Search

Previous studies based on functional Magnetic Resonance Imaging (fMRI) demostrated that several human brain areas present functional sexual dimorphisms, and recent researches demostrated peculiar patterns of brain acivation in Gender Disphoria (GD) subjects. In these studies fMRI were performed during standard mental tasks; aim of our study was to design and validate for the first time a fMRI protocol with specific visual stimulation involving body image and gender identity. [Extracted from the article]

An abstract of the article "Distal repair of tunica albuginea for herniation of penile implant: comparison of outcomes using two types of non-autologous graft" by C. Ceruti and colleagues is presented.

An abstract of the article "Patient satisfaction and long term result of surgery for Peyronie's disease: a retrospective study on more than 120 patients treated in one referral centre" by C. Ceruti and colleagues is presented.

An abstract of the article "Treatment of prostate cancer and sexual rehabilitation when a nerve-sparing procedure is not feasible: placement of the reservoir for a three-component penile implant during robotic extra-aponeurotic radical prostatectomy" by C. Ceruti and colleagues is presented.

An abstract of the study "A single center analysis on the learning curve of male to female peno-scrotal vaginoplasty by multiple outcome measures" by M. Timpano and colleagues is presented.

To report the outcomes of a multiple-staged buccal mucosa metoidioplasty Methods From September 2016 to August 2019 a consecutive series of 12 male transgenders underwent a metoidioplasty. Metoidioplasty was conducted as a multiple-staged procedure: 1) urethral lengthening and dorsal buccal mucosa grafting 2) tabularization of the urethral plate, vaginectomy and scrotoplasty 3) bilateral testicular prosthesis implantation. Conclusions The multiple-staged buccal mucosa metoidioplasty may represent a valuable option for GGAS minimizing urethral postoperative complications. [Extracted from the article]

Particularly, functional outcomes and patients' reported outcomes (PRO's) have been rarely investigated. The aim of our study is to report functional outcomes and PRO's of total glans resurfacing (TGS) in a consecutive series of patients with lichen sclerosus (LS) or localized penile cancer (PC). [Extracted from the article]

Induratio Penis Plastic or La peyronie disease is a disease of connective tissue that involves the albuginea tunic of the corpora cavernosa. Surgical Procedure Exeresis of whole lenght penis IPP Was made an longitudinal penoscrotal incision. Next steps were.suspension, incision and dilatation of the cavernous bodies (Untill 10.5 mm of diameter) for removing the calcified and sclerotic tissue bilaterally. [Extracted from the article]

Penis size and inpotence has been a source of anxiety for men throughout history, and still today, men often feel a need to enlarge their penises or to find a cheap solution of their sexual disfunction in order to improve self-esteem or to satisfy and impress their partners. In 2016 the patient injected himself with cosmetic silicone at penis shaft. Isolation of scrotal dartos and excision of the skin and penile subcutis involved by the marked tissue reaction.It was made a scrotal rotary flap for penile scrotal housing, scrotoplasty and relaxation of the ventral part of the penis then was made reconstruction of tension-free dartos and subcutaneous tissue and skin. [Extracted from the article]

Penile prosthesis implantation (PPI) could result in negative outcomes in terms of complications and low satisfaction level after surgery. Results Follow-up data were available for 256 patients [median age 60 years (IQR:56-67)] submitted to PPI. Overall 10%(25) of patients experienced post-operative complications, with 2(8%) and 10(40%) patients reporting Clavien-Dindo 2 and 3 complications. [Extracted from the article]

