Journal of Sexual Medicine最新文献

{"title":"Mechanical failure of inflatable penile prostheses: time to failure and reasons for replacement.","authors":"Ryan Griggs, Gerard Henry, Valeria Vasylieva, Edward Karpman","doi":"10.1093/jsxmed/qdaf053","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf053","url":null,"abstract":"<p><strong>Background: </strong>Despite advancements in the composition material, pump design, and infection retardant coatings, inflatable penile prosthetics (IPPs) remain prone to mechanical failure.</p><p><strong>Aim: </strong>To distinguish IPP mechanical failure etiologies and time to failure among the 2 most common manufacturers: American Medical Systems/Boston Scientific (BSCI) and Coloplast (CP).</p><p><strong>Methods: </strong>A retrospective chart review of 2 high-volume IPP surgeon revision and virgin cases was conducted from January 2018 to September 2023. Mechanical revision indications were stratified by brand and component location (pump, tubing, cylinder, and reservoir), while non-mechanical revision cases and those with missing data were excluded. Subgroup analysis regarding the cylinder rupture rate between BSCI controlled-expansion (Cx) ≤18 vs ≥21 cm devices was also performed. Categorical variables were assessed with chi-square or Fisher exact analysis, while continuous variables were evaluated with Student and Mann-Whitney U tests. The log-rank test was used to compare BSCI component-specific survival.</p><p><strong>Outcomes: </strong>Outcomes included time to failure, site-specific mechanical failure location in IPPs among BSCI and CP devices, and cylinder rupture rate among ≤18 vs ≥21 cm BSCI (Cx) cylinders.</p><p><strong>Results: </strong>We identified a total of 410 cases: 220 BSCI and 190 CP devices. One hundred twenty-nine were revisions. Seventy-two met the inclusion criteria (63 BSCI and 9 CP). BSCI mechanical failures included: cylinder rupture, 26/63 (41.3%), tubing fracture, 7/63 (11.1%), reservoir rupture, 3/63 (4.8%), cylinder aneurysm, 6/63 (9.5%), and pump failure, 21/63 (33.3%). Coloplast mechanical failure included: tubing fracture 7/9 (77.8%), while reservoir rupture and cylinder aneurysm each were 1/9 (11.1%). Time to mechanical failure was a median of 48 and 41 months, respectively, for BSCI and CP devices.</p><p><strong>Clinical implications: </strong>Mechanical failure site distribution between device manufacturers is significant and should be considered during primary and revision cases.</p><p><strong>Strengths and limitations: </strong>This study adds to the literature indicating when and where mechanical failure occurs in IPPs between the 2 major IPP manufacturers. Collaborative prospective studies would provide a more robust evaluation.</p><p><strong>Conclusions: </strong>The current study provides a breakdown of failure modes for contemporary 3-piece inflatable penile prostheses. Larger series are required to validate findings.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804762","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":"Experience with gender affirming hormones and puberty blockers (gonadotropin releasing hormone agonist): a qualitative analysis of sexual function.","authors":"Jamie L Finegan, Maja Marinkovic, Kyle Okamuro, Ron S Newfield, Jennifer T Anger","doi":"10.1093/jsxmed/qdaf061","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf061","url":null,"abstract":"<p><strong>Background: </strong>Gender-affirming medical therapy (GAMT), including puberty blockers (PB) and gender-affirming hormone therapy (GAHT), is part of the transition for many transgender and nonbinary (TGNB) individuals; however, there have been few studies investigating sexual function and desire during GAMT, and no reports on individuals who received PB.</p><p><strong>Aim: </strong>We aimed to qualitatively evaluate the sexual experience of TGNB individuals during GAMT and identify significant and consistent themes that arose from our analysis.</p><p><strong>Methods: </strong>We performed an Institutional Review Board-approved two-institutional study. Our study group (n = 63) included individuals who had received or were receiving puberty blockers (GnRHa) and/or GAHT (estrogen or testosterone) at the time of enrollment.</p><p><strong>Outcomes: </strong>The enrolled subjects were interviewed using an open-ended topic-based guide, and qualitative analysis was performed by hand coding the interview transcripts using Constructivist Grounded Theory qualitative methods until thematic saturation was reached.</p><p><strong>Results: </strong>A total of 63 TGNB subjects (33 transgender women, 20 transgender men, 10 non-binary, or another gender identity), aged 18-25 years, were interviewed about the effect of GAMT on their sexual function and desire. Our analysis uncovered several themes that were consistent among subjects from different subgroups. Half the participants reported feeling no regrets regarding GAMT therapy, and the other half reported that they wished they had started GAMT sooner. Two notable themes were identified: many subjects reported \"less dysphoria\" as a positive change in sexual desire, and others reported more enjoyable sexual experiences since being on GAMT. The subgroup of subjects with a history of GnRHa use did not differ in their experiences and responses from the subgroup on GAHT alone, which indicated no negative effect of GnRHa on sexual function.