scholarly journals Access to penile prostheses differ across provinces in Canada: A survey of Canadian urologists

2020 ◽  
Vol 15 (7) ◽  
Author(s):  
Stewart Whalen ◽  
Gavin Langille ◽  
Josh White ◽  
Greg Bailly
Keyword(s):  
Online Survey ◽  
Standard Treatment ◽  
Penile Prosthesis ◽  
Surgical Volume ◽  
Medical Systems ◽  
Geographical Differences ◽  
Full Coverage ◽  
Penile Prostheses ◽  
Surgical Implantation ◽  
Canadian Provinces

Introduction: Surgical implantation of a penile prosthesis is the gold standard treatment for refractory erectile dysfunction. The purpose of this study was to investigate use of and access to these procedures in Canada. Methods: Canadian urologists known to perform penile prostheses procedures were surveyed on areas such as surgical volume, type of device used, and the direct cost to patients for both malleable and inflatable devices. Results: Of the 50 urologists invited to participate in the study, 34 (68%) completed the online survey. Participants represented nine Canadian provinces and included a mix of academic (65%) and community (35%) urologists. Most participants (79%) performed less than 10 procedures per year. Roughly three-quarters of participants (74%) used inflatable devices in over 90% of cases, while half implanted inflatable devices exclusively. The most common devices implanted were American Medical Systems (AMS). Participants from Alberta, Manitoba, New Brunswick, and Newfoundland reported full coverage for both malleable and inflatable devices. Saskatchewan was the only province where no coverage was reported. The remaining provinces were found to have variable degrees of coverage. Across all centers without full coverage, the median reported cost to patients for a malleable and inflatable device was $5000 and $6000, respectively. Conclusions: The urologists surveyed most perform inflatable penile prostheses procedures. Significant geographical differences exist with respect to reported coverage for these procedures. This study highlights the need for continued advocacy on behalf of the urological community towards the goal of equity in coverage for penile prostheses across Canada.

scholarly journals Perioperative management of patients undergoing penile prosthesis surgery in the UK: A survey of current practice

2020 ◽  
pp. 205141582093126
Author(s):  
Thomas Ellul ◽  
Nicholas Bullock ◽  
Martin Steggall ◽  
Gareth Brown
Keyword(s):  
Online Survey ◽  
Perioperative Management ◽  
Penile Prosthesis ◽  
Diabetic Control ◽  
Level Of Evidence ◽  
Common Solution ◽  
Penile Prostheses ◽  
Intraoperative Management ◽  
Penile Implant ◽  
The Uk

Objectives: This study aimed to define contemporary perioperative management of patients undergoing penile implant surgery in the UK. Methods: All consultant urological surgeons responsible for the insertion of penile prostheses in the UK were invited to complete an online survey comprising of 25 questions relating to surgeon demographics, patient selection, preoperative work-up, intraoperative management and postoperative care. Anonymised responses underwent descriptive statistical analysis, with particular focus on measures employed to reduce the risk of perioperative infection. Results: Of the 34 invited surgeons, 26 (76.5%) responded to the survey. The majority reported undertaking between 10 and 30 cases in 2018 ( n=17; 65.4%). A total of 23 (88.5%) respondents reported employing a threshold for diabetic control, although the exact limit varied between surgeons. Most respondents ( n=22; 84.6%) reported routinely sampling urine for microscopy, culture and sensitivity. All but one ( n=25; 96.2%) reported routinely performing cavernosal washouts, with the most common solution being a mixture of gentamicin and vancomycin (42.3%). All reported routinely giving intravenous antibiotics on induction of anaesthesia, and although there was no clear consensus, most surgeons preferentially used an aminoglycoside in combination with one other agent (including penicillins or teicoplanin). Conclusion: The variation in current perioperative management demonstrates a potential need for the development and introduction of evidence-based guidelines to standardise practice nationwide. Level of evidence: 5

scholarly journals An Experimental Methodology to Evaluate the Rigidity of Penile Prostheses in Vitro

2000 ◽  
Author(s):  
Shyh-Jen Wang
Keyword(s):  
Penile Prosthesis ◽  
Mechanical Failure ◽  
Experimental Methodology ◽  
Prosthetic Material ◽  
Mechanical Measurement ◽  
Hardness Tester ◽  
Non Invasive ◽  
Penile Prostheses ◽  
Before And After

