Worldwide trends in penile implantation surgery: data from over 63,000 implants.

Background: Penile prosthesis implantation represents the gold standard of treatment for severe or medically refractory erectile dysfunction (ED). We sought to address the paucity of currently available literature about global penile prosthesis usage in regard to geography, patient age, surgical approach, implanter volume, and etiology of ED.

Methods: From device manufacturer information, we compiled data on over 63,000 implants performed worldwide.

Multicenter investigation on the influence of climate in penile prosthesis infection.

The purpose of this study is to investigate the relationship between inflatable penile prosthesis (IPP) infection, time of year, climate, temperature and humidity. This is a retrospective IRB-approved analysis of 211 patients at 25 institutions who underwent salvage procedure or device explant between 2001 and 2016. Patient data were compiled after an extensive review of all aspects of their electronic medical records.

Systematic Review of the Impact of Varicocele Grade on Response to Surgical Management.

Purpose: We evaluated the impact of varicocele grade on the response to varicocelectomy or spermatic vein embolization.

Materials And Methods: We systematically reviewed the published English language literature to identify studies on changes in semen quality and pregnancy outcomes after varicocele treatment, stratified by varicocele grade. Descriptive statistics and continuous random effects models were used to study the impact of varicocele grade and the surgical approach on the response to treatment.

Diabetes Is a Risk Factor for Inflatable Penile Prosthesis Infection: Analysis of a Large Statewide Database.

Introduction: Although diabetes mellitus (DM) is often discussed as a risk factor for inflatable penile prosthesis (IPP) infection, the link between DM diagnosis and IPP infection remains controversial. High-quality population-based data linking DM to an increased risk of IPP infection have not been published.

Aim: To evaluate the association of DM with IPP infection in a large public New York state database.

Sub-external oblique placement of inflatable penile prosthesis reservoirs-initial experience.

Multiple-component inflatable penile prostheses (IPPs) consist of paired intracorporal cylinders, a scrotal pump, and an abdominal fluid reservoir. In recent years, ectopic (e.g.

Convolutional Neural Networks for the Detection and Measurement of Cerebral Aneurysms on Magnetic Resonance Angiography.

Aneurysm size correlates with rupture risk and is important for treatment planning. User annotation of aneurysm size is slow and tedious, particularly for large data sets. Geometric shortcuts to compute size have been shown to be inaccurate, particularly for nonstandard aneurysm geometries.

Penile Length: Measurement Technique and Applications.

Introduction: Penile size has long been an important fixation in men's lives. On the one hand, a smaller penis has been associated with anxiety and apprehension; on the other hand, a larger penis has generally been related to virility and strength. These perceptions predominate during an erection, when penile size is representative of a man's masculinity.

A retrospective analysis of risk factors for IPP reservoir entry into the peritoneum after abdominal wall placement.

Placement of an inflatable penile prosthesis (IPP) is the most effective treatment modality for men with ED refractory to medical management. We have previously demonstrated a protocol for IPP reservoir placement within the abdominal wall musculature, which was shown to be a safer location than traditional placement in the retropubic space of Retzius. The aim of this study was to review our complications with IPP reservoir entry into the peritoneum after abdominal wall placement of the reservoir.

Three-Dimensional Photography for Quantitative Assessment of Penile Volume-Loss Deformities in Peyronie's Disease.

Background: Non-curvature penile deformities are prevalent and bothersome manifestations of Peyronie's disease (PD), but the quantitative metrics that are currently used to describe these deformities are inadequate and non-standardized, presenting a barrier to clinical research and patient care.

Aim: To introduce erect penile volume (EPV) and percentage of erect penile volume loss (percent EPVL) as novel metrics that provide detailed quantitative information about non-curvature penile deformities and to study the feasibility and reliability of three-dimensional (3D) photography for measurement of quantitative penile parameters.

Methods: We constructed seven penis models simulating deformities found in PD.

Multicenter Investigation of the Micro-Organisms Involved in Penile Prosthesis Infection: An Analysis of the Efficacy of the AUA and EAU Guidelines for Penile Prosthesis Prophylaxis.

Introduction: Penile prosthesis infections remain challenging despite advancements in surgical technique, device improvements, and adoption of antibiotic prophylaxis guidelines.

Aim: To investigate penile prosthesis infection microbiology to consider which changes in practice could decrease infection rates, to evaluate current antibiotic prophylaxis guidelines, and to develop a proposed algorithm for penile prosthesis infections.

Methods: This retrospective institutional review board-exempt multi-institutional study from 25 centers reviewed intraoperative cultures obtained at explantation or Mulcahy salvage of infected three-piece inflatable penile prostheses (IPPs).

Osteoporosis and Low Bone Mineral Density in Men with Testosterone Deficiency Syndrome.

Introduction: Testosterone deficiency syndrome (TDS) is a risk factor for low bone mineral density (BMD) and osteoporosis. Knowledge of the relationship between TDS and bone health, as well as the practical aspects of how to diagnose and treat low BMD, is therefore of practical importance to sexual medicine practitioners.

Aim: The aim of this study was to review the physiologic basis and clinical evidence of the relationship between TDS and bone health; and to provide a practical, evidence-based algorithm for the diagnosis and management of low BMD in men with TDS.

