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Li Y, Gao D, Zhang J, Wang M, Lan X, Yu X, Chang D. Penile prosthesis implantation: a bibliometric-based visualization study. Int J Impot Res 2024:10.1038/s41443-024-00927-1. [PMID: 38851852 DOI: 10.1038/s41443-024-00927-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 05/22/2024] [Accepted: 05/31/2024] [Indexed: 06/10/2024]
Abstract
The treatment of erectile dysfunction (ED) using penile prosthesis implantation (PPI) has recently garnered significant interest, but reports of bibliometric analyses of studies on PPI have yet to appear. Therefore, the purpose of this study is to use visualization techniques to statistically and qualitatively assess the state of knowledge, current research topics, and trends in this field. The Science Citation Index-Expanded (SCI-E) from the Web of Science Core Collection (WoSCC) was searched for publications about PPI from the inception of the database to 2023. VOSviewer (version 1.6.19), CiteSpace (version 6.2. R2), and Excel (version 2021) were used for the data analysis. The results show a total of 1015 original articles and reviews on PPI published over this nearly 50 years, with an increasing trend in the number of studies published each year. The United States is the country with the most published studies (n = 578). Mayo Clinic is the organization with the most publications overall (n = 46). The Journal of Sexual Medicine has the most publications (n = 184). The most prolific author is Wilson, Steven K (n = 31). The most commonly used terms were erectile dysfunction (n = 509), penile prosthesis (n = 332), implantation (n = 207), satisfaction (n = 201), surgery (n = 200), infection (n = 134), outcomes (n = 128), Peyronie's disease (n = 121), men (n = 115), and experience (n = 109). Current research focuses on four main areas: complications of PPI, the current status of inflatable penile prosthesis (IPP), the use of PPI in radical prostatectomy and Peyronie's disease populations, and patient satisfaction after PPI. Improving patient satisfaction with PPI through improved mechanical design and surgical techniques is a key concern for future research.
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Affiliation(s)
- Yingxi Li
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Dawei Gao
- Faculty of Chinese Medicine, Macau University of Science and Technology, Macau, China
| | - Jingyi Zhang
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Meijing Wang
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiucheng Lan
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xujun Yu
- Chengdu University of Traditional Chinese Medicine, Chengdu, China.
| | - Degui Chang
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
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Manfredi C, Russo GI, Capogrosso P, Falcone M, Capece M, Sokolakis I, Verze P, Salonia A, Tsambarlis P, Seligra Lopes L, Romero-Otero J, DE Sio M, Levine L. Quality of life and sexuality with penile prosthesis: a systematic review and pooled analysis. Minerva Urol Nephrol 2024; 76:166-175. [PMID: 37795696 DOI: 10.23736/s2724-6051.23.05466-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
INTRODUCTION Quality of Life and Sexuality with Penile Prosthesis (QoLSPP) is the first validated questionnaire to specifically evaluate the satisfaction of patients undergoing penile prosthesis implantation. Our primary aim was to conduct a systematic review and pooled analysis of articles reporting QoLSPP. EVIDENCE ACQUISITION A comprehensive bibliographic search on the MEDLINE, Scopus, Web of Science, and Cochrane Library databases was performed in April 2023. Studies were selected if they assessed male subjects (P) undergoing penile prosthesis implantation (I) with or without comparison with other treatments (C), reporting the patient satisfaction according to QoLSPP (O). Prospective and retrospective original studies were included (S). The risk of bias was assessed using the ROBINS-I tool and the Knoll method. Means and standard deviations (SDs) of QoLSPP scores were included in the pooled analysis. PROSPERO ID: "CRD42023427261." EVIDENCE SYNTHESIS A total of 10 studies investigating 1105 patients were included in the systematic review; of these, eight articles describing the outcomes of 693 subjects were eligible for the pooled analysis. Overall serious risk of bias was found in 2/3 of nonrandomized comparative studies (66%), while seven single-arm studies (100%) were classified as having a high risk of bias. Pooled analysis of the QoLSPP-Functional domain revealed an overall effect size (ES) of 4.22 points (95% CI 4.04-4.40; P<0.001). The QoLSPP-Relational pooled score was 4.17 points (95% CI 4.03-4.31; P<0.001). The QoLSPP-Social pooled score corresponded to 4.21 points (95% CI 4.02-4.40; P<0.001). Pooled analysis of the QoLSPP-Personal domain showed an overall ES of 3.97 points (95% CI 3.61-4.32; P<0.001). There was insufficient data to pool QoLSPP total scores. CONCLUSIONS Patients undergoing penile prosthesis implantation report positive scores in all QoLSPP domains, demonstrating high satisfaction levels. Future studies are needed to improve the evidence on the topic.
