad. Period: Jan-2014 to Jan-2017. Material & Methods: Patients with uterovaginal prolapse, admitted through OPD were selected for abdominal sacrohysteropexy. Variables of study including duration of surgery, any intra-operative and post operative complications, need of intra operative blood transfusion, post operative hospital stay; recurrence of POP, number of pregnancies in 06 moths follow up were recorded. Results: During this study period, 319 patients were admitted with uterovaginal prolapse. 32 (10.03%) cases were selected for abdominal sacrohysteropexy. In these 32 patients, 03 (9.37%) were <30years of age, 21(65.62%) were between 30-35 years and 8 (25%) were between 35-40 years of age. About 2(6.25%) were unmarried, while 30(93.7%) were married. In these married women 14(43.75%) were multiparas, another 14(43.75%) were para 1 or 2, while 4(12.5%) were para 3 or more. Duration of surgery was 40-45 minutes in 31(96.87%) patients. In 28(87.5%) cases per operative blood loss was <150ml while in 4(12.5%) it was estimated to be >150ml but less than 300ml. Post operatively only 1(3.12%) case developed wound sepsis and it was the only one (3.12%) who was discharged on 7th post operative day, while rest 31(96.87%) were discharged on 3rd post operative day. No recurrence was noticed in 06 moths follow up, while 2(6.25%) patients became pregnant. Conclusion: Abdominal sacrohysteropexy is a safe and an effective treatment in terms of overall anatomical and functional outcome, complications, post operative recovery, length of hospital stay and sexual functioning, in women who desire uterine and hence fertility preservation.

Evaluation of transverse dorsal lumbotomy in management of PUJ obstruction in patients younger than 6 months

2021 ◽  
pp. 039156032199360
Author(s):  
Saeed Alhindi ◽  
Mohamed Mubarak ◽  
Husain Alaradi
Keyword(s):  
Operative Time ◽  
Demographic Data ◽  
Renal Ultrasound ◽  
Ultrasound Scan ◽  
Operative Duration ◽  
Operative Complications ◽  
Efficient Alternative ◽  
The Mean ◽  
Operative Ultrasound

Objective: The transverse dorsal lumbotomy approach provides excellent exposure to the PUJ and causes minimal tissue damage. In this study, we assess the efficacy of dorsal lumbotomy in PUJ obstruction in children younger than 6 months. Methods: All children less than 6 months who were managed with the dorsal lumbotomy approach between 2009 and 2017 were reviewed prospectively. Data included: demographic data, pre/post-operative renal ultrasound scan with SFU grading and RDS, operative time, post-operative complications, and follow up results. Results: A total of 42 children with a mean age of 4.4 ± 1 months were included. On pre-operative RDS, all patients had an obstructive pattern and a SRF of 30.3 ± 9.3. The mean operative duration was 49 min and analgesia was minimal. Post-operative ultrasound at 6 months showed an improvement in hydronephrosis ( p < 0.05) and a mean SRF of 39.3 ± 6.1 ( p < 0.001). Conclusion: Transverse dorsal lumbotomy approach is a safe and efficient alternative in patients less than 6 month.

scholarly journals Penile prosthesis and complications: Results from 577 implants

2020 ◽  
Vol 92 (4) ◽  
Author(s):  
Diego Pozza ◽  
Andrea Marcantonio ◽  
Augusto Mosca ◽  
Carlotta Pozza
Keyword(s):  
Penile Prosthesis ◽  
Infectious Complications ◽  
Late Complications ◽  
Drop Out ◽  
Therapeutic Modalities ◽  
Number Of Patients ◽  
Operative Complications ◽  
Reduced Time ◽  
Prosthetic Surgery

