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Habous M, Khattak A, Farag M, Binsaleh S, Ralph D, Aziz M, Bettocchi C, Muir G. Investigating the risk factors of penile arterial insufficiency and veno-occlusive dysfunction in patients with erectile dysfunction. BJUI Compass 2024; 5:34-41. [PMID: 38179020 PMCID: PMC10764169 DOI: 10.1002/bco2.275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 06/20/2023] [Accepted: 07/10/2023] [Indexed: 01/06/2024] Open
Abstract
Objective To investigate the risk factors for penile arterial insufficiency (PAI), which is a known cause of erectile dysfunction (ED). Methods Patients who attended our urology clinic complaining of ED for more than 6 months were prospectively enrolled in this study over 1-year period. Patient consent was taken and ethical committee approval. Complete medical history and thorough general and local examination including body mass index (BMI), Peyronie's disease (PD) and penile size measurements (length and girth) were done for all of them. Laboratory tests included testosterone, lipid profile and glycated haemoglobin (HA1c). A penile duplex ultrasound study (PDU) was done for all patients after intracavernosal injection (ICI) with alprostadil. Peak systolic velocity (PSV) and end-diastolic velocity (EDV) were measured after 15 min. Statistical analysis was done using SPSS. Results A total of 440 patients were enrolled in this analysis. The mean age was 48(23-81), and the mean BMI was 30 (18-51). Older patients had lower PSV (r = -0.361, P = 0.000) and higher EDV (r = 0.174, P = 0.001), and both correlations were highly statistically significant. Diabetics had lower PSV (r = -0.318, P = 0.000) and higher EDV (r = 0.139, P = 0.008), which were also highly statistically significant. Smokers had lower PSV (r = -0.140, P = 0.008) and higher EDV (r = 0.178, P = 0.001), which were highly statistically significant. Men with larger penises measured skin to tip had lower EDV (r = -0.119, P = 0.024), which was less significant. Interestingly, there was neither a significant correlation between BMI and PSV (0.16, P = 0.745) nor a significant correlation between testosterone and PSV (0.029, P = 0.552). Also, there was no correlation between PSV and both dyslipidaemia and penile PD. Conclusions Ageing, tobacco consumption, DM and hypertension seem to have a negative impact on penile haemodynamics, which was statistically significant. In our patients, there was no statistically significant effect on penile haemodynamics in patients with increased BMI, low testosterone or PD or according to the size of the penis.
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Affiliation(s)
| | | | - Mohammed Farag
- Urology DepartmentAzhar University, Assiut BranchAssiutEgypt
| | - Saleh Binsaleh
- Division of Urology, Department of Surgery, Faculty of MedicineKing Saud UniversityRiyadhSaudi Arabia
| | - David Ralph
- St. Peters Institute of Andrology, UCLHLondonUK
| | - Mohammed Aziz
- Urology DepartmentMenofia UniversityShibin Al KawmEgypt
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Almannie R, Alzahrani MA, Almuhaideb M, Abunohaiah I, Habous M, Binsaleh S. Recreational use of oral erectile dysfunction medications among male physicians - A cross-sectional study. Urol Ann 2023; 15:148-157. [PMID: 37304517 PMCID: PMC10252768 DOI: 10.4103/ua.ua_33_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/13/2022] [Accepted: 04/19/2022] [Indexed: 06/13/2023] Open
Abstract
Introduction Erectile dysfunction (ED) is defined as the persistent inability to attain and maintain an erection sufficient to permit satisfactory sexual performance. Bypassing health-care providers and obtaining ED medications (EDM) without a prescription are an issue that is faced globally. Aim We attempt to assess erectile function (EF) among a local sample of physicians, the psychological effects of recreational EDM use, and compare EF among different user groups. Methods This is a cross-sectional study done solely on physicians in Saudi Arabia. A self-designed questionnaire including demographics, sexual characteristics, use of ED medication, sexual satisfaction, and the validated international index of EF (IIEF). Outcome Physicians misused EDM. Results A total of 503 physicians completed the questionnaire. Among participants reporting sexual problems, only 23% received counseling and 3.4% were professionally diagnosed with ED. Among users, 71.2% were using EDM recreationally, 14.4% prophylactically, and 14.4% were prescribed. Participants aged 20-29 IIEF-5 score was significantly lower than participants aged 30-39 years. Prescribed users had a lower IIEF-5 score compared to both recreational users and nonusers. Clinical Implications Many healthy sexually active men use EDMs recreationally to increase sexual performance. Strengths and Limitations One of the limitations of our study is that we did not use standardized tools to determine the diagnosis of some important disorders like premature ejaculation. Our study strengths include the very high response rate, with our results truly showing a nationwide self-assessment of sexual dysfunction. Conclusion Recreational use of oral EDMs may adversely impact the psychological aspects of sexual function. In our study, physicians misused EDM. We recommend labeling EDMs as restricted medication that requires a prescription to use by a licensed physician.
