Translational andrology and urology最新文献

{"title":"Surgical strategies in artificial urinary sphincter revision surgery: troubleshooting the complications.","authors":"Marcio Augusto Averbeck, Silvio Henrique Maia de Almeida","doi":"10.21037/tau-22-830","DOIUrl":"https://doi.org/10.21037/tau-22-830","url":null,"abstract":"<p><p>Post-prostatectomy urinary incontinence (PPUI) is an important issue in the urological practice and imposes a negative effect on quality of life (QoL). Despite recent technological advances, PPUI remains a common complication and the artificial urinary sphincter (AUS) is regarded as the most effective long-term surgical treatment for moderate-to-severe stress urinary incontinence. Success rates for AUS as defined by a continence status of zero to one pad per day range from 59% to 90%. One potential downside of the AUS is the need for periodic revisions in a number of patients. Revision and explantation rates due to mechanical failure, urethral atrophy, infection and erosion vary considerably among studies with reports of 8-45% and 7-17%, respectively. These complications can be classified into different categories, including recurrent or refractory incontinence, erosion and/or infection, and other complications. This review article aims to describe the main AUS-related complications and their management strategies. Diagnostic work-up strategies are explored to facilitate timely identification and management of these complications. Additionally, emerging technologies and future directions in AUS development are discussed, highlighting potential advancements to mitigate complications and enhance device performance. This review consolidates current knowledge and provides insights for clinicians to manage the complexities associated with AUS therapy effectively.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11399024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The fragile urethra: what to do next?-a narrative review.","authors":"Aroh Pandit, Chrystal Chang, Jay Simhan","doi":"10.21037/tau-22-798","DOIUrl":"https://doi.org/10.21037/tau-22-798","url":null,"abstract":"<p><strong>Background and objective: </strong>Although the artificial urinary sphincter (AUS) has demonstrated successful outcomes in treating male stress urinary incontinence (SUI) for the past five decades, this procedure also carries inherent risks, including recurrent SUI, device malfunction, local tissue compromise, and infection/erosion, all of which may require revision surgery with or without device replacement. Patients that are at the highest risk for such untoward events often possess unhealthy urethral tissue (termed a \"fragile urethra\") that is compromised and unable to provide optimal cuff coaptation and continence. Accordingly, there are several techniques to address recalcitrant SUI in the setting of a fragile urethra to afford an improved chance of return to continence. Here, we review characteristics of patients that are at higher risk for an untoward outcome following AUS implantation and further define strategies to promote optimal success with device implantation. The aim of this paper is to review the available literature and describe surgical options for male SUI in patients with known or anticipated urethral tissue compromise.</p><p><strong>Methods: </strong>A thorough literature review was completed by querying PubMed for relevant articles. Search terms included artificial urinary sphincter, failure, recalcitrant, urethral atrophy, fragile urethra, revision, radiation, cystectomy, incontinence, and/or urethroplasty published between 1975 and 2022.</p><p><strong>Key content and findings: </strong>Options for management of the fragile urethra include cuff relocation, cuff downsizing, tandem cuff placement, transcorporal cuff placement, pressure regulating balloon exchange with increased or decreased pressure, bulbospongiosus preservation, sub-cuff ventral capsulotomy, urethral wrapping with graft, and in select cases, urinary diversion, or complete device removal with a return to SUI. Proper patient selection is paramount to optimize outcomes. Advantages and disadvantages of each strategy are reviewed.</p><p><strong>Conclusions: </strong>Numerous techniques are viable options for patients with recalcitrant SUI in the setting of a fragile urethra, but high-quality evidence with reproducible outcomes for many of these strategies remain limited. Proper patient selection as well as adequate counseling by experienced implant surgeons may help optimize outcomes. Further multi-institutional investigations with longer term outcomes are needed to improve patient selection and counseling with shared decision-making prior to any intervention.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11399049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cellular regenerative therapy in stress urinary incontinence: new frontiers?-a narrative review.","authors":"Karl-Erik Andersson, Koudy Williams","doi":"10.21037/tau-22-682","DOIUrl":"https://doi.org/10.21037/tau-22-682","url":null,"abstract":"<p><strong>Background and objective: </strong>Even if treatment with stem cells has been shown to be safe and effective in many patients with stress urinary incontinence (SUI), there is still room for improvement using other regenerative medicine alternatives. Since the beneficial effects of stem cells are probably mediated by secretion of factors rather than by the cells themselves there is a good rationale for further exploring the therapeutic effects of the secretome and/or its components. However, homing factors such as stromal derived growth factor 1 (SDF-1; CXCL12), stimulation of stem cell growth and stem cell mobilization <i>in vivo</i> using low intensity shock wave therapy (Li-ESWT) or regenerative electrical stimulation (RES), are also promising approaches.