Improvising on the Fly: Comparison of a Novel Technique for Emergent Zipper Release to a Well-Established Technique in a Simulated Setting.

BACKGROUND: Penile skin zipper entrapment is an emergent medical condition in which the penile skin, scrotal skin, or foreskin gets caught within the teeth of a zipper or the slider itself. This can lead to complications such as urethral involvement, skin loss, or tissue necrosis. We propose a novel technique to aid in the release of entrapped skin utilizing wire cutters directed at the inferior portion of the zipper pull. OBJECTIVES: To describe a novel technique to free entrapped penile skin and compare its performance to the well-established median bar technique in a simulated setting. METHODS: A randomized cross-over design was used to compare techniques on successful release, time to release and tissue injury using an animal model of raw chicken skin entrapped in a zipper. Statistical significance was assessed at p < 0.05. RESULTS: Twenty-two participants were included. There was no statistically significant difference between the novel technique and the median bar technique regarding successful release (100% vs 95.5%, respectively), median time to release (29.1 vs 26.4 seconds, respectively), or frequency of tissue injury (22.7% vs 27.3%). CONCLUSION: Performance using our novel technique for removal of penile skin from a zipper is similar to the median bar release technique regarding. Our novel technique may be a valid treatment option for the release of entrapped penile skin in a zipper mechanism in the emergency department setting.

Traumatic Penile Injury: An Analysis of the Patient Age with Aetiological Type and Injury Severity in a Single Centre.

BACKGROUND: Penile trauma is associated with debilitating complications. Apart from its sparse literature, contextually relevant evidence on aetiology and standardized severity grading, and its stratification by legal age are needed. This study aimed to describe the frequency, aetiology and injury severity grade of patients, and explore the association of specific factors by legal age. SUBJECTS, MATERIALS AND METHODS: A single-centre retrospective cross-sectional study was conducted in our centre. Male patients with penile trauma managed by urologists were included. Data on age, year of presentation, aetiology, penile injury extent and co-existing genitourethral injuries were obtained. Descriptive and inferential statistics were undertaken using SPSS and MedCalc. Pvalue < 0.05 was considered significant. RESULTS: Forty-two patient records were analyzed. The median age and interquartile range for legal minors and legal adults were 9.5 (5.0-14.8) years and 31.0 (22.5-41.0) years, and they constituted 28.6% (n=12) and 71.4% (n=30) of the study population respectively. Penile trauma was isolated in 26.2% (n=11) of the total population.Its annual frequency was below the median volume between 2001 and 2008 but shifted to a rate above the average level between 2017 and 2021. The rate of conveyor belt-related aetiology and high-grade trauma was 41.7% and 75.0% in legal minors while it was 26.1% and 53.3% respectively in legal adults. CONCLUSIONS: Grade IV trauma was the most predominant while conveyor belt injury was the most common cause of the injury. Albeit limitations of statistical comparison, the rate of conveyor belt injury and high-grade trauma was numerically high in legal minors.

CONTEXTE: Les traumatismes du pénis sont associés à des complications débilitantes. Outre la rareté de la littérature, des preuves contextuel l ement per tinentes sur l ' étiol ogie et l a classification standardisée de la gravité, ainsi que leur stratification par âge légal, sont nécessaires. Cette étude visait à décrire la fréquence, l'étiologie et le degré de gravité des blessures des patients, et à explorer l'association de facteurs spécifiques par âge légal. SUJETS, MATÉRIELS ET MÉTHODES: Une étude rétrospective transversale monocentrique a été réalisée dans notre centre. Les patients masculins ayant subi un traumatisme pénien pris en charge par des urologues ont été inclus. Les données sur l'âge, l'année de présentation, l'étiologie, l'étendue de la blessure pénienne et les blessures génito-urétrales coexistantes ont été obtenues. Des statistiques descriptives et inférentielles ont été réalisées à l'aide de SPSS et MedCalc. Une valeur de p < 0,05 a été considérée comme significative. RÉSULTATS: Quarante-deux dossiers de patients ont été analysés. L'âge médian et l'intervalle interquartile pour les mineurs légaux et les adultes légaux étaient de 9,5 (5,0-14,8) ans et 31,0 (22,5-41,0) ans, représentant respectivement 28,6 % (n=12) et 71,4 % (n=30) de la population étudiée. Le traumatisme pénien était isolé chez 26,2 % (n=11) de la population totale. Sa fréquence annuelle était inférieure au volume médian entre 2001 et 2008, mais a dépassé le niveau moyen entre 2017 et 2021. Le taux d'étiologie liée aux tapis roulants et de traumatismes graves était de 41,7 % et 75,0 % chez les mineurs légaux, contre 26,1 % et 53,3 % respectivement chez les adultes légaux. CONCLUSIONS: Le traumatisme de grade IV était le plus prédominant, tandis que les blessures causées par les tapis roulants étaient la cause la plus courante de lésion. Bien que limitées par des comparaisons statistiques, les taux de blessures par tapis roulant et de traumatismes graves étaient numériquement élevés chez les mineurs légaux. MOTS-CLÉS: Facteurs d'âge, Étiologie, Score de gravité des blessures, Pénis.