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Affiliation(s)
- Celeste Manfredi
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, Luigi Vanvitelli University of Campania, Naples, Italy -
- Department of Urology, Rush University Medical Center, Chicago, IL, USA -
| | - Giorgio I Russo
- Urology Section, Department of Surgery, University of Catania, Catania, Italy
| | - Paolo Capogrosso
- Department of Urology and Andrology, Ospedale di Circolo and Macchi Foundation, Varese, Italy
| | - Marco Falcone
- Department of Urology, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Marco Capece
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Ioannis Sokolakis
- Department of Urology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Paolo Verze
- Scuola Medica Salernitana, Department of Medicine, Surgery, Dentistry, University of Salerno, Salerno, Italy
| | - Andrea Salonia
- Division of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy
| | - Peter Tsambarlis
- Department of Urology, Rush University Medical Center, Chicago, IL, USA
| | | | | | - Marco DE Sio
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Laurence Levine
- Department of Urology, Rush University Medical Center, Chicago, IL, USA
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Xiang A, Braun AE, Chang C, Swerdloff D, Gross MS, Simhan J. Penoscrotal inflatable penile prosthesis recipients often fully recover from pain at two weeks following placement. Int J Impot Res 2024:10.1038/s41443-024-00871-0. [PMID: 38561424 DOI: 10.1038/s41443-024-00871-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 12/19/2023] [Accepted: 03/04/2024] [Indexed: 04/04/2024]
Abstract
The symptoms and duration of pain following inflatable penile prosthesis (IPP) surgery remains poorly understood. We characterize postoperative pain following penoscrotal 3-piece inflatable penile prosthesis placement in patients managed with a standardized pain management protocol. This is a single-center prospective analysis of 96 virginal penoscrotal 3-piece IPP recipients (9/2019 to 9/2021) excluding patients with chronic pain, IPPs performed with alternative approaches or concomitantly with other surgeries and those with infections. Standardized pain questionnaire was performed by phone on post-operative day (POD) 2, 7, 14, and 30. The primary outcome was self-reported pain scores, measured by pain score 0-10 (0 = no pain, 10 = unbearable, "worst pain you have ever felt") at various locations (incision, penile, scrotal, abdominal) over the first 30 days postoperatively. A majority of pain reported was outside the scrotal area with 67.6% of complaints in the shaft, glans, abdomen and incision. From POD2 to POD30, there was a significant decrease in severe pain from 46.2 to 11.1% (p = 0.05) with an increase in mild pain from 23.1 to 62.4% (p = 0.05). Roughly half of the participants (47.9%, n = 46) reported no pain by POD14. Penoscrotal IPP recipients often fully recover from pain at the two-week period following surgery and those with lingering discomfort predominantly complain of penile shaft and glans pain.
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Affiliation(s)
- Alice Xiang
- Department of Urology, Jefferson Einstein Healthcare Network, Philadelphia, PA, USA
- Department of Urology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Avery E Braun
- Department of Urology, Jefferson Einstein Healthcare Network, Philadelphia, PA, USA
- Department of Urology, Fox Chase Cancer Center, Philadelphia, PA, USA
- Department of Urology, University California of San Francisco, San Francisco, CA, USA
| | - Chrystal Chang
- Department of Urology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Daniel Swerdloff
- Department of Urology, Jefferson Einstein Healthcare Network, Philadelphia, PA, USA
| | - Martin S Gross
- Section of Urology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Jay Simhan
- Department of Urology, Fox Chase Cancer Center, Philadelphia, PA, USA.
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Di Pierro GB, Di Lascio G, Lemma A, Grande P, Frisenda M, Del Giudice F, Antonini G, Nardi F, De Berardinis E, Cristini C, Franco G, Sciarra A, Salciccia S. Mid-term outcomes of minimally invasive infrapubic approach for inflatable penile prosthesis implantation: A single-center study and literature review. Andrology 2024; 12:624-632. [PMID: 37452742 DOI: 10.1111/andr.13497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/22/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND The minimally invasive infrapubic approach (MIIA) for inflatable penile prosthesis (IPP) placement has shown favorable peri-operative safety and efficacy profile, but scarce data exist on long-term follow-up. OBJECTIVES We investigated the safety and efficacy of IPP implantation via the MIIA after a minimum 5-year follow-up. MATERIALS AND METHODS We identified data of implanted patients prospectively included in our institutional database. Complications and functional outcomes were assessed by using validated tools. Specifically, quality of life and patient satisfaction were evaluated by the Quality of Life and Sexuality with Penile Prosthesis (QoLSPP) questionnaire. Kaplan-Meier method was used to analyze IPP survival (defined as a working IPP). RESULTS Overall, 67 patients implanted by MIIA with a median (IQR) age of 64 years (61-70) were included. The median (IQR) follow-up duration was 71 months (63-80). Fifteen (22%) patients experienced complications: minor (Clavien ≤2) events included changes in penile sensitivity (n = 1; 1.5%), orgasmic dysfunction (n = 1; 1.5%), pain (n = 5; 7%), urinary tract infection (n = 2; 3%), and chronic discomfort (n = 1; 1.5%); major (Clavien 3) complications were represented by mechanical failure (n = 3; 4.5%), IPP infection (n = 1; 1.5%), and cylinder protrusion (n = 1; 1.5%). The estimated IPP survival was 94% (95% CI, 91.4-96.6), 92.5% (95% CI, 89.7-95.3), and 92.5% (95% CI, 89.7-95.3) at 3, 5, and 7 years after implantation, respectively. In patients using the device at follow-up (n = 61; 91%), median (IQR) scores for QoLSPP domains demonstrated favorable functional outcomes and patient satisfaction: functional 21 (19-23), personal 16 (15-18), relational 14 (12-15), and social 12 (11-14). DISCUSSION AND CONCLUSION This study represents the longest follow-up using validated tools to assess the outcomes of IPP implantation via MIIA so far. IPP placement via MIIA confirms to be safe and to offer high satisfaction to both patients and partners at mid-term evaluation.
