International Journal of Impotence Research, Feb 4, 2019
Penile shunting is the standard of care in management of ischemic priapism refractory (IPR) to no... more Penile shunting is the standard of care in management of ischemic priapism refractory (IPR) to non-surgical interventions. Due to high rates of impotence, corporal fibrosis, and loss of penile length, recent literature suggests these patients benefit from immediate penile prosthesis (PP) placement. An IRB-exempt anonymous electronic survey of the 2,168 members of the International Society for Sexual Medicine (ISSM) was conducted. The survey included demographic information, confidence and experience related management of IPR. The aim was to evaluate current practice patterns in management of IPR and to investigate the role of immediate PP implantation in the management of prolonged (>36-hours) IPR. The survey response rate was 11.6% (n=251). Most respondents were urologists (173), from the USA (49.1%), and had completed a fellowship in male sexual medicine, men's health, reconstruction, or andrology (71.1%). The majority (91.3%) see at least one case of prolonged priapism (>36 hours) that requires surgical management yearly. When looking at volume in training and after, our respondents had a significantly higher experience with penile prostheses (over 70%, >=10) as compared to shunts (less than 40%, >=10). Overall, 70.9% of respondents felt more comfortable with a malleable PP than a shunt. However, penile shunts are still preferred as the first line of surgical management by nearly 80% of respondents as compared to 12.7% who instead prefer a PP. We also found that under 40% of respondents currently use penile MRI or corporal biopsies in their management of prolonged assessment. This is the first study to assess current clinical practices in management of IPR globally. As in any anonymous self-reported survey-based Users may view, print, copy, and download text and data-mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use:
Introduction & Objectives: Penile prostheses (PP) that are dipped in antimicrobial solutions can ... more Introduction & Objectives: Penile prostheses (PP) that are dipped in antimicrobial solutions can be specially selected by the implanter and tailored towards the patient. The best choice for antimicrobial solution is widely debated and remains a surgeon's preference. We conducted a multi-institutional study of diabetic patients undergoing primary Coloplast Titan PP implantation and compared post-operative outcomes based on the antimicrobial solutions used for dipping. Materials & Methods: Between April 2003 and May 2018, data was collected from 18 different institutions, and charts of 473 patients with diabetes receiving primary PP implantation with Coloplast Titan devices were reviewed. Antibiotics and antifungals used for device impregnation were recorded for each patient. Primary outcome was post-operative infection rate and secondary outcomes were explantation and revision rates. Patients had a median follow-up time of 7 months (range: 0-157). Patients were included in the analysis only if they had complete information regarding peri-procedural antimicrobial dip use and the above mentioned outcomes. Univariate comparisons of proportions were completed for rates of infection, explantation, and revision between different antimicrobial regimens. Results: Overall, 468 patients had complete information and were included. The total number of infections, explantations, and revisions were 15 (3.3%), 18 (4.0%), and 27 (6.0%), respectively. Vancomycin + Gentamicin dipping solution was used in 276 devices, 177 devices were dipped in Gentamicin + a different antibiotic solution, of which 143 were dipped in Rifampin + Gentamicin. When comparing the number of infections, those dipped with Vancomycin + Gentamicin had significantly lower infections (1.4%) than those with Gentamicin + a different antibiotic (5.6%, p=0.014), and those with Rifampin + Gentamicin (5.6%, p=0.014). There was no significant difference in infections when comparing implants that were dipped Abstracts EAU20 Virtual Congress and Theme Week Eur Urol Open Sci 2020;19(Suppl 2):e761 in Rifampin (158) vs. no Rifampin (310), (p=0.057). In our cohort, 190 patients had an antifungal used in their dipping solution (Amphotericin) and 278 did not. In the group that had antifungals, there were 5 (2.6%) recorded infections compared to 11 (4.0%) in the group of patients that did not receive any antifungals (p=0.414). Conclusions: The use of a Vancomycin + Gentamicin antibiotic dip seems to provide the greatest protection against post-operative infections compared to other antibiotic dips in diabetic patients. The use of antifungal dips, however, does not seem to provide an increased protection against post-operative infections in diabetic patients.
