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Int J Impot Res 2020 Jun 4. Epub 2020 Jun 4.

A.O.U. Città della Salute e della Scienza di Torino-Presidio Unità Spinale Unipolare-SC Neurourologia, Turin, Italy.

Actas Urol Esp 2020 May 31. Epub 2020 May 31.

Unidade de Urologia/Andrologia, Saúde Atlântica, Clínica do Dragão, Oporto, Portugal. Electronic address:

Inflatable penile prosthesis was developed in 1973 as a definitive treatment for erectile dysfunction. Since then these prosthetic devices underwent huge modifications, and scientific and technologic advances were accomplished, improving reliability, longevity and the surgical outcomes. Surgical implantation of a penile prosthesis may be considered in patients with erectile dysfunction who do not respond to pharmacotherapy or who prefer a permanent solution to their problem. Read More

Int J Impot Res 2020 Jun 2. Epub 2020 Jun 2.

Department of Urology, Institute of Urologic Excellence, La Quinta, CA, USA.

The penoscrotal (PS), infrapubic (IP), and subcoronal (SC) incisions are used for inserting an inflatable penile prosthesis (IPP). Each surgical approach has its advantages and disadvantages and experts continue to debate which technique has the best outcomes. We performed a critical review of the published English-language studies up to April 2020 investigating the PS, IP, or SC approach for IPP placement. Read More

Int J Impot Res 2020 Jun 2. Epub 2020 Jun 2.

Ospedale San Raffaele, Vita-Salute University, Milano, Italy.

Previous studies have shown discrepancies among countries in terms of treatment indications and patients' management due to different health care policies. Penile prosthesis implantation (PPI) is a highly effective treatment for erectile dysfunction (ED), which may have different accessibility according to the type of health system. We compared clinical characteristics of patients included in two national registries on PPI to investigate the influence of different health care systems on treatment indication and accessibility. Read More

Sex Med 2020 May 17. Epub 2020 May 17.

Department of Urology, Jessa Hospital, Hasselt, Belgium; Faculty of medicine, Hasselt University, Hasselt, Belgium; University Hospitals Leuven, Leuven, Belgium.

Introduction: At the moment, there is an ongoing debate regarding the controversial issue of the ideal reservoir placement (RP) surgical technique during implantation of a 3-piece inflatable penile prosthesis, but a definitive winner has not yet emerged.

Aim: In this light, we herein describe our modified technique for RP into the space of Retzius through the external oblique muscle fascia and present its results.

Methods: In total, 253 inflatable penile prosthesis procedures (110 AMS 700 and 143 Coloplast Titan) via a single transverse penoscrotal incision were retrospectively reviewed. Read More

Int J Impot Res 2020 May 18. Epub 2020 May 18.

University of Texas Medical School, Houston, TX, USA.

The constant refrain for patients seeking penile implant is, "can you make it bigger?" It is a different request when the patient is young and fully potent compared with the mature individual suffering from erectile dysfunction (ED) for whom conservative therapies don't work. The purpose of this workshop is to review strategies to make the ED patient undergoing inflatable penile prosthesis (IPP) have an enhanced penile appearance by having more of his phallus visible outside his body. Our common procedures are to use a combination of vacuum device preparation, oversizing the cylinders 1-2 cm, and daily aggressive cycling of the device for at least 6 months following implantation. Read More

J Sex Med 2020 May 7. Epub 2020 May 7.

Department of Andrology, Kasr El Aini Faculty of Medicine, Cairo University, Cairo, Egypt.

Background: Penile prosthesis implantation in cases of severe Peyronie's disease may require plaque excision/incision and grafting, which may require mobilization of the neurovascular bundle or urethra, posing the risks of penile hyposensitivity or urethral injury, and is time-consuming, possibly increasing infection risk.

Aim: Evaluating transcorporeal debulking of Peyronie's plaques by "Shaeer's punch technique."

Methods: Penile prosthesis implantation and punch technique (PPI-Punch) was performed for 26 patients. Read More

J Sex Med 2020 May 7. Epub 2020 May 7.