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Affiliation(s)
| | - Giovanni Di Lascio
- Department of Maternal and Child Health and Urological Sciences, ''Sapienza'' University, Rome, Italy
| | - Andrea Lemma
- Department of Maternal and Child Health and Urological Sciences, ''Sapienza'' University, Rome, Italy
| | - Pietro Grande
- Department of Maternal and Child Health and Urological Sciences, ''Sapienza'' University, Rome, Italy
| | - Marco Frisenda
- Department of Maternal and Child Health and Urological Sciences, ''Sapienza'' University, Rome, Italy
| | - Francesco Del Giudice
- Department of Maternal and Child Health and Urological Sciences, ''Sapienza'' University, Rome, Italy
| | - Gabriele Antonini
- Department of Maternal and Child Health and Urological Sciences, ''Sapienza'' University, Rome, Italy
| | - Francesco Nardi
- Department of Maternal and Child Health and Urological Sciences, ''Sapienza'' University, Rome, Italy
| | - Ettore De Berardinis
- Department of Maternal and Child Health and Urological Sciences, ''Sapienza'' University, Rome, Italy
| | - Cristiano Cristini
- Department of Maternal and Child Health and Urological Sciences, ''Sapienza'' University, Rome, Italy
| | - Giorgio Franco
- Department of Maternal and Child Health and Urological Sciences, ''Sapienza'' University, Rome, Italy
| | - Alessandro Sciarra
- Department of Maternal and Child Health and Urological Sciences, ''Sapienza'' University, Rome, Italy
| | - Stefano Salciccia
- Department of Maternal and Child Health and Urological Sciences, ''Sapienza'' University, Rome, Italy
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Ricapito A, Sedigh O, Rubino M, Gobbo A, Falagario UG, Annese P, Mancini V, Ferro M, Buffi N, Cormio L, Carrieri G, Busetto GM, Bettocchi C. Penoscrotal approach for inflatable penile prosthesis implant: why it should be preferred. Minerva Urol Nephrol 2023; 75:711-717. [PMID: 38126284 DOI: 10.23736/s2724-6051.23.05475-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
INTRODUCTION Inflatable penile prosthesis are the definitive treatment for erectile dysfunction. The two most used surgical approaches to position the implants are the penoscrotal and the infrapubic. Current trends showed that the penoscrotal approach is extensively preferred however, there is not conclusive evidence demonstrating the superiority of one technique over the other. The aim of this review is to summarize the scientific evidence available and to underline strengths and weaknesses of the two techniques. EVIDENCE ACQUISITION We conducted a comprehensive search of MEDLINE, Cochrane Library, and National Center for Biotechnology Information PubMed to identify relevant published articles. The included studies had to explicitly examine the use of three-piece inflatable penile prosthesis with a focus on the surgical access method and complications. EVIDENCE SYNTHESIS Twenty-six articles were included in the review: seven narrative reviews, five retrospective observational studies, five prospective observational studies, and nine mixed methodology studies. The most frequent approach was the penoscrotal, which was also found more comfortable (RG1) by the operators in one study. The infrapubic approach lasts less and one study demonstrated higher satisfaction by the patients. CONCLUSIONS There is no evidence of significant differences in complications among the penoscrotal and infrapubic approaches. While the infrapubic approach is faster and patients were more satisfied, the penoscrotal approach is the most used by far. This is likely related to the more straightforward procedure through this access and the excellent surgical field exposure. For these reasons, it is also preferred in the most complex cases.