</p><p><strong>Methods: </strong>A literature search was performed based on PubMed, Scopus and Google Scholar. The search criteria included original basic science articles, systematic reviews and randomized control trials. All studies were published between 2000 and 2023. Selected, peer-reviewed studies were further analyzed to identify those of relevance. Keywords searched included: \"female stress incontinence\", \"homing factors\", \"CXCL12\", \"secretome\", \"low intensity shockwave therapy\" and \"regenerative electrical stimulation\". The peer-reviewed publications on the key word subjects that contained a novel addition to the existing body of literature were included.</p><p><strong>Key content and findings: </strong>There is evidence from studies on non-human primates (NHPs) with experimental urinary sphincter injury that CXCL12 can restore sphincter structure and function. Studies with homing factors in human patients with SUI are still to be performed. A large number of clinical studies on the use of secretome or secretome products from mesenchymal stem cells (MSCs) on indications other than human SUI are already available. However, controlled clinical trials on patients with SUI, have to the best of our knowledge, not yet been performed. Also, RES has not been studied in patients with SUI. In contrast, there is clinical evidence that Li-ESWT may improve female SUI.</p><p><strong>Conclusions: </strong>Treatment with homing factors, MSC secretome/secretome components, Li-ESWT and RES are promising frontiers in the treatment of human SUI caused by sphincter damage.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11399031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A personal tribute to Dr. F. Brantley Scott and the artificial urinary sphincter.","authors":"Ross A Cartmill","doi":"10.21037/tau-23-23","DOIUrl":"https://doi.org/10.21037/tau-23-23","url":null,"abstract":"","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11399029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial urinary sphincter and stricture disease: surgical principles in management.","authors":"Francisco E Martins, José Bernal, Liliya Tryfonyuk, Henriette Veiby Holm","doi":"10.21037/tau-23-16","DOIUrl":"https://doi.org/10.21037/tau-23-16","url":null,"abstract":"<p><p>Iatrogenic stress urinary incontinence (SUI) is the most common complication of surgical treatment of prostate cancer, regardless of operative approach, and has a major impact on patients' quality of life. Although SUI can occur after surgical treatment of benign prostatic hyperplasia, specifically transurethral prostate resection, laser enucleation of the prostate, and simple open prostatectomy, these therapeutic modalities play a much less significant role in the etiology of SUI. Artificial urethral sphincter (AUS) implantation is considered the standard treatment modality providing high success rates, including durable efficacy, and optimal patient satisfaction for moderate to severe urinary incontinence resulting mainly from radical prostatectomy. However, although complication rates are generally acceptably low, revision and/or explantation may be required due to mechanical failure and non-mechanical problems, specifically urethral atrophy/cuff deficient occlusion, infection, and cuff erosion. Several risk factors for AUS failure associated with a fragile, compromised urethra have been identified and these play a critical role in device cuff erosion and subsequent removal of the device. Among others, apparently the most impacting factors are irradiation, urethral stent placement, a previous AUS placement, and importantly presence of urethral stricture or prior urethroplasty. Generally, any clinical situation leading to a diseased urethra or lack of urethral integrity is associated with impaired local blood perfusion, and consequently lower success rates. The present review aims to evaluate the impact of the presence of prior urethral strictures and urethroplasty on the outcomes of AUS implantation on one hand, and vice-versa, the influence of AUS placement on later urethral stricture surgery, particularly following cuff erosion.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11399027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Male sling versus artificial urinary sphincter for the treatment of incontinence after prostate surgery: a systematic review with meta-analysis.","authors":"Hai-Chao Chen, Peng-Cheng Hu, Jia-Tao Yao, Shi-Jie Ye, Qi Ma","doi":"10.21037/tau-24-107","DOIUrl":"https://doi.org/10.21037/tau-24-107","url":null,"abstract":"<p><strong>Background: </strong>Urinary incontinence following prostate treatment (IPT) represents a significant complication that detrimentally impacts the quality of life for patients who have undergone prostate surgery. Presently, there is a scarcity of evidence regarding the preferred surgical techniques for IPT. We conducted a meta-analysis to compare the outcomes of the male sling and artificial urinary sphincter (AUS) in the treatment of IPT.