Comparison of erectile and ejaculatory functional outcomes between unilateral and bilateral cavernosal rupture in penile fractures.

This study aimed to compare the erectile and ejaculatory functional outcomes of unilateral and bilateral ruptures of the corpus cavernosum in penile fractures. Sixty patients' data were analyzed retrospectively between June 2020 and January 2023. The patients were divided into two groups based on the affected corpus cavernosum (unilateral and bilateral). Preoperative and postoperative 3rd-, 6th-, and 12th-month self-estimated intravaginal-ejaculation-latency-time (IELT), and international index of erectile function-erectile function (IIEF-EF) scores as well as the presence of urethral injury were compared. Bilateral corpus cavernosum fractures were detected in 18.3% of the patients. The IIEF-EF scores of both groups at 3rd-, 6th-, and 12th-month were found to be significantly lower than the preoperative scores (unilateral group:24.1 ± 2.7 vs 23.2 ± 3.5 and 23.3 ± 3.4, respectively, p = 0.011 and 0.014, respectively; bilateral group: 24 ± 1.9 vs 23 ± 1.8 and 23.2 ± 1.5, respectively, p = 0.027 and 0.047, respectively). No significant difference was found between the preoperative and the postoperative 12th month IIEF-EF scores in either group (unilateral group: 24.1 ± 2.7 vs 23.4 ± 3.6, p = 0.207;bilateral group:24 ± 1.9 vs 23.2 ± 1.5, p = 0.057). The self-estimated IELTs of both groups at the postoperative 3rd, 6th, and 12th months demonstrated a significant increase from the preoperative values (unilateral group: 221.6 ± 81.8 vs 252 ± 94.6, 256.5 ± 97.6, and 250.5 ± 104.8, respectively, p < 0.001; bilateral group:241.8 ± 61.6 vs 278.1 ± 55.4, 281.8 ± 56.1, and 283.6 ± 54.2, respectively, p = 0.041, 0.030, and 0.047, respectively). The changes in self-estimated IELTs and IIEF-EF scores between the preoperative period and the postoperative 3rd, 6th, and 12th-months were compared, and no statistical difference was found between patients with unilateral and bilateral corpus cavernosum fractures (p > 0.05). In conclusion, no significant difference in erectile function was found in either group at the 12-month follow-up, and the self-estimated IELTs were found to be prolonged in both groups. Furthermore, no difference was noted between the groups at any follow-up. To explain the effects of unilateral and bilateral injuries on erectile and ejaculatory functions, further studies with a larger-number of patients are necessary.

Tratamiento de las pápulas perladas peneanas mediante uso de láser de dióxido de carbono fraccionado / Treatment of pearly penile papules using fractionated carbon dioxide laser

Las pápulas perladas del pene son angiofibromas acrales, lesiones asintomáticas benignas, no infecciosas, ubicadas alrededor del glande masculino. Debido su aspecto suelen causar angustia, disminución de autoestima y dificultades en la intimidad sexual. Todo esto lleva a un deterioro de la calidad de vida sexual. Métodos. Se incluyeron pacientes varones con pápulas perladas peneanas que recibieron tratamiento con láser de dióxido de carbono fraccionado entre diciembre de 2023 y abril de 2014. Se trataron en total 75 pacientes. Previo al tratamiento se les realizó una encuesta para saber si había realizado consulta previa con especialista y los motivos para realizar el tratamiento. Se les realizó el primer control postratamiento entre 10 a 15 días post tratamiento. En caso de presentar pápulas perladas peneanas residuales se procedió a un segundo o tercer tratamiento. Se les realizó segundo y tercer control postratamiento entre 10 a 15 días postratamiento. En dicho segundo o tercer control se les realizó encuesta de satisfacción. Resultados. Todos los pacientes incluidos en nuestro estudio informaron que se lograron eliminar sus pápulas perladas peneanas: 13% (10 pacientes) en primera sesión, 82% (62 pacientes) en segunda sesión y solo 4% (3 pacientes) requirieron una tercera sesión. Conclusiones. Las pápulas perladas peneanas, aun siendo de etiología benigna y no contagiosa, reducen significativamente la calidad de vida sexual de los varones, especialmente los jóvenes, y merecen de un tratamiento médico. El tratamiento de las pápulas perladas peneanas mediante uso de láser de dióxido de carbono fraccionado demostró ser un tratamiento rápido, seguro y eficaz