Abstract This work investigates the hardness and buckling force of penile prosthesis to further understand the rigidity of penile prosthesis before and after implantation. Evaluated herein are four prosthetic samples (inflatable 3, semi-rigid 1), five realities (inflatable 1, semi-rigid 4), and one after implantation of prosthesis. The hardness is measured with a hardness tester by pressing the tester’s indentor to the surface of the specimen. In addition, a patient after implantation is evaluated with respect to the hardness of penile versus various numbers of pumping. The buckling force of the prosthesis is also determined by a push-pull gauge and special designed sampling table. Results in this study demonstrate that although the inflatable prosthesis could only be pumped to a certain amount of hardness, hardness and buckling force correlate well with each other. After reaching the extreme hardness, prostheses can even be further pumped a few times. However, continuous pumping only puts more tension on the prosthetic material without increasing any hardness and could induce to mechanical failure of prosthesis. Results also indicate that the buckling force decreases with increasing length of the semi-rigid prostheses, and, then, enlarged when the prosthesis has a larger diameter. This in vitro non-invasive mechanical measurement of the rigidity in penile prosthesis can provide not only clinicians with further information about the penile prosthesis before implantation, but also the patients with more confidence in the prosthesis usage after implantation.

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 Safety and Efficacy Outcomes of ZSI 475 Penile Prosthesis

2017 ◽  
Vol 84 (2) ◽  
pp. 98-101 ◽  
Author(s):  
Mariusz Blewniewski ◽  
Ireneusz Ostrowski ◽  
Tobias Pottek ◽  
Frank Neugart ◽  
Janusz Ciechan ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Penile Prosthesis ◽  
Functional Results ◽  
Safety And Efficacy ◽  
Penile Prostheses ◽  
Penile Implants ◽  
Penile Implant ◽  
Self Administered Questionnaire ◽  
Three Components

Objective The aim of this study was to demonstrate safety and efficacy of ZSI 475 hydraulic penile prosthesis three components. Preparation, procedure and functional results are similar to AMS 700 and Coloplast Titan. This study was conducted from September 2012 to December 2016. Patients and Method From September 2012 to December 2016, 29 ZSI 475 hydraulic penile prostheses three components were implanted by six surgeons in 28 patients in five European centres. Mean age of patients was 60 years old (44-75). Standard peno-scrotal incision procedure was performed for the 28 patients. Erectile function was assessed by IIEF-5 self-administered questionnaire. Results Median follow-up was 35.11 months (8-47). Postoperative complications were limited to scrotal pump torsion that required a revision, an armed tubing breakage and a scrotal haematoma. At the end of follow-up, 100% of patients had a functional prosthesis and 92.86% were satisfied. Conclusions Implantation, risks of complications, functional outcome and patient satisfaction with penile implant ZSI 475 are similar to standard hydraulic penile implants three components as AMS 700 and Coloplast Titan.

scholarly journals Modeling the Purpose for Renting Passenger Vehicles

2019 ◽  
Keyword(s):  
Random Sample ◽  
Logit Model ◽  
Online Survey ◽  
Multinomial Logit Model ◽  
Multinomial Logit ◽  
Sociodemographic Characteristics ◽  
Short Term ◽  
Factors Associated ◽  
Passenger Vehicles ◽  
Canadian Provinces

This article specifies and estimates a multinomial logit model (MNL) to explain the purpose of renting a vehicle for short-term use. The model, which predicts the probability of renting a vehicle for business, leisure, temporary replacement, or other purposes, is estimated using a random sample of approximately 1,000 individuals from 10 Canadian provinces. The records used in the analysis were collected in 2016 via an online survey. The findings suggest that the purpose for renting could be predicted through factors associated with the sociodemographic characteristics of the renters and their rental plans, as well as attributes associated with the rented vehicle.

scholarly journals Chronic pain associated with penile prostheses may persist despite revision or explantation

2021 ◽  
Vol 16 (2) ◽  
Author(s):  
Jeffrey D. Campbell ◽  
Ernest Pang Chan ◽  
Andrew Di Pierdominico ◽  
Serkan Karakus ◽  
Bruce Trock ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Surgical Intervention ◽  
Penile Prosthesis ◽  
Pain Syndrome ◽  
High Volume ◽  
Persistent Pain ◽  
Self Report ◽  
Inflatable Penile Prosthesis ◽  
Penile Prostheses ◽  
Primary Indication

