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penile prosthesis implantation in Chinese patients wit severe erectile dysfunction： 10-year experience

Asian Journal of Andrology 2013年第5期15卷 658-661页

作者： Wei-Dong Song Yi-Ming Yuan Wan-Shou Cui Alex K Wu Yi-Chen Zhu Jing Liu Lin Wang Guang-Yi Ba Jing Peng Zhi-Chao Zhang Bing Gao Ying-Lu Guo Tom F Lue Zhong-Cheng Xin Andrology Center Peking University First Hospital Peking University Beijing 100034 China Department of Urology Beijing Youyi Hospital Beijing Capital University Beijing 100050 China Department of Urology University of California San Francisco CA 94143 USA

We retrospectively evaluated the clinical outcome of penile prosthesis implantation （PPI） in Chinese patients with severe erectile dysfunction （SED）. From July 2000 to December 2011, 224 patients （mean age： 35.9±11.8 years, range： 20-75 years） with SED underwent PPI by experienced surgeon according to standard PPI procedure at our centre. A malleable prosthesis （AMS 650） was implanted in 45 cases （20.1%）, and a three-piece inflatable prosthesis （AMS 700 CXM or AMS 700 CXR） was implanted in 179 cases （79.9%）. Surgical outcomes, including postoperative complications, clinical efficacy and couple satisfaction, were evaluated over than 6 months postoperatively using medical record abstraction, IIEF-5, quality of life （QoL） scores, and the patient/partner sexual satisfaction score proposed by Bhojwani etaL Of the 224 patients eligible for the study, 201 subjects （89.7%） completed follow-up. All of patients could perform sexual intercourse post PPI with the mean postoperative IIEF-5 and QoL scores were 20.02±2.32 and 5.28±0.76, respectively, which were significantly improved compared with the preoperative scores （6.29±1.5 and 2.13±0.84, P〈0.01）. Of the 201 men, mechanical malfunction occurred in four cases （2.0%） and three cases were re-implanted new device, and two cases （1.0%） developed a mild curvature of the penis. Scrotal erosion with infection occurred in one case with diabetes mellitus （0.5%） and required complete removal of the implanted AMS 700 CXM. Satisfactory sexual intercourse at least twice per month was reported by 178 men （88.6%）, and overall satisfaction with the PPI surgery was reported by 89.0% of men and 82.5% of partners. Patient satisfaction in the three-piece inflatable prosthesis group was higher than in the malleable prosthesis group （P〈0.05）. Satisfaction, however, between the types of prostheses, did not differ in the partner survey. PPI is a safe and effective treatment option for Chinese patients with SED and experienced surgeon perform PPI ac

关键词： complication erectile dysfunction (ED) implantation quality of life (QoL) penile prosthesis satisfaction

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penile prosthesis implantation and tunica albuginea incision without grafting in the treatment of Peyronie＇s disease with erectile dysfunction

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Asian Journal of Andrology 2013年第3期15卷 391-394页

作者： Miroslav L Djordjevic Vladimir Kojovic School of Medicine University of Belgrade Belgrade 11000 Serbia

We evaluated penile prosthesis implantation with tunica albuginea-relaxing incisions without grafting in the treatment of Peyronie＇s disease associated with erectile dysfunction. Between April 2005 and June 2011, 62 patients underwent surgery due to severe Peyronie＇s disease associated with erectile dysfunction. Malleable and inflatable penile prostheses were inserted in 49 and 13 cases, respectively. penile prostheses were inserted into the corpora cavernosa using the standard ventral approach. After lifting the neurovascular bundle, the tunica albuginea was incised and opened at the plaque region to correct the deformities and to lengthen the penis. Subsequently, the wide neurovascular bundle was replaced, and all incisions of the tunica albuginea were covered to prevent corporal grafting. In the median follow-up of 35 months （range 14-82 months）, the penis was completely straightened in 59 （95%） patients. Numbness of the glans, which the patients found initially upsetting, decreased or disappeared spontaneously 3-6 months later. penile prosthesis implantation with tunica albuginea incisions is a viable alternative in the treatment of Peyronie＇s disease because the extensive dissection of the neurovascular bundle allows a good approach to the plaque and provides excellent covering of the incised tunica albuginea without additional grafting.

