International Journal of Impotence Research最新文献

{"title":"Top ten surgical tricks-surgical management of adult acquired buried penis.","authors":"Maurizio D'Anna, Lluis Peri Cusí, Antonio Alcaraz Asensio, Josep Torremadé Barreda","doi":"10.1038/s41443-026-01293-w","DOIUrl":"https://doi.org/10.1038/s41443-026-01293-w","url":null,"abstract":"<p><p>Adult acquired buried penis is an increasingly prevalent condition, commonly associated with obesity, in which a normally sized penis becomes concealed by suprapubic adipose tissue. It has a negative impact on quality of life, causing urinary and sexual dysfunction, and recurrent infections. Chronic inflammation may further lead to urethral stricture, lichen sclerosus, and penile malignancy. Surgical repair is the definitive treatment, but it requires a structured reconstructive approach. This article describes ten key principles to optimize outcomes in the surgical repair of an adult acquired buried penis. These include appropriate patient selection and preoperative optimization, accurate standing-position marking, a wide transverse incision, and dissection to the aponeurosis with preservation of the spermatic cords. Penile skin must be carefully assessed to determine the need for grafts or scrotal flaps. Restoration of the penopubic angle using anchoring sutures is essential to prevent recurrence, while adjunctive lipectomy or liposuction may improve contour. Proper drainage, layered wound closure, and meticulous postoperative care are critical to minimize complications. These principles provide a practical framework for reconstructive urologists performing adult acquired buried penis repair, facilitating functional recovery, improved aesthetic outcomes, and sustained improvement in patient quality of life.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156434","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":"Predictors of penile prosthesis length: results from the PHOENIX registry.","authors":"Koenraad Van Renterghem, Alvaro Yebes, Glenn Lamers, Josep Torremadé, Carlo Bettocchi, Borja Garcia-Gomez, Wai Gin Lee, Christien Caris, Wim Witjes, Ignacio Moncada, David Ralph","doi":"10.1038/s41443-026-01294-9","DOIUrl":"https://doi.org/10.1038/s41443-026-01294-9","url":null,"abstract":"<p><p>Penile prosthesis implantation (PPI) is an effective treatment for refractory erectile dysfunction (ED), but changes in penile length after surgery remain a major determinant of patient satisfaction. We aimed to identify patient- and surgery-related factors associated with final penile length, measured as total implanted device length. We analysed prospectively collected data from the PHOENIX registry, a multicenter cohort including consecutive PPI cases from 29 centers between November 2021 and August 2024 (ClinicalTrials.gov NCT03849586). Baseline demographics and surgical variables were recorded. Variables significant at p < 0.05 in univariate analysis and clinically relevant covariates were entered into a multivariate linear regression model. After exclusions, 1033 patients were included (mean age 60.9 ± 9.06 years). Mean total device length was 20.0 ± 2.36 cm (range 6-28). In multivariate analysis, shorter total device length was independently associated with diabetes mellitus (adjusted coefficient -0.59 cm; 95% CI -0.97 to -0.22; p = 0.002), history of radical prostatectomy (-0.45 cm; 95% CI -1.01 to -0.11; p = 0.04), prior pelvic radiotherapy (-1.42 cm; 95% CI -2.42 to -0.51; p = 0.002), Peyronie's disease (-0.83 cm; 95% CI -1.32 to -0.34; p < 0.001), previous intracavernosal injections (-0.68 cm; 95% CI -0.99 to -0.37; p < 0.001). Avoidance of sequential corporal dilation was associated with a modest increase in device length (+0.15 cm; 95% CI 0.01 to 0.50; p = 0.04). Loss of penile length is a well-established cause of patient and partner dissatisfaction following PPI. Pre-operative counselling and management of expectations is critical to the success of the procedure. In this large prospective multicenter cohort different factors were found to be associated with greater or lesser length. Among them, and following multivariate analysis, diabetes, radical prostatectomy, radiotherapy, Peyronie's disease and prior intracavernosal injections were associated with shorter implanted device length, whereas no corporal dilation was associated with longer device length. These findings can inform preoperative counselling and surgical planning.