A conceptual framework for the evolution of sexual medicine and a model for the development of alternative sexual health services: 10-year experience of the center for sexual and reproductive health.

Introduction: Sexual health services are limited and inadequate to reduce factors that hinder treatment and adequate care, despite the growing interest for public awareness and prevention strategies.

Aim: The aim of this study was to present an integrative conceptual framework, which led to the development of a model of alternative sexual health services and the 10-year experience of the practice of the service.

Main Outcome Measures: Multiple-level needs assessments.

The natural history of Peyronie's disease: an ultrasonography-based study.

Objectives: To define ultrasonographic patterns reflecting different states of Peyronie's disease (PD) and to use them to evaluate the natural history of the disease.

Material And Methods: Diagnosis of PD was based on medical and sexual history, physical examination, intracavernosal injection test, and penile ultrasonography. Patients with penile fracture history were excluded from the study.

Treatment strategy for "non-responders" to tadalafil and vardenafil: a real-life study.

Objectives: To develop and test step-wise treatment strategy for erectile dysfunction "non-responders" to tadalafil and vardenafil.

Material And Methods: Two groups [tadalafil-treated (TG); vardenafil-treated (VG)] of 100 consecutive patients complaining of non-response to treatments were enrolled in three-phase study. Phase 1: inadequate use was identified and patients were rechallenged, after receiving detailed usage information.

Sildenafil failures may be due to inadequate patient instructions and follow-up: a study on 100 non-responders.

Objective: The objective of this study was to identify factors that affect efficacy response rate to sildenafil in the clinical practice.

Material And Method: The study comprised 100 consecutive sildenafil non-responders. Mean patient age was 59+/-14.

Does the extraperitoneal laparoscopic approach improve the outcome of radical prostatectomy?

Laparoscopic radical prostatectomy (LRPE) became the operative procedure of choice for patients with clinically localized prostate cancer in selected urologic centers around the world. Principal advantages are the minimal invasive nature of the procedure, a superior visualization of the operative field because of the magnification of the optical system, an exact and watertight anastomosis, the possibility of early catheter removal, and a potentially reduced amount of blood loss. Recent data show that oncologic outcome is not compromised by the minimal invasive nature of the procedure.

Management strategy for arterial priapism: therapeutic dilemmas.

Purpose: We present 7 cases of arterial high flow priapism and propose management algorithms for the condition.

Materials And Methods: We studied 2 children and 5 adults with posttraumatic arterial priapism. Blood gas analysis and color Doppler ultrasonography of the corpora cavernosa confirmed the diagnosis in 4 adults, while 1 patient had already undergone cavernous artery ligation in elsewhere.

Corporoplasty using tunica albuginea free grafts for penile curvature: surgical technique and long-term results.

Purpose: A Nesbit or plication procedure for correcting penile deformities is associated with penile shortening, especially in patients with excessive curvature and/or rotation. On the other hand, grafting procedures are associated with poor postoperative results due to graft shrinkage and veno-occlusive dysfunction. To minimize penile shortening and preserve potency we describe a new surgical technique combining the Nesbit procedure with tunica albuginea free grafting.