Impact of Intraoperative Opioid Use and a Combined Anesthesia Regimen in Patients Undergoing Radical Prostatectomy for Prostate Cancer in a Single-Center Cohort.

Higher intraoperative opioid doses may be associated with worse long-term oncological outcomes after radical prostatectomy (RP) for prostate cancer. We aimed to evaluate the impact of higher doses of intraoperative opioids and type of anesthesia on biochemical recurrence (BCR) and mortality after RP in a high-volume tertiary center. All patients underwent RP at our center between 2015 and 2021.

Perioperative outcomes of penile prosthesis implantation in Germany: results from the GRAND study.

We aimed to assess the recommended annual hospital volume for inflatable penile prosthesis implantation (PPI) and to provide evidence on perioperative outcomes of semi-rigid and inflatable PPI in Germany. We used the GeRmAn Nationwide inpatient Data (GRAND) from 2005 to 2021 and report the largest study to date with 7,222 patients. 6,818 (94.

Is cortisol an endogenous mediator of erectile dysfunction in the adult male?

Background: It has been speculated for decades whether there is a significance of the adrenal corticosteroid cortisol in the process of male sexual function, including the control of sexual arousal and penile erection. In order to investigate further the role of the adrenocorticotropic axis in the physiological process of penile erection, we aimed to determine the course of cortisol in the cavernous and systemic blood through different stages of sexual arousal in patients suffering from erectile dysfunction (ED) in comparison to a cohort of healthy males.

Methods: Fifty-four healthy adult males and 45 patients with ED were presented sexually explicit visual material in order to elicit tumescence and (in the healthy males) rigid erection.

Impact of antiangiogenic treatment on the erectile function in patients with advanced renal cell carcinoma.

We longitudinally assessed erectile function as well as the willingness to use pro-erectile treatment in a cohort on AAT for advanced RCC. Thirty-seven patients with advanced RCC completed the five-item version of the International Index of Erectile Function (IIEF-5) and other interview items before (T0) and 12 weeks into therapy (T12) with AAT. Patients were further asked if they were willing to use and pay out-of-pocket for on-demand treatment with phosphodiesterase-5-inhibitors (PDE-5i).

The Use of Vasoactive Drugs in the Treatment of Male Erectile Dysfunction: Current Concepts.

It is widely accepted that disorders of the male (uro)genital tract, such as erectile dysfunction (ED) and benign diseases of the prostate (lower urinary tract symptomatology or benign prostatic hyperplasia), can be approached therapeutically by influencing the function of both the vascular and non-vascular smooth muscle of the penile erectile tissue or the transition zone/periurethral region of the prostate, respectively. As a result of the discovery of nitric oxide (NO) and cyclic guanosine monophosphate (GMP) as central mediators of penile smooth muscle relaxation, the use of drugs known to increase the local production of NO and/or elevate the intracellular level of the second messenger cyclic GMP have attracted broad attention in the treatment of ED of various etiologies. Specifically, the introduction of vasoactive drugs, including orally active inhibitors of the cyclic GMP-specific phosphodiesterase (PDE) 5, has offered great advantage in the pharmacotherapy of ED and other diseases of the genitourinary tract.

Course of transforming growth factor ß1 in the systemic and cavernous blood of healthy males through different penile conditions.

Studies on erectile dysfunction (ED) have revealed a relationship between smooth muscle atrophy and the accumulation of collagen in the corpus cavernosum (CC). Transforming growth factor ß1 (TGF ß1) is a cytokine which has been proposed to be involved in the fibrotic process in the CC. We aimed to evaluate the course of TGF ß1 in the systemic and cavernous blood of 17 healthy males through different phases of the sexual arousal response (exemplified by the penile conditions flaccidity, tumescence, rigidity and detumescence).

Effects of Flow Disruptions on Mental Workload and Surgical Performance in Robotic-Assisted Surgery.

Background: Robotic systems introduced new surgical and technical demands. Surgical flow disruptions are critical for maintaining operating room (OR) teamwork and patient safety. Specifically for robotic surgery, effects of intra-operative disruptive events for OR professionals' workload, stress, and performance have not been investigated yet.

Is β-endorphin significant in the control of the male sexual response?

It has been assumed that β-endorphin, belonging to the family of opiodergic neuropeptides, might facilitate the inhibition of the male sexual response; however, its role in the control of the penile erectile tissue remains to be elucidated. This study aimed to evaluate in healthy men the course of β-endorphin in the systemic and cavernous blood through different stages of sexual arousal. Thirty-four (34) men were exposed to erotic stimuli to induce penile tumescence and rigidity.