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Affiliation(s)
- Anna Ricapito
- Andrology Unit, Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Omid Sedigh
- Department of Biomedical Science, Humanitas University, Rozzano, Milan, Italy
- Department of Urology and Reconstructive Andrology, Humanitas Gradenigo Hospital, Turin, Italy
| | - Matteo Rubino
- Andrology Unit, Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Andrea Gobbo
- Department of Biomedical Science, Humanitas University, Rozzano, Milan, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Ugo G Falagario
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Pasquale Annese
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Vito Mancini
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Matteo Ferro
- European Institute of Oncology (IEO) - IRCCS, Milan, Italy
| | - Nicolò Buffi
- Department of Biomedical Science, Humanitas University, Rozzano, Milan, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Luigi Cormio
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Giuseppe Carrieri
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Gian Maria Busetto
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy -
| | - Carlo Bettocchi
- Andrology Unit, Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
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Osmonov D, Ragheb AM, Petry T, Eraky A, Bettocchi C, Lamers KG, Van Renterghem K, Tropmann-Frick M, Chung E, Jünemann KP, Garaffa G, Porst H, Mohamed AG, Wilson SK. Value of prolonged scrotal drainage after penile prosthesis implantation: a multicenter prospective nonrandomized pilot study. Int J Impot Res 2023:10.1038/s41443-023-00710-8. [PMID: 37169878 DOI: 10.1038/s41443-023-00710-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 04/18/2023] [Accepted: 04/20/2023] [Indexed: 05/13/2023]
Abstract
We aimed to understand the risks and benefits of post-inflatable penile prosthesis (IPP) implantation drainage and optimal duration. Our patients were divided into 3 groups: Group 1 (n = 114) had no drain placed, Group 2 had a drain placed for 24 h (n = 114) and Group 3 had a drain placed for 72 h (n = 117). Postoperative scrotal hematoma and prosthesis infection rates were compared between the groups. The patients from Group 3 demonstrated a statistically significant lower incidence of hematoma on the 10th postoperative day: (n = 1, 0.9%) compared to Group 2: (n = 11, 9.6%) and Group 1: (n = 8, 7%), (p = 0.013). However, on the 3rd postoperative day, there was a statistically significant lower incidence of hematoma in both Groups 3 and 2: (0.9% and 6.1%, respectively) vs. Group 1: (11.4%), (p = 0.004). Hematoma rates followed the same group order after the first day of surgery: 1.7% (n = 2), 5.3% (n = 6), and 8.8% (n = 10), respectively, (p = 0.05). Five patients (4.4%) in Group 1 and four patients (3.5%) in Group 2 developed an IPP associated infection, opposed to only a single patient (0.85%) in Group 3, (p = 0.210). We concluded that prolonged scrotal drainage for 72 h after virgin IPP implantation significantly reduces hematoma and infection rates.
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Affiliation(s)
- D Osmonov
- Department of Urology and Pediatric Urology, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany.
| | - A M Ragheb
- Department of Urology and Pediatric Urology, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany
- Department of Urology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - T Petry
- Department of Urology and Pediatric Urology, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany
| | - A Eraky
- Department of Urology and Pediatric Urology, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany
| | - C Bettocchi
- Department of Emergency and Organ Transplantation, Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - K G Lamers
- Departmentof Urology, Jessa Hospital Hasselt, Hasselt, Belgium
| | | | | | - E Chung
- Princess Alexandra Hospital Southside Clinical Unit, Faculty of Medicine, Woolloongabba, QLD, Australia
| | - K P Jünemann
- Department of Urology and Pediatric Urology, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany
| | - G Garaffa
- Andrologia Internazionale, Rome, Italy
| | - H Porst
- European Institute for Sexual Health (EIHS), Hamburg, Germany
| | - A G Mohamed
- Department of Urology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - S K Wilson
- Instutute of Urologic Excellence, La Quinta, CA, USA
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7
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Micallef D, Wightman S, Naqi M, Modgil V, Pearce I. Is the infrapubic approach a safe option for patients with poorly controlled diabetes mellitus and obesity undergoing inflatable penile prosthesis surgery? JOURNAL OF CLINICAL UROLOGY 2022. [DOI: 10.1177/20514158221136351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Objective: Inflatable penile prosthesis (IPP) surgery is an effective treatment for patients with erectile dysfunction (ED). The two most used surgical approaches are infrapubic (IP) and penoscrotal (PS). Concerns exist whether raised Body Mass Index (BMI) or poor glycaemic control negatively affect outcome. We conducted a retrospective review of 50 consecutive virgin IP IPP cases investigating the effect of BMI and glycaemic control on post-operative complications and implant utilisation. Patients and Methods: Data collected included demographics, ED aetiology and risk factors, diabetic status, HbA1c and post-operative complications focusing on infection and re-operation. Telephone survey provided implant usage at 3, 6, 12 and 24 months post-operatively. All patients followed the same pre-, peri- and post-operative pathway, including antibiotic prophylaxis and implant preparation. Results: Complication rates of patients with BMI ⩾ 30 (2/20; 10%) and BMI < 30 (0/28, 0%) ( p = 0.169) and of patients with poorly controlled diabetes mellitus (DM), HbA1c > 69 mmol/mol (0/6, 0%) versus HbA1c ⩽ 69 (2/21, 9.52%) ( p = 1) were not significantly different. Two patients reported complications. Implant utilisation did not differ significantly between low or high BMI and HbA1c cohorts. Conclusion: Our study shows pre-operative HbA1c and BMI do not significantly impact complication rates or implant utilisation in patients undergoing IP IPP insertion. Level of Evidence: 2b
