International Journal of Impotence Research最新文献

Our article outlines a case study assessing the use of low-intensity shock wave therapy (LiSWT) for managing Hard Flaccid Syndrome (HFS). Given the absence of standardized treatments for HFS, LiSWT could serve as an additional tool in the treatment arsenal. The case involved a 36-year-old male presenting HFS, low libido, chronic pain, and erectile dysfunction. Treatment comprised phosphodiesterase type 5 inhibitor (PDE5-I), physical therapy, and LiSWT. Following six sessions, the patient experienced regression of bothersome symptoms and improved erections. A 2-year follow-up revealed sustained symptom relief. LiSWT presents a non-invasive means of inducing mechanical stress and microtrauma in targeted tissues, fostering neovascularization and potentially enhancing blood supply. The integration of LiSWT with PDE5-I and physical therapy suggests a potential avenue for effective HFS management. Nevertheless, further systematic research is essential to validate the therapy's benefits and assess, if any, potential drawbacks.

Solid organ transplant recipients exhibit an elevated incidence of erectile dysfunction, attributed to comorbidities and specific factors associated with organ failure. While treatment mirrors the general population's, response rates are lower, and there is a heightened concern about implanting a penile prosthesis in immunocompromised patients due to the potential occurrence of severe complications. The aim of this study was to assess the safety of penile prostheses in this population. Among fourteen included studies, ten were case reports or series of cases, and four were non randomized case-control studies with non-transplanted patients as controls. Complications affected 34 patients (11.15%), with mechanical device failures in 18 cases (5.9%) and infections in 13 cases (4.26%). Most infections required hospitalization, antibiotic treatment, and prosthesis removal, with two cases of life-threatening Fournier's gangrene. Case-control studies revealed no differences in overall reoperation rates between transplant recipients and controls. However, pelvic organ transplant recipients undergoing three-piece prosthesis implantation showed higher complications rates related to reservoir issues. Despite limited evidence, case-control studies demonstrated a generally low/moderate risk of bias within each specific domain, although overall bias was moderate/severe. As a result, clinicians may mitigate concerns regarding penile prosthesis implantation in solid organ transplant recipients.

Thermographic imaging is a technique to measure infrared radiation to report temperature and has been used in prior research to assess sexual arousal by measuring genital temperature. We hypothesized this can be used quantitatively to assess erectile function. We conducted an observational clinical trial of this technique by performing thermographic imaging in the flaccid and erect state and compared these values with hemodynamic measurements performed by penile Doppler/duplex ultrasound (PDDU). We also hypothesized that in men with Peyronie’s disease (PD), the plaque would be visible on thermographic imaging and took thermographic measurements in this area for patients with PD. Any man scheduled to undergo PDDU in our urology clinic was approached for recruitment. PDDU was performed by one of two experienced urologists. We recruited 30 men for this study. Seven of these men had PD. The change in measured temperature between flaccid and erect states correlated significantly with the peak systolic velocity r = 0.46 (p = 0.025). In the seven men with PD the mean change in temperature of the plaque was +0.9 °C versus +2.1 °C in the normal penis (p = 0.28). Thermographic imaging shows a significant correlation with objective hemodynamic measurements on PDDU.

As the authors of “Does time of intraoperative exposure to the aerobiome increase microbial growth on inflatable penile prosthesis,” we appreciate the thoughtful critiques provided by Mulcahy et al. and Atwater et al. [1,2,3]. Some of the key points are salient, and we would like to take an opportunity to acknowledge the feedback and advocate for the significance of this study.

Regarding the concern raised by Atwater et al. about whether our study adds anything substantial to the existing literature [1], we believe it is essential to emphasize the novelty of our investigation. There is no literature specifically addressing the role of ambient air exposure in inflatable penile prosthesis (IPP) surgery. Continually reassessing and expanding our understanding of all potential infection risks, including those that might seem minimal at first glance, is critical. While factors like operative time and surgeon experience are better established in influencing infection rates [4], we must not dismiss the evaluation of other potential sources of contamination, such as the aerobiome.

Erectile dysfunction (ED) is common with the estimated global prevalence set to rise from 152 million in 1995 to 322 million by the year 2025 [1]. The greatest increases have been postulated as most likely to occur in economically challenged countries. The commonest risk factors for ED in Western countries include diabetes, smoking, obesity and following pelvic surgery. However, in West African countries, this also includes ischaemic priapism (IP) especially in sickle cell disease (SCD).

SCD is a common autosomal recessive disorder affecting the β-globulin chain of haemoglobin in mainly people of African descent. It affects more than 3 million people worldwide predominantly in sub-Saharan Africa [2]. IP has been reported in up to 40% of men with SCD with a cumulative incidence of 60% by the age 40 [2]. The treatment of end-stage ED and late presenting IP is with a penile implant. The satisfaction rates have been reported as 70–80% [3]. In Senegal, this surgery is in its infancy and herein we present our initial experience at the Hopital General Idrissa Pouye (HOGIP). We present our results of 9 men who had a malleable penile prosthesis inserted between March 2022 and January 2023. All men were admitted on the day of their operation and surgery was carried out with visiting experienced andrologists. All patients received antibiotics (gentamycin) on induction and the prosthesis was soaked in a gentamycin solution prior to insertion. The malleable prosthesis inserted were Coloplast Genesis (Coloplast Corp, Minneapolis, MN, USA) or iMedicare Rigi10 (iMEDicare, Watford, UK). A standard 10-min social wash was performed after shaving. All procedures were performed under spinal anaesthesia and the incision was peno-scrotal.

We investigated the prevalence, incidence, and rates of pharmacological treatment of delayed ejaculation using the TriNetX Diamond Network. We included all men evaluated in the inpatient, outpatient, and emergency settings. Prevalence was determined by comparing the number of men diagnosed with delayed ejaculation to the entire population. Incidence was determined by comparing the number of men diagnosed with delayed ejaculation without a prior diagnosis to the overall population without a prior diagnosis. Rates of pharmacologic treatment were calculated by comparing the number of men who received a prescription to the total number of men with delayed ejaculation. Trends in prevalence and incidence were compared using six-month intervals, while trends in pharmacologic treatment were compared using one-year intervals. A total of 23,164 adult males were diagnosed with delayed ejaculation from 2013 to 2019. During the final six-month interval (July to December 2019), 2,747 of 16,496,744 men received a delayed ejaculation diagnosis, and 1,375 of 16,488,270 men without a prior diagnosis were diagnosed with delayed ejaculation. In 2019, only 916 of 4,733 (19.4%) men diagnosed with delayed ejaculation received any prescription, with the most common being testosterone (9.5%), bupropion (6.6%), and buspirone (2.3%). Prevalence, incidence and pharmacologic treatment all had increasing trends.