Pearly penile papules are acral angiofi bromas, benign, non-infectious, asymptomatic lesions around the male glans. Due to their appearance, they often cause distress, decreased self-esteem, and difficulties in sexual intimacy. All this leads to a deterioration in the quality of sexual life. Methods. Male patients with pearly penile papules who received fractionated carbon dioxide laser treatment between December 2023 and April 2014 were included. A total of 75 patients were treated. Before the treatment, a survey was conducted to fi nd out if they had previously consulted with a specialist and what motivated them to undergo the treatment. They underwent their first post-treatment control between 10 to 15 days after treatment. If residual pearly penile papules were present, a second or third treatment was performed. A second and third post-treatment control was carried out between 10 to 15 days after treatment. In said second or third control, a satisfaction survey was carried out. Results. All patients included in our study reported that their pearly penile papules were eliminated: 13% (10 patients) in the fi rst session, 82% (62 patients) in the second session, and only 4% (3 patients) required a third session. Conclusions. Pearly penile papules, even though they are of benign and non-contagious etiology. They signifi cantly reduce the quality of sexual life of men, especially young men, and deserve medical treatment. The treatment of pearly penile papules using fractionated carbon dioxide laser proved to be fast, safe, and effective.

Successful Endovascular Microembolization for Post-Traumatic High-Flow Priapism: A Case Report.

BACKGROUND High-flow (non-ischemic) priapism is a rare urological condition usually related to blind trauma to the penis or perineum causing an arterial-lacunar fistula. It can be treated conservatively, but in some cases when conservative treatment fails, the interventional approach is indicated. In the past, only surgical treatment was available, which was associated with a significant risk of complications. Endovascular techniques use a novel approach and offer clinical benefits for the patient. CASE REPORT A 51-year-old man was admitted to the hospital after referral from the urology department with high-flow priapism related to blunt trauma. Angio-computed tomography showed extravasation of contrast medium to the corpus cavernosum, and angiography revealed a fistula between the distal segment of the left internal pudendal artery and corpora cavernosa. A successful endovascular microembolization of the arterial-lacunar fistula with the use of microcoils was performed. The postprocedural period was uneventful and the patient was discharged. Despite incomplete angiographic follow-up at 6 months, the initial symptoms were fully resolved with the absence of any erectile dysfunction and no recurrence of priapism occurred. CONCLUSIONS Post-traumatic high-flow priapism can be safely and effectively treated by endovascular means. Microembolization has proven to be successful and beneficial to preserve sexual functions.

[Clinical case of penile fracture].

A clinical case of a penile fracture as a result of an unsuccessful sexual intercourse, which later required surgical treatment in the form of corporoplasty with opening and draining of the hematoma, is discussed in the article. Penile fracture is a rare urological emergency that requires immediate medical attention to avoid long-term complications, including penile curvature and erectile dysfunction.

Optimal timing of surgical intervention for penile fracture: a narrative review of the modern literature.

