British Society for Sexual Medicine (BSSM) Position statement on Premature Ejaculation.

To provide an evidence based consensus on the diagnosis and management of premature ejaculation (PE). The British Society for Sexual Medicine (BSSM) takes issue with the advice to use off label treatments, such as daily selective serotonin reuptake inhibitors treatment, favoring on-demand dapoxetine. There is increasing evidence for the use of PDE5 inhibitors which are superior to a placebo for the treatment of PE.

Pure Yolk Sac Testicular Tumour in an Adult: A Diagnostic Dilemma.

A rare case of a pure yolk sac testicular tumour presenting in an adult with learning difficulties is presented. Pure yolk sac tumours are much more common in children, but when they do occur in adults, onset can be both insidious and aggressive. The best practice for identification involves the precise use of ultrasound, blood tests for tumour markers and FDG-PET/CT imaging for staging.

Imaging findings in suspected penile fracture: alternative diagnoses and surgical correlation.

Objectives: The primary objective is to compare the imaging and surgical findings in a cohort of patients with suspected penile fracture (PF).

Methods: Retrospective cohort study of all patients with suspected PF over an 11-year period at a tertiary referral andrology centre. All dedicated presurgical imaging with ultrasound (US) and MRI was analysed and correlated with intraoperative findings; alternative diagnoses were recorded.

A Video-illustrated Overview of Reconstructive Surgical Techniques Following Penile Cancer Treatment.

Surgery is the cornerstone of treatment for penile squamous cell carcinoma. Following surgical excision, reconstructive surgery is beneficial to restore aesthetics, functionality, and overall quality of life of these patients. In this mini-review, we discuss the use of skin grafts, perineal urethrostomy, phalloplasty, and vascularised flaps as reconstructive options following penile cancer treatment.

Lightweight macroporous mesh can be used for corporal reconstruction during penile prosthesis surgery.

Background: Options to reinforce or reconstruct the corpora cavernosa during penile prosthesis surgery are limited. Synthetic grafts may confer a higher infection risk. Lightweight macroporous mesh is a promising alternative due to better integration and tissue ingrowth.

Erectile device insertion following phalloplasty in transgender and non-binary individuals assigned female at birth: a narrative review.

Genital gender affirmation surgery (gGAS) for individuals assigned female at birth (AFAB) is complex and requires the staged insertion of an erectile device to permit penetrative intercourse. This final stage of gGAS is challenging, owing to the variable anatomy and lack of supportive structures within the neophallus when compared with erectile device insertion for individuals assigned male at birth. There is a paucity in the literature at present regarding erectile device insertion in trans-sex AFAB patients.

Insertion of inflatable penile prosthesis in the neophallus of assigned female at birth individuals: a systematic review of surgical techniques, complications and outcomes.

Devices such as inflatable penile prostheses (IPP) can be used to achieve erectile rigidity after phalloplasty in assigned female at birth (AFAB) individuals. The approach to inserting an IPP in a neophallus is different and more challenging compared to that of an anatomical penis due to the absence of anatomical structures such as the corpora cavernosa, and the more tenuous blood supply of the neophallus and reconstructed urethra. In addition, the ideal surgical techniques and devices for use in the neophallus have not been defined.

Genital Reconstruction following Fournier's Gangrene.

Introduction: Fournier's gangrene is a urological emergency, comprising of type I necrotizing fasciitis resulting in anatomic defects affecting the perineum, perianal region, and external genitalia in both men and women, often requiring reconstruction.

Objectives: The aim of this article is to provide a comprehensive review of the different reconstructive techniques for Fournier's gangrene.

Methods: A literature search was performed on PubMed with the search terms "Fournier"s gangrene" "genital reconstruction" and "Fournier's gangrene phalloplasty.

Anterolateral Thigh Flap Phalloplasty for Individuals Assigned Female at Birth.

Anterolateral thigh flap phalloplasty is a suitable alternative for individuals assigned female at birth who do not want a visible donor site, but careful patient selection is essential to reduce the risk of complications.

Urological and Gynaecological Considerations for the Use of Gonadotropin-releasing Hormone Analogues in Transgender and Nonbinary Adolescents: A Narrative Review.

Context: Gonadotropin-releasing hormone analogues (GnRHAs) delay the progression of puberty in transgender and nonbinary (TGNB) adolescents and reduce the impact of dysphoria due to ongoing physical development. The intervention remains contentious despite growing evidence to support this practice.

Objective: To stimulate discussion on this topical issue in the urological and gynaecological community given potential ramifications for future fertility, physical development, and options for gender affirmation surgery (GAS).