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148143450","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":"Plaque incision and grafting for peyronie's disease: 15-year experience and functional outcomes from a high-volume andrology centre.","authors":"Shiv Sarna, Karl H Pang, Andrew N Christopher, David J Ralph, Asif Muneer, Hussain M Alnajjar","doi":"10.1038/s41443-026-01296-7","DOIUrl":"https://doi.org/10.1038/s41443-026-01296-7","url":null,"abstract":"<p><p>Plaque incision and grafting is a well-established treatment for severe or complex Peyronie's disease and preserved erectile function. This retrospective single-centre cohort study evaluated 325 patients undergoing the procedure between 2009 and 2024 at a high-volume centre. Median pre-operative curvature was 80° (IQR 60-90°) and 46.8% (152/325) had complex deformities (wasting 36.6%, hourglass 10.2%). 90.2% (293/325) completed follow-up (median 9.8 months) and were included in outcome analysis. Overall satisfaction was 87.0% (255/293), with 90.1% (264/293) resuming penetrative intercourse. Perceived length reduction occurred in 29.4% (86/293) and hypoaesthesia in 15.4% (45/293). Patients were stratified by baseline erectile status: 72.4% (212/293) had normal pre-operative erectile function and 27.6% (81/293) had pre-existing erectile dysfunction (ED). New-onset ED occurred in 22.2% (47/212) of previously potent men. Among men with pre-existing ED, 37.0% (30/81) improved and 13.6% (11/81) worsened. Multivariable regression showed cardiovascular and metabolic comorbidities were significantly associated with post-operative ED, whereas graft size and complex deformity did not. Re-operation was required in 8.5% (25/293). These findings suggest functional decline can be driven by systemic health in addition to surgical technique. Integrating cardiovascular and metabolic risk assessment into counselling is therefore essential. Management at a high-volume centre remains key to optimising outcomes.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148143481","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":"Evaluation of ChatGPT-5-generated surgical literature: the accuracy of a review on penile prosthesis implantation.","authors":"Fesih Ok, Ibrahim Halil Sukur, Murat Gül, Koenraad van Renterghem","doi":"10.1038/s41443-026-01295-8","DOIUrl":"https://doi.org/10.1038/s41443-026-01295-8","url":null,"abstract":"<p><p>The integration of artificial intelligence language models into medical literature requires rigorous evaluation of accuracy and reliability, especially in specialized domains. This study assessed ChatGPT-5's capacity to generate clinically accurate scientific content on penile prosthesis implantation. Using structured prompts, ChatGPT-5 produced a narrative review evaluated across four domains: (1) verification of factual statements, (2) reference validity via PubMed and Google Scholar, (3) plagiarism screening with iThenticate and Quetext, and (4) qualitative assessment using Scale for the Assessment of Narrative Review Articles and a peer-review rubric. ChatGPT-5 demonstrated high factual accuracy overall, correctly supporting most statements, although errors were identified in historical timelines and survival data. In contrast, reference analysis revealed significant weaknesses, with only about one-third of citations being fully accurate and several containing fabricated or incomplete bibliographic details. Text similarity rates were low. Overall quality was rated as good according to standardized assessment tools, with strong agreement between reviewers. Collectively, these findings indicate that ChatGPT-5 can produce clinically accurate, well-structured content but demonstrates important weaknesses in reference reliability and evidence synthesis. The results support a hybrid model in which artificial intelligence serves as a drafting aid under expert supervision rather than as a standalone author. Future work should prioritize strengthening citation validity to enhance reliability while safeguarding scientific integrity.