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Affiliation(s)
- Dariush Micallef
- Manchester Royal Infirmary, Manchester University NHS Foundation Trust, UK
| | - Stuart Wightman
- Manchester Royal Infirmary, Manchester University NHS Foundation Trust, UK
| | - Muhammad Naqi
- Manchester Royal Infirmary, Manchester University NHS Foundation Trust, UK
| | - Vaibhav Modgil
- Manchester Royal Infirmary, Manchester University NHS Foundation Trust, UK
| | - Ian Pearce
- Manchester Royal Infirmary, Manchester University NHS Foundation Trust, UK
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8
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Di Pierro GB, Lemma A, Di Lascio G, El Motassime A, Grande P, Di Giulio I, Salciccia S, Maggi M, Antonini G, De Berardinis E, Cristini C, Sciarra A. Primary versus revision implant for inflatable penile prosthesis: A propensity score-matched comparison. Andrologia 2021; 53:e14240. [PMID: 34498769 PMCID: PMC9285038 DOI: 10.1111/and.14240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/27/2021] [Accepted: 08/27/2021] [Indexed: 11/28/2022] Open
Abstract
Inflatable penile prosthesis (IPP) provides excellent outcomes after virgin implants. However, few data on IPP after revision surgery are available. This study aimed at comparing the outcomes of IPP in patients undergoing primary or revision implant surgery. Patients who underwent revision implant surgery (Group 1) between 2013 and 2020 were identified. Overall, 20 patients (Group 1) could be matched with a contemporary matched pair cohort of surgery‐naive patients (Group 2) in a 1:1 ratio. Patients in Group 2 had a significantly shorter operative time [median (IQR): 84 (65–97) vs. 65 (51–75) min; p = .01] and lower rate of overall complications (25% vs. 10%; p = .01). Of note, mean (SD) scores for the Quality of Life and Sexuality with Penile Prosthesis (QoLSPP) questionnaire demonstrated high satisfaction and IPP efficacy in both Groups 1 and 2: functional domain [3.9 (1.0) vs. 4.0 (1.2); p = .4], personal [3.9 (1.1) vs. 4.0 (1.1); p = .3], relational [3.8 (1.3) vs. 3.9 (1.1); p = .5] and social [3.9 (1.1) vs. 4.0 (1.2); p = .2]. These results suggest that in experienced hands, IPP offers high satisfaction to both patients and partners even in the setting of revision implant. However, it is mandatory to inform those patients about the increased risk of perioperative complications.
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Affiliation(s)
| | - Andrea Lemma
- Department of Maternal and Child Health and Urological Sciences, 'Sapienza' University, Rome, Italy
| | - Giovanni Di Lascio
- Department of Maternal and Child Health and Urological Sciences, 'Sapienza' University, Rome, Italy
| | - Alessandro El Motassime
- Department of Maternal and Child Health and Urological Sciences, 'Sapienza' University, Rome, Italy
| | - Pietro Grande
- Department of Maternal and Child Health and Urological Sciences, 'Sapienza' University, Rome, Italy
| | - Ivan Di Giulio
- Department of Maternal and Child Health and Urological Sciences, 'Sapienza' University, Rome, Italy
| | - Stefano Salciccia
- Department of Maternal and Child Health and Urological Sciences, 'Sapienza' University, Rome, Italy
| | - Martina Maggi
- Department of Maternal and Child Health and Urological Sciences, 'Sapienza' University, Rome, Italy
| | - Gabriele Antonini
- Department of Maternal and Child Health and Urological Sciences, 'Sapienza' University, Rome, Italy
| | - Ettore De Berardinis
- Department of Maternal and Child Health and Urological Sciences, 'Sapienza' University, Rome, Italy
| | - Cristiano Cristini
- Department of Maternal and Child Health and Urological Sciences, 'Sapienza' University, Rome, Italy
| | - Alessandro Sciarra
- Department of Maternal and Child Health and Urological Sciences, 'Sapienza' University, Rome, Italy
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9
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Topuz B, Ebiloğlu T, Zor M, Kaya E, Sarıkaya S, Emrah Coğuplugil A, Gürdal M, Bedir S. Penile prosthesis implantation: A single center 25 years of experience. Prog Urol 2021; 31:663-670. [PMID: 34215514 DOI: 10.1016/j.purol.2021.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/10/2021] [Accepted: 06/09/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES We analyzed the long-term results of malleable and inflatable penile prosthesis: the rates of complications, revision surgery and patient satisfaction. MATERIALS AND METHODS Between January 1996 and December 2020, a total of 138 patients underwent implantation of a malleable or inflatable types penile prosthesis. The data of the patients were derived from the patient files and digital recording system. The patients were contacted face-to-face interaction if possible. If it is not possible, phone connection was made. RESULTS The median age of patients was 56 (21-83) years. Fourteen (10.2%) 1-piece, 46 (33.3%) 2-piece and 78 (56.5%) 3-piece penile prosthesis were implanted. The mostly used perioperative antibiotic was teicoplanin+amikacin in 107 patients. Total complication rate was 30% (n=42). Prosthesis infection constituted 9% (n=13) of these complications. The total satisfaction rate was 89.1%. There was no correlation between the complications and antibiotic regimen or prosthesis type (P=0.488, P=0.454, respectively). The rate of infection showed a slight increase in 3-piece penile prosthesis without any statistically significance (P=0.633). The patients with complications expressed more dissatisfaction compared to those without complications (P=0.001). CONCLUSIONS In our series, penile prosthesis implantation seems to be a recommended treatment method with high patient satisfaction in the treatment of refractory erectile dysfunction. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- B Topuz
- Gülhane Training and Research Hospital, Department of Urology, 06010 Etlik, Ankara, Turkey.