</p><p><strong>Clinical implications: </strong>Our results illuminate the need for providers to discuss the potential impacts of GAMT on sexual function and desire with transgender and nonbinary patients.</p><p><strong>Strengths & limitations: </strong>An important strength of this study is the open-ended interview design. This design allowed subjects to speak freely and openly about their experience. One limitation is a relatively small sample size, particularly of the puberty blocker (GnRHa) subgroup. A more robust sample is needed to further investigate the effect of GAMT on sexual function and desire in TGNB individuals, specifically those receiving GnRHa.</p><p><strong>Conclusion: </strong>Themes were similar for all subjects; however, the most prominent theme among our subjects was that the positive changes in sexual function and desire outweighed any negative changes.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797096","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":"Intracavernosal injection of aviptadil and phentolamine for refractory erectile dysfunction.","authors":"Abdullah Al-Mitwalli, Fiona Holden, Angelo Di Giovanni, Andrea Gobbo, Mohammad Shah, Giovanni Chiriaco, Pippa Sangster, David Ralph, Wai Gin Lee","doi":"10.1093/jsxmed/qdaf067","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf067","url":null,"abstract":"<p><strong>Background: </strong>Intracavernosal injection (ICI), most commonly with alprostadil, is recommended for Phosphodiesterase 5 Inhibitors (PDE5i) nonresponders in erectile dysfunction (ED) treatment; however, its use can cause pain (12%) and priapism (1%).</p><p><strong>Aim: </strong>We aimed to evaluate the efficacy of another ICI, Invicorp, and a combination of aviptadil with phentolamine mesylate (AvP), in contemporary practice.</p><p><strong>Methods: </strong>We conducted a retrospective single-center analysis on patients referred for AvP because they developed intolerable Pain following Alprostadil ICI (group PA) or had Failed maximal dose (40 μg) of Alprostadil (group F). Self-administration was taught in a nurse-led clinic, followed by a 6-week telephone follow-up. Efficacy was evaluated at 3 months and was defined as resumption of penetrative sexual activity.</p><p><strong>Results: </strong>Of these, 308 men were included in this study with a mean follow-up period of 13.3 months. All these patients had a trial of alprostadil ICI, 96% had failed PDE5i, 66% had trailed a vacuum erection device, and 36% had failed intraurethral alprostadil. Overall, 182 men (59%) found AvP ICI effective. Indications were 177 in the PA group and 131 in the FA group. Efficacy of AvP in the PA group was 76% and this compares to 36% in the FA group (P < .0001). The most common adverse event was facial flushing in 69 patients (22.5%). Ischemic priapism was reported in only one patient (0.3%).</p><p><strong>Clinical implications: </strong>AvP represents an effective and well-accepted second-line option for men who have experienced failure with most nonsurgical treatments for ED.</p><p><strong>Strengths and limitations: </strong>This is the largest and only study to outline the use of AvP ICI with clear distinguishing of efficacy rates for both patients who have failed conventional maximum dose alprostadil ICIs and those who developed pain from it. Limitations of this study include its retrospective design and lack of validated instruments to objectively assess erectile function.</p><p><strong>Conclusion: </strong>Almost 60% of the participants with refractory ED were successfully managed through the administration of AvP.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796360","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":"A randomized trial on the safety and efficacy of sensate water-based and silicone-based personal lubricants for relief of intimate discomfort associated with vaginal dryness.","authors":"Michael Krychman, Karishma Hemmady, Lingyao Su, Sarah Hood, Snezhana Gaifieva, Santiago Palacios","doi":"10.1093/jsxmed/qdaf058","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf058","url":null,"abstract":"<p><strong>Background: </strong>Personal lubricants with different formulations and properties, including ingredients designed to enhance sensation or feeling, can be used to alleviate vaginal dryness and affect sexual function. Clinical data to support their safety and efficacy are limited.</p><p><strong>Aim: </strong>Determine safety and efficacy of two sensate personal lubricants for relief of discomfort associated with vaginal dryness in female participants, and report the impact on sexual satisfaction in female participants and male partners.</p><p><strong>Methods: </strong>A two-arm, parallel design study was performed in women (18-65 years) experiencing vaginal dryness. Participants were randomized to one of two sensate lubricants (water-based [tingling] or silicone-based [warming]), which had to be used during vaginal intercourse at least once a week over a 4-week period.