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148042132","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":"Correction: Penile prosthesis implantation: a systematic review of intraoperative and postoperative complications.","authors":"Andrea Cocci, Paolo Capogrosso, Suks Minhas, Carlo Bettocchi, Luca Boeri, Joana Carvalho, Nusret Can Cilesiz, Giovanni Corona, Konstantinos Dimitropoulos, Murat Gül, Georgios Hatzichristodoulou, Thomas Hugh Jones, Ates Kadioglu, Juan Ignatio Martínez Salamanca, Uros Milenkovic, Vaibhav Modgil, Giorgio Ivan Russo, Ege Can Serefoglu, Tharu Tharakan, Paolo Verze, Marco Falcone, Afonso Morgado, Andrea Salonia","doi":"10.1038/s41443-026-01282-z","DOIUrl":"https://doi.org/10.1038/s41443-026-01282-z","url":null,"abstract":"","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148029944","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":"Impact of HCV infection on male reproductive hormones; a systematic review and meta-analysis.","authors":"Hojat Dehghanbanadaki, Luke P O'Connor, Bryan Kim, Kiarad Fendereski, Joshua J Horns, Joemy M Ramsay, Alexander W Pastuszak, James M Hotaling","doi":"10.1038/s41443-026-01290-z","DOIUrl":"https://doi.org/10.1038/s41443-026-01290-z","url":null,"abstract":"<p><p>Previous research has suggested a correlation between hepatitis C infection and male reproductive hormones. This study systematically reviewed the literature and determined the pooled effect of hepatitis C infection on male reproductive hormones. PubMed, Scopus, and Web of Science were searched on 1 October 2024. Studies were included if they compared reproductive hormone levels between hepatitis C-positive and hepatitis C-negative men. Excluded were animal studies, reviews, editorials, preprints, and studies lacking hormone data or hepatitis C status differentiation. The effect measures were weighted mean differences. Heterogeneity was measured with I² index. Risk of bias was assessed using the Newcastle-Ottawa Scale, and evidence certainty was evaluated with the GRADE approach. PROSPERO Registration number=CRD42024596571. The initial search yielded 569 documents. After screening, 10 documents were eligible for meta-analysis, each showing high methodological quality (NOS score≥7). Hepatitis C infection was associated with a decrease of 22.62 pmol/L free testosterone (95%CI: -28.65, -16.60; p-value < 0.01; I² = 21.96%), an increase of 1.98 ng/ml prolactin (95%CI: 0.76, 3.19; p-value < 0.01; I² = 75.28%), and an elevation of 37.66 nmol/L sex hormone binding globulin (95%CI: 21.81, 53.51; p-value < 0.01; I² = 95.42%). No publication bias was detected for free testosterone, prolactin, or sex hormone binding globulin, whereas publication bias was observed for total testosterone and estradiol. After publication bias adjustment, hepatitis C infection was associated with 4.16 nmol/L lower total testosterone (95%CI: -4.74, -3.57) and 7.06 pg/ml higher estradiol (95%CI: 6.11, 8.02). Subgroup analysis showed stronger hepatitis C infection effects on free testosterone, prolactin, and estradiol in studies with an average participant age under 40 than in those over 40. In conclusion, hepatitis C infection has been associated with alterations in male reproductive hormones; however, as the certainty of evidence is low to very low (GRADE), these findings should be interpreted cautiously and require confirmation in well-designed studies before clinical implications can be established.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147981716","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":"Predicting sperm retrieval success in salvage testicular sperm extraction: a machine learning perspective.","authors":"Berk Hazir, Ali Sahin, Mehmet Hamza Gultekin, Cevahir Ozer, Mehmet Vehbi Kayra, Eray Hasirci, Erman Ceyhan, Mesut Altan, Tufan Cicek, Yalcin Kizilkan, Mesut Berkan Duran, Muhammed Arif İbis, Gokhan Ceker, Cem Sah, Nebil Akdogan, İyimser Ure, Ali Can Albaz, Aykut Baser, Murat Gül","doi":"10.1038/s41443-026-01291-y","DOIUrl":"10.1038/s41443-026-01291-y","url":null,"abstract":"<p><p>This multicenter retrospective observational study aimed to identify predictive factors for successful secondary testicular sperm extraction (TESE) using advanced machine learning (ML) models. Data from 503 infertile men who underwent secondary TESE between 2021 and 2024 after a previous unsuccessful attempt were analyzed. Preoperative characteristics and