Background: Nesbit corporoplasty was proposed to address penile curvature (PC), both congenital (CPC) and acquired (APC)., Aim: To evaluate surgical, functional, and patient reported outcomes (PROs) of a modified corporoplasty., Methods: From May 2005 to January 2017, a consecutive series of patients underwent a modified corporoplasty. Data were retrospectively extrapolated. Intra and postoperative complications and hospital stay were recorded as surgical outcomes. 2 validated international questionnaires were administered preoperatively and at 12 months after surgery: International Index of Erectile Function and Sexual Encounter Profile (items 2-3). An "ad hoc" questionnaire was utilized to assess PROs., Outcomes: Postoperative surgical and functional outcomes and PROs were the primary outcomes assessed in this study., Results: 87 out of 145 patients had complete data available and were included in the study. CPC was noted in 61 patients whilst APC, secondary to Peyronie's disease, was present in 26 patients. Median preoperative PC was 60° (interquartile range [IQR] 45-70). Functional and PROs were evaluated 12 months after surgery for all enrolled patients. Considering surgical outcomes, the median follow-up time was 110 months (IQR 27-132.5). Median operative time was 130 minutes for CPC (IQR 115-150) and 120 minutes for APC (IQR 95-140). Median hospital stay was 2 days for both groups (IQR 1-2). After the median follow-up time of 110 months (IQR 27-132.5), a recurrent curvature was observed in 9.2% of cases. Minor residual curvature (<20°) was detected in 13.8%. International Index of Erectile Function and Sexual Encounter Profile 2-3 scores improved in both groups. Long-term de novo postoperative erectile dysfunction was observed in 3.2% of CPC cases and in 38.5% in APC (P = .001). A multivariate analysis revealed that etiology (APC), patient age (>35 years), and postoperative complications represented independent risk factors for the development of postoperative erectile dysfunction. Postoperative complications, in terms of bleeding, infection, or poor esthetic wound healing, occurred in 12.6% of patients. No Clavien-Dindo grade III-IV intraoperative complications were reported. Postoperative hematoma was more frequent in CPC when compared to APC (P = .003). In relation to PROs, 26.4% of patients responded as being dissatisfied with postoperative penile length, with a higher incidence in the APC group (P = .001). Overall, a significant improvement in everyday and sexual life quality was observed in both categories., Clinical Implications: The modified corporoplasty described showed better residual curvature rates, whilst maintaining similar PROs even if APC patients reported less favorable outcomes when compared to CPC., Strengths & Limitations: The primary limitations of this study are its retrospective nature, no objective evaluation of postoperative curvature, and no penile length assessment., Conclusion: The aforementioned corporoplasty may represent an excellent option for PC correction, with low complication rate and high patient satisfaction. Falcone M, CerutiC, Preto M, et al. Long-Term Surgical, Functional, and Patient Reported Outcomes of a Modified Corporoplasty: A Tertiary Referral Center Experience. J Sex Med 2020;17:1779-1786., (Copyright © 2020 International Society for Sexual Medicine. All rights reserved.)

Background: Although many grafts have been used for plaque incision with grafting (PIG) and penile prosthesis (PP) implantation, there is no evidence that favors 1 specific graft over another., Aim: To compare fibrin-coated collagen fleece (TachoSil; Baxter International, Deerfield, IL, USA) with porcine small intestinal submucosa (SIS; Cook Biotech, West Lafayette, IN, USA) as grafts., Methods: From January 2007 to January 2015, 60 non-randomized consecutive patients affected by end-stage Peyronie disease underwent PIG and PP implantation (AMS 700CX; Boston Scientific, Marlborough, MA, USA). All patients underwent preoperative penile dynamic duplex ultrasound. All procedures were performed by the same surgeon. Patients were divided in 2 different groups according to the graft used to cover the albuginea defect. SIS was used for grafting in 34 patients (group A) and TachoSil was used in 26 patients (group B)., Outcomes: Overall hospital stay, operative time, 5-point Likert hematoma scale, visual analog scale, incidence of postoperative complications, and PP mechanical failure were selected as outcome measures. Functional outcomes were assessed through validated questionnaires (International Index of Erectile Function, Erectile Dysfunction Inventory of Treatment Satisfaction, and Sexual Encounter Profile questions 2 and 3) preoperatively and 3, 6, and 12 months postoperatively., Results: The patients' median age was 63 years. No statistically significant differences were detected between groups for age and type and degree of curvature (median = 65°). Average follow-up was 35 months. No major intraoperative complications were reported. The average operative time was 145 minutes for group A and 120 minutes for group B. No statistically significant differences between groups were detected for postoperative complications. Only 3 patients developed a major postoperative complication requiring a 2nd surgical intervention: 1 patient in group A for mechanic failure and 1 patient in group A and 1 in group B for inflatable PP infection. Multivariate statistical analysis showed no significant difference for all variables analyzed between the 2 groups, except for operative time, which was significantly shorter for group B., Clinical Implications: TachoSil could represent a valuable option for grafting, considering its advantages in operative time and cost compared with SIS., Strengths and Limitations: Long-term follow-up represents a strength factor. Main limitations are the non-randomized nature of the study and the small number of patients., Conclusions: TachoSil seems to represent an effective solution for grafting after PIG and PP implantation. However, additional studies are warranted to confirm our results. Falcone M, Preto M, Ceruti C, et al. A Comparative Study Between 2 Different Grafts Used as Patches After Plaque Incision and Inflatable Penile Prosthesis Implantation for End-Stage Peyronie's Disease. J Sex Med 2018;15:848-852., (Copyright © 2018 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)