INTRODUCTION AND OBJECTIVE: COVID-19 has changed the educational landscape precluding in-person s... more INTRODUCTION AND OBJECTIVE: COVID-19 has changed the educational landscape precluding in-person surgical training opportunities. We examine the utility and feasibility of remote proctoring for IPP surgical skills training using a full-procedural hydrogel simulation model. METHODS: 9 urology residents at the University of Rochester (PGY 1-4) were paired and remotely proctored by an expert at Boston University using the Zoom web conferencing tool. During IPP training sessions, both participants and proctor were given a model with a full surgical setup. Pre-learning included a narrated full-procedural demonstration by the proctor followed by a full procedure IPP simulation guided by proctor feedback. Pre- and post-training surveys assessed confidence (0-100) and procedural knowledge (15 questions). Opinions on virtual learning and its application to this training session were collected. RESULTS: 66.7% of residents never performed a live IPP placement, while the remaining completed a median (IQR) of 6 cases (4.5-8). All confidence and knowledge measures significantly increased after the remote session (Table 1). Knowledge assessment scores increased by 13% following the remote session, which was reflected in a 48%, 22% and 18% increase in participants' confidence in the ability to perform a simulated IPP procedure, knowledge of IPP procedural steps and applied anatomy respectively. Despite, 77.8% of residents with no prior experience with hands-on virtual training, 100% found remote training valuable and beneficial for learning basic IPP skills and steps of the procedure. The residents highly rated the ability to practice complex skills with zero-patient harm (88.9%), the non-biohazardous nature of the model (66.7%), and having their own hydrogel training model (88.9%). The limitations include single session, lower quality communication and lack of an interface for physical guidance within the virtual environment. CONCLUSIONS: Remote proctoring using a web conferencing tool and non-biohazardous IPP simulation model is feasible with improvement in both confidence and procedural knowledge. Despite its limitations, this approach provides opportunities for hands-on training with remote experts in a safe environment during the cessation of in-person training events.
Background Modern-day penile prostheses use infection retardant coating to decrease rates of post... more Background Modern-day penile prostheses use infection retardant coating to decrease rates of postoperative infection, subsequently reducing explantation and revision rates as well. The Coloplast Titan models are dipped into antimicrobial solutions right before implantation, and the components used for dipping can be tailored toward the patient. Aim To compare infection, explantation, and revision rates among different dipping solutions used before implantation for patients with diabetes receiving a Coloplast Titan implant. Methods We systematically reviewed 932 patients with diabetes receiving a primary penile implant across 18 different centers from the period April 2003 to August 2018. Of those patients, 473 received a Coloplast device, whereas 459 received an AMS device. Data regarding the type of antimicrobial solution used before implantation were recorded for 468 patients receiving a Coloplast Titan, including whether or not they suffered a postoperative infection and if they ...
Penile prosthesis (PP) insertion in the setting of corporal fibrosis can be challenging and a var... more Penile prosthesis (PP) insertion in the setting of corporal fibrosis can be challenging and a variety of techniques have been described to accomplish this, however the necessity of these maneuvers is debatable. Our objective was to investigate techniques and outcomes of PP placement in patients with corporal fibrosis at tertiary referral centers. Multicenter outcomes of 42 patients (mean age 53.4 ± 1.9 years) with corporal fibrosis who underwent placement of PP over a 10-year period were reviewed. The most common etiology of corporal fibrosis was prior PP explant due to either infection (40.5%) and/or erosion (16.7%). Fourteen patients (33.3%) had a history of priapism, 5 (11.9%) of which had one or more distal surgical penile shunts. Techniques used for PP placement included: sequential dilation (8-12 mm) with standard dilators in 15 (35.7%), dilation with cavernotomes in 25 (59.5%) and limited sharp corporal excision and dilation with cavernotomes in 1 (2.4%). Narrow cylinders were employed in ten patients (23.8%). Major complications occurred in one patient (2.4%) who underwent explant for infection and distal erosion. Most patients with corporal fibrosis can undergo successful placement of a PP using standard dilators or cavernotomes. Sharp corporal excision and other measures are rarely required.
