The global population is collectively getting older, and age is directly correlated with erectile dysfunction (ED). With the advent of effective oral agents and wide availability of the Internet, a larger portion of the population is becoming aware of the different treatment options for men with ED. The penile prosthesis is a definitive and effective treatment for ED which has been available for just over half a century.
Erectile Dysfunction/surgery* ; Humans ; Male ; Penile Implantation ; Penile Prosthesis

ObjectiveTo assess the effect of corporoplasty with autologous tunica vaginalis graft in the treatment of Peyronie's disease.

METHODSTen patients with Peyronie's disease underwent plaque excision and corporoplasty with autologous tunica vaginalis graft. We obtained and compared IIEF-5 scores of the patients before and at 1 and 5 years after operation.

RESULTSAfter surgery, penile curvature was obviously relieved and all the patients achieved normal penile erection and satisfactory sexual intercourse without erection-related pain or recurrent erectile dysfunction. The mean IIEF-5 score was significantly improved at 1 year (22.40±1.08) and 5 years postoperatively (23.00±1.14) as compared with the baseline, (19.20±2.28) (P<0.05 or 0.01).

CONCLUSIONSCorporoplasty with autologous tunica vaginalis graft is a safe, simple and effective option for the treatment of Peyronie's disease, though its definite efficiency is to be further supported by large-sample clinical studies.

Erectile Dysfunction ; Humans ; Male ; Penile Erection ; Penile Induration ; surgery ; Penis ; surgery ; Postoperative Period ; Testis ; transplantation

AIMTo present a simple technique during penile prosthesis implantation that promotes the perception of increased phallic length.

METHODSThe penoscrotal web is defined. A "check mark" incision is made with excision of scrotal tissue. Excellent exposure is provided for implantation of the cylinders, pump and reservoir. Wound closure is performed longitudinally.

RESULTSThis technique is a modified extension of surgeries described in the pediatric literature for webbed penis. Loss of penile length following penile implantation surgery is worrisome for patients suffering from erectile dysfunction (ED). This technique helps with patient satisfaction, cosmetic results, and improves perception of penile length.

CONCLUSIONVentral phalloplasty is a safe, technically simple procedure that may be performed in concert with penile prosthesis implantation or as a stand alone procedure under certain circumstances.

Erectile Dysfunction ; surgery ; Humans ; Male ; Penile Implantation ; adverse effects ; methods ; Penis ; pathology ; surgery

Advances in urogenital plastic surgical tissue transfer techniques have enabled urethral reconstruction surgery to become the new gold-standard for treatment of refractory urethral stricture disease. Questions remain, however, regarding the long-term implications on sexual function after major genital reconstructive surgery. In this article, we review the pathologic features of urethral stricture disease and urologic trauma that may affect erectile function (EF) and assess the impact of various specific contemporary urethroplasty surgical techniques on male sexual function.
Erectile Dysfunction ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Urethra ; surgery ; Urethral Stricture ; physiopathology ; surgery

We aimed to evaluate ten-year outcomes of penile prosthesis (PP) implantation for the treatment of erectile dysfunction and to assess predictors of early prosthetic infection (EPI). We identified 549 men who underwent 576 PP placements between 2008 and 2018. Univariate and multivariate analyses were used to identify potential predictors of EPI. An EPI predictive nomogram was developed. Thirty-five (6.1%) cases of EPI were recorded with an explant rate of 3.1%. In terms of satisfaction, 82.0% of the patients defined themselves as "satisfied," while partner's satisfaction was 88.3%. Diabetes (P = 0.012), longer operative time (P = 0.032), and reinterventions (P = 0.048) were associated with EPI risk, while postoperative ciprofloxacin was inversely associated with EPI (P = 0.014). Rifampin/gentamicin-coated 3-piece inflatable PP (r/g-c 3IPP) showed a higher EPI risk (P = 0.019). Multivariate analyses showed a two-fold higher risk of EPI in diabetic patients, redo surgeries, or when a r/g-c 3IPP was used (all P < 0.03). We showed that diabetes, longer operative time, and secondary surgeries were the risk factors for EPI. Postoperative ciprofloxacin was associated with a reduced risk of EPI, while r/g-c 3IPP had higher EPI rates without an increased risk of PP explant. After further validation, the proposed nomogram could be a useful tool for the preoperative counseling of PP implantation.
Erectile Dysfunction/surgery* ; Humans ; Male ; Patient Satisfaction ; Penile Implantation ; Penile Prosthesis ; Penis/surgery* ; Tertiary Care Centers