Department of Andrology, Cairo University, Cairo, Egypt.

Int J Impot Res 2020 Apr 30. Epub 2020 Apr 30.

Department of Urology, University of South Florida, Tampa, FL, USA.

It is safe to say that the overwhelming majority of cylinders out of place result from surgeon error at the time of implantation. There are some instances where patient comorbidities could increase the difficulty of accurate development of cylinder insertion or space. Most of the time the operator recognizes his instrument out of place and corrects it intraoperatively. Read More

Actas Urol Esp 2020 Apr 27. Epub 2020 Apr 27.

Unidad de Andrología y Urología Reconstructiva, Servicio de Urología, Hospital Universitario Ramón y Cajal, Instituto de Investigación Sanitaria IRYCIS, Madrid, España.

Penile prosthesis implantation is a good option for the treatment of refractory erectile dysfunction. However, the patient's expectations, among other factors, condition his satisfaction after surgery. This review article aims to present the scientific evidence available concerning patient satisfaction with penile prosthesis surgery. Read More

J Sex Med 2020 Apr 24. Epub 2020 Apr 24.

Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address:

Actas Urol Esp 2020 Apr 9. Epub 2020 Apr 9.

Egydio Medical Center, Sao Paulo, Brasil. Electronic address:

Introduction: Reduction in penile size is due to numerous conditions including Peyronie's disease, previous penile surgeries, diabetes, trauma, erectile dysfunction, pelvic surgery, and aging. Elasticity of the tunica albuginea is adversely affected by any of the above. Fibrosis then triggers progressive erectile dysfunction OBJECTIVES: When a penile prosthesis is indicated, it is important to determine whether the penis has already diminished in size prior to insertion of the implant. Read More

Arch Ital Urol Androl 2020 Apr 6;92(1):25-29. Epub 2020 Apr 6.

Department of Urology, Gaziantep University School of Medicine, Gaziantep.

Objective: To compare the surgical results, complications, and satisfaction levels of patients who underwent malleable penile prosthesis implantation (M-PPI) and Ambicor penile prosthesis implantation (A-PPI).

Material And Methods: One hundred forty two patients who underwent penile prosthesis implantation [M-PPI (Promedon- Tube®, Cordoba, Argentina): 81, and A-PPI (American Medical Systems, Minnesota, USA): 61] between 2013-2018 were evaluated retrospectively. Patients' age, body mass index, smoking history, etiological factors, modified "Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) Questionnaire" scores, shortening of the penis, and complications were recorded. Read More

J Sex Med 2020 Mar 28. Epub 2020 Mar 28.

Department of Urology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA.

Background: Many patients with erectile dysfunction (ED) after radical prostatectomy (RP) improve with conservative therapy but some do not; penile prosthesis implantation rates have been sparsely reported, and have used nonrepresentative data sets.

Aim: To characterize rates and timing of penile prosthesis implantation after RP and to identify predictors of implantation using a more representative data set.

Methods: The Healthcare Cost and Utilization Project State Inpatient and State Ambulatory Surgery databases for Florida from 2006 to 2015 were used. Read More

Int J Impot Res 2020 Mar 20. Epub 2020 Mar 20.

Department of Urology, Irvine Medical Center, University of California, Orange, CA, USA.

Defining the risks associated with diabetes mellitus in patients undergoing penile prosthesis implantation remains controversial. Our study aims to assess whether preoperative hemoglobin a1c and preoperative blood glucose levels are associated with an increased risk for postoperative infection in diabetic men. We performed a retrospective review of 932 diabetic patients undergoing primary penile prosthesis implantation from 18 high-volume penile prosthesis implantation surgeons throughout the United States, Germany, Belgium, and South Korea. Read More

Int J Impot Res 2020 Mar 18. Epub 2020 Mar 18.

Institute for Urologic Excellence, La Quinta, CA, USA.