关键词： erectile dysfunction neurovascular bundle penile prosthesis Peyronie's disease tunica albuginea

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Management of residual penile curvature after penile prosthesis placement

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Asian Journal of Andrology 2021年第2期23卷 129-134页

作者： Denis V Krakhotkin David J Ralph Gideon A Blecher Volodymyr A Chernylovskyi Francesco Greco Evgeny E Bakurov Ruslan A Bugaev Central District Hospital Outpatient DepartmentKamenolomniRostov Region 346480Russia University College London St Peter’s Andrology Centre and University College London Hospitals London W1G 6BJUnited Kingdom Monash University Department of SurgeryMelbourne 3168Australia The Alfred Hospital Department of UrologyMelbourne 3004Australia Department of Urology 1 City Clinical Hospital No.4Dnipro 49102Ukraine Department of Urology Humanitas GavazzeniBergamo 24125Italy Department of Surgery No.1 Rostov Regional Hospital ROKB 1Rostov-on-Don 344015Russia

Residual penile curvature is a common situation following the implantation of a penile prosthesis in patients with Peyronie’s ***,there is a variety of options for the correction of residual curvature,including penile modeling,plication techniques,as well as tunical incision/excision with or without grafting.A literature search of PubMed and Medline databases was conducted from 1964 until 2020,using search terms for all articles in the English *** this article,we provide a review of the techniques and the outcomes,according to the published literature.

关键词： grafting modeling penile curvature penile implant penile prosthesis Peyronie’s disease tunical plication

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Antibiotic-coated medical devices: with an emphasis on inflatable penile prosthesis

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Asian Journal of Andrology 2004年第3期6卷 249-257页

作者： R.Abouassaly D.K.Montague K.W.Angermeier Glickman Urological Institute Cleveland Clinic FoundationClevelandOH 44195USAGlickman Urological InstituteCleveland Clinic FoundationClevelandOH 44195USAGlickman Urological InstituteCleveland Clinic FoundationClevelandOH 44195USA

One of the most serious complications associated with the use of the inflatable penile prosthesis is infection. This can lead to significant morbidity for the patient, as well as significant health care costs. A number of methods have been used in attempts at minimizing the infection risk, including applying an antibiotic coating to the medical devise. This review aims to evaluate the effectiveness of these products in preventing clinically significant infections.

关键词： penile prosthesis infection erectile dysfunction therapeutic strategy

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Prospective and long-term evaluation of erect penile length obtained with inflatable penile prosthesis to that induced by intracavernosal injection

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Asian Journal of Andrology 2009年第4期11卷 411-416页

作者： Run Wang Galen E Howard Anthony Hoang Jiu-Hong Yuan Hao-Cheng Lin Yu-Tian Dai Division of Urology University of Texas Medical School at Houston TX 77030 USA Department of Urology University of Texas MD Anderson Cancer Center Houston TX 77030 USA Department of Urology Affiliated Drum Tower Hospital Nanjing University School of Medicine Nanjing 210008 China

We compared erect penile length after inflatable penile prosthesis （IPP） implantation with that induced by intracavemosal injection （ICI） before surgery. A total of 11 patients with full erections induced by ICI of 0.25 mL of Trimix （papaverine, phentolamine and prostaglandin E 1） at the time of penile color duplex Doppler ultrasonograpby were enrolled in this study. The patients subsequently underwent IPP implantation as the ultimate treatment for their erectile dysfunction （ED）. Erect penile length consequent to IPP implantation was measured at 6 weeks, 6 months and at I year after surgery. The Sexual Health Inventory for Men （SHIM） was administered before, and at 6 months and 1 year after IPP implantation. Erect penile length （mean ± s.c.） as induced by ICI was 13.2 ± 0.4 cm, whereas the lengths attained with IPP were 12.4 ± 0.3, 12.5 ± 0.3 and 12.5 ± 0.4 cm at the sixth week, sixth month and 1-year follow-ups, respectively. There were 0.83 ± 0.25, 0.75 ± 0.20 and 0.74 ± 0.15 cm decreases in erect penile length at 6 weeks, 6 months and 1 year, respectively, after IPP implantation when compared with that after ICI （P 〈 0.05）. The SHIM scores for patients reporting shorter penises were the same as those for patients without complaints at the 6-month and 1-year follow-ups （P 〉 0.05）. To our knowledge, this is the first study to objectively show a significant decrease in erect penile length after IPP implantation when compared with that after ICI. However, this decrease did not affect the effectiveness of IPP in treating ED.