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Affiliation(s)
- Raed Almannie
- Department of Surgery, Division of Urology, College of Medicine, King Saud University, King Saud University Medical City, Saudi Arabia
| | - Meshari A Alzahrani
- Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Mana Almuhaideb
- Department of Surgery, Division of Urology, College of Medicine, King Saud University, King Saud University Medical City, Saudi Arabia
| | - Ibrahim Abunohaiah
- Department of Surgery, Division of Urology, College of Medicine, King Saud University, King Saud University Medical City, Saudi Arabia
| | - Mohamad Habous
- Urology Unit, Al-Themal Medical Center, Abha, Saudi Arabia
| | - Saleh Binsaleh
- Department of Surgery, Division of Urology, College of Medicine, King Saud University, King Saud University Medical City, Saudi Arabia
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Habous M, Omar M, Farag M, Abdelwahab O, Laban O, Binsaleh S, Mulhall JP, Ralph D, Aziz M. Malleable Penile Implant Rod Diameter Predicts Complications and Patient Satisfaction. Sex Med 2022; 10:100486. [PMID: 35217441 PMCID: PMC9023239 DOI: 10.1016/j.esxm.2021.100486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 12/24/2021] [Indexed: 12/03/2022] Open
Abstract
Background One of the most common complaints after malleable prosthesis implantation (MPI) is thinning of the penis and decreasing girth. Some surgeons try to insert the largest diameter they can to improve patient satisfaction Aim To investigate if malleable rod diameter (MRD) has an impact on outcome and patient satisfaction Methods Consecutive malleable prosthesis implantation (MPI) was assessed in a high-volume center over 1 year. The same preoperative, intraoperative, and postoperative protocols were used for all patients and one brand of the malleable device was used only. We recorded MRD and length for all patients. All patients had data on comorbidities including glycated hemoglobin (HbA1c) and clinical Peyronie's disease (PD). Revision cases and those who lost for follow-up were excluded from the study. We also excluded patients operated on by low-volume surgeons. All complications, minor (edema, ecchymosis, pain), and major (infection and erosion) were recorded. After 1-year, patients were assessed and given a Likert scale from 1 to 5 where 5 is most satisfied with their MPI. We stratified patients according to MRD into 2 groups: group A for diameter 9.5 and 11 mm and group B for 13 mm. Outcome : Larger diameter of malleable penile implants may be associated with more complications Results 183 patients had full data and filled the questionnaire after 1-year follow-up. All patients had Coloplast, Genesis penile implants. Major complications rate (infection, erosion, and removal) was significantly higher in group B 11% vs 1.2% in group A (P = .016). At 4 weeks postoperative visit, 90 % of group A showed no complications vs 60% only in group B that was statistically significant (P = .0003). Satisfaction rate was more in patients in group A (88.6%) compared to patients in group B (75.7%) but this did not reach to be statistically significant (P = .0519) Clinical Implications MRD predicts outcome. Strengths & Limitations The strengths of our study include that it is the first prospective study with good number of malleable implants. Limitations include: no validated satisfaction instrument and MRD choice was based on surgeon preference. Conclusions Larger diameter of malleable penile implants are not associated with a higher rate of patient satisfaction Habous M, Omar M, Farag M et al. Malleable Penile Implant Rod Diameter Predicts Complications and Patient Satisfaction. Sex Med 2022;10:100486.
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Affiliation(s)
| | | | - Mohammed Farag
- Urology Department, Azhar University, Assuit Branch, Egypt
| | | | - Osama Laban
- Urology Department, King Fahad Hospital, Tabuk, Saudi Arabia
| | - Saleh Binsaleh
- Division of Urology, Department of Surgery, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - John P Mulhall
- Sexual & Reproductive Medicine, Memorial Sloan Kettering Cancer Center, New York City, NY, USA
| | - David Ralph
- St. Peters Institute of Andrology, University College London Hospital, London, UK
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Bettocchi C, Santoro V, Sebastiani F, Lucarelli G, Colombo F, Ralph DJ, Habous M, Ditonno P, Battaglia M, Spilotros M. Management of severe complications following penile surgery for erectile dysfunction and Peyronie disease: Three case reports. Medicine (Baltimore) 2020; 99:e18690. [PMID: 32049780 PMCID: PMC7035019 DOI: 10.1097/md.0000000000018690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
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. PATIENTS' CONCERNS The first case describes a patient with history of ED and PD causing penile shortening and a slight dorsal deviation of penile shaft. In the second case it is described a corporeal necrosis and urethral fistula following inflatable penile prosthesis implant. In the last case it is described the migration of reservoir into the abdomen after inflatable penile prosthesis implantation post-radical prostatectomy. DIAGNOSIS All 3 patients were investigated with a penile doppler ultrasound with PGE1 intracorporeal injection for ED and PD diagnosis. An abdominal computed tomography scan and magnetic resonance imaging were ordered for patient of case three. INTERVENTIONS The patients underwent different combined procedures depending on the case and including: glansectomy, penile prosthesis implantation associated with a penile elongation with double dorsal-ventral patch graft ("sliding technique"), penile urethroplasty with buccal mucosa graft, and laparotomy for reservoir removal. OUTCOMES No further serious complications were reported after the procedures described. LESSONS Penile surgery in patients with concomitant PD and systemic comorbidities can be at high risk of complications. As shown in this series there are possible dramatic evolution of these complications that may cause irreversible consequences to the patient. For this reason, a dedicated surgical and nursing team is necessary to reduce the chances that it happens. When this event occurs, a team trained in their management can improve the patient outcome.