| | - T Ebiloğlu
- Gülhane Training and Research Hospital, Department of Urology, 06010 Etlik, Ankara, Turkey
| | - M Zor
- Gülhane Training and Research Hospital, Department of Urology, 06010 Etlik, Ankara, Turkey
| | - E Kaya
- Gülhane Training and Research Hospital, Department of Urology, 06010 Etlik, Ankara, Turkey
| | - S Sarıkaya
- Gülhane Training and Research Hospital, Department of Urology, 06010 Etlik, Ankara, Turkey
| | - A Emrah Coğuplugil
- Gülhane Training and Research Hospital, Department of Urology, 06010 Etlik, Ankara, Turkey
| | - M Gürdal
- Gülhane Training and Research Hospital, Department of Urology, 06010 Etlik, Ankara, Turkey
| | - S Bedir
- Gülhane Training and Research Hospital, Department of Urology, 06010 Etlik, Ankara, Turkey
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10
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Manfredi C, Fortier É, Faix A, Martínez-Salamanca JI. Penile Implant Surgery Satisfaction Assessment. J Sex Med 2021; 18:868-874. [PMID: 33903044 DOI: 10.1016/j.jsxm.2021.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/01/2021] [Accepted: 03/05/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Several studies reported high satisfaction rates (> 90%) for patients and their partners after penile prosthesis (PP) implantation. AIM To describe and critically discuss the current evidence regarding the assessment of patient and partner satisfaction after penile implant surgery. METHODS A critical narrative review of the studies investigating the patient and partner satisfaction after PP implantation was designed. Papers in English-language published until January 2021 were included. OUTCOMES The main outcome investigated was patient and partner satisfaction after penile implant surgery. RESULTS The International Index of Erectile Function , the Erectile Dysfunction Inventory of Treatment Satisfaction , the Treatment Satisfaction Scale , and the Quality of Life and Sexuality with Penile Prosthesis are the best-known validated tools used to assess satisfaction after PP implantation. Except for Quality of Life and Sexuality with Penile Prosthesis , they were not validated in patients undergoing penile implant surgery. The lack of an "ad hoc" tool has led to the widespread of nonvalidated questionnaires. Several tools can be useful in the preimplantation counseling, such as the mnemonic Compulsive/obsessive, Unrealistic, Revision, Surgeon Shopping, Entitled, Denial, and Psychiatric , the Minnesota Multiphasic Personality Inventory, the Brief Sexual Symptom Checklist for Men , the Attitude towards Penile Implant , and the Attitude Attributed to the Partner towards Penile Implant . CLINICAL IMPLICATIONS Improvement of knowledge regarding the available tools to evaluate the satisfaction after penile implant surgery. STRENGTHS & LIMITATIONS Comprehensive and thorough review of all the main validated questionnaires available to assess satisfaction in patients with PP. Lack of a systematic approach and quantitative data analysis. CONCLUSION Despite the high satisfaction rate reported in the literature, most of the studies used suboptimal or non-validated questionnaires to assess patients undergoing penile implant surgery. Future research is needed to develop and validate a specific, complete and easy-to-use questionnaire. Manfredi C, Fortier É, Faix A, et al. Penile Implant Surgery Satisfaction Assessment. J Sex Med 2021;18:868-874.
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Affiliation(s)
- Celeste Manfredi
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Édouard Fortier
- Department of Urology, Montpellier University Hospital, Montpellier, France
| | - Antoine Faix
- Centre de sexologie et andrologie de la Méditerranée (CESAME), Montpellier, France; Men's Health International Surgical Center (MHISC), Genolier, Switzerland.
