The management of residual curvature after penile prosthesis implantation in men with Peyronie's disease.

Objective: • To report our experience in the management of residual curvature after implantation of a penile prosthesis in men with Peyronie's disease (PD).

Patients And Methods: • From January 1985 to June 2009, 62 (29%) of the 209 patients with PD that have undergone the insertion of a penile prosthesis have required an additional straightening procedure to correct the residual curvature after the insertion of the cylinders of the implant. • The types of additional manoeuvres, their success in correcting the residual curvature and eventual complications have been reported.

Surgical management of erectile dysfunction.

The introduction of penile prosthesis in the early 1970s has been the first breakthrough in the treatment of erectile dysfunction. Since then a variety of treatment options for erectile dysfunction have been developed, including penile vascular surgery, injection therapy, vacuum erection device therapy, intraurethral and oral pharmacotherapy. Although the percentage of men newly diagnosed with erectile dysfunction who undergo surgical treatment has declined, the number of men presenting with erectile dysfunction continues to increase out of proportion to this decline.

The immediate insertion of a penile prosthesis for acute ischaemic priapism.

Background: Ischaemic priapism (IP), which is refractory to conventional medical and surgical intervention, results in necrosis of the corpus cavernosum smooth muscle. These patients eventually develop a variable degree of corporal smooth muscle fibrosis that presents as erectile dysfunction and penile shortening.

Objectives: To evaluate the long-term outcome of patients who have undergone the immediate insertion of a penile prosthesis as a treatment for an acute episode of IP refractory to medical therapy or shunt surgery.

The management of Peyronie's disease.

Peyronie's disease has no known cause; recent understanding of the molecular mechanisms involved and the development of an animal model will aid the medical management of early disease. The medical management of chronic disease is futile as the delicate tunical architecture cannot regenerate. Surgical correction of the penile deformity is required in a minority of patients, and a choice lies between a Nesbit operation and a plaque incision and venous patch in patients who are concerned with penile shortening.

The Nesbit operation for Peyronie's disease: an analysis of the failures.

Objective: To analyse critically the reasons for a poor outcome of the Nesbit operation for Peyronie's disease in 51 patients over a 20-year period.

Patients And Methods: Fifty-one patients who were classified as having a poor result from the Nesbit operation were reviewed (mean age 53 years, mean follow-up 21 months). The factors responsible for a poor result were analysed and classified into three groups: (i) deformity > 30 degrees; (ii) penile shortening > 2 cm; and (iii) impaired erection.

Clinical aspects associated with Sertoli-cell-only histology.

Objective: To assess the clinical features found in infertile men in whom the histological diagnosis of Sertoli-cell-only (SCO) was made on testicular biopsy.

Patients And Methods: A retrospective review was carried out of the seminal fluid analysis, testis size and follicle-stimulating hormone (FSH) levels of 72 men who had bilateral testicular biopsies due to infertility when one (30) or both (42) of bilateral testicular biopsies showed tubules containing only Sertoli cells. In a subgroup of 15 men, the biopsies were re-examined to correlate the morphological features with the plasma FSH level.