Objective: Penile Prosthetic Surgery is already well characterized but the problems connected with possible complications still need to be evaluated and discussed. Material and Methods: The Authors revaluated their experience in Penile Prosthetic Surgery involving 577 patients (18 - 86 years, mean age 51.3 years) operated by the same surgeon since 1984. We implanted 199 silicone-semi-rigid (Small Carrion, Implantal, Eurogest, Subrini, SSDA GS), 200 malleable (Jonas, Omniphase, Duraphase, AMS600, MentorColoplast Genesis, Vedise) and 178 inflatable (Mentor: Mark II, Alpha I, Titan OTR; AMS: mono-component Hydroflex, Dynaflex; bi-component Ambicor; multicomponent: 700 Ultrex, 700 CX, 700 LGX) prostheses. Operative, postoperative, infectious and malfunctioning complications have been recorded. A total of 156 patients drop out at follow-up and we may not exclude possible late complications treated at different hospitals. Results: The recorded complications and the therapeutic modalities utilized to treat them are examined. Operative complications were recorded in 2 malleable prostheses (MPP) and in one inflatable prosthesis (IPP). Postoperative complications have been recorded in three cases of MPP (1.5%) and in 9 IPP (5.0%) and were strictly connected to general medical co-morbidities as diabetes mellitus (DM), coronary artery dysfunction (CAD), and Peyronie’s disease (PD). In three cases of IPP implantation, hematomas were related to the blunt surgical maneuvers utilized to insert the reservoir or the scrotal pumps. Infectious complications were mostly observed in patients with DM: 4 patients with MPP (1.0%) and 15 patients with IPP (8.4%). Malfunction rate of the prostheses in our series was really disappointing considering that 13/17 cases (77%) of mono-component IPP broke while in patients with multicomponent IPP the percentage of malfunction has been of 13/161 (8%) and malfunction was observed in only one case of MPP. We were forced to explant the prostheses in 2 patients with MPP (0.5%) and 40 with IPP (22%). However, after excluding 17 mono-component IPPs, the percentage of explants of multicomponent IPP (23 patients, 4.2%) is in line with other significative experiences. Conclusion: The number of complications of PPS are similar to those reported by well qualified urological institutions. In our experience a scrupulous antibiotic therapeutic schedule, avoiding direct contact between the prostheses and the patient’s skin, reduced time of surgery with surgeon’s experience positively influenced the results.In a limited number of patients medical treatment or minimal surgical acts allowed to solve the complications preserving the prostheses and avoiding the prosthetic explant

scholarly journals Single port paediatric heminephrouretectomy

2011 ◽  
Vol 1 (1) ◽  
pp. 18
Author(s):  
Simon Blackburn ◽  
Vanessa Chow ◽  
Varadarajan Kalidasan ◽  
Anies Mahomed
Keyword(s):  
Laparoscopic Surgery ◽  
Operative Time ◽  
Single Incision ◽  
Single Port ◽  
Single Incision Laparoscopic Surgery ◽  
Duplex Kidney ◽  
Operative Complications

We present a 4-year-old girl who underwent a single incision laparoscopic surgery (SILS) heminephrouretectomy. The procedure was completed without intra-operative complications or conversion. The operative time was 162 min. At 3 month follow up there is no evident scar and the patient is asymptomatic. SILS upper moiety heminephrouretectomy for duplex kidney is safe and technically feasible in children.

Distal Corporoplasty for Distal Cylinders Extrusion after Penile Prosthesis Implantation

2016 ◽  
Vol 84 (1) ◽  
pp. 38-39 ◽  
Author(s):  
Maurizio Carrino ◽  
Francesco Chiancone ◽  
Gaetano Battaglia ◽  
Luigi Pucci ◽  
Paolo Fedelini
Keyword(s):  
Postoperative Complications ◽  
Operative Time ◽  
Intraoperative Complications ◽  
Penile Prosthesis ◽  
Prosthetic Material ◽  
Safe Procedure ◽  
Potential Complication ◽  
Prosthesis Implantation ◽  
Mean Values