The most dreaded complication of penile prosthesis (PP) implantation is device infection. We sought to assess whether inadequate cleaning and sterilization of the reusable Furlow inserter may represent one of the last etiologies of infection in PP patients. We performed a prospective analysis of cultures of the Furlow inserter used for PP surgeries from seven centers between May 1st and June 30th, 2019. Read More

Int J Impot Res 2020 Mar 17. Epub 2020 Mar 17.

Department of Urology, Jessa Hospital, Hasselt, Belgium.

Aim of this review is to summarize and evaluate the current literature addressing the synchronous combined surgical treatment approach for co-existent post-radical prostatectomy erectile dysfunction and stress urinary incontinence. Severity of stress urinary incontinence is the basic element that defines which option of combined surgery will be offered to a patient. So, for cases of severe erectile dysfunction and severe stress urinary incontinence (>4 pads/day) the only available option is synchronous inflatable penile prosthesis plus artificial urinary sphincter dual implantation. Read More

J Sex Med 2020 May 18;17(5):1025-1032. Epub 2020 Mar 18.

Chesapeake Urology Associates, Baltimore MD, USA. Electronic address:

Background: The definitive treatment for erectile dysfunction is the surgical implantation of a penile prosthesis, of which the most common type is the 3-piece inflatable penile prosthesis (IPP) device. IPP surgery in outpatient freestanding ambulatory surgical centers (ASC) is becoming more prevalent as payers and health systems alike look to reduce healthcare costs.

Aim: To evaluate IPP surgical outcomes in an ASC as compared to contemporaneously-performed hospital surgeries. Read More

Actas Urol Esp 2020 Mar 12. Epub 2020 Mar 12.

Unidad de Andrología y Urología Reconstructiva, Unidad de Salud Integral del Varón, Servicio de Urología, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre (i+12), Universidad Complutense de Madrid, Madrid, España; Servicio de Urología, Hospitales HM Montepríncipe y Puerta del Sur, Madrid, España. Electronic address:

Introduction: The implantation of a penile prosthesis is considered a third-line treatment and is indicated in patients who do not respond adequately to pharmacotherapy or require definitive treatment. Currently, the most used devices are 3-component penile prostheses, which presently account for more than 90% of the implants used.

Material And Methods: We reviewed the evidence and the recommendations of the clinical practice guidelines regarding surgery in patients with erectile dysfunction. Read More

Curr Opin Urol 2020 May;30(3):302-308

Department of Urology, School of Medicine, University of California, Davis, Sacramento, California, USA.

Purpose Of Review: In this review, we synthesize the most current data on strategies for the prevention and reduction of infections in men undergoing penile prosthesis surgery. We highlight important strategies for preventing infections along every step from patient selection, to the preoperative, intraoperative and postoperative states.

Recent Findings: Over the last decade, significant advances have been made to help minimize penile implant infections, with the most impactful likely being the introduction of antibiotic coated penile implants. Read More

Actas Urol Esp 2020 Mar 6. Epub 2020 Mar 6.

Departamento de Urología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.

Introduction And Objective: Penile prosthesis (PP) surgery is performed in many institutions as an inpatient procedure. We have recently initiated a major ambulatory surgery (MAS) program, thus reducing the hospital stay. The objective of this study was to assess the feasibility, complications and satisfaction of the implantation of outpatient surgery PP program in our hospital. Read More

Actas Urol Esp 2020 Feb 27. Epub 2020 Feb 27.

Departamento de Urología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España. Electronic address:

Context: Penile prosthesis surgery is currently the most effective treatment for erectile dysfunction when medical treatment is ineffective or contraindicated. Among the surgical approaches described in the literature, the scrotal, infrapubic and subcoronal are the most common in the daily clinical practice.

Objectives: The main objectives were to describe the infrapubic surgical technique evaluating its indications and complications, as well as comparing its advantages and disadvantages with the penoscrotal approach. Read More

J Urol 2020 05 13;203(5):864. Epub 2020 Feb 13.

Int J Impot Res 2020 Feb 18. Epub 2020 Feb 18.

Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA.

Biol Reprod 2020 May;102(6):1225-1233

Department of Physiology, Southern Illinois University School of Medicine, Carbondale, IL, USA.