| | - Juan Ignacio Martínez-Salamanca
- Department of Urology, Puerta de Hierro-Majadahonda University Hospital, Madrid, Spain; Lyx Institute of Urology, Universidad Francisco de Vitoria, Madrid, Spain
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11
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Frydman V, Pinar U, Abdessater M, Akakpo W, Grande P, Audouin M, Mozer P, Chartier-Kastler E, Seisen T, Roupret M. Long-term outcomes after penile prosthesis placement for the Management of Erectile Dysfunction: a single-Centre experience. Basic Clin Androl 2021; 31:4. [PMID: 33658014 PMCID: PMC7931532 DOI: 10.1186/s12610-021-00123-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 01/18/2021] [Indexed: 11/11/2022] Open
Abstract
Background Penile prothesis (PP) is the gold-standard treatment of drug-refractory erectile dysfunction (ED). While postoperative outcomes have been widely described in the literature, there are few data about patient satisfaction and intraoperative events. We aimed to assess long-term patient satisfaction and perioperative outcomes after PP implantation in a single-centre cohort of unselected patients using validated scales. Results A total of 130 patients received a PP (median age: 62.5 years [IQR: 58–69]; median International Index of Erectile Function (IEEF-5) score: 6 [IQR: 5–7]). Median follow-up was 6.3 years [IQR: 4–9.4]. Thirty-two (24.6%) patients underwent surgical revision, of which 20 were PP removals (15.4%). Global PP survival rate was 84.6% and previous PP placement was a risk factor for PP removal (p = 0.02). There were six (4.6%) non-life-threatening intraoperative events including two which resulted in non-placement of a PP (1.5%). EAUiaic grade was 0 for 124 procedures (95.4%), 1 for four procedures (3.1%) and 2 for two procedures (1.5%). Of patients who still had their PP at the end of the study, 91 (80.5%) expressed satisfaction. Conclusions PP implantation is a last-resort treatment for ED with a satisfactory outcome. PPs are well accepted by patients.
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Affiliation(s)
- Valentine Frydman
- Department of Urology, Sorbonne Université, GRC n 5, Predictive Onco-Urology, APHP, Hôpital Pitié-Salpêtrière, F-75013, Paris, France
| | - Ugo Pinar
- Department of Urology, Sorbonne Université, GRC n 5, Predictive Onco-Urology, APHP, Hôpital Pitié-Salpêtrière, F-75013, Paris, France
| | - Maher Abdessater
- Department of Urology, Sorbonne Université, GRC n 5, Predictive Onco-Urology, APHP, Hôpital Pitié-Salpêtrière, F-75013, Paris, France
| | - William Akakpo
- Department of Urology, Sorbonne Université, APHP, Hôpitaux universitaires Pitié-Salpêtrière-Charles Foix, F-75013, Paris, France
| | - Pietro Grande
- Department of Urology, Sorbonne Université, APHP, Hôpitaux universitaires Pitié-Salpêtrière-Charles Foix, F-75013, Paris, France
| | - Marie Audouin
- Department of Urology, Sorbonne Université, APHP, Hôpital Tenon, F-75013, Paris, France
| | - Pierre Mozer
- Department of Urology, Sorbonne Université, APHP, Hôpitaux universitaires Pitié-Salpêtrière-Charles Foix, F-75013, Paris, France
| | - Emmanuel Chartier-Kastler
- Department of Urology, Sorbonne Université, APHP, Hôpitaux universitaires Pitié-Salpêtrière-Charles Foix, F-75013, Paris, France
| | - Thomas Seisen
- Department of Urology, Sorbonne Université, GRC n 5, Predictive Onco-Urology, APHP, Hôpital Pitié-Salpêtrière, F-75013, Paris, France
| | - Morgan Roupret
- Department of Urology, Sorbonne Université, GRC n 5, Predictive Onco-Urology, APHP, Hôpital Pitié-Salpêtrière, F-75013, Paris, France.
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Van Dyke M, Baumgarten AS, Ortiz N, Hudak SJ, Morey AF. State of the Reservoir: Current Concepts of Penile Implant Reservoir Placement and Potential Complications. Curr Urol Rep 2021; 22:20. [DOI: 10.1007/s11934-021-01041-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2021] [Indexed: 12/14/2022]
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13
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The good, the bad, and the ugly about surgical approaches for inflatable penile prosthesis implantation. Int J Impot Res 2020; 34:128-137. [DOI: 10.1038/s41443-020-0319-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/04/2020] [Accepted: 05/20/2020] [Indexed: 12/30/2022]
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14
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Infrapubic surgical approach for penile prosthesis surgery: Indications and technique. Actas Urol Esp 2020; 44:301-308. [PMID: 32115278 DOI: 10.1016/j.acuro.2019.10.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 10/28/2019] [Indexed: 12/25/2022]
Abstract
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. ACQUISITION AND SYNTHESIS OF THE EVIDENCE A literature review from 1983 until current date was carried out in Medline (PubMed and Cochrane Library databases) following PRISMA standards. Sixteen studies were included: 4 prospective, 4 retrospective, one systematic review, one randomized trial, one original article, 5 expert opinion/surgical technique descriptive paper. DISCUSSION According to the literature reviewed, although the penoscrotal approach is the most applied, the infrapubic approach showed a shorter operative time and a tendency for an earlier recovery of sexual activity after surgery. Complications are rare, having similar rates to the penoscrotal approach; no cases of glans hypoesthesia have been reported and peri-prosthetic infection rates were less than 3%. Satisfaction rates of infrapubic penile prosthesis were higher than 80%. CONCLUSIONS Penile prosthesis implantation requires of a profound knowledge of the different surgical approaches in order to best adapt each technique based on each individualized case. The infrapubic approach, even if it is not the most used, is as feasible and reliable as the penoscrotal approach. The infrapubic approach is effective and safe, with high level of both, patients and partners' satisfaction.
