We aimed to evaluate ten-year outcomes of penile prosthesis(PP)implantation for the treatment of erectile dysfunction and to assess predictors of early prosthetic infection(EPI).We identified 549 men who underwent 576...We aimed to evaluate ten-year outcomes of penile prosthesis(PP)implantation for the treatment of erectile dysfunction and to assess predictors of early prosthetic infection(EPI).We identified 549 men who underwent 576 PP placements between 2008 and 2018.Univariate and multivariate analyses were used to identify potential predictors of EPI.An EPI predictive nomogram was developed.Thirty-five(6.1%)cases of EPI were recorded with an explant rate of 3.1%.In terms of satisfaction,82.0%of the patients defined themselves as“satisfied,”while partner’s satisfaction was 88.3%.Diabetes(P=0.012),longer operative time(P=0.032),and reinterventions(P=0.048)were associated with EPI risk,while postoperative ciprofloxacin was inversely associated with EPI(P=0.014).Rifampin/gentamicin-coated 3-piece inflatable PP(r/g-c 3IPP)showed a higher EPI risk(P=0.019).Multivariate analyses showed a two-fold higher risk of EPI in diabetic patients,redo surgeries,or when a r/g-c 3IPP was used(all P<0.03).We showed that diabetes,longer operative time,and secondary surgeries were the risk factors for EPI.Postoperative ciprofloxacin was associated with a reduced risk of EPI,while r/g-c 3IPP had higher EPI rates without an increased risk of PP explant.After further validation,the proposed nomogram could be a useful tool for the preoperative counseling of PP implantation.展开更多
We read with interest the study by Cho et al.1 regarding the features of subclinical varicocele in a pediatric and young adult single-center population.Out of 98 patients identified,the majority had a rightsided subcl...We read with interest the study by Cho et al.1 regarding the features of subclinical varicocele in a pediatric and young adult single-center population.Out of 98 patients identified,the majority had a rightsided subclinical varicocele(69%,n=25),usually with a contralateral clinical varicocele.Testicular asymmetry(>20%volume difference of the affected side by testicular atrophy index formula)was assessed in nine patients with unilateral subclinical varicocele without contralateral varicocele,either clinical or subclinical.Interestingly,of 17 patients with a mean follow-up of 32 months,3(17.6%)progressed to clinical varicocele without asymmetric testicular volume,as most remained subclinical or had subsequent resolution by ultrasound.The authors concluded that subclinical varicoceles appeared unlikely to progress to a clinical disease,to affect testicular volume,or to lead to surgery.展开更多
文摘We aimed to evaluate ten-year outcomes of penile prosthesis(PP)implantation for the treatment of erectile dysfunction and to assess predictors of early prosthetic infection(EPI).We identified 549 men who underwent 576 PP placements between 2008 and 2018.Univariate and multivariate analyses were used to identify potential predictors of EPI.An EPI predictive nomogram was developed.Thirty-five(6.1%)cases of EPI were recorded with an explant rate of 3.1%.In terms of satisfaction,82.0%of the patients defined themselves as“satisfied,”while partner’s satisfaction was 88.3%.Diabetes(P=0.012),longer operative time(P=0.032),and reinterventions(P=0.048)were associated with EPI risk,while postoperative ciprofloxacin was inversely associated with EPI(P=0.014).Rifampin/gentamicin-coated 3-piece inflatable PP(r/g-c 3IPP)showed a higher EPI risk(P=0.019).Multivariate analyses showed a two-fold higher risk of EPI in diabetic patients,redo surgeries,or when a r/g-c 3IPP was used(all P<0.03).We showed that diabetes,longer operative time,and secondary surgeries were the risk factors for EPI.Postoperative ciprofloxacin was associated with a reduced risk of EPI,while r/g-c 3IPP had higher EPI rates without an increased risk of PP explant.After further validation,the proposed nomogram could be a useful tool for the preoperative counseling of PP implantation.
文摘We read with interest the study by Cho et al.1 regarding the features of subclinical varicocele in a pediatric and young adult single-center population.Out of 98 patients identified,the majority had a rightsided subclinical varicocele(69%,n=25),usually with a contralateral clinical varicocele.Testicular asymmetry(>20%volume difference of the affected side by testicular atrophy index formula)was assessed in nine patients with unilateral subclinical varicocele without contralateral varicocele,either clinical or subclinical.Interestingly,of 17 patients with a mean follow-up of 32 months,3(17.6%)progressed to clinical varicocele without asymmetric testicular volume,as most remained subclinical or had subsequent resolution by ultrasound.The authors concluded that subclinical varicoceles appeared unlikely to progress to a clinical disease,to affect testicular volume,or to lead to surgery.