Androgens are essential for penile development and for maintaining penile structural and functional integrity. Loss of androgen levels or function results in a decrease in smooth muscle content, accumulation of adipocytes in the corpora cavernosa, and inhibition of erectile function. Our previous studies with a mouse model (KiLHRD582G) of constitutive luteinizing hormone receptor activity also showed structural abnormalities in the penis caused by a decrease in smooth muscle content, accumulation of chondrocytes, and sexual dysfunction. Read More

Transl Androl Urol 2020 Feb;9(1):43-49

University of Texas Southwestern Medical Center, Department of Urology, Dallas, TX, USA.

Background: Scrotal hematoma formation is a dreaded complication of penile prosthesis surgery that increases patient pain and healthcare costs, as well the risk for eventual device infection and failure. The efficacy of hemostatic agents in reducing the incidence of scrotal hematoma development has not been extensively studied in urologic prosthetic surgery. In this paper we further evaluate our experience with oxidized regenerated cellulose (ORC; Surgicel Fibrillar™) as an adjunct to standard hemostatic practices in inflatable penile prosthesis (IPP) implantation. Read More

Transl Androl Urol 2020 Feb;9(1):31-37

Department of Urology, Mayo Clinic, Rochester, MN, USA.

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. Read More

Medicine (Baltimore) 2020 Feb;99(7):e18690

Division of Urology, Department of Emergency and Organ Transplantation, University of Bari, Bari.

Rationale: Erectile dysfunction (ED) and Peyronie's disease (PD) are conditions commonly observed in andrology. Despite the surgical refinement and the technical improvement in this field, even in expert hands, detrimental consequences have been reported and it can be related to patient's comorbidities or misconduct in the postoperative period. In this article we report anecdotal cases of severe complications following penile surgery for ED and PD in high volume centers, describe the strategies adopted to treat it and discuss the options that would have helped preventing these events. Read More

Int J Impot Res 2020 Feb 7. Epub 2020 Feb 7.

Urology department, Città della Salute e della Scienza-Molinette Hospital, University of Turin, Turin, Italy.

A variety of approaches are available to address a genital gender affirming surgery (GGAS) in transgender men. The aim of the present study is to report surgical and functional outcomes after a suprapubic pedicled phalloplasty (SPP). From November 2008 to August 2018, a consecutive series of 34 patients underwent an SPP in two tertiary referral centers. Read More

Int J Impot Res 2020 Feb 3. Epub 2020 Feb 3.

Ark-La-Tex Urology, Bossier City, LA, USA.

Purpose: The aim of this study was to identify the factors associated with infection in patients who undergo penile prosthesis implantation.

Methods: We performed a systematic review/meta-analysis, including clinical trials, quasi-experiments, retrospective and prospective cohort studies, and case-control studies. Searching was done in CENTRAL, MEDLINE, and EMBASE databases. Read More

Urologiia 2019 12(6):166-169

Department of Urology of A.I. Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia.

Implantation of three-piece penile prosthesis is a gold standard in patients with severe erectile dysfunction. Currently, three surgical approach (scrotal, suprapubic and subcoronal) are used for prosthetic implantation. A method of implantation for three-piece penile prosthesis is still under discussion. Read More

J Sex Med 2020 Mar 23;17(3):526-530. Epub 2020 Jan 23.

Sexual & Reproductive Medicine Program, Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, NY, USA. Electronic address:

Introduction: The systemic effect of intracavernosal liposomal bupivacaine (Exparel) injection during inflatable penile prosthesis (IPP) implantation on systemic hemodynamics has not been clarified.

Aim: To evaluate whether intraoperative intracavernosal Exparel injection affects systemic hemodynamics.

Methods: We studied 56 consecutive patients who underwent IPP implantation under general anesthesia using the transverse scrotal approach. Read More

Int J Impot Res 2020 Jan 2. Epub 2020 Jan 2.

Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.