INTRODUCTION: Penile fracture is traditionally considered a surgical emergency warranting immediate repair with the goal to maximize long-term erectile function and minimize penile curvature. Nonetheless, consensus on the optimal timing for penile fracture repair remains to be elucidated and is the subject of continued research efforts. OBJECTIVES: This review aims to summarize the contemporary literature pertaining to optimal timing of penile fracture repair and associated outcomes. METHODS: We queried PubMed/MEDLINE and Google Scholar for relevant articles published between 2012 and 2022 to evaluate the most recent literature on the queried topic of early vs delayed intervention for penile fracture. All examined review articles were published within the last decade but may have included analyses of studies published prior to 2012. Reference lists of articles and reviews were manually reviewed to identify additional relevant articles. RESULTS: We identified 16 articles that met inclusion criteria: 12 primary articles and 4 systematic reviews or meta-analyses. Importantly, definitions of early and delayed intervention varied greatly among studies, making quantitative comparison challenging. In summary, 6 primary studies and 2 systematic review articles favored early intervention. There were also 6 primary studies and 2 systematic review articles suggesting equivocal outcomes between early and delayed repair. No articles demonstrated improved outcomes with delayed repair relative to early intervention. CONCLUSION: Surgical intervention for penile fracture remains the gold standard, with superior long-term sexual and functional outcomes when compared with conservative management. Optimal timing of penile fracture repair remains to be elucidated with data limited by low incidence, resulting in small case series and a lack of randomized controlled trials. Nonetheless, recent data suggest that a brief delay in surgical intervention for patients presenting with penile fractures does not affect long-term sexual and functional outcomes.

Honey dressing for penile skin avulsion caused by traditional circumcision: a case report.

OBJECTIVE: Penile skin avulsion is a rare complication of circumcision but commonly encountered as the result of traditional practice. We aimed to present the use of honey dressing and the benefit of its wound healing properties for management of such a complex wound. CASE: A 24-year-old male patient with penile bleeding presented to the emergency department after undergoing traditional circumcision. Complete degloving of the penis with active bleeding and foul odour, along with heavy contamination of chewed betel leaves and powdered amoxicillin was found. Honey (Madu Nusantara, PT. Madu Nusantara, Indonesia) was used as dressing after copious irrigation using saline and povidone-iodine with bleeding control. RESULTS: Honey dressing was shown to be effective for secondary wound healing of such a complicated and contaminated wound-in this case due to its antimicrobial, anti-inflammatory, immunostimulatory and autolytic debridement properties. A complete re-epithelialisation of the wound was achieved without progression to the hard-to-heal state by day 43. Suboptimal sexual function and aesthetic result due to wound contracture were observed as surgical reconstruction via split-thickness skin graft was refused due to cost. CONCLUSION: In this case report, honey dressing was shown to be effective for wound healing, even in a penile avulsion with complete skin loss and heavy contamination. In rural settings, where penile avulsion due to traditional circumcision is common, honey should be considered as one of the dressing choices.

What is the most dangerous sexual position that caused the penile fracture? A systematic review and meta-analysis.

PURPOSE: Penile fracture (PF) affects 1,14 to 10,48 men in every 100.000 men in East Asia, and the primary aetiology is sexual intercourse, but the knowledge regarding the most dangerous sexual position is not well explained. This study compares three sexual positions: man on top position (MTP), woman on top position (WTP), and doggy style position (DSP), leading to PF potential. MATERIALS AND METHODS: A search of sexual position-related PF in Google Scholar, PubMed, Cochrane, and PMC Europe was performed. Criteria inclusion was the full text of relevant articles which describ the number of sexual positions. It was analyzed by odds ratio, random model effect, and the OR and 95%CI were calculated. RESULTS: 12 relevant papers involving 490 patients comprised 169 MTP, 120 WTP, 158 DSP, and 43 no intercourse cases. Meta-analysis of all sexual positions was a MTP P= 0,04, WTP P=0,49, and DSP P=0,0005. CONCLUSION: The man-dominant positions (MTP and DSP) were significantly potential for PF, which speculated that when a man is dominant and very excited, intercourse may become highly vigorous and impact trauma. This study found that man's dominant position consists of DSP and the MTP significantly lead to PF.

Surgical management and post-operative functional outcomes of patients with a penile fracture-a single centre experience over 10 years.

BACKGROUND: Penile fractures are uncommon urological emergencies which occur when there has been a breach in the tunica albuginea of the corpora cavernosum that may be unilateral and bilateral and can extend to involve the urethra. AIM: To assess the management and outcomes of penile fractures in a single institution in Ireland. METHODS: A retrospective review of the emergency theatre logbooks was performed between 2011 and 2021 to identify patients who had undergone an exploration for a suspected penile fracture. OUTCOMES: Seventeen patients were initially identified on review of theatre logbooks as having an exploration for a suspected penile fracture. Two patients were excluded from the study due to a lack of clinical notes being available. A further 4 patients on chart review were found to not have a penile fracture at exploration. RESULTS: Eleven patients had a confirmed penile fracture intra-operatively, four of whom had an associated urethral injury. Nine (9/11) patients had preserved normal erections post-operatively documented on follow-up; two, however, reported erectile dysfunction requiring phosphodiesterase inhibitors. CLINICAL IMPLICATIONS: Our study supports urgent surgical exploration for penile fractures to ensure good functional outcomes. STRENGTHS AND LIMITATIONS: This is a retrospective review of theatre logbooks to identify patients with a suspected penile fracture. CONCLUSION: The results of our cohort show a good outcome of erectile function following surgical repair of a penile fracture (9/11; 82%). Four patients (4/11; 36%) had a urethral injury diagnosed intra-operatively, one of whom required a formal urethroplasty.

