1.Management of urethral atrophy after implantation of artificial urinary sphincter: what are the weaknesses?
Nathaniel H HEAH ; Ronny B W TAN
Asian Journal of Andrology 2020;22(1):60-63
The use of artificial urinary sphincter (AUS) for the treatment of stress urinary incontinence has become more prevalent, especially in the "prostate-specific antigen (PSA)-era", when more patients are treated for localized prostate cancer. The first widely accepted device was the AMS 800, but since then, other devices have also entered the market. While efficacy has increased with improvements in technology and technique, and patient satisfaction is high, AUS implantation still has inherent risks and complications of any implant surgery, in addition to the unique challenges of urethral complications that may be associated with the cuff. Furthermore, the unique nature of the AUS, with a control pump, reservoir, balloon cuff, and connecting tubing, means that mechanical complications can also arise from these individual parts. This article aims to present and summarize the current literature on the management of complications of AUS, especially urethral atrophy. We conducted a literature search on PubMed from January 1990 to December 2018 on AUS complications and their management. We review the various potential complications and their management. AUS complications are either mechanical or nonmechanical complications. Mechanical complications usually involve malfunction of the AUS. Nonmechanical complications include infection, urethral atrophy, cuff erosion, and stricture. Challenges exist especially in the management of urethral atrophy, with both tandem implants, transcorporal cuffs, and cuff downsizing all postulated as potential remedies. Although complications from AUS implants are not common, knowledge of the management of these issues are crucial to ensure care for patients with these implants. Further studies are needed to further evaluate these techniques.
Atrophy
;
Humans
;
Postoperative Complications/therapy*
;
Prosthesis Failure
;
Prosthesis Implantation
;
Prosthesis-Related Infections/therapy*
;
Urethra/pathology*
;
Urethral Diseases/therapy*
;
Urethral Stricture/surgery*
;
Urinary Incontinence, Stress/surgery*
;
Urinary Sphincter, Artificial
2.The Non-Surgical Treatment of Peyronie Disease: 2013 Update.
Eric James SHAW ; Gregory Clyde MITCHELL ; Ronny B TAN ; Premsant SANGKUM ; Wayne John G HELLSTROM
The World Journal of Men's Health 2013;31(3):183-192
Peyronie disease is a common cause of penile deformity and sexual dysfunction. Although surgery is regarded as the definitive management for this condition, there are many medical and minimally invasive therapies available, with widely varying efficacy reported in the literature. The purpose of this review is to describe the current state-of-the-art for each of the most commonly used as well as several developing non-surgical treatments. Further, we hope to offer perspectives that will aid practitioners in deciding among these treatments that are either already in use or have the potential to be used as alternatives to surgery in the management of this frustrating disease.
Congenital Abnormalities
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Erectile Dysfunction
;
Hope
;
Male
;
Penile Induration*