Drug use among men with unfulfilled wish to father children: a retrospective analysis and discussion of specific drug classes.

Purpose: Male infertility is a multifactorial state. Among other risk factors, drugs can adversely affect male fertility and male sexual function. In a retrospective study we aimed to analyse how many involuntarily childless men seeking fertility evaluation consume drugs, which drugs and if these are potentially affecting male reproductive function.

An innovative technique of robotic-assisted/laparoscopic re-pyeloplasty in horseshoe kidney in patients with failed previous pyeloplasty for ureteropelvic junction obstruction.

Objectives: To describe an innovative laparoscopic/robotic-assisted re-pyeloplasty technique in patients with recurrent ureteropelvic junction obstruction (UPJO) in horseshoe kidneys.

Patients And Methods: Data from five patients (37-65, median 54 years) with symptomatic recurrence of UPJO in horseshoe kidney who underwent laparoscopic/robotic-assisted re-pyeloplasty at our institution since 2004 were evaluated retrospectively. The upper ureter together with wedge resection of the pelvis at the lower calyx was performed.

Probe-based confocal laser endomicroscopy (pCLE): a preclinical investigation of the male genital tract.

The aim of this study was to assess the potential of probe-based confocal laser endomicroscopy (pCLE) as a new diagnostic imaging technique for the male genital tract. For this purpose, testes, epididymides, and vasa deferentia were obtained during transsexual surgery of healthy patients (n = 10, 26-52 years). Prior to this, testes of rats (n = 10, Sprague-Dawley) and mice (n = 8, wild-type) were examined.

The extent of changes in the membranous urethra angle is associated with the outcome of retrourethral transobturator sling procedure.

Purpose: To evaluate the outcome of the retrourethral transobturator sling (RTS) by functional magnetic resonance imaging (MRI) and to identify parameters associated with sling failure.

Methods: Of thirty recruited men with postprostatectomy stress urinary incontinence (SUI), 26 consecutively underwent functional MRI before sling procedure and 12 months thereafter in a prospective clinical cohort observational study. Periurethral/urethral fibrosis and sling visualization were evaluated on static sequences.

Pelvic floor muscle function is an independent predictor of outcome after retrourethral transobturator male sling procedure.

Purpose: To evaluate the impact of the retrourethral transobturator sling (RTS) on pelvic floor muscle function (PFMF) and whether preoperative PFMF is associated with RTS outcome.

Methods: Between May 2008 and December 2010, 59 consecutive men with postprostatectomy stress urinary incontinence (PSUI) underwent PFMF assessment before RTS and 6 months thereafter in a prospective cohort study. The assessments included demographic and clinical characteristics, and quality of life (QoL) questionnaires.

Prospective comparison of one year follow-up outcomes for the open complete intrafascial retropubic versus interfascial nerve-sparing radical prostatectomy.

Current work provides a prospective direct comparison between Open complete intrafascial-radical-prostatectomy (OIF-RP) and interfascial-RP in all outcomes in single centre series. Both techniques were done prospectively in 430 patients. Inclusion criteria for OIF-RP (n=241 patients) were biopsy Gleason-score ≤6 and PSA ≤10 ng/ml while for interfascial-RP (n=189) were Gleason-score ≤7 and PSA ≤15.

Probe-based confocal laser endomicroscopy (pCLE) - a new imaging technique for in situ localization of spermatozoa.

In azoospermic patients, spermatozoa are routinely obtained by testicular sperm extraction (TESE). However, success rates of this technique are moderate, because the site of excision of testicular tissue is determined arbitrarily. Therefore the aim of this study was to establish probe-based laser endomicroscopy (pCLE) a noval biomedical imaging technique, which provides the opportunity of non-invasive, real-time visualisation of tissue at histological resolution.

Do we need the nerve sparing radical prostatectomy techniques (intrafascial vs. interfascial) in men with erectile dysfunction? Results of a single-centre study.

Objectives: To report effect of different nerve sparing techniques (NS) during radical prostatectomy (RP) (intrafascial-RP vs. interfascial-RP) on post-RP incontinence outcomes (UI) in impotent/erectile dysfunction (ED) men.

Patients And Methods: A total of 420 impotent/ED patients (International Index of Erectile Function-score <15) with organ-confined prostate cancer were treated with bilateral-NS [intrafascial-RP (239) or interfascial-RP (181)] in our institution.

