Immediate sexual rehabilitation by simultaneous placement of penile prosthesis in patients undergoing radical prostatectomy: initial results in 50 patients

OBJECTIVES

To evaluate the results of simultaneous placement of a penile prosthesis with radical prostatectomy.

METHODS

From June 1993 to June 1996, 50 men underwent a combination procedure of non-nerve sparing radical retropubic prostatectomy and placement of a penile prosthesis. We performed a retrospective chart review of these patients, examining patient age, preoperative prostate-specific antigen level, Gleason score, operative time, estimated blood loss, analgesic use, length of hospital stay, time until intercourse, and complications. This group was compared with a group of 72 men undergoing radical prostatectomy alone during the same time interval.

RESULTS

No significant differences were noted in preoperative patient variables. The mean operative time for prosthesis insertion was 82 minutes, and the mean time to sexual intercourse was 12.7 weeks. No prosthesis infections have occurred, with a mean follow-up of 1.7 years. Four men (8%) have required revision of their inflatable penile prosthesis. There were no significant differences between the combination procedure and radical prostatectomy alone with regard to estimated blood loss, length of hospital stay, or analgesic use.

CONCLUSIONS

Simultaneous placement of a penile prosthesis during radical prostatectomy provides early return to sexual function, with no apparent increase in morbidity. Further study will be required to determine the impact of combination surgery on psychosocial adjustment and quality of life.

Design considerations in penile prostheses: the American Medical Systems product line

Penile prostheses represent an important treatment modality for erectile dysfunction. A review of the design considerations for penile prostheses is presented, using the American Medical Systems, Inc., product line as a practical example. Current models include both inflatable hydraulic and solid malleable designs. The challenge for the future is to develop devices with improved durability while optimizing ease of use and cosmetic appearance.

Urothelial extension of Wilms tumor presenting as a prolapsing urethral mass

We report a unique case of Wilms tumor presenting as a urethral mass in a patient with bilateral ureteral duplication. The prolapsing urothelial component was contiguous with the intrarenal Wilms tumor and consisted of fetal skeletal muscle free of blastemal or tubular elements.

Instrumentation and separation results of medium pressure liquid chromatography

This paper describes the assembly, usage, operation, and separation results of a medium pressure liquid chromatography (MPLC) instrument. Its ability to separate compounds with high resolution makes it a powerful tool for many chemistry laboratories. This equipment can be easily built from inexpensive commercially available materials. Due to the constant reuse of packing materials and infrequent maintenance, MPLC provides a simple, reliable, and economical means of purification.