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Affiliation(s)
- Carlo Bettocchi
- Division of Urology, Department of Emergency and Organ Transplantation, University of Bari, Bari
| | - Valeria Santoro
- Division of Urology, Department of Emergency and Organ Transplantation, University of Bari, Bari
| | - Francesco Sebastiani
- Division of Urology, Department of Emergency and Organ Transplantation, University of Bari, Bari
| | - Giuseppe Lucarelli
- Division of Urology, Department of Emergency and Organ Transplantation, University of Bari, Bari
| | - Fulvio Colombo
- Department of Urology, Sant’Orsola Hospital - University of Bologna, Bologna, Italy
| | - David John Ralph
- The Institute of Urology, University College London Hospitals, London, UK
| | - Mohamad Habous
- Department of Urology and Andrology, Elaj Medical Center, Jeddah, Saudi Arabia
| | - Pasquale Ditonno
- Division of Urology, Department of Emergency and Organ Transplantation, University of Bari, Bari
| | - Michele Battaglia
- Division of Urology, Department of Emergency and Organ Transplantation, University of Bari, Bari
| | - Marco Spilotros
- Division of Urology, Department of Emergency and Organ Transplantation, University of Bari, Bari
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Habous M, Teloken P, Abdelwahab O, Binsaleh S, Bettocchi C, Ralph D, Kamil U, Mulhall J. PS-07-013 Larger rod diameters in malleable implant surgery are correlated with more complications and less patient satisfaction. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Hariri A, Abbarh S, Ameen A, Sabra A, Salman A, Alhulaimi Y, Aabed M, Habous M, Madbouly K, Binsaleh S. Prevalence and awareness of varicocele among athletes in Riyadh, Saudi Arabia. Res Rep Urol 2019; 11:21-27. [PMID: 30859094 PMCID: PMC6386205 DOI: 10.2147/rru.s195582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the prevalence and awareness about symptoms, and complications of varicocele among athletes (bodybuilding and aerobics exercises) in Riyadh, Saudi Arabia. Patients and methods A cross-sectional study of male athletes aged between 18 and 48 years old was carried out in multiple branches of fitness centers over a period of 13 months in Riyadh, Saudi Arabia. A total of 382 face-to-face interviews using a predesigned questionnaire were conducted to identify the levels of knowledge, attitude, and practice. A randomly selected 48 subjects were examined. Varicocele was diagnosed and graded based on clinical examination and Doppler ultrasonography. Results Of the participants, 157 (41%) lacked knowledge and awareness regarding varicocele, its symptoms and complications. Of the examined participants, 22 (46%) were found to have varicocele. No difference in varicocele was found among bodybuilders and aerobic athletes (P=0.249). Similarly, no difference was related to duration of exercise session whether for 1 hour or more (P=0.131). However, our study revealed a higher rate of varicocele among athletes who exercised more than three times per week (P=0.009). Testicular volume was neither significantly different among respondents with and without varicocele nor between the left or right sides within each group. Conclusion Knowledge about varicocele, its symptoms and complications is poor among male athletes in Riyadh, Saudi Arabia. Varicocele is more common in athletic men who are frequently exercising. Efforts to increase knowledge and enhance awareness of varicocele in young males, in general, are strongly warranted.
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Affiliation(s)
- Albara Hariri
- Faculty of Medicine, Al-Maarefa University, Riyadh, Saudi Arabia
| | - Shahem Abbarh
- Faculty of Medicine, Al-Maarefa University, Riyadh, Saudi Arabia
| | - Aref Ameen
- Faculty of Medicine, Al-Maarefa University, Riyadh, Saudi Arabia
| | - Ahmad Sabra
- Faculty of Medicine, Al-Maarefa University, Riyadh, Saudi Arabia
| | - Ahmad Salman
- Faculty of Medicine, Al-Maarefa University, Riyadh, Saudi Arabia
| | - Yaser Alhulaimi
- Faculty of Medicine, Al-Maarefa University, Riyadh, Saudi Arabia
| | - Mahmoud Aabed
- Faculty of Medicine, Al-Maarefa University, Riyadh, Saudi Arabia
| | - Mohamad Habous
- Department of Urology and Andrology, Elaj Medical Centers, Jeddah, Saudi Arabia
| | - Khaled Madbouly
- Department of Urology, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia
| | - Saleh Binsaleh
- Division of Urology, Department of Surgery, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia,
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Habous M, Malkawi I, Han E, Farag M, Muir G, Abdelwahab O, Nassar M, Mahmoud S, Santucci R, Binsaleh S. Peyronie's Disease is common in poorly controlled diabetics but is not associated with the Metabolic Syndrome. Urol Ann 2019; 11:252-256. [PMID: 31413501 PMCID: PMC6676820 DOI: 10.4103/ua.ua_164_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Purpose: The purpose of the study is to investigate if metabolic syndrome (MS) and other comorbidities are associated with Peyronie's disease (PD). Methods: A total of 1833 patients retrospectively investigated and divided into two groups: Group A – PD patients (n = 319) and Group B – non-PD patients (n = 1303). The two groups were fully evaluated for diabetes mellitus (DM) with the glycated hemoglobin (HbA1c), hypertension (HTN), dyslipidemia (DL), obesity by measuring body mass index, total testosterone (T), penile vascular circulation measuring Peak systolic velocity (PSV) as indicator of arterial supply, end-diastolic velocity (EDV) as indicator of venous output, and finally, smoking. Results: The presence of diabetes was significantly correlated with PD (P = 0.005). Patients with diabetes had a 7% higher incidence of PD. However, patients with the highest HbA1c level of >8.5 had an increased odds ratio of 1.6 (P = 0.025, confidence interval [CI] =1.061–2.459) of having PD. Increased age was significantly correlated with PD (P = 0.025). For each year of life, the likelihood of having PD increases by an odds ratio of 1.019, or 2% per year (P = 0.001, CI = 1.004–1.027). Unexpectedly, DL (P = 0.006) and smoking (P = 0.041) were associated with lower incidences of PD. Patients with DL or smoking had a 5%–7% lower incidence of PD with an odds ratio of 0.6 (P = 0.006, CI = 0.410–0.864). HTN (P = 0.621) and the total number of comorbidities (P = 0.436) were not correlated with PD. Mean serum T values were statistically (P = 0.43) but not clinically significant among patients with Peyronie's versus patients without Peyronie's (4.62 vs. 4.38 ng/ml). Neither low PSV (Fisher's exact test P = 0.912) nor abnormal EDV (Fisher's exact test P = 0.775) was correlated with the finding of PD. Conclusions: While MS was not associated with PD, diabetes, particularly poorly controlled diabetes, was associated with an increased rate. Further research into the interaction of PD and metabolic disease is warranted.
