International Journal of Impotence Research最新文献

{"title":"Evolution and innovation in urethroplasty: a comprehensive narrative review of graft types and surgical techniques.","authors":"Donato Cannoletta, Filippo Pederzoli, Christian Yepes, Pankaj Joshi, Andrea Salonia, Alberto Briganti, Francesco Montorsi, Sanjay Kulkarni, Marco Bandini","doi":"10.1038/s41443-025-01040-7","DOIUrl":"https://doi.org/10.1038/s41443-025-01040-7","url":null,"abstract":"<p><p>Urethroplasty has evolved over last decades, with significant improvements in surgical techniques and graft types. In this narrative review, we aimed to explore the evolution of urethroplasty techniques for bulbar urethral strictures. To do this, the review is structured into three main sections: the Historical Background section highlights the seminal contribution from early pioneers to contemporary techniques, which re-gained momentum in reconstructive urology. Starting with the early techniques in the 19th and 20th centuries, we focused on the pioneering innovations of the 1990s, ultimately leading to the most recent tissue-preserving techniques. The second part presents a literature review comparing different graft types and critically evaluating surgical outcomes from multiple original articles and meta-analysis. Specifically, similar success rates were reported for oral and preputial grafts for the treatment of anterior urethral strictures, while long-term outcomes suggest graft deterioration over time. Furthermore, data on optimal surgical techniques remain limited. Lastly, Future Perspectives address ongoing innovations, including new graft and flap combinations for complex strictures, emphasizing the continuous refinement of less invasive, tissue-preserving techniques.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empowering people affected by penile cancer: towards a model for supportive self-management.","authors":"Catherine Paterson, Wayne Earle, David Homewood, Justin Chee, Henry Yao, Shomik Sengupta, Oluwaseyifunmi Andi Agbejule, Reegan Knowles, Carolyn Ee, Theo Niyonsenga, Ian D Davis","doi":"10.1038/s41443-025-01042-5","DOIUrl":"https://doi.org/10.1038/s41443-025-01042-5","url":null,"abstract":"<p><p>Improvements in the quality of penile cancer management are difficult due to the rarity of the condition and a limited evidence base for treatment decisions. Penile cancer and some of its highly morbid treatments can cause profound psychosexual and physical effects that negatively impact quality of life. Multidisciplinary interventions are required to equip patients with the support necessary to manage their emotional, physical, work, and lifestyle challenges to optimize health, well-being, and recovery. This paper outlines a model of supported self-management, which is a novel model of care for people with penile cancer to mitigate disease and treatment morbidity.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simultaneous penile prosthesis placement and collagen fleece (TachoSil) grafting. Where do we stand in 2024?","authors":"Georgios Hatzichristodoulou","doi":"10.1038/s41443-025-01046-1","DOIUrl":"https://doi.org/10.1038/s41443-025-01046-1","url":null,"abstract":"<p><p>Surgical therapy of Peyronie's disease is the gold standard for correction of the associated penile curvature. In patients with co-existing erectile dysfunction, not responding to medical/conservative treatment, penile prosthesis implantation is indicated and recommended. Severe residual curvature in these cases can be addressed by plaque incision and grafting. The novel collagen fleece TachoSil^® (Corza Medical, MA, USA) has emerged as a reliable and robust graft for this purpose, with favorable results. Hatzichristodoulou was the first to publish his new technique of plaque incision and grafting with TachoSil^® for residual curvature correction during penile prosthesis implantation in 2018 (PICS Technique). Since then, this technique was adopted and used by various surgeons. In the current narrative review all publications using this novel graft after plaque incision for residual curvature correction will be presented and respective results discussed. Moreover, the surgical technique will be highlighted in detail. The TachoSil^® has self-adhesive properties which make it unique and the ideal graft for this indication. Results of the studies on this topic, that are available so far, are excellent. The technique is safe. However, data from more patients and even more long-term follow-up results of patients treated with this technique and graft are requested.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy of penoscrotal decompression for refractory ischaemic priapism: a systematic review and meta-analysis.","authors":"Mohamed Mubarak, Qasim Isa, John Hayes, Ian Pearce, Vaibhav Modgil","doi":"10.1038/s41443-025-01044-3","DOIUrl":"https://doi.org/10.1038/s41443-025-01044-3","url":null,"abstract":"<p><p>Penoscrotal decompression (PSD) has emerged as a promising surgical intervention for refractory ischaemic priapism, involving proximal corporotomies and the drainage of ischaemic blood. Initial outcomes have shown high success rates in achieving detumescence, low recurrence rates, and relatively good preservation of erectile function. This meta-analysis aims to comprehensively evaluate PSD's effectiveness across three key metrics: detumescence, prevention of recurrence, and erectile function preservation. A systematic review and meta-analysis, following PRISMA guidelines, identified 9 