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.

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.

scholarly journals Comparative Effectiveness of Chuna Manipulative Therapy for Non-Acute Lower Back Pain: A Multi-Center, Pragmatic, Randomized Controlled Trial

2020 ◽  
Vol 9 (1) ◽  
pp. 144 ◽  
Author(s):  
Sun-Young Park ◽  
Eui-Hyoung Hwang ◽  
Jae-Heung Cho ◽  
Koh-Woon Kim ◽  
In-Hyuk Ha ◽  
...  
Keyword(s):  
Comparative Effectiveness ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Leg Pain ◽  
Manipulative Therapy ◽  
Pragmatic Randomized Controlled Trial ◽  
Randomized Controlled ◽  
Lower Back ◽  
Acute Lower Back Pain

Current evidence on the effectiveness and safety of Chuna manipulative therapy (CMT) for managing non-acute lower back pain (LBP) is insufficient. We investigated the comparative effectiveness and safety of CMT, a Korean style of manipulation, plus usual care (UC) compared to UC alone for non-acute LBP. We conducted a parallel, two-armed, multi-centered, assessor blinded, pragmatic, randomized controlled trial at four major Korean medical hospitals. Overall, 194 patients were randomly allocated to either CMT plus UC (n = 97) or UC alone (n = 97), for six weeks of treatment and six months follow-up. The primary outcome was measured using the numerical rating scale (NRS) of LBP intensity at 7 weeks. Secondary outcomes included NRS of leg pain, Oswestry Disability Index (ODI) for functional disability, patient global impression of change (PGIC) scale, and safety. A total of 194 patients were included in the intention-to-treat analysis, and 174 patients provided complete data for the primary outcome. At 7 weeks, clinically significant differences between groups were observed in the NRS of LBP (CMT + UC: −3.02 ± 1.72, UC: −1.36 ± 1.75, p < 0.001), ODI scores (CMT + UC: −5.65 ± 4.29, UC: −3.72 ± 4.63, p = 0.003), NRS of leg pain (CMT + UC: −2.00 ± 2.33, UC: −0.44 ± 1.86, p < 0.0001), and PGIC (CMT + UC: −0.28 ± 0.85, UC: 0.01 ± 0.66, p = 0.0119). Mild to moderate safety concerns were reported in 21 subjects. CMT plus UC showed higher effectiveness compared to UC alone in patients with non-acute LBP in reducing LBP and leg pain and in improving function with good safety results using a powered sample size and including mid-term follow-up.

047 Inflatable Penile Prosthesis Using Rear-Tip Extenders: Device Outcomes with 5-Year Follow-Up Data from a Single High-Volume Implanter

2019 ◽  
Vol 16 (4) ◽  
pp. S25
Author(s):  
W.J.G. Hellstrom ◽  
A. Gabrielson ◽  
N. Scherzer ◽  
L. Alzweri ◽  
J. Greenberg ◽  
...  
Keyword(s):  
Penile Prosthesis ◽  
High Volume ◽  
Inflatable Penile Prosthesis

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.

AMS 700CX/CXM Inflatable Penile Prosthesis Has High Mechanical Reliability at Long-Term Follow-Up

2010 ◽  
Vol 7 (7) ◽  
pp. 2602-2607 ◽  
Author(s):  
Dong Suk Kim ◽  
Kwang Mo Yang ◽  
Hyun Jin Chung ◽  
Hyun Min Choi ◽  
Young Deuk Choi ◽  
...  
Keyword(s):  
Penile Prosthesis ◽  
Mechanical Reliability ◽  
Inflatable Penile Prosthesis ◽  
Long Term Follow Up

1380 LONG-TERM INFECTION OUTCOMES AFTER HYDROPHILIC COATED INFLATABLE PENILE PROSTHESIS IMPLANTS: 11 YEARS OF FOLLOW-UP

2012 ◽  
Vol 187 (4S) ◽  
Author(s):  
Ege Can Serefoglu ◽  
Sree Harsha Mandava ◽  
Ahmet Gokce ◽  
Wayne J.G. Hellstrom
Keyword(s):  
Penile Prosthesis ◽  
Inflatable Penile Prosthesis

scholarly journals Penile Corporeal Reconstruction during Difficult Placement of a Penile Prosthesis

2008 ◽  
Vol 2008 ◽  
pp. 1-4 ◽  
Author(s):  
Viet Q. Tran ◽  
Timothy F. Lesser ◽  
Dennis H. Kim ◽  
Sherif R. Aboseif
Keyword(s):  
Adverse Events ◽  
Sexual Activity ◽  
Erectile Function ◽  
Penile Prosthesis ◽  
Inflatable Penile Prosthesis ◽  
Fascia Graft ◽  
Mean Time ◽  
Rectus Fascia ◽  
Difficult Placement

For some patients with impotence and concomitant severe tunical/corporeal tissue fibrosis, insertion of a penile prosthesis is the only option to restore erectile function. Closing the tunica over an inflatable penile prosthesis in these patients can be challenging. We review our previous study which included 15 patients with severe corporeal or tunical fibrosis who underwent corporeal reconstruction with autologous rectus fascia to allow placement of an inflatable penile prosthesis. At a mean follow-up of 18 months (range 12 to 64), all patients had aprosthesisthat was functioning properly without evidence of separation, herniation, or erosion of the graft. Sexual activity resumed at a mean time of 9 weeks (range 8 to 10). There were no adverse events related to the graft or its harvest. Use of rectus fascia graft for coverage of a tunical defect during a difficult penile prosthesis placement is surgically feasible, safe, and efficacious.

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 Study on Prolapsed Intervertebral Disc Cases Admitted in Military Hospitals

2020 ◽  
Vol 15 (2) ◽  
pp. 221-223
Author(s):  
ASM Zulfiquer Ali ◽  
Farzana Zafreen ◽  
Md Abdul Wahab
Keyword(s):  
Intervertebral Disc ◽  
Lumbar Disc ◽  
Leg Pain ◽  
Military Hospital ◽  
Lumbar Region ◽  
Lumbar Intervertebral Disc ◽  
Lower Back ◽  
Operative Complications ◽  
Prolapsed Intervertebral Disc ◽  
Post Operative Complications

Introduction: Prolapsed intervertebral disc is a condition that can occur anywhere along the spine, but most often occurs in the lower back. It is sometimes called a bulging, protruding or ruptured disc. It is one of the most common causes of lower back pain as well as leg pain or sciatica. Objective: To study the demographic characteristics of prolapsed lumbar intervertebral disc by age, gender, clinical presentation, levels of spinal column involvement, treatment options and post operative complications for lumbar disc prolapse. Materials and Methods: This cross sectional study was conducted in Rangpur and Saidpur Combined Military Hospital from September2017 to December 2018. A Total of 223 Cases was studied and data were collected by semi-structured questionnaire by face to face interview and medical documents. Results: Most commonly affected disc spaces were L5/S1(35.87%)followed by L4/L5 (33.18%) and L4/L5,L5/S1(14.28%). Males were mostly affected and commonest among 30-39 years’ age group (45.29%). Chi-square test is done and result is statistically significant (p<0.01). Most of the cases given conservative treatment 202(90.58%), surgical treatment given 21(9.41%). Mechanical backache wasthe most common (14.29%) post operative complications. Conclusion: In this study prolapsed intervertebral disc was common in the lower lumbar region at the level of L4/L5 and L5/S1. JAFMC Bangladesh. Vol 15, No 2 (December) 2019: 221-223

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