Penile prosthesis implant for erectile dysfunction: A new minimally invasive infrapubic surgical technique

Erectile dysfunction, the most common male sexual disorder after premature ejaculation, with its important impact on man and partner’s sexuality and quality of life is a persistent inability to obtain and maintain an erection sufficient to permit satisfactory sexual performance. Non-surgical treatments with controversial results are usually applyed before surgical treatment that has reached high levels of satisfaction. We describe a new surgical technique to implant three-pieces penile prosthesis in patients suffering from erectile dysfunction (ED) not responding to conventional medical therapy or reporting side effects with such a therapy. Implantation of an inflatable prosthesis, for treatment of ED, is a safe and efficacious approach with high satisfaction reported by patients and partners. Surgical technique should be minimally invasive and latest technology equipment should be implanted in order to decrease common complications and to obtain a better aesthetic result.

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Incontinence and Erectile Dysfunction Following Radical Prostatectomy: A Review

The Scientific World JOURNAL ◽

10.1100/tsw.2005.94 ◽

2005 ◽

Vol 5 ◽

pp. 747-758 ◽

Cited By ~ 41

Author(s):

Gerasimos Alivizatos ◽

Andreas Skolarikos

Keyword(s):

Quality Of Life ◽

Prostate Cancer ◽

Erectile Dysfunction ◽

Radical Prostatectomy ◽

Surgical Technique ◽

Localized Prostate Cancer ◽

Health Related Quality ◽

Related Quality ◽

Health Related

Radical prostatectomy remains the treatment of choice for localized prostate cancer in age-appropriate and health-appropriate men. Although cancer control is the most important aspect of a radical prostatectomy, minimization of postoperative morbidity, especially urinary incontinence and erectile dysfunction, is becoming a greater concern. We reviewed recent data available on Medline regarding the incidence, pathophysiology, evaluation, and treatment of incontinence and sexual dysfunction after radical prostatectomy. Health-related quality of life issues have been specifically addressed. Although low incidences of incontinence and erectile dysfunction after radical prostatectomy have been reported in the hands of experienced surgeons, the literature review revealed a great variety, with incontinence rates ranging from 0.3–65.6% and potency rates ranging from 11–87%. Several factors contribute to this wide difference, the most important being the application of a meticulous surgical technique. General and cancer-specific health-related quality of life is not being affected after radical prostatectomy. The incidence of incontinence and erectile dysfunction is higher after radical prostatectomy when compared to the incidence observed when other therapies for localized prostate cancer are applied. However, the majority of the patients undergoing radical prostatectomy would vote for the operation again. Today, avoidance of major complications after radical prostatectomy depends mostly on a high-quality surgical technique. When incontinence or erectile dysfunction persists after radical prostatectomy, the majority of the treated patients can be managed effectively by various methods.

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Surgical Removal of Defects in the Palate with the Use of TiNi Mesh

KnE Materials Science ◽

10.18502/kms.v2i1.819 ◽

2017 ◽

Vol 2 (1) ◽

pp. 354

Author(s):

M.N. Shakirov ◽

R.N. Dzhonibekova ◽

I.D. Tazin ◽

X.O. Gafarov ◽

V.Y. Mitasov

Keyword(s):

Surgical Technique ◽

Connective Tissue ◽

Minimally Invasive ◽

Surgical Procedures ◽

Surgical Techniques ◽

The Body ◽

Surgical Removal ◽

Minimally Invasive Surgical ◽

Body Tissues

Application of a thin- profiled mesh NiTi with filaments thickness of 40 micrometer sand with the cell size of 3x3-5x5 mm for patients allows to improve the quality of the surgical technique in conducting surgical procedures for eliminating different forms and sizes of the palate defects. Due to its biochemical, biophysical compatibility with the body tissues and the peculiar integration properties a connective tissue grows around and through the structure of the implant by forming a durable frame. At the same time this process takes place by type of covering the muco-periosteal cover from the wound periphery to the center of the palate, over the implant material and completes with the full elimination of the existing defect. The developed method should be considered as minimally invasive surgical techniques and is recommended as a method of choice for patients with various background diseases.

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Recent advancements in penile prosthetics

F1000Research ◽

10.12688/f1000research.17407.1 ◽

2019 ◽

Vol 8 ◽

pp. 193 ◽

Cited By ~ 2

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.

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Penile reinnervation as a new technique for treating erectile dysfunction in patients after radical prostatectomy

Herald Urology ◽

10.21886/2308-6424-2020-8-4-135-144 ◽

2020 ◽

Vol 8 (4) ◽

pp. 135-144

Author(s):

S. V. Popov ◽

I. N. Orlov ◽

A. M. Gul'ko ◽

G. V. Medvedev ◽

I. O. Shemiakin ◽

...