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Affiliation(s)
- Mohamad Habous
- Department of Urology and Andrology, Elaj Medical Centers, Jeddah, Saudi Arabia
| | - Ibraheem Malkawi
- Detroit Medical Center, Michigan State University, East Lansing, Michigan, USA
| | - Esther Han
- Detroit Medical Center, Michigan State University, East Lansing, Michigan, USA
| | - Mohammed Farag
- Department of Urology, Al-Azhar Faculty of Medicine, Assiut, Egypt
| | - Gordon Muir
- Department of Urology, King's College, London, UK
| | | | - Mohammed Nassar
- Department of Urology and Andrology, Elaj Medical Centers, Jeddah, Saudi Arabia
| | - Saad Mahmoud
- Department of Urology and Andrology, Elaj Medical Centers, Jeddah, Saudi Arabia
| | - Richard Santucci
- Detroit Medical Center, Michigan State University, East Lansing, Michigan, USA
| | - Saleh Binsaleh
- Division of Urology, Department of Surgery, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
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Habous M, Giona S, Tealab A, Aziz M, Sherif H, Abdelwahab O, Binsaleh S, Ralph D, Bettocchi C, Mulhall JP, Muir G. Penile length is preserved after implant surgery. BJU Int 2018; 123:885-890. [DOI: 10.1111/bju.14604] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Mohamad Habous
- Department of Urology and Andrology; Elaj Medical Centers; Jeddah Saudi Arabia
| | | | - Alaa Tealab
- Department of Urology; Zagazig University; Zagazig Egypt
| | - Mohammed Aziz
- Department of Urology; Menoufia University; Menoufia Egypt
| | | | | | - Saleh Binsaleh
- Division of Urology; Department of Surgery; Faculty of Medicine; King Saud University; Riyadh Saudi Arabia
| | - David Ralph
- St. Peters Institute of Andrology; University College London Hospitals; London UK
| | - Carlo Bettocchi
- Department of Urology, Andrology and Kidney Transplantation Unit; Department of Emergency and Organ Transplantation; University of Bari; Bari Italy
| | - John P. Mulhall
- Sexual and Reproductive Medicine; Memorial Sloan-Kettering Cancer Center; New York NY USA
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Habous M, Giona S, Williamson B, Mekawi Z, Abdelrahman Z, Nassar M, Binsaleh S, Muir G. 546 Assessment of predictors of abnormal peak systolic velocity and end diastolic velocity in penile doppler ultrasound. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.04.451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Habous M, Giona S, Muir G, Binsaleh S, Abdelwahab O, Nassar M, Abdelrahman Z, Elserafy A, Mulhall J, Ralph D. 259 Penile prosthesis implantation preserves penile length. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.04.224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Habous M, Malkawi I, Han E, Nassar M, Abdelrahman Z, Binsaleh S, Bettocchi C, Ralph D, Santucci R. 668 Peyronie's Disease is common in poorly controlled diabetics but is not associated with the metabolic syndrome. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.04.576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Habous M, Giona S, Binsaleh S, Abdelrahman Z, Nassar M, Tealab A, Mulhall J, Muir G. 440 Serum testosterone in diabetic men is not linked to diabetic control. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.04.346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Habous M, Nassar M, Mahmoud S, Abdelrahman Z, Elserafy A, Abdelwahab O, Mekawi Z, Binsaleh S, Ralph D, Christopher N. 628 Comparing the outcome and adverse events in malleable versus inflatable penile implants. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.04.535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Habous M, Giona S, Abdelrahman Z, Nassar M, Tealab A, Muir G, Binsaleh S. 710 Investigating the correlation between vitamin D and metabolic syndrome. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.04.619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Habous M, Giona S, Tealab A, Aziz M, Williamson B, Nassar M, Abdelrahman Z, Remeah A, Abdelkader M, Binsaleh S, Muir G. Clomiphene citrate and human chorionic gonadotropin are both effective in restoring testosterone in hypogonadism: a short-course randomized study. BJU Int 2018; 122:889-897. [DOI: 10.1111/bju.14401] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Mohamad Habous
- Urology and Andrology Department; Elaj Medical Centres; Jeddah Saudi Arabia
| | | | | | - Mohammed Aziz
- Urology Department; Menoufia University; Shibin Al Kawm Egypt
| | | | - Mohammed Nassar
- Urology and Andrology Department; Elaj Medical Centres; Jeddah Saudi Arabia
| | - Zeyad Abdelrahman
- Urology and Andrology Department; Elaj Medical Centres; Jeddah Saudi Arabia
| | - Abdallah Remeah
- Urology and Andrology Department; Elaj Medical Centres; Jeddah Saudi Arabia
| | - Mohamed Abdelkader
- Urology and Andrology Department; Elaj Medical Centres; Jeddah Saudi Arabia
| | - Saleh Binsaleh
- Division of Urology; Department of Surgery; Faculty of Medicine; King Saud University; Riyadh Saudi Arabia
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Habous M, Muir G, Soliman T, Farag M, Williamson B, Binsaleh S, Elhadek W, Mahmoud S, Ibrahim H, Abdelwahab O, Abdelrahman Z, Abdelkader M, Jenkins LC, Mulhall JP. Outcomes of variation in technique and variation in accuracy of measurement in penile length measurement. Int J Impot Res 2018; 30:21-26. [DOI: 10.1038/s41443-017-0013-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 09/18/2017] [Accepted: 10/23/2017] [Indexed: 11/09/2022]