that a wand would be required to generate 10Watt of power, 150Watts in case of a 2 second activat... more that a wand would be required to generate 10Watt of power, 150Watts in case of a 2 second activation time. Conclusion: Our experiments demonstrate that the amount of energy required for the activation of the prosthesis is strongly influenced by the coupling between the external wand and the prosthesis geometry. Our data showed that a perfectly circular section would create a loop of eddy currents that would facilitate rapid activation of the prosthesis. Thus, battery use is feasible with use of closed loop geometry SMA prosthesis. Disclosure: Work supported by industry: yes, by Boston Scientific. A consultant, employee (part time or full time) or shareholder is among the authors (Uronext LLC).
Texas with only 39.8% of plans having ED coverage and 56% of all plans having IPP exclusions. In ... more Texas with only 39.8% of plans having ED coverage and 56% of all plans having IPP exclusions. In contrast, 95.3% of men with plans through BCBS of North Carolina (73% MS in NC) have ED coverage with only 2.3% of all plans having an IPP exclusion. CONCLUSIONS: While it is difficult to determine the true coverage rate for ED treatment (and specifically for IPPs) for all men in the US, an appreciable number of men do not have insurance coverage for ED therapy and have exclusions for IPPs. As a result of the high variability in coverage differences, many survivors of PC in the US may be doomed to impotence based upon the lack of federally protected men 0 s rights and are at the mercy of the insurers which dominate their marketplace.
The field of sexual medicine is continuously advancing, with novel outcomes reported on a regular... more The field of sexual medicine is continuously advancing, with novel outcomes reported on a regular basis. Given the rapid evolution, updated guidelines are essential to inform practicing clinicians on best practices. To summarize the current literature and provide clinical guidelines on penile traction therapy, vacuum erection devices, and penile revascularization. A consensus panel was held with leading sexual medicine experts during the 2015 International Consultation on Sexual Medicine (ICSM). Relevant literature was reviewed and graded based on Oxford criteria to develop evidence-based guideline and consensus statements. The development of clinically relevant guidelines. Penile traction therapy is a viable therapy to modestly improve penile length as a primary therapy, before penile prosthesis placement in men with decreased penile length or after surgery for Peyronie's disease. It also might have a role in the acute phase of Peyronie's disease but has inconsistent outcom...
ABSTRACTIntroductionIschemic priapism is an uncommon urologic emergency characterized by a compar... more ABSTRACTIntroductionIschemic priapism is an uncommon urologic emergency characterized by a compartment syndrome-like ischemic insult to the corpora cavernosa of the penis. The goal of treatment in ischemic priapism is rapid detumescence to prevent long-term erectile dysfunction. Non-surgical treatment options include aspiration, irrigation, and intracavernous injections of sympathomimetic agents. At our institution, phenylephrine is used in the treatment of ischemic priapism at concentrations and doses that are higher than those recommended in established guidelines.AimTo characterize our experience with high-concentration intracavernous phenylephrine in the treatment of ischemic priapism at an urban tertiary care center.MethodsA retrospective chart review identified 58 unique patients presenting to the emergency department on 136 occasions and receiving the diagnosis of ischemic priapism by urologic physicians. Patients' charts were reviewed to record the dosing of phenylephrin...