Introduction Distal extrusion of cylinders is a potential complication of the penile prosthesis implantation. Several methods have been proposed for repairing a distal penile erosion. We present our preliminary experience in “Distal corporoplasty” technique. Methods We enrolled 18 consecutive patients whose underwent a distal corporoplasty with simultaneous reimplantation of an “AMS 700 inflatable penile prosthesis (LGX)” from January 2013 to November 2015 at our hospital. All procedures were performed by a single surgical team. Intraoperative and postoperative complications have been classified and reported according to Satava6 and Clavien-Dindo (CD) system.7 Mean values with standard deviations (±SD) were computed and reported for all items. Results Mean age of the patients was 53.61 (±11.90) years. Mean body max index (BMI) was 24.22 (±2.51). Mean operative time was 85.2 (±13.1) minutes. Blood losses were minimal. No intraoperative complications are reported according to Satava classification. Four out of 18 patients (22.22%) experienced postoperative complications according to CD system. All patients had sexual intercourse for the first time postsurgery after a mean of 59.11 ± 2.08 days. Mean follow-up was 22.11 (±9.95). Discussions Distal extrusion of cylinders is a potential complication of the penile prosthesis implantation. Distal corporoplasty was first described by Mulcahy. He reported a series of 14 patients with a follow-up of about 2 years with optimal functional outcomes. Moreover, distal corporoplasty resulted in shorter operative time, better function, less pain, and fewer recurrences than Gortex windsock repair.10 In our experience, distal corporoplasty is a simple and safe procedure in the treatment of distal cylinders extrusion when the prosthetic material is not exposed to the exterior.

scholarly journals Isolated nerve palsy following insertion of a three-piece inflatable penile prosthesis

2021 ◽  
Author(s):  
Paulina Kosk ◽  
Alastair McKay ◽  
Arthur McPhee ◽  
David Cowell ◽  
Michael Fraser
Keyword(s):  
Penile Prosthesis ◽  
Adductor Muscle ◽  
Obturator Nerve ◽  
Leg Pain ◽  
Inflatable Penile Prosthesis ◽  
Lower Back ◽  
Operative Complications ◽  
Mri Scans ◽  
Type Two Diabetes

Case report of a 57 year-old male who underwent insertion of an inflatable penile prosthesis due to erectile dysfunction, secondary to poorly controlled Type two diabetes and Peyronie’s disease. The surgical procedure was uneventful and there were no immediate post-operative complications. During a routine follow up the patient described problems with the deflation of the implant and severe lower back and leg pain. Diagnostic MRI scans revealed reservoir migration, impingement of the obturator nerve and oedema in the adductor muscle group. The reservoir was initially repositioned, and later on removed due to on-going symptoms.

938: Optimization of Tunica Albuginea Free Graft for Corporoplasty in the Baboon: A 6 Months Follow Up

2005 ◽  
Vol 173 (4S) ◽  
pp. 254-254
Author(s):  
Raouf M. Seyam ◽  
Alaa Mokhtar ◽  
Walid Mourad ◽  
Raafat Alsayed ◽  
Kamal Hanash
Keyword(s):  
Tunica Albuginea ◽  
Free Graft

LAPAROSCOPIC TRANS-ABDOMINAL PRE-PERITONEAL (TAPP) REPAIR FOR TREATMENT INGUINAL HERNIA DISEASE

2018 ◽  
Vol 8 (4) ◽  
pp. 76-80
Author(s):  
Thao Nguyen Minh ◽  
Vu Pham Anh ◽  
Tri Nguyen Huu ◽  
Phu Nguyen Doan Van ◽  
Phuc Nguyen Thanh ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Operative Time ◽  
Bilateral Hernia ◽  
Repair Method ◽  
Tapp Repair ◽  
Post Operation ◽  
Average Operative Time ◽  
The Mean

Background: Inguinal hernia is one of the commonest surgical diseases and there are many different techniques applied. The laparoscopic trans-abdominal pre-peritoneal (TAPP) repair allows a better view of the inguinal anatomy, evaluation of opposite side and resolve combined peritoneal diseases as well. Patient and method: The study included 60 cases with inguinal hernia that have been treated by laparoscopic transabdominal pre-peritoneal (TAPP) repair. Method: Description, prospective follow-up. Result: The mean age was 58±18.2. 96.7% were males. The average operative time was 45.6±15.1 minutes for one side hernia, 73±25.2 minutes for bilateral hernia. 02 cases have been post-operation inguinal seroma complication (3.3%), 02 cases with hydrocele (3.3%), 01 case with abdominal seroma (1.7%). 04 cases (6.7%) opposite inguinal hernia were detected and 05 cases (8.3%) with combined diseases were resolved. Duration of post-operative stay was 3.9±1.1 days. Conclusion: TAPP is a safe and feasible procedure, allows evaluation of opposite side and resolve combined peritoneal diseases.

