The role of penile prosthetic surgery in the modern management of erectile dysfunction.
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The management of erectile dysfunction looks set to be revolutionised with the introduction of effective oral therapies. There will remain, however, some men who do not respond to conservative measures. This article reviews the important role of penile prosthetic surgery as a treatment option in these patients. (+info)
Gastroenterology-urology devices: reclassification of the penile rigidity implant. Food and Drug Administration, HHS. Final rule.
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The Food and Drug Administration (FDA) is reclassifying the penile rigidity implant from class III to class II when intended to provide penile rigidity in men diagnosed as having erectile dysfunction. The special control is the FDA guidance document entitled "Guidance for the Content of Premarket Notifications for Penile Rigidity Implants." This action is taken on FDA's own initiative based on new information. This action is being taken under the Federal Food, Drug, and Cosmetic Act (the act), as amended by the Medical Device Amendments of 1976, the Safe Medical Devices Act of 1990, and the FDA Modernization Act of 1997. (+info)
The history of erectile dysfunction management.
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This article describes the evolution or revolution in the management of erectile dysfunction over the centuries. In recent history there has been a rapid movement away from a predominant role for the specialist towards the primary care physician. The physician is increasingly faced with the need to individualize therapy to meet patient expectations. (+info)
Risk of connective-tissue disease in men with testicular or penile prostheses: a preliminary study.
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AIM: To help clarifying the possibility of connective-tissue diseases in men with penile or testicular prostheses. METHODS: Eight patients underwent inflatable penile prostheses and 15, testicular prostheses consented to the study. Their medical records were reviewed and a follow-up interview and physical and serological examinations were performed. RESULTS: In patients with penile prostheses, there was no abnormal antinuclear antibody (ANA) or IgM elevation. The serum levels of the rheumatoid factor (RF), C4, IgA and IgG were abnormal in one patient, and the levels of erythrocyte sedimentation rate (ESR) and C3, abnormal in two. Four had elevated IgE. In patients with testicular prostheses, there was no abnormal RF, ANA or IgM. The serum levels of ESR and IgA were abnormal in two, and three had abnormal C4, ten abnormal C3, and eleven decreased IgG. All had increased IgE. Men with penile prostheses had higher serum levels of IgG and IgM than those with testicular prostheses (P=0.001, P=0.016, respectively). The rates of abnormal values of IgE and IgG were higher in men with testicular prostheses than in men with penile prostheses (P=0.008, P=0.009, respectively). Physical examination was normal in all patients and nobody had documented symptoms pertinent to connective-tissue diseases. CONCLUSION: Our findings suggest that the risk of connective-tissue diseases is not higher in patients wearing prostheses as the ANA is negative and there is no apparent manifestation suggestive of connective-tissue diseases. (+info)
Distal penile prosthesis extrusion: treatment with distal corporoplasty or Gortex windsock reinforcement.
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Subcutaneous extrusion of penile prosthesis cylinders beneath the glans penis is an unusual but difficult complication of penile prosthesis. Without surgical repair, extrusion, infection, and corporeal fibrosis may ensue. Twenty-eight patients with distal corporeal extrusion were reviewed to identify the optimum treatment outcome for these penile prosthesis complications. Records of 28 men with subcutaneous distal penile prosthesis cylinder extrusion were reviewed. Mean age was 56.2 y. Etiology of erectile dysfunction was diabetes mellitus in 11, vasculogenic in 10, Peyronie's disease in five, radical pelvic surgery in five. Duration of penile prosthesis was 8-72 months (mean 42.6). No patient had penile prosthesis infection or device exposure through the skin. Distal corporoplasty was treated on 18/28 men using cylinder repositioning and direct tunica albuginea repair. Ten men underwent repair using a Gortex windsock. 8/18 corporoplasty and 6/10 windsock patients required glans fixation for treatment of hypermobile glans following cylinder relocation. In two patients with windsock repair, extrusion recurrence occurred 6 and 18 months following surgery and 1/6 had post operative infection requiring prosthesis removal. Mean surgical time for corporoplasty was 52.8 minutes while windsock reconstruction was 89.6 minutes. Distal subcutaneous penile prosthesis cylinder extrusion produces coital pain and predisposes to cylinder exposure and infection. Early repair with or without additional prosthetic materials will return penile prostheses to a normal functioning state. Distal corporoplasty with cylinder repositioning appears to be a simple, low morbidity solution to this difficult dilemma. Outcomes with distal corporoplasty result in better function, less pain, and fewer recurrences than Gortex windsock repair. (+info)
Penile implant on bone scan imaging: a case study.
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We present an unusual case of the incidental finding of a penile implant on a whole-body bone scan obtained for back pain in a patient with osteoporosis and vertebral body fractures. On 2 separate occasions, this patient underwent 3-h delayed whole-body bone scanning with (99m)Tc-methylene diphosphonate. The images showed acute and then subacute vertebral body fractures. On both imaging occasions, the bone scan that included the region of the implant clearly showed the penis, but visualization was better on the second scan. Penile implants have not been described in the nuclear medicine literature, and it is important to recognize the diagnostic possibilities when penile photopenia is identified. (+info)
Antibiotic prophylaxis in dental patients with body prostheses.
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Antibiotic administration before performing dental treatments, with the purpose of preventing the possible risks associated with bacteremia, has received much support but also considerable criticism. Advances in surgery have led dental professionals to deal with patients carrying body prostheses of different kinds - thus giving rise to situations in relation to dental management that require careful evaluation. In this context, when deciding whether or not to provide antibiotic prophylaxis, the dental professional must also be able to adequately assess other aspects such as oral status, the dental treatment required, the type of body implant involved, the potential risk of infection in relation to the prosthesis, associated secondary pathologies, the type of antibiotic indicated and its spectrum of action, as well as the dosage, side effects and economical cost of the antibiotic administered. (+info)
Priapism is an undue and sustained erection in the absence of sexual stimulus. In the elderly population drug induced, thromboembolic and malignant aetiologies are common. This report demonstrates that in elderly demented patients, penile prosthesis should be considered in the differential diagnosis of such a condition. A plain X-ray of the pelvic region incorporating the penis could prove very useful, particularly in the absence of a proper history. (+info)