Since the introduction of inflatable penile prostheses (IPPs), risk of infection has decreased. H... more Since the introduction of inflatable penile prostheses (IPPs), risk of infection has decreased. However, concurrent substance abuse has not been investigated in prosthetic urology. To determine whether substance abuse would stand out as a relevant risk factor for infection in patients undergoing IPP implantation. This retrospective study was conducted on charts from the past 12 years at our institution, where a single surgeon completed 602 primary IPP surgeries, with only 12 cases (2%) resulting in postoperative infection. Five of these patients (42%) were actively misusing at least one substance at the time of operation (ie, alcohol, marijuana, cocaine, heroin, other illicit substances, and prescription narcotics). Substance abuse was identified in the medical chart by International Classification of Diseases, Ninth Revision code or by clear documentation by a provider. Multivariate logistic regression analysis was used to estimate the probability of infection as a function of demo...
Journal of Integrative Nephrology and Andrology, 2015
We report the case of a 49-year-old man presenting with a recurrent penile fracture 1-year after ... more We report the case of a 49-year-old man presenting with a recurrent penile fracture 1-year after undergoing delayed repair for a previous penile fracture. To the authors′ knowledge, this case represents the first documented instance of repeat fracture occurring after delayed repair. Risk factors for repeat penile fracture are not well documented due to the rarity of this condition. A review of literature regarding repeat penile fracture and the impact of delayed repair is discussed.
We present a case of corpus cavernosum hematoma mimicking priapism. A 42-year-old man presented t... more We present a case of corpus cavernosum hematoma mimicking priapism. A 42-year-old man presented to the emergency room with penile pain and partial erection. Examination revealed partial erection and palpable space-occupying lesion of the corpus cavernosum without lymphadenopathy. Malignant workup was negative. Imaging assisted in diagnosis of unilateral hematoma of the corpus cavernosum. The lesion spontaneously resolved without the need for intervention.
IntroductionThe aim of this article was to determine the prevalence and management of ischemic an... more IntroductionThe aim of this article was to determine the prevalence and management of ischemic and arterial priapism in our center (Fundació Puigvert).
International Journal of Impotence Research, Feb 4, 2019
Penile shunting is the standard of care in management of ischemic priapism refractory (IPR) to no... more Penile shunting is the standard of care in management of ischemic priapism refractory (IPR) to non-surgical interventions. Due to high rates of impotence, corporal fibrosis, and loss of penile length, recent literature suggests these patients benefit from immediate penile prosthesis (PP) placement. An IRB-exempt anonymous electronic survey of the 2,168 members of the International Society for Sexual Medicine (ISSM) was conducted. The survey included demographic information, confidence and experience related management of IPR. The aim was to evaluate current practice patterns in management of IPR and to investigate the role of immediate PP implantation in the management of prolonged (>36-hours) IPR. The survey response rate was 11.6% (n=251). Most respondents were urologists (173), from the USA (49.1%), and had completed a fellowship in male sexual medicine, men's health, reconstruction, or andrology (71.1%). The majority (91.3%) see at least one case of prolonged priapism (>36 hours) that requires surgical management yearly. When looking at volume in training and after, our respondents had a significantly higher experience with penile prostheses (over 70%, >=10) as compared to shunts (less than 40%, >=10). Overall, 70.9% of respondents felt more comfortable with a malleable PP than a shunt. However, penile shunts are still preferred as the first line of surgical management by nearly 80% of respondents as compared to 12.7% who instead prefer a PP. We also found that under 40% of respondents currently use penile MRI or corporal biopsies in their management of prolonged assessment. This is the first study to assess current clinical practices in management of IPR globally. As in any anonymous self-reported survey-based Users may view, print, copy, and download text and data-mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use:
Introduction & Objectives: Penile prostheses (PP) that are dipped in antimicrobial solutions can ... more Introduction & Objectives: Penile prostheses (PP) that are dipped in antimicrobial solutions can be specially selected by the implanter and tailored towards the patient. The best choice for antimicrobial solution is widely debated and remains a surgeon's preference. We conducted a multi-institutional study of diabetic patients undergoing primary Coloplast Titan PP implantation and compared post-operative outcomes based on the antimicrobial solutions used for dipping. Materials & Methods: Between April 2003 and May 2018, data was collected from 18 different institutions, and charts of 473 patients with diabetes receiving primary PP implantation with Coloplast Titan devices were reviewed. Antibiotics and antifungals used for device impregnation were recorded for each patient. Primary outcome was post-operative infection rate and secondary outcomes were explantation and revision rates. Patients had a median follow-up time of 7 months (range: 0-157). Patients were included in the analysis only if they had complete information regarding peri-procedural antimicrobial dip use and the above mentioned outcomes. Univariate comparisons of proportions were completed for rates of infection, explantation, and revision between different antimicrobial regimens. Results: Overall, 468 patients had complete information and were included. The total number of infections, explantations, and revisions were 15 (3.3%), 18 (4.0%), and 27 (6.0%), respectively. Vancomycin + Gentamicin dipping solution was used in 276 devices, 177 devices were dipped in Gentamicin + a different antibiotic solution, of which 143 were dipped in Rifampin + Gentamicin. When comparing the number of infections, those dipped with Vancomycin + Gentamicin had significantly lower infections (1.4%) than those with Gentamicin + a different antibiotic (5.6%, p=0.014), and those with Rifampin + Gentamicin (5.6%, p=0.014). There was no significant difference in infections when comparing implants that were dipped Abstracts EAU20 Virtual Congress and Theme Week Eur Urol Open Sci 2020;19(Suppl 2):e761 in Rifampin (158) vs. no Rifampin (310), (p=0.057). In our cohort, 190 patients had an antifungal used in their dipping solution (Amphotericin) and 278 did not. In the group that had antifungals, there were 5 (2.6%) recorded infections compared to 11 (4.0%) in the group of patients that did not receive any antifungals (p=0.414). Conclusions: The use of a Vancomycin + Gentamicin antibiotic dip seems to provide the greatest protection against post-operative infections compared to other antibiotic dips in diabetic patients. The use of antifungal dips, however, does not seem to provide an increased protection against post-operative infections in diabetic patients.
INTRODUCTION AND OBJECTIVE: COVID-19 has changed the educational landscape precluding in-person s... more INTRODUCTION AND OBJECTIVE: COVID-19 has changed the educational landscape precluding in-person surgical training opportunities. We examine the utility and feasibility of remote proctoring for IPP surgical skills training using a full-procedural hydrogel simulation model. METHODS: 9 urology residents at the University of Rochester (PGY 1-4) were paired and remotely proctored by an expert at Boston University using the Zoom web conferencing tool. During IPP training sessions, both participants and proctor were given a model with a full surgical setup. Pre-learning included a narrated full-procedural demonstration by the proctor followed by a full procedure IPP simulation guided by proctor feedback. Pre- and post-training surveys assessed confidence (0-100) and procedural knowledge (15 questions). Opinions on virtual learning and its application to this training session were collected. RESULTS: 66.7% of residents never performed a live IPP placement, while the remaining completed a median (IQR) of 6 cases (4.5-8). All confidence and knowledge measures significantly increased after the remote session (Table 1). Knowledge assessment scores increased by 13% following the remote session, which was reflected in a 48%, 22% and 18% increase in participants' confidence in the ability to perform a simulated IPP procedure, knowledge of IPP procedural steps and applied anatomy respectively. Despite, 77.8% of residents with no prior experience with hands-on virtual training, 100% found remote training valuable and beneficial for learning basic IPP skills and steps of the procedure. The residents highly rated the ability to practice complex skills with zero-patient harm (88.9%), the non-biohazardous nature of the model (66.7%), and having their own hydrogel training model (88.9%). The limitations include single session, lower quality communication and lack of an interface for physical guidance within the virtual environment. CONCLUSIONS: Remote proctoring using a web conferencing tool and non-biohazardous IPP simulation model is feasible with improvement in both confidence and procedural knowledge. Despite its limitations, this approach provides opportunities for hands-on training with remote experts in a safe environment during the cessation of in-person training events.