Is a wider angle of the membranous urethra associated with incontinence after radical prostatectomy?

Purpose: To investigate whether differences in the anatomy and dynamics of the pelvic floor (PF) in patients after radical prostatectomy (RP) depicted on magnetic resonance imaging (MRI) are associated with continence status.

Methods: In the prospective designed study, 24 patients with post-prostatectomy stress urinary incontinence were enrolled. Additionally, 10 continent patients after RP were matched for age, body mass index and perioperative parameters.

Patients' perception of surgical outcomes and quality of life after retroperitoneoscopic and open pyeloplasty.

Purpose: To report postoperative health-related quality of life (HRQoL) and patients' subjective evaluations of open pyeloplasty (OP) and retroperitoneoscopic pyeloplasty (RP) and influences on preoperative counselling.

Methods: 107 patients (age 16-80 years, mean 31.5) with symptomatic primary ureteropelvic junction obstruction who underwent OP (32) or RP (75) were evaluated prospectively.

18F-Fluoroethylcholine PET/CT identifies lymph node metastasis in patients with prostate-specific antigen failure after radical prostatectomy but underestimates its extent.

Background: The detection of lymph node metastases (LNMs) is one of the biggest challenges in imaging in urology.

Objective: To evaluate the accuracy of combined 18F-fluoroethylcholine (FEC) positron emission tomography (PET)/computed tomography (CT) in the detection of LNMs in prostate cancer (PCa) patients with rising prostate-specific antigen (PSA) level after radical prostatectomy.

Design, Settings, And Participants: From June 2005 until November 2011, 56 PCa patients with biochemical recurrence after radical prostatectomy underwent bilateral pelvic and/or retroperitoneal lymphadenectomy based on a positive 18F-FEC PET/CT scan.

Ex vivo comparison of the tissue effects of six laser wavelengths for potential use in laser supported partial nephrectomy.

Laparoscopic/robotic partial nephrectomy (LPN) is increasingly considered for small renal tumors (RT). This demands new compatible surgical tools for RT-resection, such as lasers, to optimize cutting and coagulation. This work aims to characterize ex vivo handling requirements for six medically approved laser devices emitting different light wavelengths (940, 1064, 1318, 1470, 1940, and 2010 nm) amenable for LPN.

Laparoscopic marsupialisation of pelvic lymphoceles in different anatomic locations following radical prostatectomy.

Background: Pelvic lymphoceles (LCs) following radical prostatectomy (LC-RPs) are a well-described complication. Symptomatic LC-RPs are the most frequent, nonfunctional, postradical prostatectomy complications.

Objectives: Description of the clinical presentations of LC-RPs and the detailed technique of laparoscopic pelvic LC marsupialisation (LM), including perioperative results and follow-up.

Morphology and dynamics of the male pelvic floor before and after retrourethral transobturator sling placement: first insight using MRI.

Purpose: We prospectively evaluated changes in morphology and dynamics of the male pelvic floor on magnetic resonance imaging (MRI) associated with retrourethral transobturator sling (RTS) placement.

Patients And Methods: Twenty-six men with post-prostatectomy incontinence consecutively underwent functional cine-MRI before and 12 months after RTS. The membranous urethra length (MUL) and severity of periurethral/urethral fibrosis were assessed on static MRI.

Single-Incision Laparoscopic Surgery (SILS) in Reconstructive Urological Cases.

Single-incision laparoscopic surgery (SILS) is a recent development in minimally invasive surgery. This is an initial SILS experience in reconstructive urology to prove feasibility and provide a comparison with conventional laparoscopy during perioperative and convalescent periods. A single surgeon performed two complex SILS operations (psoas bladder hitch with Boari flap for high ureteric stricture [SILS-PB] and nephropexy for severe nephroptosis [SILS-Np]).

Open complete intrafascial nerve-sparing retropubic radical prostatectomy: technique and initial experience.

Objective: To report our refinement of open intrafascial retropubic radical prostatectomy (OIF-RP) and 1-year follow-up results.

Patients And Methods: OIF-RP was performed in 231 cases of clinically localized Prostate cancer in a prospective study from January 2007 to December 2009. Inclusion criteria were good potency (IIEF-5 score ≥ 15), Gleason score ≤ 6, prostate-specific antigen (PSA) ≤ 10, and clinical T1-2 tumors.