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Habous M, Tealab A, Farag M, Soliman T, Williamson B, Mahmoud S, Elserafy A, Mekawi Z, Remeah A, Nassar M, Laban O, Abdelwahab O, Binsaleh S, Giona S, Ralph D, Mulhall J. Malleable Penile Implant Is an Effective Therapeutic Option in Men With Peyronie's Disease and Erectile Dysfunction. Sex Med 2018; 6:24-29. [PMID: 29336942 PMCID: PMC5815935 DOI: 10.1016/j.esxm.2017.10.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Revised: 10/21/2017] [Accepted: 10/23/2017] [Indexed: 01/06/2023] Open
Abstract
Background The inflatable penile prosthesis (IPP) is typically the preferred implant for Peyronie’s disease (PD) and malleable penile prostheses (MPPs) have been discouraged. Aims To evaluate the effectiveness and patient satisfaction of the MPP vs IPP in patients with PD. Methods Men with PD and erectile dysfunction who elected for penile implant surgery constituted the study population. Preoperatively, demographic and comorbidity parameters were recorded. Curvature was measured with a goniometer at maximum rigidity after intracavernosal injection of a vasoactive agent. Postoperatively, overall satisfaction was measured at 3, 6, 12, and 24 months on 5-point Likert scale from 1 (dissatisfied) to 5 (very satisfied). Results 166 men with a mean age of 59 ± 10 years were analyzed. The mean preoperative curvature in the entire cohort was 65° (range = 30–130°). 94% of patients with MPP had total resolution of their curvature at the end of the operation, whereas 8 patients (6%) had residual curvature (25–40°). In the IPP group 25 of 30 (83.3%) had a straight penis at the end of surgery, whereas 5 of 30 (16.7%) had residual curvature, with the mean magnitude being 33° in the MPP group and 30° in the IPP group. 86% of all patients had diabetes. There were no differences between the 2 implant groups in age, hemoglobin A1c, body mass index, or smoking status. The mean patient satisfaction was 4.42 ± 0.70 (range = 2–5) and there was no difference between the 2 groups. The mean follow-up period was 23.4 months (range = 6–29 months). Conclusion We found that the MPP is as effective as the IPP in curvature correction in patients with PD, with similar patient satisfaction for the 2 groups. Habous M, Farag M, Tealab A, et al. Malleable Penile Implant Is an Effective Therapeutic Option in Men With Peyronie’s Disease and Erectile Dysfunction. Sex Med 2018;6:24–29.
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Affiliation(s)
| | - Alaa Tealab
- Urology Department, Zagazig University, Zagazig, Egypt
| | - Mohammed Farag
- Urology Department, Al-Azhar Faculty of Medicine, Assiut, Egypt
| | | | | | | | | | | | | | | | - Osama Laban
- Urology Department, King Khaled Hospital, Tabouk, Saudi Arabia
| | | | - Saleh Binsaleh
- Division of Urology, Department of Surgery, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - David Ralph
- St Peter's Andrology Centre & The Institute of Urology, UCLH, London, UK
| | - John Mulhall
- Sexual and Reproductive Medicine Program, Memorial Sloan Kettering Cancer Center, NY, USA
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Habous M, Tal R, Tealab A, Soliman T, Nassar M, Mekawi Z, Mahmoud S, Abdelwahab O, Elkhouly M, Kamr H, Remeah A, Binsaleh S, Ralph D, Mulhall J. Defining a glycated haemoglobin (HbA1c) level that predicts increased risk of penile implant infection. BJU Int 2017; 121:293-300. [PMID: 29124870 DOI: 10.1111/bju.14076] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To re-evaluate the role of diabetes mellitus (DM) as a risk factor for penile implant infection by exploring the association between glycated haemoglobin (HbA1c) levels and penile implant infection rates and to define a threshold value that predicts implant infection. PATIENTS AND METHODS We conducted a multicentre prospective study including all patients undergoing penile implant surgery between 2009 and 2015. Preoperative, perioperative and postoperative management were identical for the entire cohort. Univariate analysis was performed to define predictors of implant infection. The HbA1c levels were analysed as continuous variables and sequential analysis was conducted using 0.5% increments to define a threshold level predicting implant infection. Multivariable analysis was performed with the following factors entered in the model: DM, HbA1C level, patient age, implant type, number of vascular risk factors (VRFs), presence of Peyronie's disease (PD), body mass index (BMI), and surgeon volume. A receiver operating characteristic (ROC) curve was generated to define the optimal HbA1C threshold for infection prediction. RESULTS In all, 902 implant procedures were performed over the study period. The mean patient age was 56.6 years. The mean HbA1c level was 8.0%, with 81% of men having a HbA1c level of >6%. In all, 685 (76%) implants were malleable and 217 (24%) were inflatable devices; 302 (33.5%) patients also had a diagnosis of PD. The overall infection rate was 8.9% (80/902). Patients who had implant infection had significantly higher mean HbA1c levels, 9.5% vs 7.8% (P < 0.001). Grouping the cases by HbA1c level, we found infection rates were: 1.3% with HbA1c level of <6.5%, 1.5% for 6.5-7.5%, 6.5% for 7.6-8.5%, 14.7% for 8.6-9.5%, 22.4% for >9.5% (P < 0.001). Patient age, implant type, and number of VRFs were not predictive. Predictors defined on multivariable analysis were: PD, high BMI, and high HbA1c level, whilst a high-volume surgeon had a protective effect and was associated with a reduced infection risk. Using ROC analysis, we determined that a HbA1c threshold level of 8.5% predicted infection with a sensitivity of 80% and a specificity of 65%. CONCLUSION Uncontrolled DM is associated with increased risk of infection after penile implant surgery. The risk is directly related to the HbA1c level. A threshold HbA1c level of 8.5% is suggested for clinical use to identify patients at increased infection risk.