</p><p><strong>Methods: </strong>Data were extracted through electronic literature searches on PubMed, Web of Science, and Embase databases until September 2023. Eligible studies included patients who underwent AUS or male sling procedures for IPT and had a follow-up duration exceeding 12 months. The primary end point was the success rate, with the secondary outcome focusing on complication rates. A fixed-effects or random-effects models were used to calculate the pooled estimate and its 95% confidence interval (CI). The publication bias was assessed using funnel plots and Egger's regression test.</p><p><strong>Results: </strong>The meta-analysis included nine studies, involving a total of 1,350 participants. No statistically significant difference in success rates was found between AUS and male sling [odds ratio (OR): 0.96, 95% CI: 0.91-1.01]. In terms of the complication rate, there was no significant disparity between the two procedures (OR: 0.87, 95% CI: 0.86-1.12).</p><p><strong>Conclusions: </strong>The findings from this study indicated that male sling surgery yielded success and complication rates comparable to those of AUS. This suggests that male sling could serve as a viable alternative surgical option in the treatment of IPT.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11399032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External pressure induces the dysfunction of spermatogonia via triggering the intrinsic pathway of apoptosis.","authors":"Yuxin Liu, Qihao Sun, Kun Du, Houtao Long, Daofeng Zhang, Junhao Zheng, Yong Zhao, Haiyang Zhang","doi":"10.21037/tau-24-158","DOIUrl":"https://doi.org/10.21037/tau-24-158","url":null,"abstract":"<p><strong>Background: </strong>Cryptorchidism, the failure of testes to descend into the scrotum, exposes the testes to higher temperature and external pressure. Scholars from Razi University found through research conducted at different pressure gradients (0, 25, 50, and 100 mmHg) and time gradients (2 and 4 h) that high hydrostatic pressure may lead to sperm apoptosis. In this work, we investigated the effect of external pressure on spermatogonia, exploring a new mechanism of male infertility caused by cryptorchidism.</p><p><strong>Methods: </strong>Various pressure gradients (0, 25, 50, and 100 mmHg) were applied to spermatogonia for different durations (0, 2, and 4 h) in the Cell Counting Kit-8 (CCK8) experiment. Morphological changes, cell ultrastructure, apoptosis rates, and the expression of apoptosis-related proteins (bax, bcl-2, caspase-3, and caspase-9) were assessed through immunofluorescence, electron microscopy, terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) assay, flow cytometry, immunohistochemistry, real-time quantitative polymerase chain reaction (qPCR), and western blot.</p><p><strong>Results: </strong>The cell viability assay showed that higher external pressure had a greater negative time-dependent impact on cell viability. Immunofluorescence results indicated that external pressure stimuli altered the morphology of spermatogonia. The results of TUNEL assay and flow cytometry demonstrated that external pressure stimuli induced apoptosis in spermatogonia. Transmission electron microscopy (TEM) observations showed the generation of apoptotic bodies, mitochondrial swelling, vacuolization, and mitochondrial cristae fusion. The results of immunohistochemistry indicated that pressure induced the expression of caspase-3 and caspase-9 proteins. qPCR and western blot analyses revealed an increased ratio of bax/bcl-2 and expression of caspase-3 and caspase-9. Methazolamide (cytochrome C inhibitor) blocked the pressure-induced cell apoptosis and inhibited the activation of caspase-3 while Z-IETD-FMK (caspase-8 inhibitor) did not.</p><p><strong>Conclusions: </strong>External pressure promotes spermatogonia apoptosis through the intrinsic apoptosis pathway, which may be one of the mechanisms of male infertility induced by cryptorchidism.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11399028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of warning biopsies in percutaneous nephrolithotomy.","authors":"Jiajia Qiao, Cong Tian, Lizhe An, Yang Hong, Xiaobo Huang, Jun Liu","doi":"10.21037/tau-24-91","DOIUrl":"https://doi.org/10.21037/tau-24-91","url":null,"abstract":"<p><strong>Background: </strong>At present, few articles on percutaneous nephrolithotomy (PCNL) for renal calculi and renal pelvic tumors detected by intraoperative biopsy exist, which has provided limited guidance for clinical practice. In this article, we aimed to further study the relationship between renal calculi and renal pelvic tumors.</p><p><strong>Methods: </strong>We retrospectively analyzed the medical records of patients with abnormal mucosal biopsy results who underwent PCNL for kidney stones in the Urology Department of Peking University People's Hospital from January 2011 to November 2021.</p><p><strong>Results: </strong>In total, 2,801 patients underwent PCNL for kidney stones, of whom 69 underwent intraoperative mucosal biopsy. Biopsy results indicated that 8 cases were malignant (11.60%), and 61 cases were benign (88.40%). All malignant cases were renal pelvic carcinoma. Seven were urothelial carcinoma, and one of these was urothelial carcinoma with squamous differentiation. Only one was squamous cell carcinoma. The preoperative information of patients with a malignant mucosa biopsy was analyzed. To provide clinical guidance, an early warning biopsy system was established based on the abnormal mucosa found during the operation. We found that PCNL should be considered if the following risk factors are associated with stones: advanced age, long history of kidney stones, severe hydronephrosis, urinary tract infection, multiple or staghorn stones.