Biodegradable nano black phosphorus based SDF1-α delivery system ameliorates Erectile Dysfunction in a cavernous nerve injury rat model by recruiting endogenous stem/progenitor cells.

Stem cell (SC) therapy has been shown high prospects in erectile dysfunction (ED) treatment. Without ethical issues and risks of immune rejection and tumorigenesis of exogenous SC therapy, endogenous stem/progenitor cells (S/PCs) have a better potential for ED management, and their homing and redistribution are controlled by SDF1-α/CXCR4 axis. Considering black phosphorus nanosheet (BPNS) has emerged as an efficient and safe drug vehicle due to its large surface area, biodegradability, and the ability to retain and slowly release its loaded drugs, BPNS is utilized to load SDF1-α, a chemokine for S/PCs, to construct the BP@SDF1-α complex to efficiently recruit stem cells (SCs) by injury-site injection and thus ameliorate ED within the bilateral cavernous nerve injury (BCNI) rat models. We find that BP@SDF1-α can efficiently recruit exogenous SCs and endogenous S/PCs to corpus cavernosum and main pelvic ganglion (MPG) by local administration. Of note, ascribing to endogenous S/PCs recruitment, it also successfully alleviates ED in BCNI rat models by enhancing the protein expression levels of α-SMA, CD31, and nNOs, and eliciting less collagen deposition in the penis after its combined injection at corpus cavernosum and MPG. Thus, this study provides a new insight into the treatment of ED with endogenous S/PCs. BIODEGRADABLE NANO BLACK PHOSPHORUS BASED SDF1-α DELIVERY SYSTEM AMELIORATES ERECTILE DYSFUNCTION IN A CAVERNOUS NERVE INJURY RAT MODEL BY RECRUITING ENDOGENOUS STEM/PROGENITOR CELLS.

A review of the literature and proposed algorithm for penile fracture management.

INTRODUCTION: In the management of penile fractures, immediate surgical repair has resulted in better outcomes when compared with a conservative approach; however, there is currently no consensus on the treatment of patients presenting beyond the immediate period (>24 hours) following injury. OBJECTIVES: To examine the latest literature on management strategies in penile fracture and propose an optimal algorithm for the treatment of patients with delayed presentation. METHODS: A comprehensive search was conducted following the PRISMA-P 2020 guidelines. A search was performed in several databases with the following strategy: ("Penile fracture" OR "fracture of penis" OR "rupture of corpora cavernosa" OR "rupture of tunica albuginea") AND (management OR treatment OR surgery OR "surgical reconstruction" OR "surgical repair"). This resulted in 108 relevant articles. Two independent reviewers screened these articles according to the inclusion criteria. Full-text review of 56 articles was performed, and ultimately 20 studies were selected. Measures included the use of diagnostic imaging, timing of surgical repair (immediate, <24 hours after injury; delayed, >24 hours), surgical approach, and long-term complications (ie, erectile dysfunction and penile curvature). RESULTS: The review highlighted the benefits of immediate surgical repair in penile fractures, demonstrating improved patient outcomes. Furthermore, it found that surgical repair should be considered even in cases with delayed presentation (>24 hours after injury). To better evaluate the long-term impact of delayed surgical intervention on patient outcomes, we recommend standardized postoperative follow-up, with routine assessments of erectile function and penile curvature. CONCLUSION: Contemporary literature suggests that immediate and delayed surgical repair of penile fractures leads to adequate postoperative outcomes, and patients presenting >24 hours after injury should still be considered for surgery.

[Clinical effects of autologous split-thickness skin grafting for prefabricating urethra combined with scrotal flap in repairing middle urethral defect with penile defect].

