Background Penile prosthesis implantation in cases of severe Peyronie’s disease may require plaqu... more Background Penile prosthesis implantation in cases of severe Peyronie’s disease may require plaque excision/incision and grafting, which may require mobilization of the neurovascular bundle or urethra, posing the risks of penile hyposensitivity or urethral injury, and is time-consuming, possibly increasing infection risk. Aim Evaluating transcorporeal debulking of Peyronie’s plaques by “Shaeer’s punch technique.” Methods Penile prosthesis implantation and punch technique (PPI-Punch) was performed for 26 patients. After corporotomy and dilatation, Peyronie’s plaques were punched out from within the corpora cavernosa using the punch forceps, and then a penile prosthesis was implanted. Comparison to a matching retrospective group of 18 patients operated upon by plaque excision-grafting and penile prosthesis implantation was performed. Outcomes The study outcomes were straightness of the erect penis, complication, satisfaction with length on a 5-point scale, the International Index of E...
ABSTRACT Purpose: Patients with primary erectile dysfunction (ED) are unable to report on the pos... more ABSTRACT Purpose: Patients with primary erectile dysfunction (ED) are unable to report on the possibly existing congenital penile curvature. Curvature is recognized only after implantation, in which case the implant can be extracted and its length modified or the curvature corrected, adding to the complexity of the procedure and the risk of infection. This study describes a method to evaluate congenital curvature in cases of primary ED before surgery and to correct curvature upon prosthesis implantation, even before calibration of the corpora cavernosa. Materials and methods: Before prosthesis implantation, artificial erection is induced by basal compression and saline infusion, demonstrating curvature, if any. Surgery is performed through a penoscrotal incision. One or more cruciate corporotomy incisions are cut over the point of maximum curvature, straightening the penis. Full correction is checked by covering the corporotomy with sterile surgical glove material sutured to its edges and by reinducing artificial erection. Dilatation of the corpora, calibration, and implantation proceeds as usual and the corporotomies are sealed by a tunica vaginalis graft. Results: Curvature was demonstrated in nine out of 16 cases, necessitating correction in four, in whom curvature was fully corrected and prosthesis was successfully implanted and followed for 6–8 months. Conclusion: Congenital curvature can coexist with primary ED (nine out of 16 patients in this series); yet, it is not reported by the patient who has never experienced a rigid erection sufficient to reveal the curvature. Preoperative detection of curvature is of value for patient counseling and planning of the procedure. Correction of curvature before implantation (in the same session) can help implanting the suitable length of prosthesis in a straight penis, without undue complexity and risk of infection.
The glans penis is prone to mutilation in a handful of conditions, some accidental and others iat... more The glans penis is prone to mutilation in a handful of conditions, some accidental and others iatrogenic. Deformed functioning remnants of the glans challenge the surgeon's decision. Neither is the glans totally amputated, justifying a neoglansplasty, nor are the remnants cosmetically acceptable, though retaining sensibility and engorgement. In this work, we described the "reconfiguration of the glans penis" whereby deformed glanular tissue remnants can be made into a functional and cosmetically acceptable glans. Five patients with separate mutilated lumps of functioning glanular tissue were operated upon. The lumps were mobilized and flattened into sheets and configured to redrape the summit of the penis, minding their vascular and nerve supply. Cosmetic and functional outcome. The outcome was cosmetically acceptable for all patients in comparison to the preoperative state. Glans reconfiguration may possibly confer an acceptable cosmetic outlook to a mutilated glans without compromising valuable functional characteristics.
Background Penile prosthesis implantation in cases of severe Peyronie’s disease may require plaqu... more Background Penile prosthesis implantation in cases of severe Peyronie’s disease may require plaque excision/incision and grafting, which may require mobilization of the neurovascular bundle or urethra, posing the risks of penile hyposensitivity or urethral injury, and is time-consuming, possibly increasing infection risk. Aim Evaluating transcorporeal debulking of Peyronie’s plaques by “Shaeer’s punch technique.” Methods Penile prosthesis implantation and punch technique (PPI-Punch) was performed for 26 patients. After corporotomy and dilatation, Peyronie’s plaques were punched out from within the corpora cavernosa using the punch forceps, and then a penile prosthesis was implanted. Comparison to a matching retrospective group of 18 patients operated upon by plaque excision-grafting and penile prosthesis implantation was performed. Outcomes The study outcomes were straightness of the erect penis, complication, satisfaction with length on a 5-point scale, the International Index of E...
ABSTRACT Purpose: Patients with primary erectile dysfunction (ED) are unable to report on the pos... more ABSTRACT Purpose: Patients with primary erectile dysfunction (ED) are unable to report on the possibly existing congenital penile curvature. Curvature is recognized only after implantation, in which case the implant can be extracted and its length modified or the curvature corrected, adding to the complexity of the procedure and the risk of infection. This study describes a method to evaluate congenital curvature in cases of primary ED before surgery and to correct curvature upon prosthesis implantation, even before calibration of the corpora cavernosa. Materials and methods: Before prosthesis implantation, artificial erection is induced by basal compression and saline infusion, demonstrating curvature, if any. Surgery is performed through a penoscrotal incision. One or more cruciate corporotomy incisions are cut over the point of maximum curvature, straightening the penis. Full correction is checked by covering the corporotomy with sterile surgical glove material sutured to its edges and by reinducing artificial erection. Dilatation of the corpora, calibration, and implantation proceeds as usual and the corporotomies are sealed by a tunica vaginalis graft. Results: Curvature was demonstrated in nine out of 16 cases, necessitating correction in four, in whom curvature was fully corrected and prosthesis was successfully implanted and followed for 6–8 months. Conclusion: Congenital curvature can coexist with primary ED (nine out of 16 patients in this series); yet, it is not reported by the patient who has never experienced a rigid erection sufficient to reveal the curvature. Preoperative detection of curvature is of value for patient counseling and planning of the procedure. Correction of curvature before implantation (in the same session) can help implanting the suitable length of prosthesis in a straight penis, without undue complexity and risk of infection.
The glans penis is prone to mutilation in a handful of conditions, some accidental and others iat... more The glans penis is prone to mutilation in a handful of conditions, some accidental and others iatrogenic. Deformed functioning remnants of the glans challenge the surgeon's decision. Neither is the glans totally amputated, justifying a neoglansplasty, nor are the remnants cosmetically acceptable, though retaining sensibility and engorgement. In this work, we described the "reconfiguration of the glans penis" whereby deformed glanular tissue remnants can be made into a functional and cosmetically acceptable glans. Five patients with separate mutilated lumps of functioning glanular tissue were operated upon. The lumps were mobilized and flattened into sheets and configured to redrape the summit of the penis, minding their vascular and nerve supply. Cosmetic and functional outcome. The outcome was cosmetically acceptable for all patients in comparison to the preoperative state. Glans reconfiguration may possibly confer an acceptable cosmetic outlook to a mutilated glans without compromising valuable functional characteristics.
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Papers by Prof.Osama Shaeer