Keyword(s):

Erectile Dysfunction ◽

Radical Prostatectomy ◽

Young Patients ◽

Penile Prosthesis ◽

Nerve Graft ◽

General Idea ◽

New Methods ◽

The World ◽

A New Technique

Nowadays, radical prostatectomy (RPE) is the «gold standard» in the treatment of localized prostate cancer (PCa). However, this intervention is associated with a high risk of developing iatrogenic erectile dysfunction (ED), which significantly reduces the quality of life of a man. One of the surgical solutions to this complication is the installation of a penile prosthesis. Nevertheless, it must be borne in mind that this manipulation is associated with certain risks of intra-and postoperative complications. During the operation, there may be complications such as perforation (cavernous, septal, urethral), crossover (intersection of rods or cylinders), haemorrhage, difficulties in suturing the operating wound, damage to the components of the prosthesis. The most common problem is an infection in the postoperative period. It is also worth noting the high cost of implants and artificial erection, which is crucial for some young patients. Countries around the world are searching for new methods to restore physiological erectile function in patients after RPE. Recently, the attention of specialists has been drawn to the possibility of restoring the innervation of the penis by transplanting a nerve graft. The study aimed to provide a general idea of the ED treatment in patients after RPE by nerve graft transplantation with the development and realization of our own described at the end as a clinical case.

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Surgery

ESC CardioMed ◽

10.1093/med/9780198784906.003.0250 ◽

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.

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Minimally invasive infrapubic inflatable penile prosthesis implant for erectile dysfunction: evaluation of efficacy, satisfaction profile and complications

International Journal of Impotence Research ◽

10.1038/ijir.2015.33 ◽

2015 ◽

Vol 28 (1) ◽

pp. 4-8 ◽

Cited By ~ 30

Author(s):

G Antonini ◽

G M Busetto ◽

E De Berardinis ◽

R Giovannone ◽

P Vicini ◽

...

Keyword(s):

Erectile Dysfunction ◽

Minimally Invasive ◽

Penile Prosthesis ◽

Inflatable Penile Prosthesis

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Comparative evaluation of minimally invasive ‘tibial tuberoplasty’ surgical technique versus conventional open surgery for Schatzker II–III tibial plateau fractures: design of a multicentre, randomised, controlled and blinded trial (TUBERIMPACT study)

BMJ Open ◽

10.1136/bmjopen-2018-026962 ◽

2019 ◽

Vol 9 (8) ◽

pp. e026962

Author(s):

Tanguy Vendeuvre ◽

Olivier Monlezun ◽

Claire Brandet ◽

Pierre Ingrand ◽

Isabelle Durand-Zaleski ◽

...

Keyword(s):

Surgical Technique ◽

Minimally Invasive ◽

Open Surgery ◽

Tibial Plateau ◽

Tibial Plateau Fracture ◽

Tibial Plateau Fractures ◽

Plateau Fracture ◽

Randomised Controlled ◽

Conventional Open Surgery

IntroductionFractures of the tibial plateau are in constant progression. They affect an elderly population suffering from a number of comorbidities, but also a young population increasingly practicing high-risk sports. The conventional open surgical technique used for tibial plateau fractures has several pitfalls: bone and skin devascularisation, increased risks of infection and functional rehabilitation difficulties. Since 2011, Poitiers University Hospital is offering to its patients a new minimally invasive technique for the reduction and stabilisation of tibial plateau fractures, named ‘tibial tuberoplasty’. This technique involves expansion of the tibial plateau through inflation using a kyphoplasty balloon, filling of the fracture cavity with cement and percutaneous screw fixation. We designed a study to evaluate the quality of fracture reduction offered by percutaneous tuberoplasty versus conventional open surgery for tibial plateau fracture and its impact on clinical outcome.Methods and analysisThis is a multicentre randomised controlled trial comparing two surgical techniques in the treatment of tibial plateau fractures. 140 patients with a Schatzker II or III tibial plateau fracture will be recruited in France. They will be randomised either in tibial tuberoplasty arm or in conventional surgery arm. The primary outcome is the postoperative radiological step-off reduction blindly measured on CT scan (within 48 hours post-op). Additional outcomes include other radiological endpoints, pain, functional abilities, quality of life assessment and health-economic endpoints. Outcomes assessment will be performed at baseline (before surgery), at day 0 (surgery), at 2, 21, 45 days, 3, 6, 12 and 24 months postsurgery.Ethics and disseminationThis study has been approved by the ethics committee Ile-De-France X and will be conducted in accordance with current Good Clinical Practice (GCP) guidelines, Declaration of Helsinki and standard operating procedures. The results will be disseminated through presentation at scientific conferences and publication in peer-reviewed journals.Trial registration numberClinicaltrial.gov:NCT03444779.

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

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2013.3.133 ◽

2013 ◽

Vol 85 (3) ◽

pp. 133 ◽

Cited By ~ 23

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.

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