laboratory findings were assessed using ten ML algorithms, including Xtreme Gradient Boosting, Random Forest, Gradient Boosting, Decision Tree, AdaBoost, Logistic Regression, Multi-Layer Perceptron, Support Vector Machine, K-Nearest Neighbors, and Naive Bayes. Model performance was evaluated using accuracy, sensitivity, specificity, predictive values, F1 score, Youden Index, and area under the ROC curve. Sperm retrieval succeeded in 211 patients (41.9%) and failed in 292 (58.1%). Mean infertility duration was 7.25 years. Xtreme Gradient Boosting consistently outperformed other algorithms across all performance metrics. Key predictors of successful secondary TESE included preoperative body mass index, TESE location, luteinizing hormone level, and semen volume. Testicular volumes and infertility duration also contributed significantly to prediction accuracy. Incorporating multiple clinical and laboratory parameters into ML-based predictive models can improve surgical planning and preoperative counseling. For men undergoing secondary TESE, these models may identify those with a very low chance of success, reducing unnecessary repeat surgical interventions.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147981737","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":"Vasectomy revisited: Safe procedure in a changing reproductive landscape.","authors":"Rashed Rowaiee, Omer Raheem","doi":"10.1038/s41443-026-01273-0","DOIUrl":"https://doi.org/10.1038/s41443-026-01273-0","url":null,"abstract":"","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147981686","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":"Vasectomy at a crossroads: utilization, equity, and clinical practice in a changing reproductive landscape.","authors":"Rashed Rowaiee, Omer Raheem","doi":"10.1038/s41443-026-01274-z","DOIUrl":"https://doi.org/10.1038/s41443-026-01274-z","url":null,"abstract":"","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147981700","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":"Attention-deficit/hyperactivity disorder stimulant use is associated with reduced semen volume in reproductive-age men: a multi-center analysis.","authors":"Jayant Siva, Sanjay Vallabhaneni, Rishi Jonnalagadda, Nicholas Heller, Andrew Barr, Sahil Patel, Bryan D Naelitz, Scott D Lundy, Raevti Bole","doi":"10.1038/s41443-026-01289-6","DOIUrl":"https://doi.org/10.1038/s41443-026-01289-6","url":null,"abstract":"<p><p>Stimulant medications are increasingly prescribed for attention-deficit/hyperactivity disorder (ADHD) in men of reproductive age, yet their impact on semen quality remains poorly characterized. We aimed to evaluate whether recent stimulant exposure would negatively affect semen parameters in reproductive-age men with ADHD. We performed a multi-center retrospective analysis of 2039 men aged 18-40 years with a diagnosis of ADHD and available semen volume data between 1995-2025. We excluded men with diagnoses or treatments known to affect spermatogenesis or ejaculatory function. Exposure was defined as an active outpatient prescription for methylphenidate, amphetamine, lisdexamfetamine, dextroamphetamine, or methamphetamine within 90 days prior to semen testing. Exposed patients were matched 2:1 by age (±4 years) to stimulant-unexposed controls with ADHD. The final cohort included 388 exposed and 776 matched controls, with median ages of 33 (IQR 30-37) and 33 (IQR 29-37) years, respectively. Stimulant exposure was associated with lower semen volume (median 2.70 mL [IQR 1.9-3.7] vs. 2.95 mL [IQR 2.0-4.1], p = 0.02). No significant differences were observed between groups in other semen parameters (p > 0.25). On univariable regression, stimulant exposure was associated with a 5.7% decrease in semen volume (p = 0.02). After adjustment in multivariable regression, stimulant exposure remained associated with an 8.4% lower semen volume (p = 0.01). Among reproductive-age men with ADHD, recent stimulant use was associated with a modest decrease in semen volume, while other semen parameters remained unchanged. Importantly, preserved sperm quality suggests that stimulant use during attempts at conception is unlikely to significantly impair fertility.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147981745","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}