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Affiliation(s)
- Mohamad Habous
- Urology and Andrology Department, Elaj Medical Centers, Jeddah, Saudi Arabia
| | - Raanan Tal
- Sexual and Reproductive Medicine Program, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | | | - Mohammed Nassar
- Urology and Andrology Department, Elaj Medical Centers, Jeddah, Saudi Arabia
| | - Zenhom Mekawi
- Urology and Andrology Department, Elaj Medical Centers, Jeddah, Saudi Arabia
| | - Saad Mahmoud
- Urology and Andrology Department, Elaj Medical Centers, Jeddah, Saudi Arabia
| | | | - Mohamed Elkhouly
- Urology and Andrology Department, Elaj Medical Centers, Jeddah, Saudi Arabia
| | - Hatem Kamr
- Urology and Andrology Department, Elaj Medical Centers, Jeddah, Saudi Arabia
| | - Abdallah Remeah
- Urology and Andrology Department, Elaj Medical Centers, Jeddah, Saudi Arabia
| | - Saleh Binsaleh
- Division of Urology, Department of Surgery, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - David Ralph
- St Peters Andrology Centre and The Institute of Urology, University College London Hospital (UCLH), London, UK
| | - John Mulhall
- Sexual and Reproductive Medicine Program, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Habous M, Abdelwahab O, Laban O, Mahmoud S, Nassar M, Tealab A, Binsaleh S, Mulhall J. 02 Studying the Erectile Function Impact of Vitamin D Therapy in Patients with ED: Interim Analysis From A Randomized Controlled Study. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2017.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Habous M, Giona S, Muir G, Abdelwahab O, Laban O, Mahmoud S, Nassar M, Tealab A, Binsaleh S, Mulhall J. 01 Penile Implants Preserve Penile Length Irrespective of the Type of Implant. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2017.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Wilson SK, Mora-Estaves C, Egydio P, Ralph D, Habous M, Love C, Shamsodini A, Valenzuela R, Yafi FA. Glans Necrosis Following Penile Prosthesis Implantation: Prevention and Treatment Suggestions. Urology 2017. [PMID: 28648967 DOI: 10.1016/j.urology.2017.06.020] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To examine possible etiology and treatment outcomes in 21 patients with glans necrosis following penile prosthesis implantation. METHODS Glans necrosis typically presented with a dusky glans on the first postoperative day following prosthesis implantation. RESULTS The blood supply to the glans penis consists of the dorsal arteries and the terminal branches of the spongiosal arteries. Using the cohort in our study, we compiled preoperative comorbidities and adjunctive surgical maneuvers that might compromise glans vascularity, leading to glans necrosis. Preoperative risk factors were arteriosclerotic cardiovascular disease (90%), diabetes mellitus (81%), smoking (81%), previous prosthesis explantation (57%), and previous radiation therapy (48%). The most prevalent intraoperative and postoperative factor was subcoronal incision for reasons as simple as coincident circumcision or as complex as for penile degloving (86%). Other factors detected were penile wrapping with an occlusive elastic bandage (62%), use of a sliding technique for penile lengthening (33%), and coincident distal urethral injury repair (29%). Seventeen patients (81%) managed expectantly with preservation of implanted prosthesis sustained significant glandular loss. Four patients managed with immediate prosthesis removal healed without sequelae. CONCLUSION Patients with preoperative risk factors undergoing penile prosthesis implantation should avoid high-risk adjunctive surgical maneuvers. Upon development of signs of glans necrosis postoperatively, in the setting of these high-risk factors, immediate implant removal may prevent subsequent glans necrosis.
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Affiliation(s)
| | | | | | - David Ralph
- University College London Hospital, London, UK
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Abstract
OBJECTIVES To investigate frailty as a predictor of surgical outcome in elderly patients undergoing penile prosthesis implantation. MATERIAL AND METHODS A total of 54 elderly patients, above 60 years of age, underwent penile prosthesis implantation between 2012 and 2014. Their data were collected and retrospectively analyzed. A modified frailty index (mFI) was calculated for each patient based on 11 risk factors from the Canadian Study of Health and Aging Frailty Index. The 1-year adverse outcomes were correlated with mFI, patients' and procedure's risk factors. RESULTS Mean age was 64.9 ± 5.2 years. No mortality was reported in our patients, however, one-year adverse outcomes were encountered in 43 (79.6%) patients. Among all studied variables, the 1-year adverse outcomes was not significantly association with mFI, but with preoperative glycosylated hemoglobin A1c (HbA1c) (p = 0.031) and associated Peyronie's disease (PD) (p = 0.000). HbA1c, dyslipidemia, hypertension, PD and duration of the procedure were predictive of infection complications (p < 0.05). Only PD and HbA1c sustained an independent significant impact. CONCLUSIONS mFI is not a predictive of post-penile prosthesis implantation adverse outcomes in elderly patients with impotence. Degree of diabetic control and association with PD was associated with the 1-year adverse outcomes and infection complications.