</p><p><strong>Outcomes: </strong>Primary outcome: change from baseline in total Female Sexual Function Index (FSFI) score after 4 weeks of lubricant use. Secondary outcomes: change from baseline in FSFI domain scores; adverse events (AE); vulvovaginal and oral tolerance; female participant and male partner perception of lubricants; improvement in sexual intimacy (assessed using Subject Perceived Questionnaires [SPQ] and Patient Global Impression of Change).</p><p><strong>Results: </strong>Sixty-six female participants completed the study. The primary endpoint (prespecified increase in FSFI ≥4 points from baseline) was achieved for both lubricants. A positive change was observed across all six FSFI domains. All AEs were mild in severity; no serious AEs were reported; the discontinuation rate was 1.5% (one female participant; warming lubricant). For both lubricants, vulvovaginal tolerance was \"good/very good\" and oral tolerance was generally \"very good\" (\"acceptable\" for one participant in each treatment arm). For both lubricants, most female participants and their male partners agreed that first penetration during vaginal sex was smoother, and there was an improvement in sexual intimacy.</p><p><strong>Clinical implications: </strong>Safety and efficacy of both lubricants containing sensate ingredients was demonstrated, giving reassurance that they can be safely recommended by healthcare professionals to relieve vaginal dryness and enhance sexual pleasure.</p><p><strong>Strengths/limitations: </strong>Evidence is provided for the safety and efficacy of two sensate lubricants for relieving vaginal dryness and improving sexual pleasure in healthy participants across a wide age range. The SPQ is not a clinically validated tool, and the sample of participants was not diverse, which may limit the generalizability of data.</p><p><strong>Conclusions: </strong>The use of sensate lubricants showed significant improvement in sexual function coupled with improved satisfaction for both male and female participants. No severe or serious AE were reported during the study period.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797094","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":"From hyper- to hypo-: ADHD medications & sexual dysfunction.","authors":"Elijah W Hale, Tyler J Igoe, Oscar R Bernat, Tyler D Cohan, Katherine P Thompson","doi":"10.1093/jsxmed/qdaf054","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf054","url":null,"abstract":"<p><strong>Background: </strong>Although attention-deficit/hyperactivity disorder's (ADHD's) impact on academic and social outcomes is well documented, its influence on sexual health, especially in adolescents, remains poorly understood and adolescents with ADHD are at higher risk for high-risk sexual behaviors (HRSBs) and sexual dysfunction, which prior research has indicated may be somewhat influenced by medication.</p><p><strong>Aim: </strong>To define the relationship between ADHD treatment and sexual dysfunction in adolescents, focusing on the effects of stimulant versus non-stimulant medications and gender differences.</p><p><strong>Methods: </strong>Using de-identified electronic medical records from the TriNetX platform, this retrospective cohort study analyzed over 600 000 adolescents with ADHD. Patients were divided into male and female cohorts and further classified by stimulant, non-stimulant, or no medication use. Propensity score matching was applied to control for demographic factors. Sexual outcomes were identified using ICD-10 codes, including HRSBs, erectile dysfunction in males, and dyspareunia in females.</p><p><strong>Outcomes: </strong>The primary outcomes of interest were HRSB with both opposite- and same-sex partners, paraphilia disorder, increased libido, hyper/compulsive sexual behavior, ejaculatory dysfunction, erectile dysfunction, contraception use, and dyspareunia.</p><p><strong>Results: </strong>Stimulant medications were linked to increased libido and hypersexual behaviors, especially in males, who also reported higher rates of erectile dysfunction. Females on stimulants exhibited higher rates of contraceptive use and slightly elevated libido. Non-stimulant medications showed fewer sexual side effects.</p><p><strong>Clinical implications: </strong>The findings underscore the need for clinicians to carefully consider the sexual side effects of ADHD medications, particularly stimulants, when developing treatment plans for adolescents, and gender differences in sexual dysfunction and high-risk sexual behaviors suggest that tailored interventions are necessary to address the unique needs of male and female patients.</p><p><strong>Strengths and limitations: </strong>The limitations of this paper include its retrospective nature and the fact that the data collected were self-reported. Additionally, the lack of diversity in the patient population is a limitation.</p><p><strong>Conclusions: </strong>Stimulant medications may exacerbate certain sexual dysfunctions, particularly in males, while non-stimulant treatments have milder effects; gender-specific differences suggest distinct sexual health impacts for males and females and clinicians should consider the potential sexual side effects of ADHD medications, particularly in adolescents, and further research is needed to explore the long-term effects of ADHD treatments on sexual health.