Background Modern-day penile prostheses use infection retardant coating to decrease rates of post... more Background Modern-day penile prostheses use infection retardant coating to decrease rates of postoperative infection, subsequently reducing explantation and revision rates as well. The Coloplast Titan models are dipped into antimicrobial solutions right before implantation, and the components used for dipping can be tailored toward the patient. Aim To compare infection, explantation, and revision rates among different dipping solutions used before implantation for patients with diabetes receiving a Coloplast Titan implant. Methods We systematically reviewed 932 patients with diabetes receiving a primary penile implant across 18 different centers from the period April 2003 to August 2018. Of those patients, 473 received a Coloplast device, whereas 459 received an AMS device. Data regarding the type of antimicrobial solution used before implantation were recorded for 468 patients receiving a Coloplast Titan, including whether or not they suffered a postoperative infection and if they ...
Penile prosthesis (PP) insertion in the setting of corporal fibrosis can be challenging and a var... more Penile prosthesis (PP) insertion in the setting of corporal fibrosis can be challenging and a variety of techniques have been described to accomplish this, however the necessity of these maneuvers is debatable. Our objective was to investigate techniques and outcomes of PP placement in patients with corporal fibrosis at tertiary referral centers. Multicenter outcomes of 42 patients (mean age 53.4 ± 1.9 years) with corporal fibrosis who underwent placement of PP over a 10-year period were reviewed. The most common etiology of corporal fibrosis was prior PP explant due to either infection (40.5%) and/or erosion (16.7%). Fourteen patients (33.3%) had a history of priapism, 5 (11.9%) of which had one or more distal surgical penile shunts. Techniques used for PP placement included: sequential dilation (8-12 mm) with standard dilators in 15 (35.7%), dilation with cavernotomes in 25 (59.5%) and limited sharp corporal excision and dilation with cavernotomes in 1 (2.4%). Narrow cylinders were employed in ten patients (23.8%). Major complications occurred in one patient (2.4%) who underwent explant for infection and distal erosion. Most patients with corporal fibrosis can undergo successful placement of a PP using standard dilators or cavernotomes. Sharp corporal excision and other measures are rarely required.
that a wand would be required to generate 10Watt of power, 150Watts in case of a 2 second activat... more that a wand would be required to generate 10Watt of power, 150Watts in case of a 2 second activation time. Conclusion: Our experiments demonstrate that the amount of energy required for the activation of the prosthesis is strongly influenced by the coupling between the external wand and the prosthesis geometry. Our data showed that a perfectly circular section would create a loop of eddy currents that would facilitate rapid activation of the prosthesis. Thus, battery use is feasible with use of closed loop geometry SMA prosthesis. Disclosure: Work supported by industry: yes, by Boston Scientific. A consultant, employee (part time or full time) or shareholder is among the authors (Uronext LLC).
Texas with only 39.8% of plans having ED coverage and 56% of all plans having IPP exclusions. In ... more Texas with only 39.8% of plans having ED coverage and 56% of all plans having IPP exclusions. In contrast, 95.3% of men with plans through BCBS of North Carolina (73% MS in NC) have ED coverage with only 2.3% of all plans having an IPP exclusion. CONCLUSIONS: While it is difficult to determine the true coverage rate for ED treatment (and specifically for IPPs) for all men in the US, an appreciable number of men do not have insurance coverage for ED therapy and have exclusions for IPPs. As a result of the high variability in coverage differences, many survivors of PC in the US may be doomed to impotence based upon the lack of federally protected men 0 s rights and are at the mercy of the insurers which dominate their marketplace.