关键词： erectile dysfunction intracavemosal injection length penile prosthesis radical prostatectomy

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Three-dimensional mapping and comparative analysis of the distal human corpus cavernosum and the inflatable penile prosthesis

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Asian Journal of Andrology 2013年第4期15卷 567-570,I0012页

作者： Tariq S Hakky Daniel Ferguson Philippe E Spiess Paul Bradley Tom FLue Rafael E Carrion Department of Urology University of South Florida Tampa General Circle Tampa FL 33602 USA 23D3Solutions Burnaby BCV5J 5M8 Canada and Department of Urology University of Southern California San Francisco 400 Parnassus Ave San Francisco CA 94143 USA

The intricate anatomy of the corpus cavernosum in both the flaccid and tumescent state has not been fully elucidated. We report our experience using a three-dimensional （3D） scanner to reconstruct cadaveric casts and compare them with 3D images of two prototypes of penile prosthesis. Two different models of the Titan Coloplast inflatable penile prosthesis were analyzed using a 3D scanner. The first was the standard model and the second was a newer model with a rounder silicone tip. Two cadaveric phalluses were harvested using Smooth-Cast 300Q polyurethane molding. The molds were excised and scanned along side the penile prosthesis. 3D scans were completed and analyzed using Leios Mesh software, and GOM Inspect software. The 3D scans demonstrated the mean human corporal radii 2 mm from the distal tip to be 36.51 mm （36.01-37.0 mm）, which is an obtuse angle. The standard Titan penile prosthesis spherical radius at the same level was 202.52 mm, while the new silicone tip prosthesis had a radius of 139.33 mm. 3D mapping further demonstrated the trajectory of the cavernosa appeared curvilinear and the distal ends appeared blunt. The use of cadaveric cavernosal molds in combination with the 3D scanner allowed us to accurately image the corpus cavernosum for the first time. Our findings suggest that anatomically accurate corporal tips appear to be relatively blunt and that the new Titan silicone tip penile prosthesis more closely resembles the human corporal tip.

关键词： corpus cavernosum penile prosthesis three-dimensional analysis

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Simultaneous penile prosthesis and male sling/artificia urinary sphincter

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Asian Journal of Andrology 2013年第1期15卷 10-15页

作者： Dominic Lee Claudio Romero Frances Alba O Lenaine Westney Run Wang Department of Urology University of Texas MD Anderson Cancer Center Houston TX 77030 USA and Division of Urology University of Texas Medical School at Houston Houston TX 77030 USA

Erectile dysfunction （ED） and stress urinary incontinence （SUI） from urethral sphincteric deficiency is not an uncommon problem. The commonest etiology is intervention for localized prostate cancer and/or radical cystoprostatectomy for muscle invasive bladder cancer. Despite advances in surgical technology with robotic assisted laparoscopic prostatectomy and nerve sparing techniques, the rates of ED and SUI remain relatively unchanged. They both impact greatly on quality of life domains and have been associated with poor performance outcomes. Both the artificial urinary sphincter and penile prosthesis are gold standard treatments with proven efficacy, satisfaction and durability for end-stage SUI and ED respectively. Simultaneous prosthesis implantation for concurrent conditions has been well described, mostly in small retrospective series. The uptake of combination surgery has been slow due in part to technical demands of the surgery and to an extent, a heightened anxiety over potential complications. This paper aims to discuss the technical aspect of concurrent surgery for both disease entity and the current published outcomes of the various surgical techniques with this approach.

关键词： artificial urinary sphincter dual implants erectile dysfunction penile prosthesis stress urinary incontinence

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Outcome of penile prosthesis implantation： are malleable prostheses an appropriate treatment option in patients with erectile dysfunction caused by prior radical surgery？

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Asian Journal of Andrology 2017年第4期19卷 477-481页

作者： Cuneyd Sevinc Orkunt Ozkaptan Muhsin Balaban Ugur Yucetas Tahir Karadeniz Department of Urology Medicana International Hospital Istanbu134521 Turkey Department of Urology Kolan International Hospital Istanbu134384 Turkey Department of Urology Istanbul Training and Research Hospital Istanbu 134098 Turkey