Introduction: The phosphodiesterase type 5 (PDE5) inhibitors are generally well tolerated and effective for treating erectile dysfunction (ED), including in patients with significant comorbidity. Because of this benign safety profile, investigators have used PDE5 inhibitors to treat patients with ED and severe renal disease or those who have received renal transplants., Aim: To assess safety and efficacy of PDE5 inhibitors in patients receiving dialysis or renal transplants., Main Outcome Measures: Erectile function as assessed by the International Index of Erectile Function (IIEF) and Global Assessment Questions; adverse events (AEs)., Methods: We reviewed published studies of PDE5 inhibitors in patients receiving dialysis or renal transplants., Results: In double-blind, placebo-controlled studies in patients receiving dialysis or renal transplants, sildenafil significantly improved erectile function as assessed by the IIEF, and 75-85% of patients reported improved erectile function on Global Assessment Questions; efficacy was more variable in less well-controlled studies. In >260 patients undergoing dialysis who received sildenafil in clinical studies, there were only six reported discontinuations because of AEs (headache [N=3], headache and nausea [N=1], gastrointestinal [N=1], and symptomatic blood pressure decrease [N=1]). In approximately 400 patients with renal transplants who received sildenafil, only three patients discontinued because of AEs. Vardenafil improved IIEF scores of up to 82% of renal transplant recipients in randomized, controlled studies (N=59, total), with no reported discontinuations because of AEs. Limited data also suggest benefit with tadalafil., Conclusions: ED is common in patients undergoing renal dialysis or postrenal transplant and substantially affects patient quality of life. Sildenafil and vardenafil appear to be efficacious and well tolerated in patients receiving renal dialysis or transplant., (© 2013 International Society for Sexual Medicine.)

Introduction: Peyronie's disease is the result of the formation of fibrous plaques in the tunica albuginea of the penis; typical presentations of the disease are represented by pain during erection, erectile dysfunction, and penile deformities, such as curvature, narrowing, and penile shortening. The most complex treatment is related to penile shortening., Aim: To find a safe procedure in penile shortening due to Peyronie's disease providing a satisfactory lengthening, allowing an early stabilization of the penis, and preventing axial tension on the neurovascular bundles during dilation., Methods: We describe a new lengthening surgical procedure based on a ventro-dorsal incision of the tunica albuginea, penile prosthesis implantation, and double dorsal-ventral patch grafting with porcine small intestinal submucosa. Three patients, affected by Peyronie's disease with penile shortening and erectile dysfunction, underwent this procedure with approval of our local ethical committee. We evaluated the penis lengthening, intraoperative and postoperative complications, patient's preoperative and postoperative sexual life satisfaction (International Index of Erectile Function [IIEF] questionnaire)., Results: The average operative time was 2 hours and 50 minutes. No major intraoperative nor postoperative complications occurred. No significant bleedings were recorded. Patients were discharged after 48-72 hours. The average increase in length obtained was 3.2 cm. All patients resumed sexual intercourses with satisfaction; no significant loss of sensitivity or any sign of vascular distress of the glans was recorded. The follow-up is 13 months. The average IIEF score is 60., Conclusions: The lengthening of the penis by a double dorsal-ventral patch graft is an innovative procedure that is based on current techniques of plaque incision and grafting, and that can easily resolve severe shortening of the penis due to Peyronie's disease. In the cases presented, this procedure resulted easily, effectively, and safely. Nevertheless, the technique proposed in this article shall be validated through prospective studies with larger samples., (© 2012 International Society for Sexual Medicine.)