International Journal of Impotence Research最新文献_第2页

Congenital penile curvature treatments in adults: a systematic review of techniques and outcomes.

IF 2.8 3区医学

International Journal of Impotence Research Pub Date : 2025-02-20 DOI: 10.1038/s41443-025-01033-6

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

{"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":"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.","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}

引用次数: 0

How to improve functional outcome of inflatable penile implant surgery? a narrative review.

IF 2.8 3区医学

International Journal of Impotence Research Pub Date : 2025-02-18 DOI: 10.1038/s41443-025-01030-9

Ahmet Vural, Helene De Bruyn, Koenraad Van Renterghem

引用次数: 0

The effectiveness of electrical stimulation in the treatment of erectile dysfunction: a systematic review of randomized controlled trials.

IF 2.8 3区医学

International Journal of Impotence Research Pub Date : 2025-02-17 DOI: 10.1038/s41443-025-01032-7

Gislaine Bonete, Diego N Araujo, Cibele T D Ribeiro, Íllia N D F Lima, Hellen Roehrs, Fernando A L Dias

{"title":"The effectiveness of electrical stimulation in the treatment of erectile dysfunction: a systematic review of randomized controlled trials.","authors":"Gislaine Bonete, Diego N Araujo, Cibele T D Ribeiro, Íllia N D F Lima, Hellen Roehrs, Fernando A L Dias","doi":"10.1038/s41443-025-01032-7","DOIUrl":"https://doi.org/10.1038/s41443-025-01032-7","url":null,"abstract":"We aimed to summarize in a systematic review the current evidence on the effectiveness of electrical stimulation in the treatment of erectile dysfunction. Following the PRISMA guidelines, we performed a literature search for randomized controlled trials using Medline, CINAHL, Embase, and Web of Science, and searched unpublished studies and trial registrations. We used Cochrane's risk-of-bias assessment tool and GRADE system to assess the certainty of evidence. From 3 586 potentially relevant records, we included three trials. Overall, 82 men with erectile dysfunction (20-65 years old), assessed using the IIEF-5 questionnaire, were randomized. Transcutaneous electrical stimulation was compared to placebo (Mean difference-MD:4.60, 95% Confidence interval-CI 0.28-8.92, n = 22), aerobic exercise (MD:6.50, 95%CI 5.10-7.90, n = 30), and used in association with pelvic floor muscle training with biofeedback and compared to the same procedure without electrical stimulation (MD:4.80, 95% CI 1.29-8.31, n = 30). We were unable to combine studies for meta-analysis due to clinical heterogeneity. This review was limited by the quality of existing evidence. The certainty of the evidence was very low due to risk of bias and small sample sizes. There is inconclusive evidence of the effectiveness of electrical stimulation in the treatment of erectile dysfunction.","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440883","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}

引用次数: 0

Optimizing neurorrhaphy to improve sensation in phalloplasty: a systematic review.

IF 2.8 3区医学

International Journal of Impotence Research Pub Date : 2025-02-15 DOI: 10.1038/s41443-025-01021-w

Peter C Ferrin, Elliot Burghardt, Jing Xu, Blair R Peters

{"title":"Optimizing neurorrhaphy to improve sensation in phalloplasty: a systematic review.","authors":"Peter C Ferrin, Elliot Burghardt, Jing Xu, Blair R Peters","doi":"10.1038/s41443-025-01021-w","DOIUrl":"https://doi.org/10.1038/s41443-025-01021-w","url":null,"abstract":"Phalloplasty aims to construct a functional and aesthetic phallus in transgender and gender diverse and cisgender patients with absence or loss of penile tissue. Sensation is a critical outcome in postoperative quality of life, impacting placement of erectile devices, sexual function, and overall well-being. Despite this, there is currently a lack of consensus on strategies to optimize sensation in phalloplasty. A comprehensive search of Medline and Embase databases was conducted with keywords related to phallic sensation in penile reconstruction. 237 abstracts were identified, and 28 articles, with 178 patients, met inclusion for final analysis. Studies consistently demonstrate improved sensation with neurorrhaphy; however, significant heterogeneity exists in the reported number of nerve coaptations and coaptation techniques as well as donor and recipient nerve selection. Reported sensory outcomes are mostly limited to presence or absence of sensation (tactile and/or erogenous or unspecified) and/or orgasmic ability. The lack of granularity in reported outcomes makes it challenging to draw robust evidence-based conclusions regarding optimal surgical techniques for maximizing sensory outcomes. Additionally, there is minimal discussion of approaches beyond solely performing nerve coaptations. Based on literature review, histomorphometric data, and our experience in phalloplasty and peripheral nerve surgery, we present a comprehensive approach to optimizing sensory outcomes in phalloplasty based on four key factors: nerve topography, selecting optimal nerve coaptations, considering the impact of sensory end-organ receptors, and integration of sensory re-education protocols targeting cortical plasticity and sexual rehabilitation.","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425289","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}

引用次数: 0

Post-finasteride syndrome - a true clinical entity?