The aim of our study was to evaluate the outcome of penile prosthesis implantation in patients with various comorbidities as a cause of erectile dysfunction （ED）. The data of 181 patients who underwent surgery between 1998 and 2012 in two centers were evaluated. The mean age of the patients was 52.2 years （range： 31-71 years）. The study group contained 162 patients （89.5%） with malleable prostheses and 19 （10.5%） with inflatable implants. All patients were re-evaluated 1 month later to assess prosthesis function and complications, and further re-examinations were performed if needed. Satisfaction was defined as having satisfactory intercourse and happiness with the device in general. The follow-up period was at least 12 months for each patient. The postoperative complication rate was 32% （n = 58）. The number of complications with inflatable and malleable prostheses was 7 （3.9%） and 51 （28.1%）, respectively. Overall, 21 prostheses （11.6%） had to be removed because of various complications and patient dissatisfaction. Patients with prior radical surgery had higher extraction rates （n = 14.606, P 〈 0.05, Chi-square test）. The main reasons for removal were erosion （n = 11; 6.1%） and infection （n = 3; 2.1%）. With respect to satisfaction during intercourse, we found that 104 （57.5%） patients described themselves as very satisfied with the prosthesis, while 21 （11.6%） were unsatisfied. The high explantation rate in patients with prior surgery was remarkable in our study. Our results revealed that a malleable prosthesis should not be the preferred type of implant for patients with prior surgery.

关键词： erectile dysfunction erosion impotence penile prosthesis radical surgery satisfaction

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Implantation of AMS 700 LGX penile prosthesis preserves penile length without the need for penile lengthening procedures

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Asian Journal of Andrology 2016年第1期18卷 114-117页

作者： Carlo Luigi Augusto Negro Matteo Paradiso Alessandro Rocca Franco Bardari Department of Urology Ospedale Cardinal Massaia ASL AT Asti Italy.

Implantation of an inflatable penile prosthesis （IPP） is a well-established definitive solution for erectile dysfunction when conservative treatments fail. penile implants may shorten the penis. The AMS 700 LGX IPP is in common use but reports on its mechanical reliability, medium-term postsurgical patient satisfaction, and mean penile length preservation are lacking. We investigate the mean penile length, mechanical reliability, and patient satisfaction at 6 and 12 months after implantation of the AMS 700 LGX. This prospective study consecutively enrolled men undergoing first-time IPP implant surgery from February 2009 to April 2012. Stretched flaccid penile length, penile length at 50% and 100% of stiffness （PSO and P100） and International Index of Erectile Function （IIEF） and Erectile Dysfunction Inventory of Treatment Satisfaction （EDITS） scores, were measured at 6 and 12 months postsurgery. Of 45 patients who underwent AMS 700 LGX implantation （median age 61 years） and completed 6 months＇ follow-up, 36 （80%） completed the study. A significant difference in stretched flaccid penile length was seen between 6 and 12 months （P= 0.033）. P100 was also significantly increased at 6 and 12 months, with a mean 10% increase （1.3 ±0.4 cm） from baseline to 12 months. Differences in mean IIEF scores at 6 and 12 months were significant for the desired domain （P = 0.0001） and for overall satisfaction （P = 0.002）; however, mean EDITS scores at 6 and 12 months were not significantly improved. AMS 700 LGX is a powerful tool for preserving penile length in men undergoing penile prosthesis implantation.

关键词： AMS 700 LGX penile erection penile implantation penile prosthesis

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Initial experience of a single center with the use of ZSI 475 penile prosthesis

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Asian Journal of Urology 2021年第2期8卷 176-182页

作者： Fulvio Colombo Giorgio Gentile Valerio Vagnoni Alessandro Fiorillo Pietro Piazza Fabrizio Sartorio Alessandro Franceschelli Andrology Unit University Hospital S.Orsola-MalpighiBolognaItaly Department of Urology University of BolognaBolognaItaly

Objective:To evaluate surgical outcomes after implantation of the Zephyr ZSI 475 inflatable penile prosthesis(IPP)and patients’quality of ***:From December 2014 to September 2018,15 patients underwent prosthesis implantation with ZSI 475.A retrospective review of clinical data was ***’quality of life after implantation was investigated with Quality of Life and Sexuality with penile prosthesis(QoLSPP)***:The median age of patients was 57 years and the average follow-up time was 22 *** patients received a standard implantation due to severe erectile dysfunction(ED);three patients also presented penile curvature and additional corporoplasty with grafting was *** procedures had to be interrupted due to defects of the insertion *** one case a manufacturing defect resulted in a pump *** one case,a severe postoperative complication occurred,which requested explanation of the *** the follow-up,four patients experienced mechanical failure of the *** of QoLSPP questionnaire at 12 months were skewed toward the positive end of the scale in all ***:In our initial experience,ZSI 475 suffered a high rate of mechanical failures;on the other hand,the company showed great commitment in order to improve the quality and reliability of the *** lower cost of ZSI 475 may add to the chances of the product to become a cost-effective alternative to treat those patient who need a IPP.

关键词： Erectile dysfunction Implantation penile prosthesis Satisfaction Zephyr ZSI 475

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