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Affiliation(s)
- Khaled Madbouly
- a Department of Urology , Prince Mohammed Bin Abdulaziz Hospital , Riyadh , Saudi Arabia
| | - Dulaim AlHajeri
- b Division of Urology , Department of Surgery, Faculty of Medicine, King Saud University , Riyadh , Saudi Arabia , and
| | - Mohamad Habous
- c Urology Department, Elaj Medical Group , Jeddah , Saudi Arabia
| | - Saleh Binsaleh
- b Division of Urology , Department of Surgery, Faculty of Medicine, King Saud University , Riyadh , Saudi Arabia , and
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Habous M, Abdelwahab O, Laban O, Tal R, Mahmoud S, Tealab A, Binsaleh S, Mulhall J. MP25-02 EXPLORING THE PREDICTORS OF LOW SATISFACTION AFTER PENILE PROSTHESIS IMPLANTATION. J Urol 2017. [DOI: 10.1016/j.juro.2017.02.752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Habous M, Tal R, Abdelwahab O, Laban O, Mahmoud S, Tealab A, Binsaleh S, Mulhall J. PD22-11 A CUT-OFF HBA1C VALUE OF 8.5% PREDICTS INCREASED RISK OF PENILE IMPLANT INFECTION. J Urol 2017. [DOI: 10.1016/j.juro.2017.02.1062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Habous M, Tal R, Abdelwahab O, Mekawi Z, Mahmoud S, Binsaleh S, Mulhall J. PS-05-003 A cut-off Hba1c value of 8.5% predicts increased risk of penile implant infection. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2017.03.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Habous M, Tal R, Mahmoud S, Tealab A, Mekawi Z, Kamr H, Kamil U, Elkhouly M, Binsaleh S, Abdelwahab O, Laban O, Mulhall J. 338 Predicting High Satisfaction in Men Undergoing Penile Implant Surgery. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2016.11.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Habous M, Tal R, Nassar M, Mahmoud S, Tealab A, Elkhouly M, Kamil U, Kamr H, Mekawi Z, Remeah A, Abdelwahab O, Mulhall J. 163 Defining Predictors of Penile Implant Infection. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2016.11.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Alosaimi FD, Bukhari M, Altuwirqi M, Habous M, Madbouly K, Abotalib Z, Binsaleh S. Gender differences in perception of psychosocial distress and coping mechanisms among infertile men and women in Saudi Arabia. HUM FERTIL 2016; 20:55-63. [PMID: 27778521 DOI: 10.1080/14647273.2016.1245448] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The objective of the study was to evaluate the differences in psychosocial distress and coping mechanisms among infertile men and women in Saudi Arabia (SA). We performed a cross-sectional study of infertile patients (206 women and 200 men) attending infertility clinics in three referral hospitals in Riyadh, SA. A semi-structured questionnaire was developed to assess socio-demographic, clinical and psychosocial variables. Infertility-related psychosocial pressures were reported in 79 (39.7%) male and 97 (47.3%) female participants (p = 0.123). Males suffered more from intrusive questions and pressure to conceive, remarry or get divorced, while females were stressed more from psychological and emotional exhaustion, marital discord, attitudes of mothers-in-law or society, and persistent desire by the husband to have children. To cope with infertility, females engaged more in religious activities (p < 0.001) and spoke more to someone regarding their problems (p < 0.001). To solve their infertility problems, 50% tried to find solutions via the internet, and 38.5% of males and 51% of females reported using alternative medicines (p = 0.012). The patients with infertility in SA face multiple psychosocial stressors related to their infertility, and cope differently based on the gender and culture-specific knowledge of infertility. The female participants were significantly more affected from psychosocial stressors and the persistent desire by their spouse to have children.
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Affiliation(s)
- Fahad D Alosaimi
- a Department of Psychiatry , King Saud University , Riyadh , Saudi Arabia
| | - Mujahid Bukhari
- b Department of Obstetrics and Gynaecology , King Saud University , Riyadh , Saudi Arabia
| | - Maram Altuwirqi
- a Department of Psychiatry , King Saud University , Riyadh , Saudi Arabia
| | - Mohamad Habous
- c Urology Department , Elaj Medical Group , Jeddah , Saudi Arabia
| | - Khaled Madbouly
- d Department of Urology , Prince Mohammed Bin Abdulaziz Hospital , Riyadh , Saudi Arabia
| | - Zeinab Abotalib
- b Department of Obstetrics and Gynaecology , King Saud University , Riyadh , Saudi Arabia
| | - Saleh Binsaleh
- e Division of Urology, Department of Surgery , King Saud University , Riyadh , Saudi Arabia
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Habous M, Farag M, Williamson B, Laban O, Mahmoud S, Abdelwahab O, Elkhouly M, Kamil U, Binsaleh S, Tal R, Ralph D, Mulhall JP. Conservative Therapy is an Effective Option in Patients With Localized Infection After Penile Implant Surgery. J Sex Med 2016; 13:972-6. [PMID: 27162191 DOI: 10.1016/j.jsxm.2016.04.064] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 04/05/2016] [Accepted: 04/10/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Traditionally, penile implant (PI) infections have been managed by removal with immediate or delayed replacement. Recently, interest has been focused on conservative therapy (CT) using antibiotic therapy. AIM To investigate the success rate and predictive factors affecting the outcome of CT in PI infection patients. METHODS Patients diagnosed with early, localized PI infection were considered candidates for CT. Exclusion criteria included temperature >37.5°C, WBC >13,000/μL, and appearance of any sign of sepsis. In patients with purulent drainage, culture swabs were taken and an antibiotic was chosen based on sensitivity results. Oral antibiotics were used until the local infection was completely resolved. Patients were evaluated weekly during this process. RESULTS Thirty-seven patients were retrospectively reviewed and constituted the study population. Mean age was 58.1 (range 37-85; SD 9.9) years. All were diabetic. Mean BMI was 31.8 (range 24-47; SD 5.0). PI was malleable in 33 cases and inflatable in 4 cases. Culture results (n = 19) included Staphylococcus epidermidis (42 %), pseudomonas (21%), Escherichia coli (21%), and S aureus (16%). Four of 37 patients needed the PI removed due to CT failure and onset of systemic symptoms, at a mean time-point of 75 ± 1.8 days after CT commencement. In men who were cured, mean time to complete healing was 49 (range 29-97; SD 15.8) days. Two of 37 patients (5%) had PI removal because of persistent penile pain despite complete wound healing, at a mean time point of 128 ± 2.5 days after CT commencement. All men managed conservatively resumed sexual intercourse. CONCLUSION CT of localized PI infection appears to be a viable option for such patients, with the majority of patients retaining their implant and resuming sexual activity.