A lack of uniformity exists for insurance payer coverage for all categories of penile prostheses (PP). We sought to determine common insurance coverage criteria and barriers to implantation across common insurance plans from healthcare referral regions (HRR) nationwide. Coverage criteria and stipulations were reviewed regarding erectile dysfunction (ED) etiology, ED duration, contributing comorbid conditions, medications, drug use, diagnostic tests, use of procedures and prior interventions. Read More

Eur Urol Focus 2019 Dec 23. Epub 2019 Dec 23.

Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.

Context: The genesis of neurogenic sexual dysfunction (NSD) can be central, peripheral, or both. The correct stratification of the level of sexual dysfunction allows the clinician to choose the best type of treatment, in order to reduce sexual complaints.

Objective: The aim of our review is to focus on the management of NSD due to central nervous system disorders and peripheral neuropathy. Read More

J Sex Med 2020 Mar 20;17(3):518-525. Epub 2019 Dec 20.

Department of Urology, Einstein Healthcare Network, Philadelphia, PA, USA; Department of Urology, Fox Chase Cancer Center, Philadelphia, PA, USA. Electronic address:

Introduction: Despite the pain associated with inflatable penile prosthesis (IPP) implantation, there has been a lack of standardized, nonopioid pain control regimens described to date.

Aim: To assess the effectiveness of a multimodal analgesic regimen in patients undergoing implantation of an IPP compared with patients treated with an opioid-only regimen.

Methods: A large, multicenter patient cohort undergoing IPP implantation whose pain was managed using a multimodal analgesia (MMA) protocol (preoperative and postoperative acetaminophen, meloxicam orcelecoxib, and gabapentin and intraoperative dorsal and pudendal nerve blocks) was compared with a matched cohort of patients managed via an opioid-only protocol. Read More

J Sex Med 2020 Feb 20;17(2):325-330. Epub 2019 Dec 20.

Albany Medical Center, 50 New Scotland Ave, Albany 12208 NY, USA. Electronic address:

Introduction: Medical websites and discussion boards are commonly used by patients to obtain information. The online forum FrankTalk.org provides a venue specifically for men to discuss sexual dysfunction and particularly inflatable penile prosthesis (IPP). Read More

Can J Urol 2019 Dec;26(6):10039-10044

Sorbonne Universite, GRC no5, ONCOTYPE-URO, AP-HP, Urology, Hopital Pitie-Salpetriere, F-75013 Paris, France.

Introduction: To investigate the mid-term results of penile prosthesis (PP) implantation in patients with erectile dysfunction (ED) from a "real-life" historic cohort in a French academic center.

Materials And Methods: All patients receiving an inflatable PP between 2004 and 2014 in our institution were included in this study. ED was assessed preoperatively using the IEEF-5 questionnaire. Read More

Asian J Androl 2019 Dec 17. Epub 2019 Dec 17.

St. Joseph Medical Center, Houston, TX 77002, USA.

Penile rehabilitation after inflatable penile prosthesis (IPP) implantation for the treatment of erectile dysfunction includes leaving the device partially inflated so as to preserve the penile length and to maintain hemostasis. With a partially inflated device, the penis becomes more sensitive and more susceptible to unintended insults during the immediate postoperative management. The "Wang Collar," a device intended to protect the penis in the early postoperative period, is hereby described. Read More

Arch Esp Urol 2019 Dec;72(10):1043-1045

Departamento de Cirugía. División Urología. Hospital General de Agudos "Dr. C.G. Durand". Buenos Aires. Argentina.

Objective: To report the finding of malleable penile prosthesis extension tips in an ectopic position.

Method: We retrospectively analyzed two clinical cases of ectopic finding of prosthetic implant extension tips and performed a bibliographic review.

Results: In the cases described, conservative behavior was decided given the absence of signs, symptomatology and the efficacy of the normally positioned implant. Read More

J Urol 2020 03 10;203(3):448. Epub 2019 Dec 10.

J Urol 2020 03 10;203(3):448-449. Epub 2019 Dec 10.

Andrology 2020 May 22;8(3):731-746. Epub 2019 Dec 22.

Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia.

Background: Diabetes mellitus is one of the risk factors for male subfertility/infertility. Malaysian propolis is reported to decrease hyperglycaemia in diabetic state.