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796270","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":"Changing or stopping testosterone-lowering medication in men convicted of sexual offenses: clinical evaluation of the COSTLow-R scale.","authors":"Jochen Wolba, Safiye Tozdan, Peer Briken, Roland Freese, Wolfgang Retz, Daniel Turner","doi":"10.1093/jsxmed/qdaf056","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf056","url":null,"abstract":"<p><strong>Background: </strong>Men convicted of sexual offenses (MCSO) can be treated with testosterone-lowering medications (TLM) in order to support the control of paraphilic sexual fantasies and to decrease the risk of sexual recidivism. However, due to partly severe side effects, TLM should not be a lifelong treatment.</p><p><strong>Aim: </strong>The Change or Stop Testosterone-Lowering Medication (COSTLow)-R Scale was developed to assist forensic professionals in deciding on whether to change or stop TLM treatment in MCSO. The current study aimed to evaluate the scale in forensic outpatient aftercare practice.</p><p><strong>Methods: </strong>The COSTLow-R Scale was applied retrospectively in a forensic-psychiatric outpatient institution in Hesse, Germany, on 72 MCSO. TLM was stopped in 30 patients (41.7%). Moreover, 10 forensic professionals of the institution (23.3%) as well as an experienced working group within the institution focusing on the treatment of MCSO, qualitatively evaluated the COSTLow-R Scale by participating in an open designed survey.</p><p><strong>Outcomes: </strong>The COSTLow-R Scale ratings as assessed by forensic professionals were collected. In addition, a survey was performed among these professionals about the usefulness of the scale and their practical experiences with it.</p><p><strong>Results: </strong>TLM stopping decisions were significantly associated with three COSTLow-R Scale items: the compliance for monitoring effects and side effects, the possibility of psychotherapy before TLM treatment, and the therapeutic alliance before starting TLM treatment. In sum, the decision towards stopping TLM was more likely for patients whose compliance was considered higher, and for those who had demonstrated a greater treatment readiness as well as therapeutic alliance before starting TLM. The forensic professionals described the scale as a good and structured tool that displays which aspects are important to consider during TLM treatment decisions.</p><p><strong>Clinical implications: </strong>The COSTLow-R Scale provides structure to the decision whether to change or stop TLM and should thus be implemented in the forensic treatment process of patients with TLM more frequently.</p><p><strong>Strengths & limitations: </strong>Although the small sample size limits generalizability of the findings, the present study was conducted directly in a forensic center and, therefore, has high external validity and a strong impact on the life and health of patients treated with TLM.</p><p><strong>Conclusion: </strong>The results indicate that the COSTLow-R Scale can be a useful instrument facilitating the TLM decision-making process by providing a structured compendium of criteria. Further research is still needed to evaluate the scale and to provide additional evidence for the results of the current study.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797095","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":"Injection therapy in the acute phase of Peyronie's disease: a systematic review of current evidence.","authors":"Celeste Manfredi, Giorgio Ivan Russo, Paolo Capogrosso, Marco Falcone, Ioannis Sokolakis, Nadja Schoentgen, Andrey Morozov, Mazhar Ortaç, Afonso Morgado, Marco Capece, Davide Arcaniolo, Javier Romero-Otero, Riccardo Autorino, Marco De Sio, Laurence Levine","doi":"10.1093/jsxmed/qdaf044","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf044","url":null,"abstract":"<p><strong>Background: </strong>Injection therapy has emerged as a possible treatment for the acute phase of Peyronie's disease (PD).</p><p><strong>Aim: </strong>To systematically review the current evidence on the efficacy and safety of injection therapy for patients in the acute phase of PD.</p><p><strong>Methods: </strong>A comprehensive bibliographic search on the MEDLINE, Scopus, and Web of Science Core Collection databases was conducted in June 2024. Articles were selected if they included patients with PD in acute phase (P) undergoing injection therapy (I) with or without comparison with other treatments (C), evaluating its efficacy or safety (O). Prospective and retrospective original studies were included (S). Articles were assessed for risk of bias using Cochrane risk-of-bias tool for randomized trials version 2, risk of bias in non-randomized studies-of interventions, and Joanna Briggs Institute critical appraisal tool. Data were synthesized narratively.</p><p><strong>Outcomes: </strong>Primary outcomes were penile curvature, penile pain, and adverse events.