ABSTRACT
Since their popularization, genitourinary prosthetics have remained a gold-standard therapy for the treatment of erectile dysfunction and stress urinary incontinence and in cases of testicular loss or dysfunction. They have also represented an area of significant innovation, which has contributed to excellent long-term outcomes. Given this history, the objective of the current review was to provide a 5-10-year outlook on anticipated trends and developments in the field of genitourinary prosthetics. To accomplish this objective, a PubMed and patent search was performed of topics relating to penile and testicular prostheses and urinary sphincters. In regard to penile prostheses, findings demonstrated several new concepts including temperature-sensitive alloys, automated pumps, devices designed specifically for neophalluses, and improved malleable designs. With artificial urinary sphincters, new concepts include the ability to add or remove fluid from an existing system, two-piece systems, and new mechanisms to occlude the urethra. For testicular prosthetics, future implementations may not only better replicate the feel of a biological testicle but also add endocrinological functions. Beyond device innovation, the future of prosthetics is also one of expanding geographic boundaries, which necessitates variable cost modeling and regulatory considerations. Surgical trends are also changing, with a greater emphasis on nonnarcotic, postoperative pain control, outpatient surgeries, and adjunctive techniques to lengthen the penis and address concomitant stress incontinence, among others. Concomitant with device and surgical changes, future considerations also include a greater need for education and training, particularly given the rapid expansion of sexual medicine into developing nations.
Subject(s)
Humans , Male , Erectile Dysfunction/surgery , Penile Implantation , Penile Prosthesis/trends , Prostheses and Implants/trends , Prosthesis Design/trends , Prosthesis Implantation/trends , Testicular Diseases/surgery , Urinary Incontinence, Stress/surgery , Urinary Sphincter, Artificial/trends , Urologic Surgical Procedures, Male/trendsABSTRACT
Neuroprosthesis or brain-machine interfaces are electronic devices created to directly interact with the nervous system for replacing an absent or damaged sensory or motor function. Three types of auditory neuroprosthetics devices have been developed in Otolaryngology, (i) cochlear implants, (ii) brainstem auditory implants and (iii) auditory midbrain implants. These devices allow young deaf children to acquire oral language and to restore auditory function in deafened adults. On the other hand, a new vestibular prosthesis that could be useful for patients with severe disequilibrium has been developed. Main characteristics and clinical utility of these prostheses are reviewed in this article.
Subject(s)
Humans , Male , Female , Auditory Brain Stem Implantation/trends , Cochlear Implantation/trends , Prosthesis Implantation/trends , Auditory Brain Stem Implants/trendsABSTRACT
La artroplastía total de hombro se está convirtiendo en un procedimiento cada vez más frecuente. A pesar de los buenos resultados la artroplastía total de hombro tipo Neer es difícil, esto, debido a la complejidad del procedimiento. Por este motivo se desarrolló en 1987 el hombro biangular para facilitar la preparación del glenoides y la implantación del componente humeral. En este trabajo se presentan los resultados de una paciente femenina de 74 años con fractura en cuatro partes de cabeza humeral izquierda, a corto plazo, que son buenos tanto como los de la artroplastía total de cadera y de rodilla.
Subject(s)
Humans , Female , Aged , Osteotomy , Shoulder Fractures , Prosthesis Implantation/methods , Prosthesis Implantation/trends , Recovery of Function/physiologyABSTRACT
Una serie de 16 pacientes con obstrucción de la vía biliar fueron tratados mediante la utilización de una endoprótesis metálica expandible con balón, tipo palmaz, durante 2 años, en el hospital Militar Central. 14 de ellos presentaban patología neoplásica maligna, y 2, de tipo benigno. las edades oscilaban entre los 48 y 86 años (x=65,5 años), 8 de sexo masculino y 8 de sexo femenino. La colocación de la endoprótesis dejando derivación interna-externa, y en el segundo derivación interna definitiva. El número de endoprótesis requeridas osciló entre 1 y 5 (x=3), cuidando que el más distal siempre sobrepasara al menos en 2 cm el punto de obstrucción. Se presentaron 6 complicaciones menores (35.3 por ciento) y 2 mayores (11,7 por ciento), se obstruyó en 2 pacientes (11,7 por ciento) requiriendo reintervención. La mortalidad el primer mes fué de 11.7 por ciento, entre el 1o y el 6o mes de 23,5 por ciento y entre el 6o y 1er año de 17,6 por ciento. La sobrevida general al momento es del 41,2 por ciento. Se obstuvo excelente paliación y mejoría en la calidad de vida de los pacientes, los resultados son comparables a los obtenidos en otras series