Objectives: The present study investigated the protective effect of Malaysian propolis on diabetes-induced subfertility/infertility. Read More

J Sex Med 2020 Feb 4;17(2):210-237. Epub 2019 Dec 4.

Endocrinology Unit, Medical Department, AziendaUsl Bologna Maggiore-Bellaria Hospital, Bologna, Italy.

Introduction: To date, several aspects of inflatable penile prosthesis (IPP) surgical procedure have been poorly studied.

Aim: The aim of this study was to review the evidence associated with IPP implantation and provide clinical recommendations on behalf of the European Society for Sexual Medicine (ESSM). Overall, 130 peer-reviewed studies and systematic reviews, which were published from 2007-2018 in the English language, were included. Read More

Am J Mens Health 2019 Nov-Dec;13(6):1557988319893568

University of California, San Diego, San Diego, CA, USA.

Penile prosthetic surgery is an effective treatment for men with erectile dysfunction. Cancellation of surgery is disruptive and costly to patients, physicians, and the healthcare system. This pilot study sought to analyze surgery cancellations and implement a video-based patient education program to decrease surgery noncompletion. Read More

Prog Urol 2019 Dec 27;29(16):947-954. Epub 2019 Nov 27.

Service d'urologie et d'andrologie, hôpital Claude-Huriez, CHRU de Lille, 59000, Lille, France.

Introduction: Inflatable penile prosthesis surgery is relatively rare in France, and around ten surgeons perform most of this surgery. The objective of this study was to define the learning curve concerning this surgery.

Methods: This study is a retrospective monocentric cohort of first time implantation of inflatable penile prosthesis between 2008 and 2016 in a university hospital. Read More

Rev Int Androl 2019 Nov 25. Epub 2019 Nov 25.

Servicio de Urología, Hospital Clínico Universidad de Chile, Santiago, Región Metropolitana, Chile; Departamento de Urología, Clínica Las Condes, Santiago, Región Metropolitana, Chile.

Introduction: Penile prosthesis (PP) implantation is the treatment of choice for refractory erectile dysfunction (ED). They show a high satisfaction rate (75%-100%) and a complication rate that varies between 2.1% and 28. Read More

AJR Am J Roentgenol 2020 01 26;214(1):W27-W36. Epub 2019 Nov 26.

Department of Surgery, Division of Plastic and Reconstructive Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, MAC 3168C, Portland, OR 97239.

Masculinizing genital surgeries for transgender individuals are currently performed at only a select few centers; however, radiologists in any geographic region may be confronted with imaging studies of transgender patients. The imaging findings of internal and external genital anatomy of a transgender patient may differ substantially from the imaging findings of a cisgender patient. This article provides the surgical and anatomic basis to allow appropriate interpretation of preoperative and postoperative imaging findings. Read More

Curr Urol 2019 Oct 1;13(2):94-100. Epub 2019 Oct 1.

Department of Urology, Jessa Hospital Hasselt, Hasselt, Belgium.

Background: Erectile dysfunction (ED) is a common disorder, which affects at least 50% of males aged 50-70 years. According to EAU Guidelines on male sexual dysfunction, implantation of an inflatable penile prosthesis (IPP) is a valid, third-line therapeutic option for treatment of ED.

Objective: We conducted a retrospective single centre study to analyze mechanical reliability, complication rate, patient satisfaction and quality of life after penile prosthesis implantation. Read More

Sex Med 2020 Mar 22;8(1):114-119. Epub 2019 Nov 22.

Jessa ziekenhuis, Hasselt, Belgium; University Hospitals Leuven, Leuven, Belgium; UHasselt, Hasselt, Belgium. Electronic address:

Introduction: Previous research in the field of cardiovascular diseases suggests a relaxing effect of testosterone (T) on smooth muscle cells. Therefore, it was hypothesized that T could play a significant role in erection development.

Aim: To investigate the relaxing effect of T and other molecules of the T signaling pathway on human corpus cavernosum (HCC) tissue. Read More