Introduction: Inflatable penile prosthesis (IPP) implantation is the gold-standard treatment for medically refractory erectile dysfunction. New chronic pain after IPP implantation is rarely discussed and the optimal treatment is unclear. We evaluated whether IPP reoperation for a primary indication of chronic pain improves patients’ symptoms. Our secondary aim was to explore factors associated with resolution or persistence of pain after IPP reoperation. Methods: We conducted a retrospective analysis of 315 patients who had an IPP revision or explantation at two high-volume prosthetic centers between May 2007 and May 2017. We excluded patients who had device malfunction, pain for <2 months, pain associated with infection or erosion, and patients without long-term followup data. Persistent pain was diagnosed based on patient self-report. Results: A total of 31 patients met our criteria for having undergone a surgical revision (n=18) or explantation (n=13) for pain relief. Eighteen (58%) patients had persistent pain despite surgical intervention. Only patients who had pain secondary to a device malposition improved after reoperation (n=13). A prior diagnosis of a chronic pain syndrome was associated with persistent pain despite intervention. Pain improvement was not associated with age, comorbid conditions, duration of implant, or the number of surgical revisions performed. Conclusions: Surgical intervention for chronic penile prosthesis pain is unlikely to relieve symptoms, particularly for patients with chronic pain disorders. Patients should be counselled that IPP reoperative procedures as a treatment for pain should be avoided unless the device is identified to be malpositioned, and consideration of alternative therapeutic options may be more beneficial.

Mechanical Failure of the American Medical Systems Ultrex Inflatable Penile Prosthesis: Before and After 1993 Structural Modification

2002 ◽  
pp. 2502-2506 ◽  
Author(s):  
AARON J. MILBANK ◽  
DROGO K. MONTAGUE ◽  
KENNETH W. ANGERMEIER ◽  
MILTON M. LAKIN ◽  
SARAH E. WORLEY
Keyword(s):  
American Medical ◽  
Structural Modification ◽  
Penile Prosthesis ◽  
Mechanical Failure ◽  
Medical Systems ◽  
Inflatable Penile Prosthesis ◽  
Before And After

scholarly journals Comparison of the patient’s satisfaction underwent penile prosthesis; Malleable versus Ambicor: Single center experience

2020 ◽  
Vol 92 (1) ◽  
pp. 25-29
Author(s):  
Omer Bayrak ◽  
Sakip Erturhan ◽  
Ilker Seckiner ◽  
Mehmet Ozturk ◽  
Haluk Sen ◽  
...  
Keyword(s):  
Treatment Satisfaction ◽  
Penile Prosthesis ◽  
The Other ◽  
Smoking History ◽  
Surgical Results ◽  
Single Center ◽  
Medical Systems ◽  
Prosthesis Implantation ◽  
Patient’S Satisfaction ◽  
Single Center Experience

Objective: To compare the surgical results, complications, and satisfaction levels of patients who underwent malleable penile prosthesis implantation (M-PPI) and Ambicor penile prosthesis implantation (A-PPI). Material and methods: One hundred forty two patients who underwent penile prosthesis implantation [M-PPI (Promedon- Tube®, Cordoba, Argentina): 81, and A-PPI (American Medical Systems, Minnesota, USA): 61] between 2013-2018 were evaluated retrospectively. Patients’ age, body mass index, smoking history, etiological factors, modified “Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) Questionnaire” scores, shortening of the penis, and complications were recorded. Results: The patients who performed A-PPI implantation were younger (56.27 ± 10.81 vs. 51.47 ± 11.79, p = 0.009). The EDITS scores of 31(38.2%) patients who underwent M-PPI and 44 (72.4%) patients who underwent A-PPI were available. It was observed that the scores on the following questions were statistical significantly higher in the A-PPI group: “Overall, are you satisfied with your penile prosthesis?, How much of your expectations did penile prosthesis meet?, How often do you use your penile prosthesis?” (p = 0.05, p = 0.048, p = 0.038). No difference was observed between the groups in terms of the scores on the other three questions (p = 0.447, p = 0.326, p = 0.365). A 61.3% of patients in MPPI (19/31) group, and 56.8% of patients in A-PPI (25/44) group stated penile shortening (p = 0.417). Mean shortening was reported as 2.1 ± 0.45 cm, and 2.12 ± 0.52 cm, in M-PPI and A-PPI groups, respectively (p = 0.90). Conclusion:It is remarkable that the patients who underwent A-PPI experienced higher satisfaction with their prosthesis. Even though it has not been evidenced in the current literature data, patients who have had either M-PPI or A-PPI should be informed about the risk of penile shortening.

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