The field of sexual medicine is continuously advancing, with novel outcomes reported on a regular... more The field of sexual medicine is continuously advancing, with novel outcomes reported on a regular basis. Given the rapid evolution, updated guidelines are essential to inform practicing clinicians on best practices. To summarize the current literature and provide clinical guidelines on penile traction therapy, vacuum erection devices, and penile revascularization. A consensus panel was held with leading sexual medicine experts during the 2015 International Consultation on Sexual Medicine (ICSM). Relevant literature was reviewed and graded based on Oxford criteria to develop evidence-based guideline and consensus statements. The development of clinically relevant guidelines. Penile traction therapy is a viable therapy to modestly improve penile length as a primary therapy, before penile prosthesis placement in men with decreased penile length or after surgery for Peyronie's disease. It also might have a role in the acute phase of Peyronie's disease but has inconsistent outcom...
ABSTRACTIntroductionIschemic priapism is an uncommon urologic emergency characterized by a compar... more ABSTRACTIntroductionIschemic priapism is an uncommon urologic emergency characterized by a compartment syndrome-like ischemic insult to the corpora cavernosa of the penis. The goal of treatment in ischemic priapism is rapid detumescence to prevent long-term erectile dysfunction. Non-surgical treatment options include aspiration, irrigation, and intracavernous injections of sympathomimetic agents. At our institution, phenylephrine is used in the treatment of ischemic priapism at concentrations and doses that are higher than those recommended in established guidelines.AimTo characterize our experience with high-concentration intracavernous phenylephrine in the treatment of ischemic priapism at an urban tertiary care center.MethodsA retrospective chart review identified 58 unique patients presenting to the emergency department on 136 occasions and receiving the diagnosis of ischemic priapism by urologic physicians. Patients' charts were reviewed to record the dosing of phenylephrin...
Since the introduction of inflatable penile prostheses (IPPs), risk of infection has decreased. H... more Since the introduction of inflatable penile prostheses (IPPs), risk of infection has decreased. However, concurrent substance abuse has not been investigated in prosthetic urology. To determine whether substance abuse would stand out as a relevant risk factor for infection in patients undergoing IPP implantation. This retrospective study was conducted on charts from the past 12 years at our institution, where a single surgeon completed 602 primary IPP surgeries, with only 12 cases (2%) resulting in postoperative infection. Five of these patients (42%) were actively misusing at least one substance at the time of operation (ie, alcohol, marijuana, cocaine, heroin, other illicit substances, and prescription narcotics). Substance abuse was identified in the medical chart by International Classification of Diseases, Ninth Revision code or by clear documentation by a provider. Multivariate logistic regression analysis was used to estimate the probability of infection as a function of demo...
Journal of Integrative Nephrology and Andrology, 2015
We report the case of a 49-year-old man presenting with a recurrent penile fracture 1-year after ... more We report the case of a 49-year-old man presenting with a recurrent penile fracture 1-year after undergoing delayed repair for a previous penile fracture. To the authors′ knowledge, this case represents the first documented instance of repeat fracture occurring after delayed repair. Risk factors for repeat penile fracture are not well documented due to the rarity of this condition. A review of literature regarding repeat penile fracture and the impact of delayed repair is discussed.
We present a case of corpus cavernosum hematoma mimicking priapism. A 42-year-old man presented t... more We present a case of corpus cavernosum hematoma mimicking priapism. A 42-year-old man presented to the emergency room with penile pain and partial erection. Examination revealed partial erection and palpable space-occupying lesion of the corpus cavernosum without lymphadenopathy. Malignant workup was negative. Imaging assisted in diagnosis of unilateral hematoma of the corpus cavernosum. The lesion spontaneously resolved without the need for intervention.
IntroductionThe aim of this article was to determine the prevalence and management of ischemic an... more IntroductionThe aim of this article was to determine the prevalence and management of ischemic and arterial priapism in our center (Fundació Puigvert).
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