</p><p><strong>Conclusions: </strong>Early warning information should be established for patients with kidney stones based on preoperative clinical characteristics and intraoperative mucous membrane observations. An early warning biopsy should be performed for patients with possible tumors to detect tumors in a timely manner and provide early treatment to improve patient prognosis.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11399046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rigicon ContiClassic and ContiReflex artificial urinary sphincter devices.","authors":"Orhan Koca, Rasim Güzel, Duygu Kırkık, M İhsan Karaman, Eric Chung","doi":"10.21037/tau-23-464","DOIUrl":"https://doi.org/10.21037/tau-23-464","url":null,"abstract":"<p><p>The modern AMS 800 artificial urinary sphincter (AUS) is often considered the standard of care for the treatment of moderate to severe stress urinary incontinence in male patients. Nonetheless, the AMS 800 device has several inherent limitations, and these factors can potentially impact its clinical utility and impede excellent clinical outcomes. The new Rigicon AUS devices such as ContiClassic and ContiReflex urinary sphincters are designed to overcome some of the existing issues pertaining to the AMS 800 device. The ContiClassic device is similar in terms of device design to the AMS 800 apart from the inclusion of a hydrophilic coating, has a greater range of cuff sizes with 0.25-cm diameter increments, and an Easy Clink Connectors which negates the need for an assembly tool. In contrast, The ContiReflex device differs from the ContiClassic model in that it features an extra stress relief balloon (SRB) to provide a safeguard on the urethral occlusive mechanism against any sudden increase in intra-abdominal pressure, and a larger pump system that is responsible to cycle fluid between the higher pressure two-balloon system and the sphincteric cuff. The following brief report evaluates the current device design and technology of the Rigicon ContiClassic and ContiReflex AUS devices.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11399054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A narrative review on synchronous concurrent versus delayed sequential surgery in the artificial urinary sphincter and penile prosthesis implantation.","authors":"Eric Chung","doi":"10.21037/tau-23-22","DOIUrl":"https://doi.org/10.21037/tau-23-22","url":null,"abstract":"<p><strong>Background and objective: </strong>In a patient who complains of both stress urinary incontinence (SUI) and erectile dysfunction (ED), prosthetic surgery with a urinary continence device and penile prosthesis implant can offer a definitive solution to address both problems. The AMS 800 artificial urinary sphincter (AUS) device is considered the standard of care to restore SUI while the inflatable penile prosthesis (IPP) device is thought to be superior to a malleable prosthesis to provide a more natural penile erection with higher patient satisfaction rates. The following article explores the current understanding of AMS 800 AUS surgery and IPP device in treating males with concurrent SUI and ED as well as evaluates the advantages and disadvantages of concurrent synchronous dual <i>vs</i>. delayed or staged device implantation.</p><p><strong>Methods: </strong>The available literature on AUS and IPP implantation was reviewed on PubMed and Embase databases between 1 January 2000 and 1 December 2022. This narrative review evaluates relevant key features pertaining to prosthetic surgery with an emphasis on arguments for concurrent synchronous dual <i>vs</i>. delayed sequential surgery for AUS and IPP devices. Additionally, this paper provides a brief surgical description of the techniques and potential complications relating to both prosthetic procedures.</p><p><strong>Key content and findings: </strong>While a great deal is known about the excellent outcomes of both AUS and IPP implantation, there is limited literature published on the outcomes of dual AUS and IPP surgery. The decision to proceed with concurrent synchronous dual <i>vs</i>. delayed sequential two-stage implants is likely determined by the patient's preference, the surgeon's expertise, and the availability of prostheses. In either situation, patients should be counselled regarding the advantages and disadvantages of undergoing synchronous concurrent <i>vs</i>. delayed sequential implants and associated surgical challenges are likely dependent on the patient's anatomy and the surgeon's preference.</p><p><strong>Conclusions: </strong>For carefully selected patients with SUI and ED, dual implantation of AUS and IPP provides a definitive treatment to address both conditions at the same time. Patients should be counselled regarding the advantages and disadvantages of synchronous concurrent <i>vs</i>. sequentially delayed implants while technical considerations regarding the sequence of prosthetic device surgery are likely dependent on the patient's factors and the surgeon's preference and surgical expertise.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11399055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}