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Andrology
Published in Manit Arya, Taimur T. Shah, Jas S. Kalsi, Herman S. Fernando, Iqbal S. Shergill, Asif Muneer, Hashim U. Ahmed, MCQs for the FRCS(Urol) and Postgraduate Urology Examinations, 2020
All the following are TRUE for a three-piece inflatable penile prosthesis except:Infection rate with penile implant is 1%–3%Patients should be warned of migration, erosion and mechanical failure.Penile prosthesis satisfaction rates are 70%–87%.Both the flaccid penis and erection produced with prosthesis are no different than normal.Infection and erosion are significantly higher in spinal cord injury patients.
Erectile Dysfunction
Published in Botros Rizk, Ashok Agarwal, Edmund S. Sabanegh, Male Infertility in Reproductive Medicine, 2019
Mark Johnson, Marco Falcone, Tarek M. A. Aly, Amr Abdel Raheem
The penile prosthesis implantation is considered the definitive solution for medically refractory ED or for patients keen to request a definitive solution for ED. Two different classes of penile implant can be considered currently: Semirigid, which are composed of two flexible cylinders, implanted in the corpora cavernosa. The penis after the implantation appears permanently firm but can be manually placed in an erect or flaccid state. The advantages of this class of implants are the simple use as well the long-term mechanical reliability [45]. (Figure 12.5) Inflatable, two or three pieces are composed by a hydraulic system (cylinder, pump, and reservoir). All of the components are fully concealed. The advantages of this class of implant are the “natural-wise” functioning, the ability to pass from a complete flaccid to an erect state and the possibility to conceal the implant. On the other hand, they present a cumulative 5-year risk of mechanical failure of around 5% [46,47]. (Figure 12.6)
Urethra and Penis
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Erectile dysfunction ED is common after pelvic fracture with urethral injury and is due to damage of either the cavernosal nerves, which innervate the penis, or the penile arteries, which also lie close to the site of the urethral disruption. Indeed, surgical treatment of the urethral disruption can itself cause ED by similar mechanisms. If this does occur, treatment is with an orally active agent such as sildenafil or if that fails, with intracavernosal prostaglandin injections, a vacuum device or a penile implant.
Sexual Rehabilitation After Prostate Cancer Through Assistive Aids: A Comparison of Gay/Bisexual and Heterosexual Men
Published in The Journal of Sex Research, 2019
Jane M. Ussher, Janette Perz, Duncan Rose, Andrew Kellett, Gary Dowsett
Sexual rehabilitation after PCa treatment has most often focused on regaining erectile function to improve sexual satisfaction and penile health (Walker et al., 2015). Common biomedical interventions for erectile dysfunction and/or penile rehabilitation include PDE5 inhibitor drugs (e.g., Cialis, Viagra, Spedra, and Levitra), penile injection therapy, penile implant (i.e., surgical prosthesis), and vacuum pump erection devices (Wassersug & Wibowo, 2017). Approximately half of PCa patients report utilizing a medical aid for penile rehabilitation after PCa treatment (Bergman, Gore, Penson, Kwan, & Litwin, 2009; Schover et al., 2004). However, despite reports of gains in penile rigidity, up to 73% of patients discontinue using these aids within the first year (Walker et al., 2015). Little is known about why couples abandon the use of assistive aids, leading to a plea for more research in this area (Beck, Robinson, & Carlson, 2009). Reasons for discontinuation have been suggested to include difficulties achieving erectile firmness equivalent to pretreatment or that which is required for penetrative sex (Nelson, Scardino, Eastham, & Mulhall, 2013); a mismatch between treatment effectiveness and patient’s expectations for recovery (Wittmann et al., 2011); a sense that use of aids results in unnatural and obligatory intercourse (Gray, Fitch, Phillips, Labrecque, & Fergus, 2002); limited motivation from some partners regarding sexual recovery (Neese, Schover, Klein, Zippe, & Kupelian, 2003); and lack of ongoing information and support across the disease pathway to address difficulties with rehabilitation when they arise (Sinfield et al., 2009). However, many of the published accounts of patient experience of sexual rehabilitation after PCa are based on clinical vignettes, and there is a lack of literature reporting on men’s subjective experiences of sexual rehabilitation to support treatment recommendations and delivery of care (Beck et al., 2009).
Urethral instillation of chlorhexidine gel is an effective method of sterilisation
Published in Arab Journal of Urology, 2021
Osama Shaeer, Amr Abdel- Raheem, Haitham Elfeky, Ahmad Seif, Tarek M. Abdel-Raheem, Amgad Elsegeiny, May Sherif Soliman, Emad B. Basalious, Kamal Shaeer
The 111 surgeries performed included 38 primary penile implant insertion procedures (13 chlorhexidine group and 25 control group). There were no implant infections in the chlorhexidine group vs two PP infections in the control group, with one of the two patients being diabetic.