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15
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Jayadevan R, Eleswarapu SV, Mills JN. Infrapubic approach for placement of inflatable penile prosthesis: contemporary review of technique and implications. Int J Impot Res 2019; 32:10-17. [PMID: 31537910 DOI: 10.1038/s41443-019-0193-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 05/31/2019] [Accepted: 07/10/2019] [Indexed: 11/09/2022]
Abstract
Inflatable penile prosthesis (IPP) is an effective treatment for erectile dysfunction refractory to nonsurgical management. The infrapubic approach for IPP placement is less frequently employed than the penoscrotal approach, with only about 25% of IPPs placed via this method. Underutilization of the infrapubic method may be due to fear of injuring the penile dorsal neurovascular bundle, perceived difficulties of scrotal pump placement through a distant location, or insufficient distal corporal exposure. However, this approach appears to result in favorable operative times, faster time to device activation, equivalent postoperative satisfaction and quality of life, and similar complication rates. We provide a contemporary review of literature published before May 2019 regarding the infrapubic approach for IPP placement, technical considerations, and postoperative expectations.
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Affiliation(s)
- Rajiv Jayadevan
- Department of Urology, University of California, Los Angeles, CA, USA
| | | | - Jesse N Mills
- Department of Urology, University of California, Los Angeles, CA, USA.
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Chierigo F, Capogrosso P, Dehò F, Pozzi E, Schifano N, Belladelli F, Montorsi F, Salonia A. Long-Term Follow-Up After Penile Prosthesis Implantation-Survival and Quality of Life Outcomes. J Sex Med 2019; 16:1827-1833. [PMID: 31501062 DOI: 10.1016/j.jsxm.2019.08.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 07/29/2019] [Accepted: 08/04/2019] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Hydraulic penile prostheses have shown an overall good mechanical reliability up to 10 years after surgery; however, few data have been published on very long-term follow-up. AIM We looked at long-term (≥15 years) complications, including functional and quality of life (QoL) outcomes, after 3-piece inflatable penile prosthesis (IPP) implantation in patients with erectile dysfunction (ED). METHODS Data regarding 149 patients submitting to IPP placement before 2001 were analyzed. All patients were implanted with AMS CX and Ultrex Plus 3-piece prostheses. MAIN OUTCOME MEASURE Patients were reassessed to evaluate rates of complications and functional outcomes. The validated questionnaire Quality of Life and Sexuality with Penile Prosthesis (QoLSPP) was used to assess patient QoL. Kaplan-Meier analysis estimated the probability of prosthesis survival (defined as working device/not-explanted). RESULTS Median follow-up of 51 patients was 206 months (interquartile range [IQR], 145-257). The etiology of ED was vasculogenic (n = 20; 39%), Peyronie's disease (n = 15; 29%), pelvic surgery (n = 4; 7.8%), organic other than vasculogenic (n = 3; 5.9%), or other (n = 9; 18%). Throughout the follow-up, 24 patients (49%) experienced complications: mechanical failure (n = 19; 79%), pain (n = 3; 12%), orgasmic dysfunctions (n = 1; 4.5%), or device infection (n = 1; 4.5%). The estimated IPP survival was 53% (95% CI, 36-67) at 20-year follow-up. Baseline characteristics (age, Charlson comorbidity index, body mass index, and erectile dysfunction etiology) were not significantly associated with the risk of IPP failure over time by Cox regression analysis. At 20-year follow-up, 41% (95% CI, 19-49) of the patients were still using the device. Among them, QoLSPP median domain scores were high: functional 22/25 (IQR, 20-23), relational 17/20 (IQR, 15-18), personal 14/15 (IQR, 12-15), and social 14/15 (IQR, 11-15). CLINICAL IMPLICATIONS The longevity of the device and long-term satisfaction rates should be comprehensively discussed during patient consultation for IPP surgery. STRENGTHS & LIMITATIONS To our knowledge, this is the first study reporting long-term QoL outcomes using a dedicated questionnaire for penile prostheses. The low response rate for the telephone interviews, the retrospective design of the study, and the relatively small number of patients are the main limitations. CONCLUSION Long-term follow-up data after IPP placement showed that almost half of the devices still worked properly 20 years after the original penile implant, as 60% of patients were still using the device with high satisfaction and adequate QoL outcomes. Both patients and physicians should be aware of the expected life and outcomes of IPP implants. Chierigo F, Capogrosso P, Dehò, et al. Long-Term Follow-Up After Penile Prosthesis Implantation-Survival and Quality of Life Outcomes. J Sex Med 2019;16:1827-1833.
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Affiliation(s)
- Francesco Chierigo
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Paolo Capogrosso
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Federico Dehò
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Edoardo Pozzi
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy
| | - Nicolò Schifano
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Federico Belladelli
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy
| | - Francesco Montorsi
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy.
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