International Journal of Impotence Research最新文献

Vasectomy reversal (VR) has remained the longstanding gold standard for men seeking paternity following a history of vasectomy. Ever since its initial description, numerous innovations have occurred in the field of reproductive urology to optimize perioperative outcomes. Additional considerations such as preoperative patient and patient's partner evaluation, medical optimization, and perioperative surveillance protocols are now a paramount component of caring for patients with obstructive azoospermia undergoing vasectomy reversal. Finally, numerous surgical innovations have been described which may lead to increased duration of patency in the postoperative setting. This review aims to provide a comprehensive update on the management of obstructive azoospermia secondary to vasectomy and all salient considerations including preoperative evaluation, intraoperative decision making, surgical technique, and postoperative surveillance.

We aimed to determine the content, reliability, and quality of YouTube videos related to intracavernosal injection (ICI). A search for the keyword "intracavernosal injection" was conducted on YouTube in February 2025, and the first 100 videos were watched. Video features were recorded. Each video was evaluated by two independent urologists using the comprehensiveness scale designed specifically for this study, modified DISCERN and Global Quality Scale (GQS). The study included 60 videos after exclusion criteria were applied. Videos were classified as belonging to one of two categories: useful or misleading. Useful videos contained scientific suggestions, while misleading videos contained insufficient or unproven information. Analysis revealed that 52 videos provided useful information, whereas 8 videos disseminated misleading content. Useful videos demonstrated significantly higher scores on the comprehensiveness, modified DISCERN, and GQS compared to misleading videos (p < 0.001). Most narrators were urologists, and their videos were more useful (94.4 vs. 75.0%, p = 0.03). Videos narrated by urologists scored significantly higher GQS compared to others (p = 0.018). We also found that USA-based videos were more useful than other countries (93.8 vs 58.3%, p = 0.001). Additionally, videos from the USA had higher comprehensiveness and GQS scores (p = 0.023 and p = 0.038, respectively). Our analysis revealed that YouTube videos about ICI exhibited high quality, reliability, and rich informational content. The current findings highlight the significance of actively encouraging the utilization of urologist-narrated training video materials.

Male cancer survivors may develop sexual dysfunction (SD) even many years after recovery from cancer. We aimed to evaluate the prevalence of and the clinical characteristics of cancer survivors among men seeking medical help for SD (any) in the real-life setting of an andrological tertiary-referral centre. Complete data from 2712 men consecutively assessed for new-onset SD between 2005 and 2022 were analysed. All patients were assessed with a comprehensive sexual and medical history, including history of any non-metastatic cancer (i.e., urological cancers, non-urological solid cancers, haematological malignancies). All patients were invited to complete the International Index of Erectile Function (IIEF). The IIEF-Erectile function (IIEF-EF) domain was categorized according to Cappelleri's criteria. Of all, 239 (8.8%) patients primarily assessed for SD reported a history of non-metastatic cancers. Among cancer survivors, the most frequent complaint was ED (76.2%), followed by Peyronie's disease (PD) (13.8%), low sexual desire/interest (LSD/I) (13.4%), premature ejaculation (PE) (6.7%), and delayed ejaculation (DE) (2.1%), respectively. Of all, prostate cancer (PCa) and colorectal cancer (CRC) survivors accounted for 36.0% and 10.5% of all cancer survivors, respectively. Men with a history of PCa and/or CRC more frequently complained of ED [104(93.7) vs. 78(60.9) men; p = 0.002] and had lower median (IQR) IIEF-EF scores [7(3-10.5) vs. 11(7-21); (p < 0.001)], compared to patients with a history of other malignancies, whom conversely reported higher rates of PE [4(3.6%) vs. 12(9.4%) men; p = 0.04] and PD [10(9.0%) vs. 23(18.0%) men; p = 0.009]. Almost one out of ten men seeking first medical help for SD in a tertiary-referral andrology centre are cancer survivors. Following the improvement of survivorship rates in male patients, an andrological assessment should always be included over the follow-up of cancer survivors.

Penile prosthesis implantation following penile cancer surgery presents a unique set of challenges. While penile sparing surgery, such as glansectomy and partial penectomy, aim to preserve urinary and sexual function, erectile dysfunction remains a consequence due to tissue loss and psychological distress. This review explores erectile function outcome following glansectomy and partial penectomy and provides practical framework for penile prosthesis implantation in this context. Specific considerations include anatomical changes, surgical timing and approach, prosthesis choice, patient counselling, and follow-up care. The selection of a penile prosthesis device should be individualized. Oversizing should be avoided, and downsizing should be considered, particularly in cases with significant corporal fibrosis. Moreover, inflatable penile prostheses are generally preferred, but malleable devices remain useful in selected cases, particularly following partial penectomy to facilitate unburying of the penis. Surgical strategies must account for altered penile and urethral anatomy to avoid complications such as urethral injury and prosthesis erosion. Post-prosthesis cancer surveillance remains essential and should adhere to current guidelines for penile cancer. A multidisciplinary approach and tailored surgical planning are essential to achieve satisfactory outcomes while maintaining oncological safety.

Peyronie's disease (PD) continues to represent one of the most challenging conditions in sexual medicine, particularly in its acute phase, where pain, progressive curvature, and psychological distress converge to disrupt patients' lives. For decades, clinicians have been limited to watchful waiting or off-label therapies, with collagenase Clostridium histolyticum (CCH) emerging as the most rigorously studied intralesional option in the chronic phase. Yet, the acute phase has largely remained an uncharted therapeutic territory. In this perspective, we present our preliminary clinical experience with Perovial® (IBSA, Italy), a novel intraplaque therapy administered in 10 weekly sessions, combined with daily vacuum therapy and penile modeling. Among 16 acute-phase patients with a median baseline curvature of 43° (IQR 30-62), we observed a median curvature reduction of 15° (IQR 7.5-19), significant pain relief, and no complications. These results, although preliminary, raise provocative questions: could Perovial® not only mirror but even surpass the benefits of CCH in acute disease? And more importantly, should the field of sexual medicine embrace earlier, mechanism-driven interventions rather than waiting for the disease to stabilize? We propose a possible game changer for acute PD.