scholarly journals Incidence of valvular regurgitation and leaflet perforation by using automated titanium fasteners (CORKNOT®) in heart valve repair or replacement: less usual than reported

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Faizus Sazzad ◽  
Ong Zhi Xian ◽  
Ashlynn Ler ◽  
Chang Guohao ◽  
Kang Giap Swee ◽  
...  
Keyword(s):  
Heart Valve ◽  
Operative Time ◽  
Tertiary Care ◽  
Paravalvular Leak ◽  
Valvular Regurgitation ◽  
Care Hospital ◽  
Valve Repair ◽  
Replacement Surgery ◽  
Triple Valve

Abstract Background CORKNOT® facilitates a reduction in cardiopulmonary bypass (CPB) time, aortic cross clamp (ACC) time and operative time, but reported to be associated with other complications. We aim to quantify the incidence of valvular complications related to CORKNOT® and determine the feasibility of its use between different valvular surgeries. Methods Patients who underwent heart valve repair or replacement surgery via the use of automated titanium suture fasteners (CORKNOT®) in a tertiary care hospital were included in the study. This single-centre retrospective study was conducted on 132 patients between January 2016 and June 2018. Results In our study, the overall mean operative time was 320.0 ± 97.0 min, mean CPB time was 171.4 ± 76.0 min and the calculated mean ACC time was 105.9 ± 54.0 min. Fifty-eight patients (43.9%) underwent minimally invasive valve replacement or repair surgery and 66 patients (50.0%) underwent concomitant procedures. A total of 157 valves were operated on, with 112 (84.8%) single valve surgeries, 15 (11.4%) double valve surgeries and 5 (3.8%) triple valve surgeries. After reviewed by the cardiologist blinded towards the study, we report trivial and/or mild paravalvular leak (PVL) in immediate post-operative echocardiography was found in 1 (1.01%) patients. There were no reported cases of valvular thrombosis, leaflet perforation, device dislodgement or embolization, moderate and/or severe PVL during hospitalization and follow-up echocardiography within 1 year. Single mitral valve and aortic surgeries had comparable incidences of post surgical complications. Conclusion We conclude the feasibility of CORKNOT® utilisation in mitral and aortic valve surgeries. Additionally, incidence of CORKNOT® related complications in heart valve repair or replacement surgery is less usual in our setting than previously reported. These results motivate the use of CORKNOT® as a valid alternative with complete commitment.

scholarly journals First reported case of penile prosthesis infection from brucellosis: case report

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Nabil Nabil Moohialdin ◽  
Ahmad Shamsodini ◽  
Steven K. Wilson ◽  
Osama Abdeljaleel ◽  
Ibrahim Alnadhari ◽  
...  
Keyword(s):  
Case Report ◽  
Broad Spectrum ◽  
Surgical Intervention ◽  
Penile Prosthesis ◽  
Raw Milk ◽  
Prosthesis Infection ◽  
Case Presentation ◽  
First Case ◽  
Milk Ingestion

Abstract Background Infection after the penile prosthesis can be devastating to both the patient and surgeon with various complications and consequences. After introduction of antibiotic-coated implants, the rate of infection has dramatically decreased, but still we see uncommon organisms causing infection. We present a first case report of penile prosthesis infection by brucellosis due to raw milk ingestion. To our knowledge, this is the first reported case of brucellosis penile prosthesis infection. Case presentation We present a first case report of penile prosthesis infection by brucellosis due to raw milk ingestion. A 75-year-old, diabetic male patient presented with penile prosthesis infection 5 months post-penile exchange surgery due to mechanical malfunctioning of 2-piece penile prosthesis which was inserted 11 years ago. The initial treatment with broad spectrum antibiotics did not subside the infection. After diagnosis of brucellosis, the antibiotic was changed to anti-brucellosis (Rifampicin + Tetracycline). The patient improved dramatically and was discharged home with smooth follow-up course. Conclusion Brucellosis can cause infection of penile prosthesis and can be treated with anti-brucellosis antibiotics without necessitating surgical intervention and removal of prosthesis.

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