Phalloplasty following penectomy for penile cancer.

Objective: Penile reconstruction or phalloplasty following penectomy can be offered where the functional penile length is inadequate for a man to void while standing or to have sexual intercourse. Phalloplasty is usually staged due to the complex surgical techniques required. This narrative review describes the technical concepts and summarises the contemporary outcomes following phalloplasty in this challenging cohort.

Genital Reconstruction following Fournier's Gangrene.

Introduction: Fournier's gangrene is a urological emergency, comprising of type I necrotizing fasciitis resulting in anatomic defects affecting the perineum, perianal region, and external genitalia in both men and women, often requiring reconstruction.

Objectives: The aim of this article is to provide a comprehensive review of the different reconstructive techniques for Fournier's gangrene.

Methods: A literature search was performed on PubMed with the search terms "Fournier"s gangrene" "genital reconstruction" and "Fournier's gangrene phalloplasty.

Gender Affirmation Surgery, Transmasculine.

Transmasculine genital gender affirmation surgery (GAS) is evolving rapidly due to social and surgical advances over recent decades. Important innovations include the use of free or pedicled sensate tissue flaps with integrated urethra coupled with an improved understanding of how best to offer inclusive care. Disappointingly, most publications have thus far failed to address standardization, classification systems, and prospective trials to help guide shared decision making.

Long-term outcomes of peritoneal dialysis catheters inserted by laparoscopic and percutaneous techniques in a single regional dialysis centre.

Background: Minimally invasive insertion of catheters for peritoneal dialysis can be performed laparoscopically or percutaneously under image guidance. In Geelong (Victoria, Australia) both methods are used. Our aim was to analyse the outcomes of all catheters inserted by both laparoscopic and percutaneous techniques and compare them against published studies from tertiary referral centres.

A Rare Cause of Autoinflation after Penile Prosthesis Insertion: Case Series and Systematic Review.

Background: In 2016, we reported the first case of high flow priapism and arteriocavernosal fistula caused by penile prosthesis insertion that mimicked device autoinflation.

Aim: To raise awareness amongst implanters, we describe further cases from our institution and perform a systematic review of the literature to understand the rarity of this phenomenon.

Methods: Patient demographics, management and outcomes were extracted retrospectively.

Advances in Penile Prosthesis Surgery: A Clinical Update.

Despite the introduction of effective oral pharmacotherapy for the treatment of erectile dysfunction (ED), penile implants are still the standard care for patients who do not respond well to medical therapy. Since the first inflatable penile implant surgery was performed almost 40 years ago, a variety of improvements in the penile prosthesis design, and advancements in material science, surgical technique, and post-operative care have been developed to increase patients' satisfaction, as well as that of their partners. Penile implants have evolved vastly during that same time frame and now represent the cutting-edge technology, durability, and function.

Prevalence of diabetes in liver cirrhosis: A systematic review and meta-analysis.

An association between diabetes mellitus (DM) and liver cirrhosis is well-known, but estimates of the prevalence of DM in patients with liver cirrhosis vary widely. A systematic review was undertaken to determine the prevalence of DM in adult patients with liver cirrhosis. The Medline, EMBASE, and Cochrane Library databases were searched for peer-reviewed studies published in English (1979-2017) that investigated the prevalence of diabetes in adult patients with cirrhosis.

The use of portable video media vs standard verbal communication in the urological consent process: a multicentre, randomised controlled, crossover trial.

Objectives: To determine if portable video media (PVM) improves patient's knowledge and satisfaction acquired during the consent process for cystoscopy and insertion of a ureteric stent compared to standard verbal communication (SVC), as informed consent is a crucial component of patient care and PVM is an emerging technology that may help improve the consent process.

Patients And Methods: In this multi-centre randomised controlled crossover trial, patients requiring cystoscopy and stent insertion were recruited from two major teaching hospitals in Australia over a 15-month period (July 2014-December 2015). Patient information delivery was via PVM and SVC.

Nadolol reduces insulin sensitivity in liver cirrhosis: a randomized double-blind crossover trial.

Background: Liver cirrhosis is frequently complicated by portal hypertension leading to increased mortality from variceal bleeding and hepatic decompensation. Noncardioselective β-blockers not only reduce portal hypertension and prevent variceal bleeding in cirrhosis but also impair glucose tolerance and insulin sensitivity in other settings. This study aimed to determine whether nonselective β-blockade with nadolol impairs glucose metabolism in liver cirrhosis.