Male patients with prolactinomas usually present with typical hyperprolactinemia symptoms, including sexual dysfunction and infertility. However, clinical factors related to sexual dysfunction and surgical outcomes in these patients remain unclear. This study aimed to investigate the outcomes of male patients with prolactinomas after transsphenoidal surgery and the risk factors affecting sexual dysfunction. This study was conducted on 58 male patients who underwent transsphenoidal surgery for prolactinomas between May 2014 and December 2020 at the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. We evaluated the sexual function of patients before and after surgery through International Index of Erectile Function-5 scores, libido, and frequency of morning erection. Of the 58 patients, 48 (82.8%) patients had sexual intercourse preoperatively. Among those 48 patients, 41 (85.4%) patients presented with erectile dysfunction. The preoperative International Index of Erectile Function-5 scores in patients with macroprolactinomas were significantly higher than those in patients with giant prolactinomas (17.63 ± 0.91 vs 13.28 ± 1.43; P = 0.01). Postoperatively, the incidence of erectile dysfunction was 47.9%, which was significantly lower than that preoperatively (85.4%; P = 0.01). Twenty-eight (68.3%) patients demonstrated an improvement in erectile dysfunction. Tumor size and invasiveness were significantly correlated with the improvement of erectile dysfunction. Preoperative testosterone <2.3 ng ml^-1 was an independent predictor of improvement in erectile dysfunction. In conclusion, our results indicated that tumor size and invasiveness were important factors affecting the improvement of sexual dysfunction in male patients with prolactinoma. The preoperative testosterone level was an independent predictor related to the improvement of erectile dysfunction.
Humans ; Male ; Prolactinoma/surgery* ; Erectile Dysfunction/etiology* ; Retrospective Studies ; Sexual Dysfunction, Physiological/complications* ; Testosterone ; Pituitary Neoplasms/pathology*

Advanced chronic kidney disease is associated with impaired spermatogenesis and testicular damage. Semen analysis typically shows a decreased volume of ejaculate, oligo- or complete azoospermia, and a low percentage of motile sperm. Erectile dysfunction (ED) is also common in patients with chronic renal failure (CRF) and is observed in excess of 50% of these patients. There have been ongoing improvements in survival and quality of life after renal transplantation. One of the most impressive aspects of successful renal transplantation in the young people is the ability of the male patient to father a child. In this article we first review pathophysiology of reproductive failure in end-stage renal disease (ESRD), then ED in ESRD and its management are discussed, finally sexual function in renal transplant patients and management of ED in these patients are reviewed.
Erectile Dysfunction ; therapy ; Humans ; Kidney Failure, Chronic ; physiopathology ; surgery ; Kidney Transplantation ; Male ; Reproduction

OBJECTIVETo analyze the impact of transurethral resection of the prostate (TURP) on erectile function and the factors influencing postoperative erectile function.

METHODSAltogether 64 male patients aged 53 -75 (mean 66.5) years underwent TURP for prostatic hyperplasia. Before and 3 months after surgery, we observed the nocturnal penile tumescence of the patients and analyzed their scores on the 5-item version of the International Index of Erectile Function (IIEF-5) and the Self-Rating Anxiety Scale (SAS).

RESULTSIntraoperative prostatic capsule perforation and postoperative stress were significantly related to postoperative erectile dysfunction (P < 0.05). The mean score of IIEF-5 was significantly decreased (P < 0.01) while that of SAS remarkably increased (P < 0.01) after TURP as compared with those before surgery. The frequency of nocturnal penile tumescence was reduced at 3 months after surgery, but with no statistically significant difference.

CONCLUSIONIntraoperative prostatic capsule perforation and postoperative stress obviously affect postoperative erectile function.

Aged ; Erectile Dysfunction ; etiology ; Humans ; Male ; Middle Aged ; Prostatic Hyperplasia ; surgery ; Transurethral Resection of Prostate ; adverse effects

Rectal cancer is a common malignancy in the alimentary tract with an increasing incidence, the current treatments of which include surgery, radiotherapy, chemotherapy, and integrated comprehensive options. Sexual dysfunction, especially erectile dysfunction (ED), is one of the commonest complications in men after rectal cancer treatment and is generally attributed to the damage to the pelvic autonomic nerves. However, recent studies show that ED after rectal cancer treatment is a complex pathophysiological process associated with neurogenic, vasculogenic, and psychological factors. This article reviews the pathogeneses of ED after rectal cancer treatment in order to provide some theoretical evidence for its prevention and treatment.
Erectile Dysfunction ; etiology ; Humans ; Male ; Postoperative Complications ; etiology ; Rectal Neoplasms ; surgery

OBJECTIVETo improve the clinician's ability for emergency treatment of priapism.

METHODSBoth cases received 2 mg to 8 mg of metaraminol injection at the root of cavernous body, and perfusion of heparinized saline at glans and root of cavernous body of the penis by contrecoup, but they had not good response to the above therapy. At last surgery was performed.

RESULTSTotal penectomy was performed for both cases. One case was diagnosed of penile sarcoma, and another was metastatic transitional cell carcinoma.

CONCLUSIONPriapism due to neoplasma is infrequent, it should not be misdiagnosed in case of emergency.

Erectile Dysfunction ; diagnosis ; etiology ; therapy ; Humans ; Male ; Middle Aged ; Penile Neoplasms ; complications ; surgery