Impact of Surgeon Case Volume on Reoperation Rates after Inflatable Penile Prosthesis Surgery.

Purpose: We investigated the impact of surgeon annual case volume on reoperation rates after inflatable penile prosthesis surgery.

Materials And Methods: The New York Statewide Planning and Research Cooperative System database was queried for inflatable penile prosthesis cases from 1995 to 2014. Multivariate proportional hazards regression was performed to estimate the impact of surgeon annual case volume on inflatable penile prosthesis reoperation rates.

Management of Perforation Injuries During and Following Penile Prosthesis Surgery.

Introduction: Distal extrusion of penile prosthesis cylinders is a challenging problem that is associated with pain and imminent erosion through penile skin. Distal extrusion and other perforation injuries, including crural and urethral, are other manifestations of tunica albuginea injuries that result in poor clinical outcomes and patient satisfaction.

Aim: A description of Dr.

Pseudo-malfunction of the Coloplast Titan Inflatable Penile Prosthesis One-Touch Release Pump.

Objective: To define and describe a type of pseudo-malfunction of the Coloplast Titan Inflatable Penile Prosthesis (IPP) One-Touch Release (OTR) pump (Coloplast Corp, Minneapolis, MN).

Materials And Methods: We retrospectively reviewed a consecutive series of 550 patients with refractory organic erectile dysfunction who were implanted with a Coloplast Titan IPP with the OTR pump during a period of approximately 4 years.

Results: All patients were implanted using standard techniques through an infrapubic or penoscrotal approach.

Is there a rationale for penile rehabilitation following radical prostatectomy?

Erectile function recovery after radical prostatectomy (RP) is an increasingly prominent quality-of-life outcome following surgery. Following RP many men, despite the advent of cavernous nerve-sparing surgical technique, have moderately or significantly impaired erectile function (EF). The term penile rehabilitation (PR) is used to define interventions that maintain the health of erectile tissue in the context of nervous, vascular, and structural tissue injury.

Use of a preoperative checklist reduces risk of penile prosthesis infection.

Purpose: Infection of a penile prosthesis is a devastating complication that necessitates the removal of all device components. Many aspects of preoperative and intraoperative infection prophylaxis practices have been examined but the specific relevant factors remain unknown. We determined whether use of a mandatory checklist of perioperative practices believed to reduce the risk of prosthesis infection would impact patient safety.

Reproductive sequelae of diabetes in male patients.

Diabetes mellitus (DM) is an increasingly prevalent public health concern. A recent study projected the number of people worldwide with DM to increase from 171 million in 2000 to 366 million in 2030. Although DM is a systemic disease that often leads to end-organ dysfunction of multiple body systems, the effects of the condition on male fertility are often not fully appreciated.

Lifestyle, environment, and male reproductive health.

A large number of environmental and lifestyle factors may negatively affect spermatogenesis and male fertility. This article enumerates the current state of knowledge regarding those that have been identified, and extrapolates the predicted magnitude of these effects over the next 20 years based on current societal trends. However, it is likely that additional factors have yet to be recognized.

Outcomes of abdominal wall reservoir placement in inflatable penile prosthesis implantation: a safe and efficacious alternative to the space of Retzius.

Introduction: Inflatable penile prosthesis (IPP) surgery is a successful therapeutic option for men with erectile dysfunction. Traditional placement of the reservoir in the retropubic space of Retzius is associated with the rare occurrence of significant complications including bladder, bowel, and vascular injury. An alternative site, posterior to the abdominal wall musculature, has been identified as a potentially safer location for reservoir placement.

Concordance between patient and physician assessment of the magnitude of Peyronie's disease curvature.

Introduction: The magnitude of penile deformity is a critically important factor in Peyronie's disease, as it is associated with increased difficulty in penetrative sexual intercourse and in turn with negative psychosocial consequences. Deformity magnitude also influences treatment choice when surgical correction is indicated.

Aim: To determine the concordance between patient and physician assessment of magnitude of penile curvature in men with Peyronie's disease.

Erectile dysfunction in men treated for testicular cancer.

Objective: To study the unique characteristics of erectile dysfunction (ED) in a population of men who developed ED after testicular cancer (TC) diagnosis and treatment.

Patients And Methods: All men treated for TC who presented for sexual function evaluation were included in an institutional database. All men underwent standard evaluation including a history/physical examination, completion of the International Index of Erectile Function (IIEF) questionnaire, testosterone/gonadotropin measurement and penile duplex Doppler ultrasonography (DUS).

Aggressive angiomyxoma of the scrotum.

Introduction: Aggressive angiomyxoma (AAM) is a rare, benign mass with propensity for local invasion and recurrence after resection. Infrequently, this tumor can be found arising from the scrotum or cord structures in males.

Aim/methods: A case report is presented followed by a review of relevant literature addressing the diagnosis, imaging, management and follow-up for aggressive angiomyxoma of the scrotum.

Preoperative erectile function is an independent predictor for decision to spare cavernous nerves during radical prostatectomy.

Introduction: Cavernous nerve sparing (NS) is critical for recovery of erectile function (EF) as well as erectile tissue preservation following radical prostatectomy (RP). Clinical experience suggests that surgeons may opt for non-NS RP in patients with impaired baseline EF.

Aim: This study was performed to define if baseline EF is an independent predictor of NS status during RP.