</p><p><strong>Results: </strong>A total of 20 studies (1291 patients) were included, with 4 (20%) being randomized controlled trials. The mean/median duration of PD symptoms ranged from 2.0 to 18.6 months across the papers. The injectable agents tested included calcium channel blockers, hyaluronic acid, Collagenase Clostridium histolyticum, interferon, and corticosteroids. In most studies, improvements in penile curvature and pain were observed, with variable magnitude and in a varying percentage of patients. Adverse events were mostly mild and localized, including bruising, swelling, and ecchymosis. No severe complications were reported in any of the studies.</p><p><strong>Clinical implications: </strong>Limited evidence support the feasibility of injection therapy for the acute phase of PD.</p><p><strong>Strengths and limitations: </strong>The first systematic review on injection therapy for acute PD. Low-to-intermediate quality and heterogeneous methodology of primary studies, impossibility of reliable quantitative data synthesis.</p><p><strong>Conclusion: </strong>Injection therapy for the acute phase of PD demonstrates variable efficacy depending on the agent used and a relatively favorable safety profile; however, the overall quality of evidence remains low and is characterized by significant methodological limitations.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796356","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":"Association between surgeon procedure volume and reoperation rates for penile prosthesis implantation.","authors":"Juan J Andino, Navid Leelani, Ryoko Sato, Young Shin, Sirikan Rojanasarot, Thiago Furtado, Helen L Bernie, Petar Bajic, Carolyn A Salter, Joshua A Halpern","doi":"10.1093/jsxmed/qdaf064","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf064","url":null,"abstract":"<p><strong>Background: </strong>Prior studies have examined patient-specific predictors of reoperation following penile prosthesis (PP) insertion at the local and regional level, but little is known about patient factors and volume-outcome relationships at the national level.</p><p><strong>Aim: </strong>To assess the impact of patient characteristics and surgeon volume on reoperation rates following PP placement in a Medicare population.</p><p><strong>Methods: </strong>We utilized the 100% Medicare Standard Analytical Files to identify men aged ≥65 years who underwent PP implantation between 2018 and 2021. Surgeon volume data were obtained from the Atlas All-Payor Claims dataset, and quartiles were calculated. Multivariable logistic regression was used to evaluate associations between reoperation rates, patient characteristics, and surgeon volume.</p><p><strong>Outcomes: </strong>The reoperation rate at 1-year post-implantation, the cause of reoperation, and factors associated with a higher reoperation rate.</p><p><strong>Results: </strong>Among 8343 patients, 2.3% required reoperation at 90 days and 6.3% at 1 year. The most common comorbidities were diabetes (35.2%), cardiovascular disease (23.9%), Peyronie's disease (15.4%), and obesity (11.5%). Surgeon volume quartiles were calculated, with the highest-volume surgeons performing >31 cases annually versus <6 for the lowest quartile. Lower surgeon volume, older patient age, and smoking were associated with higher reoperation rates. Patients treated by top-quartile surgeons had 25%-28% lower odds of reoperation at 1 year [OR 0.72; 95% CI 0.56-0.93; OR 0.75; 95% CI 0.59-0.97].</p><p><strong>Clinical implications: </strong>While higher surgeon volume was associated with lower reoperation rates, PP surgery remained safe across all volume levels.</p><p><strong>Strengths and limitations: </strong>Strengths include the use of a nationally representative Medicare dataset and All-Payor volume-outcome analysis. Limitations include accuracy of claims data, inability to fully characterize reoperations, and lack of data for procedures performed in ambulatory surgery centers.</p><p><strong>Conclusion: </strong>In a nationally representative Medicare cohort, PP reoperation rates were low (6.3%), with mechanical complications accounting for 41% of reoperations (2.6% of the cohort). Higher-volume surgeons had lower reoperation rates, but outcomes remained acceptable across all volume levels, reinforcing the overall safety of the procedure.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773624","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":"Novel technique of horizontal plication with corporoplasty for Peyronie's disease: the rare Christmas tree deformity.","authors":"Ramzy T Burns, Juliet K Hardesty, Helen L Bernie","doi":"10.1093/jsxmed/qdaf060","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf060","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774572","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":"Editorial comment on \"Association between surgeon procedure volume and reoperation rates for penile prosthesis implantation\".","authors":"Edward Karpman","doi":"10.1093/jsxmed/qdaf066","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf066","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773964","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}