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.
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