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2. Long-term experience with AMS-700 CXR inflatable penile prosthesis in high-risk patients with corporal fibrosis

Author

Johnson, Blake E., Langford, Brian T., VanDyke, Maia E., Matz, Ethan L., Cook, Grayden S., Franzen, Bryce P., and Morey, Allen F.

Abstract

Despite the widespread use of narrow diameter inflatable penile prosthesis (IPP) cylinders in patients with corporal fibrosis, outcomes data is sparse. We evaluated patients who underwent IPP placement with AMS™ 700 Controlled Expansion Restricted (CXR) cylinders from 2007–2021. Patient characteristics, device details, and surgical outcomes were assessed. A non-validated questionnaire was also distributed to patients to assess satisfaction. Among 982 IPPs placed over the study period at our institution, 49 (5.0%) used CXR cylinders. Indications for narrow cylinders: prior explant for infection (67.3%), ischemic priapism (16.3%), and idiopathic fibrosis (16.3%). Median corporal length was 19 cm (IQR 17–21 cm). Discordant intraoperative corporal measurements (24.5%) and RTE lengths (26.5%) were common. Post-operative complications occurred in 8 patients (16.3%) and included 3 infections (6.1%), 2 cylinder herniations (4.1%), 2 mechanical failures (4.1%), and one case of glans necrosis (2.0%). Five of these (10.2%) required explantation, while 4 (8.2%) were managed with revision. Over the follow-up period, 73.5% of patients reported satisfaction with rigidity. Primary drivers of dissatisfaction were perceived loss of penile length and girth. The AMS™ 700 CXR is a useful tool for challenging corporal fibrosis cases and shows acceptable surgical outcomes with moderate patient acceptability.

Published
2024
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5. Outcomes of patients undergoing concurrent radical cystectomy and nephroureterectomy: A single-institution series

Author

Carpinito, Gianpaolo P., Cook, Grayden S., Tverye, Aaron N., Gold, Samuel A., Lotan, Yair, Margulis, Vitaly, and Howard, Jeffrey M.

Subjects
Oncology, Urology, Original Research
Abstract

Introduction: Radical cystectomy (RC) and radical nephroureterectomy (RNU) are commonly performed in urological oncology. Concurrent disease in the upper tract and bladder is rare, so performing both procedures in the same setting is uncommon. Here, we report the perioperative and oncological outcomes of a single-institution series of concurrent RC+RNU. Methods: We retrospectively reviewed the charts of patients who underwent concurrent RC+RNU for bladder and/or upper tract urothelial carcinoma between 2006 and 2020. Patient demographic and clinical factors, perioperative parameters, and oncological outcomes were obtained. Results: Twenty-seven patients underwent RC+RNU during the study period; 22 (81%) were male. Median (interquartile range) patient age was 71 (67–75) years. All had a diagnosis of bladder cancer. Concurrent upper tract urothelial carcinoma (UTUC) was the indication for RNU in 12 cases (44%) and non-functional renal unit in the remainder. Two patients (7%) experienced early postoperative mortality. Eight patients (30%) experienced major complications (Clavien-Dindo >3). Complications did not vary significantly between those rendered anephric (5/16, 31%) and those who were not (3/11, 27%) (p=0.82, Chi-squared test). Median (95% confidence interval) and five-year overall survival were 47 (41–52) months and 42%, respectively. Six of 22 male patients (27%) experienced a urethral recurrence and three of 14 patients (21%) with non-functional kidneys had occult UTUC discovered on final pathology. Conclusions: Combined RC+RNU carries an elevated perioperative risk, primarily in highly comorbid patients. Striking rates of occult UTUC in non-functional kidneys and of urethral recurrence after cystectomy were noted. RC+RNU is an appropriate option in select patients.

Published
2022

8. The Impact of COVID-19 on Surgical Education

Author

Nagaraj, Madhuri B., primary, Weis, Holly B., additional, Weis, Joshua J., additional, Cook, Grayden S., additional, Bailey, Lisa W., additional, Shoultz, Thomas H., additional, Farr, Deborah E., additional, AbdelFattah, Kareem R., additional, and Dultz, Linda A., additional

Published
2021
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9. Distance From Critical Pelvic Structures: Radiographic Comparison of High Submuscular and Space of Retzius IPP Reservoir Placement Techniques.

Author

Kavoussi, Mehraban, Cook, Grayden S., Nordeck, Shaun M., Dropkin, Benjamin M., Joice, Gregory A., Sanders, Sarah C., Hudak, Steven J., Pruitt, Jeffrey H., and Morey, Allen F.

Subjects
*CROSS-sectional imaging, *PENILE prostheses, *BLADDER, *SHORT selling (Securities), *RADIOLOGISTS, *ABDOMINAL surgery, *INDOLE compounds, *RETROSPECTIVE studies
Abstract

Objective: To evaluate the distance from critical pelvic structures (CPS, defined as bladder and iliac vessels) among inflatable penile prosthesis (IPP) reservoirs placed into the space of Retzius (SOR) and high submuscular (HSM) locations using cross-sectional imaging. IPP reservoir placement into the HSM location has been proposed as a strategy to prevent injury due to greater distance from CPS.Methods: Our institutional database was retrospectively reviewed to identify men who underwent IPP insertion between 2007 and 2020 and had available cross-sectional abdominopelvic imaging after the time of surgery. Patients were grouped based on reservoir placement technique (SOR vs. HSM). Staff radiologists blinded to placement technique evaluated reservoir position to determine the shortest distance between CPS and the reservoir and if a mass effect was present on CPS. Variables were analyzed using chi-squared, Fisher's exact, and student's T-tests as indicated.Results: Among 1,010 IPP cases performed during the study interval, 139 (13%) were imaged. Compared with SOR reservoirs (n = 32), HSM reservoirs (n =107) were significantly less likely to induce a mass effect on the bladder (72 vs. 9%, P = <.01) or iliac vessels (34 vs. 4%, P = <.01) and were located roughly 5 times further from the bladder (10 ± 22 vs. 49 ± 36 mm, P = <.01) and iliac vessels (5 ± 9 vs. 23 ± 26 mm, P = <.01).Conclusion: This study radiographically confirms that IPP reservoirs are located significantly further away from CPS following HSM placement compared to SOR placement. [ABSTRACT FROM AUTHOR]

Published
2022
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10. International prevalence and risk factors evaluation for drug-resistant Streptococcus pneumoniae pneumonia

Author

Aliberti, Stefano, primary, Cook, Grayden S., additional, Babu, Bettina L., additional, Reyes, Luis F., additional, H. Rodriguez, Alejandro, additional, Sanz, Francisco, additional, Soni, Nilam J., additional, Anzueto, Antonio, additional, Faverio, Paola, additional, Sadud, Ricardo Franco, additional, Muhammad, Irfan, additional, Prat, Cristina, additional, Vendrell, Ester, additional, Neves, Joao, additional, Kaimakamis, Evangelos, additional, Feneley, Andrew, additional, Swarnakar, Rajesh, additional, Franzetti, Fabio, additional, Carugati, Manuela, additional, Morosi, Manuela, additional, Monge, Elisa, additional, and Restrepo, Marcos I., additional

Published
2019
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