IF 2.8 3区医学

International Journal of Impotence Research Pub Date : 2025-02-14 DOI: 10.1038/s41443-025-01025-6

Simone Cilio, Georgios Tsampoukas, Afonso Morgado, Pedro Ramos, Suks Minhas

{"title":"Post-finasteride syndrome - a true clinical entity?","authors":"Simone Cilio, Georgios Tsampoukas, Afonso Morgado, Pedro Ramos, Suks Minhas","doi":"10.1038/s41443-025-01025-6","DOIUrl":"https://doi.org/10.1038/s41443-025-01025-6","url":null,"abstract":"This review critically examines Post-Finasteride Syndrome (PFS), a condition eventually reported by men who have used finasteride for androgenetic alopecia or benign prostatic enlargement and experienced persistent adverse effects after discontinuation. We explore the clinical manifestations, including sexual dysfunction, neuropsychiatric symptoms, and physical changes, that collectively challenge both diagnosis and management. This review evaluates the evidence for PFS, discusses potential mechanisms including neurobiological alterations, genetic predispositions, and addresses the controversies surrounding its existence and recognition by the medical community. Emphasis is placed on the role of patient education and the need for thorough risk assessment before prescribing finasteride. Although contrasting data from literature, men treated with finasteride could develop a plethora of non-neglectable physical and psychological symptoms identifying PFS. A multidisciplinary approach to research, policy-making, and patient advocacy is essential to better understand, diagnose, and manage PFS, underlining the necessity for greater awareness and scientific inquiry into this contentious and impactful syndrome.","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425293","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}

引用次数: 0

Intraoperative frozen section examination for penile cancer surgery: a systematic review.

IF 2.8 3区医学

International Journal of Impotence Research Pub Date : 2025-02-11 DOI: 10.1038/s41443-025-01024-7

Mohammad Z Yunis, Karl H Pang, Asif Muneer, Hussain M Alnajjar

{"title":"Intraoperative frozen section examination for penile cancer surgery: a systematic review.","authors":"Mohammad Z Yunis, Karl H Pang, Asif Muneer, Hussain M Alnajjar","doi":"10.1038/s41443-025-01024-7","DOIUrl":"10.1038/s41443-025-01024-7","url":null,"abstract":"Penile cancer (PeCa) is rare but aggressive and life changing. Penile-preserving surgery (PPS) allows length preservation for sexual activity and normal voiding. Intraoperative frozen section examination (FSE) of resection margins helps to decide on how much penile tissue is excised. Oncological outcomes and diagnostic accuracy of FSE to date, however, are not well documented. The objective of this systematic review was to evaluate the efficacy of FSE in the treatment of PeCa and its impact on oncological outcomes. A systematic review was conducted with reference to the PRISMA statement. Studies published from 2009 to 2024 were identified through a search conducted between 1975 and 2024. The search yielded 7 studies involving 574 patients. Intraoperative FSE had a high percentage of accuracy, with a mean accuracy of 95.4% and a range of 92.9-99.4%. The mean values of sensitivity, specificity, positive predictive value, and negative predictive values were 71.4%, 99.9%, 98.8%, and 96.5%, respectively. Functional outcomes with PPS were encouraging, especially in terms of sexual function. The average local recurrence rate was 7.9%. There is a paucity of data on PeCa FSE in the literature. However, it appears that FSE is accurate and can be helpful in guiding surgeons intraoperatively when performing PPS.","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398975","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}

引用次数: 0

Individualised shockwave therapy for erectile dysfunction: importance of establishing precise therapeutic range.

IF 2.8 3区医学

International Journal of Impotence Research Pub Date : 2025-02-08 DOI: 10.1038/s41443-025-01028-3

Romeq Bm Giezen, Eric Chung, Ranjith Ramasamy

引用次数: 0

The role of the urologist in managing high flow priapism.

IF 2.8 3区医学

International Journal of Impotence Research Pub Date : 2025-02-05 DOI: 10.1038/s41443-025-01017-6

Murat Dursun, Arif Kalkanlı, Seyfettin Anıl Tantekin, Ahmet Halil Sevinç, Turgay Kaçan, Celal Caner Ercan, Ateş Kadıoğlu