publications that met the inclusion criteria. They encompassed five case reports, two abstracts, and two observational cohort studies, with data on 62 patients who presented with refractory ischaemic priapism. Notably, around half (46.7%) of the patients had conventional distal shunts prior to PSD. Overall following PSD, detumescence was achieved in 89.3% (CI 95%, 0.78-0.95). Post-PSD recurrence of ischaemic priapism occurred in 12.7% (95% CI, 0.06-0.24). Erectile function was preserved in 54.8% of the patients who had follow-up (95% CI, 0.40-0.68). These findings inform us that PSD proves to be a viable and effective surgical option for refractory ischaemic priapism with a key feature being better sexual function preservation outcomes compared to shunting procedures. Given the paucity of data, further larger scale prospective studies of robust designs are still necessary to better establish PSD's role within the treatment algorithm for refractory ischaemic priapism.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of cosmetic concerns after gender-affirming vaginoplasty: a retrospective case series and guide to revisions.","authors":"John B Smith, Ahmad Hefnawy, Grace Chen, Ervin Kocjancic, Omer Acar","doi":"10.1038/s41443-025-01039-0","DOIUrl":"https://doi.org/10.1038/s41443-025-01039-0","url":null,"abstract":"<p><p>This retrospective study examines 58 transgender women who presented with cosmetic concerns following gender-affirming vaginoplasty between January 2020 and April 2023. The cohort's mean age was 36.8 years (±9.8), with a mean BMI of 29.5 kg/m² (±7.1). Most patients were Black or African American (41.4%) or White (31.4%), and 43.0% had wound healing comorbidities. Of the total cohort, 62.1% (36/58) underwent penile inversion vaginoplasty (PIV), 31.0% (18/58) robotic-assisted vaginoplasty with peritoneal flaps, and 6.9% (4/58) shallow-depth vaginoplasty. A total of 36.2% (21/58) patients reported cosmetic concerns, most frequently labial (20.7%), clitoral (12.1%), hypergranulation tissue (8.6%), mons pubis fullness (5.2%), and introital scarring (5.2%). Management included expectant care, in-office procedures (e.g., silver nitrate for hypergranulation), and surgical revision. Surgical revision was performed in 80.9% of patients, with all reporting post-operative cosmetic satisfaction. A guide to surgical revision is discussed for each cosmetic concern subgroup. A tiered approach involving expectant management, in-office interventions, and surgical revision can effectively address these issues and enhance patient satisfaction.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pelvic physical therapy for male sexual disorders: a narrative review.","authors":"Emel Sahin, Alma Brand, Elif Nazli Cetindag, Bert Messelink, Hayri Baran Yosmaoglu","doi":"10.1038/s41443-025-01034-5","DOIUrl":"https://doi.org/10.1038/s41443-025-01034-5","url":null,"abstract":"<p><p>Pelvic physical therapy is an evidence-based, first-line treatment for many pelvic floor disorders and sexual dysfunction. Studies have shown that pelvic physical therapy programs can both improve pelvic floor dysfunctions and sexual function. This article aims to provide an overview of the current state of the art regarding pelvic physical therapy for male sexual dysfunction to inform healthcare providers who treat men with sexual dysfunction better. A literature review was performed in Google Scholar, PubMed, and Science Direct to find review articles, research articles, and case studies about the effect of pelvic physical therapy treatments for male sexual dysfunction. Twenty-six articles were found about various pelvic physical therapy interventions. Besides this overview of the literature, an overview of interventions used in clinical practice is also provided. This narrative review supports the potential efficacy of pelvic physical therapy in addressing male sexual dysfunction. Pelvic physical therapy approaches that comprise exercise modalities, electrotherapy approaches, manipulative techniques, lifestyle changes, behavioral suggestions, and pain management strategies, should be suggested for potential benefits in improving erectile function, premature ejaculation, and sexual dysfunction-associated chronic pelvic pain. More research is needed to examine the effect of pelvic physical therapy on hypoactive sexual desire and delayed ejaculation.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bedtime sildenafil oral suspension improves sexual spontaneity and time-concerns compared to on-demand treatment in men with erectile dysfunction: results from a real-life, cross-sectional study.","authors":"Luca Boeri, Fabrizio Palumbo, Tommaso Cai, Carlos Miacola, Carlo Ceruti, Marco Bitelli, Danilo Di Trapani, Andrea Piasentin, Giorgio Piubello, Chiara Polito, Davide Arcaniolo, Marco Magliocchetti, Alessandro Palmieri","doi":"10.1038/s41443-025-01035-4","DOIUrl":"https://doi.org/10.1038/s41443-025-01035-4","url":null,"abstract":"<p><p>Phosphodiesterase type 5 inhibitors (PDE5i) are among the first line treatment options in men with erectile dysfunction (ED). On-demand sildenafil has proved to be an effective PDE5i but with lower spontaneity scores compared to daily tadalafil treatment. We aimed to investigate the impact of on-demand sildenafil compared to bedtime use on efficacy and spontaneity scores in men with ED. We retrospectively analysed data from a cohort of men with mild/moderate ED treated for three months with on-demand sildenafil 50 mg oral suspension formulation (OSF) (group 1, n = 40), bedtime sildenafil 50 mg OSF (group 2, n = 40) and bedtime sildenafil 37.5 mg OSF (group 3, n = 40). After three months patients were evaluated with the International Index of Erectile Function-5 items (IIEF-5) and the Psychological and Interpersonal Relationship Scales-Short Form (PAIRS-SF) questionnaires. Propensity score matching was used to adjust for baseline confounders. The IIEF-5 and PAIRS-SF scores were compared between groups at follow-up with the repeated measures ANOVA test. Linear regression analyses tested the associations between study variables and spontaneity scores. After matching, median patient's age and ED duration were 56 (50-61) years and 18 (10-20) months, respectively. Compared to baseline, IIEF-5 scores significantly improved after sildenafil OSF treatment, irrespective of the therapeutic approach (all p < 0.01 vs. baseline). The PAIRS-SF spontaneity score was significantly better in group 2 [15 (13-16), p < 0.01] and group 3 [14 (14-16), p < 0.01] compared to the on-demand use [13 (12-13)]. Fewer time concerns were reported for bedtime use than on-demand sildenafil. Sildenafil OSF bedtime use was found to be an independent predictor for better spontaneity and fewer time concerns scores (all p < 0.001). Bedtime sildenafil OSF showed similar efficacy but better spontaneity scores than on-demand use. Bedtime sildenafil is a valuable option for men with ED prioritizing efficacy and sexual spontaneity.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-related decline in total testosterone levels among young men: insights from a large single-center observational study.","authors":"Christian Corsini, Edoardo Pozzi, Federico Belladelli, Alessandro Bertini, Fausto Negri, Massimiliano Raffo, Luca Boeri, Eugenio Ventimiglia, Luigi Candela, Alessia D'Arma, Francesco Montorsi, Andrea Salonia","doi":"10.1038/s41443-025-01029-2","DOIUrl":"https://doi.org/10.1038/s41443-025-01029-2","url":null,"abstract":"<p><p>We aimed to depict the age-specific distribution of total Testosterone (tT) levels among young men presenting to a single academic centre with uro-andrological complaints. Overall, tT levels from 2593 men aged 20-44 years were analyzed. Men were grouped into 'infertile men' and 'men with sexual dysfunction (SD)' according to their primary complaints. Data was also collected from 71 same-ethnicity age-comparable fertile controls. Linear regression fitted the relationship between tT and increasing age. Distribution of tT was determined for each 5-year age-group, both for the overall population and the subgroups. tT quantiles were reported for each sample sub-group and age-group. Of 2664 men, 1913 (71.81%) were classified as infertile, 680 (25.52%) with SD and 71 as fertile men (2.67%), respectively. tT levels depicted a reduction of 0.14 nmol/L per year between 20 and 44 years of age (p < 0.001) within the overall study population. Significant reduction was also observed for the population stratified by urological complaints (all p < 0.05). This is the first study to describe tT levels as a function of baseline clinical status in a large same-ethnicity cohort of young men, uniformly assessed using a standardized laboratory method.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous angioplasty of internal pudendal artery stenosis with drug-eluting paclitaxel-coated balloons for the treatment of severe erectile dysfunction: a single-center pilot experience.","authors":"Filippo Migliorini, Claudio Brancelli, Sonia Costantino, Nicola De Maria, Anna Marcer, Antonio Benito Porcaro, Alessandro Veccia, Riccardo Rizzetto, Riccardo Bertolo, Flavio Luciano Ribichini, Alessandro Antonelli","doi":"10.1038/s41443-025-01037-2","DOIUrl":"https://doi.org/10.1038/s41443-025-01037-2","url":null,"abstract":"","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Congenital penile curvature treatments in adults: a systematic review of techniques and outcomes.","authors":"Marco Capece, Simone Cilio, Afonso Morgado, Paolo Capogrosso, Giuseppe Celentano, Vincenzo Altieri, Andrea Cocci, Marco Falcone, Celeste Manfredi, Luigi Napolitano, Giorgio Ivan Russo, Roberto La Rocca","doi":"10.1038/s41443-025-01033-6","DOIUrl":"https://doi.org/10.1038/s41443-025-01033-6","url":null,"abstract":"<p><p>Congenital penile curvature is a rare condition identified by an abnormal penile curvature present from birth. Surgical intervention is currently the most effective treatment and is generally deferred until after puberty; however, early correction is recommended by some due to its impact on psychosexual development. This systematic review aims to evaluate the literature on surgical techniques for congenital penile curvature correction, focusing on their efficacy, safety, and patient-reported outcomes. Conducted in accordance with PRISMA guidelines and registered with PROSPERO (ID: CRD42024526737), the review includes 59 studies meeting inclusion criteria. The findings indicate that numerous surgical techniques have been documented over the past decades, predominantly focusing on shortening procedures such as Nesbit, Yachia, tunica albuginea plication, and Essed-Schröder. These historically utilized methods remain effective for correcting congenital penile curvature, but they may result in side effects like penile shortening and erectile dysfunction. The review emphasizes the necessity for well-designed studies to better compare the benefits of various surgical techniques.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}