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Affiliation(s)
- Mohamad Habous
- Elaj Medical Centers, Urology and Andrology Department, Jedda, Saudi Arabia.
| | | | | | | | - Saad Mahmoud
- Elaj Medical Centers, Urology and Andrology Department, Jedda, Saudi Arabia
| | | | - Mohamed Elkhouly
- Elaj Medical Centers, Urology and Andrology Department, Jedda, Saudi Arabia
| | - Usama Kamil
- Elaj Medical Centers, Urology and Andrology Department, Jedda, Saudi Arabia
| | - Saleh Binsaleh
- Division of Urology, Department of Surgery, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Raanan Tal
- Male Sexual Dysfunction & Male Infertility, Urology Department, Rambam Health Care Campus, Haifa, Israel
| | - David Ralph
- St Peters Andrology Centre &The Institute of Urology, UCLH, London, UK
| | - John P Mulhall
- Sexual & Reproductive Medicine Program, Memorial Sloan Kettering Cancer Center, New York, USA
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Habous M, Elkhouly M, Abdelwahab O, Farag M, Madbouly K, Altuwaijri T, Spilotros M, Bettocchi C, Binsaleh S. Noninvasive treatments for iatrogenic priapism: Do they really work? A prospective multicenter study. Urol Ann 2016; 8:193-6. [PMID: 27141191 PMCID: PMC4839238 DOI: 10.4103/0974-7796.176874] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objectives: Intracorporeal injections (ICIs) of vasoactive substances during penile Doppler ultrasound (PDU) are a common investigation for erectile dysfunction (ED) diagnosis. ICI can be responsible of priapism, a pathological condition of prolonged penile erection not related to sexual stimulation. The aim of our study is to investigate the effectiveness of physical exercise and medical treatment as noninvasive therapy to restore detumescence in prolonged erections after ICI. Materials and Methods: Data were prospectively collected on men undergoing PDU in three urological centers. Three hundred and sixty-nine patients underwent PDU for the investigation of ED. All the participants received an ICI of quadrimix; prostaglandine E1, papaverine, phentolamine, and atropine. The data of the patients have been analyzed to record their comorbidities, results of PDU, and the complications encountered. Results: Fifty-three patients (14.4%) developed prolonged erections. Physical exercise alone was successful in reversing prolonged erection within 30 min in 21 (39.6%) patients. Out of the remaining 32 patients, oral salbutamol induced detumescence in 18 (34%) within the observation period of 60 min. Nonresponders were managed successfully with aspiration and irrigation of corpora with saline (11 patients, 20.75%) or with Phenylephrine (three patients, 5.66%). Conclusions: Physical exercise and oral salbutamol are safe and effective in restoring detumescence of pharmacologically-induced priapism. Noninvasive therapy may save a significant number of these patients an invasive treatment.
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Affiliation(s)
- Mohamad Habous
- Department of Urology and Andrology, Elaj Medical Center, Jeddah, Saudi Arabia
| | - Mohammed Elkhouly
- Department of Urology and Andrology, Elaj Medical Center, Jeddah, Saudi Arabia
| | | | | | - Khaled Madbouly
- Department of Urology, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia
| | - Talal Altuwaijri
- Department of Vascular Surgery, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia
| | - Marco Spilotros
- Department of Urology, University College Hospital London, London, United Kingdom
| | - Carlo Bettocchi
- Department of Emergency and Organ Transplantation - Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Saleh Binsaleh
- Department of Surgery, Division of Urology, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
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Habous M, Mahmoud S, Abdelwahab O, Laban O, Remeah A, Williamson B, Mulhall J. PS-01-004 Clomiphene citrate and human chorionic gonadotropins are good alternative therapy for hypogonadal men in restoring serum testosterone and improving patient symptoms. J Sex Med 2016. [DOI: 10.1016/j.jsxm.2016.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Habous M, Mahmoud S, Tealab A, Abdelwahab O, Laban O, Williamson B, Mulhall J, Ralph D. HP-05-003 Malleable penile prosthesis is an effective therapeutic option in patients with Peyronie's disease and erectile dysfunction. J Sex Med 2016. [DOI: 10.1016/j.jsxm.2016.03.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Affiliation(s)
- Mohamad Habous
- Urology Department, Elaj Medical Group, Jedda, Saudi Arabia
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Habous M, Muir G, Tealab A, Williamson B, Elkhouly M, Elhadek W, Mahmoud S, Laban O, Binsaleh S, Abdelwahab O, Mulhall JP, Veale D. Analysis of the Interobserver Variability in Penile Length Assessment. J Sex Med 2015; 12:2031-5. [DOI: 10.1111/jsm.13005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Habous M, Tealab A, Williamson B, Binsaleh S, El Dawy S, Mahmoud S, Abdelwahab O, Nassar M, Mulhall JP, Veale D, Muir G. Erect Penile Dimensions in a Cohort of 778 Middle Eastern Men: Establishment of a Nomogram. J Sex Med 2015; 12:1402-6. [DOI: 10.1111/jsm.12894] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abdelwahab O, Soliman T, Sherif H, Habous M, Laban O, Santucci R. MP3-08 BIPOLAR VAPORIZATION CAUSES HIGHER COMPLICATION RATES COMPARED TO BIPOLAR LOOP RESECTION: A RANDOMIZED PROSPECTIVE TRIAL. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Habous M, Laban O, Abdelwahab O, Santucci R, Mahmoud S, Mulhall J. PD40-11 CONSERVATIVE THERAPY IS A FEASIBLE AND EFFECTIVE OPTION IN PATIENTS WITH LOCALIZED INFECTION AFTER PENILE IMPLANT SURGERY. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.2445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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