{"title":"The role of the urologist in managing high flow priapism.","authors":"Murat Dursun, Arif Kalkanlı, Seyfettin Anıl Tantekin, Ahmet Halil Sevinç, Turgay Kaçan, Celal Caner Ercan, Ateş Kadıoğlu","doi":"10.1038/s41443-025-01017-6","DOIUrl":"https://doi.org/10.1038/s41443-025-01017-6","url":null,"abstract":"High-flow priapism (arterial) is a prolonged erection caused by irregular cavernous arterial flow, often resulting from blunt perineal or penile trauma, or iatrogenic needle injury. This condition leads to the formation of an arteriolacunar fistula, causing unregulated arterial blood flow into the sinusoidal spaces of the penis. Unlike low-flow priapism, high-flow priapism typically presents with a partially erect, non-painful penis. The diagnosis is confirmed through characteristic findings on color Doppler ultrasound, which reveals turbulent high-velocity flow pinpointing the fistula's location. Blood gas analysis typically reflects arterial values, helping to differentiate high-flow priapism from its low-flow counterpart. Although high-flow priapism was historically considered non-urgent, recent evidence suggests that delayed treatment may increase the risk of erectile dysfunction. Therefore, prompt intervention by urologists is crucial. The primary goal is to close the fistula, and the treatment plan should be individualized based on the severity and duration of the condition. Urologists play a critical role in managing this condition, offering a range of therapeutic options. These include conservative approaches, such as observation and compression, medical therapy, arterial embolization, and, in some cases, surgical intervention. The choice of treatment depends on the patient's condition, the fistula's location, and the resources available. By ensuring timely and appropriate management, urologists can minimize complications and preserve erectile function.","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255538","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}

引用次数: 0

Adherence to american urological association (AUA) vasectomy guidelines: a systematic review of current practice among healthcare providers.

IF 2.8 3区医学

International Journal of Impotence Research Pub Date : 2025-02-01 DOI: 10.1038/s41443-025-01023-8

Mohammed Mahdi, Muhammed A M Hammad, Elia Abou Chawareb, Mana Almuhaideb, Faysal A Yafi

{"title":"Adherence to american urological association (AUA) vasectomy guidelines: a systematic review of current practice among healthcare providers.","authors":"Mohammed Mahdi, Muhammed A M Hammad, Elia Abou Chawareb, Mana Almuhaideb, Faysal A Yafi","doi":"10.1038/s41443-025-01023-8","DOIUrl":"https://doi.org/10.1038/s41443-025-01023-8","url":null,"abstract":"Vasectomy, a common male sterilization procedure, has seen a surge in popularity following the 2022 reversal of Roe v. Wade. The American Urological Association (AUA) vasectomy guidelines provide essential guidance for providers, outlining best practices for the procedure. We reviewed studies that examined adherence to the AUA vasectomy guidelines with regard to pre-procedure counseling, surgical technique, and post vasectomy semen analysis (PVSA) practice, as well as studies evaluating the impact of these guidelines on urology and non-urology practices. A total of five studies were identified that assessed adherence to the guidelines. Only one of these studies evaluated adherence to all three aspects of the guidelines. The remaining four studies focused solely on the practice of PVSA. Overall, urologists exhibited greater adherence to the guidelines compared to other healthcare providers. However, the adherence rates were still suboptimal. Five additional studies were included that evaluated the use of home-based PVSA, which is not part of the AUA guidelines. Conflicting results were found regarding the test compliance. While the studies evaluating home-based PVSA may raise the question of including this approach in the guidelines panel discussion, it is important to consider the potential benefits and drawbacks before incorporating it as an option in future guidelines.","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074367","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}

引用次数: 0

Comparing vasectomy techniques, recovery and complications: tips and tricks.

IF 2.8 3区医学

International Journal of Impotence Research Pub Date : 2025-01-31 DOI: 10.1038/s41443-025-01018-5

Joseph A Borrell, Catherine Gu, Nancy Ye, Jesse N Mills, Juan J Andino

{"title":"Comparing vasectomy techniques, recovery and complications: tips and tricks.","authors":"Joseph A Borrell, Catherine Gu, Nancy Ye, Jesse N Mills, Juan J Andino","doi":"10.1038/s41443-025-01018-5","DOIUrl":"https://doi.org/10.1038/s41443-025-01018-5","url":null,"abstract":"Vasectomies are safe and effective, achieving up to 99.7% in sterilization, with complication rates around 1-2%. As vasectomy uptake rises, physicians should stay informed about counseling, isolation and occlusion techniques, post-op recovery, and associated risks and complications. Historically, pre-vasectomy counseling has been performed in-person, but recent literature has shown that telehealth is a viable alternative, and a physical exam may not be necessitated. With regard to vas isolation and occlusion, current international guidelines support a minimally invasive approach such as no-scalpel vasectomy with mucosal cautery and fascial interposition, as they are the most effective in achieving vasectomy success and have the lowest complication rates. After a vasectomy, patients should undergo a post-vasectomy semen analysis 8-16 weeks after the procedure to ensure severe non-motile oligozoospermia (≤100,000 non-motile sperm/mL) or azoospermia. While risks and complications from vas isolation and occlusion are rare, patients should be informed about the potential for hematomas, infections, postoperative pain, and vas recanalization. In the U.S, vasectomies have increased in utilization from previous years, likely in the setting of increased access to telehealth and restricted female reproductive access. This trend raises questions about future fertility options such as vasectomy reversals and highlights the need for informed decision-making.","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074370","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}

引用次数: 0