Penile Implant Surgery Satisfaction Assessment.

BACKGROUND: Several studies reported high satisfaction rates (> 90%) for patients and their partners after penile prosthesis (PP) implantation. AIM: To describe and critically discuss the current evidence regarding the assessment of patient and partner satisfaction after penile implant surgery. METHODS: A critical narrative review of the studies investigating the patient and partner satisfaction after PP implantation was designed. Papers in English-language published until January 2021 were included. OUTCOMES: The main outcome investigated was patient and partner satisfaction after penile implant surgery. RESULTS: The International Index of Erectile Function , the Erectile Dysfunction Inventory of Treatment Satisfaction , the Treatment Satisfaction Scale , and the Quality of Life and Sexuality with Penile Prosthesis are the best-known validated tools used to assess satisfaction after PP implantation. Except for Quality of Life and Sexuality with Penile Prosthesis , they were not validated in patients undergoing penile implant surgery. The lack of an "ad hoc" tool has led to the widespread of nonvalidated questionnaires. Several tools can be useful in the preimplantation counseling, such as the mnemonic Compulsive/obsessive, Unrealistic, Revision, Surgeon Shopping, Entitled, Denial, and Psychiatric , the Minnesota Multiphasic Personality Inventory, the Brief Sexual Symptom Checklist for Men , the Attitude towards Penile Implant , and the Attitude Attributed to the Partner towards Penile Implant . CLINICAL IMPLICATIONS: Improvement of knowledge regarding the available tools to evaluate the satisfaction after penile implant surgery. STRENGTHS & LIMITATIONS: Comprehensive and thorough review of all the main validated questionnaires available to assess satisfaction in patients with PP. Lack of a systematic approach and quantitative data analysis. CONCLUSION: Despite the high satisfaction rate reported in the literature, most of the studies used suboptimal or non-validated questionnaires to assess patients undergoing penile implant surgery. Future research is needed to develop and validate a specific, complete and easy-to-use questionnaire. Manfredi C, Fortier É, Faix A, et al. Penile Implant Surgery Satisfaction Assessment. J Sex Med 2021;18:868-874.

Radical Prostatectomy after Vascular Targeted Photodynamic Therapy with Padeliporfin: Feasibility, and Early and Intermediate Results.

PURPOSE: Vascular targeted photodynamic therapy with TOOKAD® is a new therapeutic option for localized prostate cancer management. The objectives of this study were to assess the feasibility of radical prostatectomy after vascular targeted photodynamic therapy and describe functional and oncologic outcomes. MATERIALS AND METHODS: We retrospectively included in study 45 patients who underwent salvage radical prostatectomy after vascular targeted photodynamic therapy for recurrent prostate cancer at a total of 14 surgical centers in Europe between October 2008 and March 2017. Of the 42 radical prostatectomies performed 16 were robot-assisted, 6 were laparoscopic and 20 were open surgery. Primary end points were morbidity and technical difficulties. Secondary end points were early and intermediate postoperative functional and oncologic outcomes. RESULTS: Median operative time was 180 minutes (IQR 150-223). Median blood loss was 200 ml (IQR 155-363). According to the surgeons the surgery was easy in 29 patients (69%) and difficult in 13 (31%). Nerve sparing was feasible in 14 patients (33%). Five postoperative complications (12%) were found, including 2 Clavien I, 2 Clavien II and 1 Clavien IIIB complications. Of the cases 13 (31%) were pT3 and 21 (50%) were pT2c. Surgical margins were positive in 13 patients (31%). Prostate specific antigen was undetectable at 6 to 12 months in 37 patients (88%). Nine patients underwent complementary radiotherapy. Four patients had final prostate specific antigen greater than 0.2 ng/ml at a median followup of 23 months (IQR 12-36). At 1 year 27 patients (64%) were completely continent (no pads) and 10 (24%) had low incontinence (1 pad). Four patients (11%) recovered potency without treatment and 23 (64%) recovered potency with appropriate treatment. CONCLUSIONS: Salvage radical prostatectomy after vascular targeted photodynamic therapy treatment was feasible and safe without difficulty for most of the surgeons.

Benefits of Urologic-Dermatologic Consultations for the Diagnosis of Cutaneous Penile Lesions: A Prospective Study.

INTRODUCTION: We evaluated the benefits of a specialized consultation created in 2014 for cutaneous penile lesions. MATERIALS AND METHODS: We performed a descriptive prospective study evaluating all patients sent for a monthly urologic-dermatologic consultation at a French university hospital from September 2014 to September 2015 for cutaneous penile lesions. All patients evaluated were included. We collected the demographic data, clinical examination findings, and the proposed diagnosis and treatment for every patient. RESULTS: A total of 27 patients were included; 4 (14.8%) had been referred by a general physician and 23 (85.2%) by a specialist. Cutaneous penile lesions had evolved within 12 months in 15 patients (55.6%). Penile cancer was diagnosed in 5 patients (18.5%), of which 3 were squamous cell carcinoma (11.1%), 1 was metastasis of melanoma (3.7%), and 1 was extramammary Paget disease (3.7%). In addition, 1 patient (3.7%) had a premalignant lesion on a condyloma, 12 (44.4%) had balanitis, 2 (7.4%) had psoriasis lesions, 3 (11.1%) had condylomas, 1 (3.7%) had genital melanosis, and 3 (11.2%) had normal findings. Four patients (16.6%) underwent biopsy, 8 (33.3%) underwent surgery, and 12 (50%) received local treatment. CONCLUSION: The use of urologic-dermatology specialized consultations resulted in encouraging findings. Patients can benefit from multidisciplinary expertise and rapid treatment of various disorders. Thus, it seems important to develop reference centers created specifically for cancerous disease.