Objective: To investigate the clinical effects of autologous split-thickness skin grafting for prefabricating urethra combined with scrotal flap in repairing middle urethral defect with penile defect. Methods: The retrospective observational study was conducted. Eight male patients (aged 14 to 58 years) with middle urethral defect and penile defect caused by various injuries who met the inclusion criteria were admitted to the First Affiliated Hospital of Air Force Medical University from January 2015 to January 2022. The length of urethral defect was 3 to 5 cm, and the wound area of penile defect after debridement was 5.0 cm×2.5 cm to 7.0 cm×5.5 cm. All the patients underwent autologous split-thickness skin grafting for prefabricating defect urethra in stage Ⅰ, and urethral anastomosis was performed and unilateral scrotal flap was transferred to reconstruct urethra and penis in stage Ⅱ. The area of scrotal flap was 6.0 cm×3.0 cm to 8.0 cm×6.0 cm. The wound in the donor area of skin graft was covered by oil gauze, and the wound of flap donor area was sutured directly. On the 7th day after the operation of stage Ⅱ, the survival of the flap was observed. In 3 weeks after the operation of stage Ⅱ, the urinary flow rate was measured by the urinary flow rate detector (urinary flow rate >15 mL/s was regarded as unobstructed urination), the urinary fistula and erectile function were observed, and the self-made therapeutic satisfaction questionnaire was used to investigate the therapeutic satisfaction degree of patients. During follow-up, the appearance of the flap recipient area was observed, the Vancouver scar scale (VSS) was used to evaluate the scar situation in the donor areas of skin graft and flap, the urinary flow rate was detected as before, the urethral stricture, urinary fistula, and erectile function were observed, and the therapeutic satisfaction degree of patients was investigated. Results: On the 7th day after the operation of stage Ⅱ, the flaps survived completely in 8 patients. In 3 weeks after the operation of stage Ⅱ, the urinary flow rate was 25.3 (18.0, 38.5) mL/s, with unobstructed urination, without urinary fistula and with erectile function, and the score of therapeutic satisfaction degree was 14.3 (14.0, 15.0). During follow-up of 1 to 7 years, the flap recipient area of 8 patients was full in appearance and not swollen, with similar color to the surrounding tissue; the VSS scores of the donor areas of skin graft and flap were 11.5 (10.0, 13.0) and 10.5 (9.3, 12.0), respectively, the urinary flow rate was 24.6 (17.7, 34.1) mL/s, with no urethral stricture, urinary fistula, and erectile dysfunction, and the score of therapeutic satisfaction degree was 13.5 (13.3, 14.8). Conclusions: Autologous split-thickness skin grafting for prefabricating urethra combined with scrotal flap in repairing the urethral and penile defects not only reconstructs the structure of urethra and the shape of penis, but also restores the sensation and erectile function of penis, with few postoperative complications, no obvious scar hyperplasia, and high satisfaction degree of patients, which is worthy of clinical promotion.

Functional recovery of injured cavernous nerves achieved through endogenous nerve growth factor-containing bioactive fibrous membrane.

Radical prostatectomy is a highly successful treatment for prostate cancer, among the most prevalent manifestations of the illness. Damage of the cavernous nerve (CN) during prostatectomy is the main cause of postoperative erectile dysfunction (ED). In this study, the capability of a personalized bioactive fibrous membrane to regenerate injured CN was investigated. The fibrous membrane bioactivity is conferred by the selectively bound nerve growth factor (NGF) present in the rat urine. In a rat model of bilateral CN crush, the implanted bioactive fibrous membrane induces CN regeneration and restoration of erectile function, showing a significantly increased number of smooth muscle cells and content of endothelial and neuronal nitric oxide synthases (eNOS; nNOS). In addition, the bioactive fibrous membrane promotes nerve regeneration by increasing the number of myelinated axons and nNOS-positive cells, therefore reversing the CN fibrosis found in untreated rats or rats treated with a bare fibrous membrane. Therefore, this personalized regenerative strategy could overcome the recognized drawbacks of currently available treatments for CN injuries. It may constitute an effective treatment for prostate cancer patients suffering from ED after being subject to radical prostatectomy. STATEMENT OF SIGNIFICANCE: The present work introduces a unique strategy to address post-surgical ED resulting from CN injury during pelvic surgery (e.g., radical prostatectomy, radical cystoprostatectomy, abdominoperineal resection). It comprises a bioactive and cell-free fibrous implant, customized to enhance CN recovery. Pre-clinical results in a rat model of bilateral CN crush demonstrated that the bioactive fibrous implant can effectively heal injured CN, and restore penile structure and function. This implant selectively binds NGF from patient fluids (i.e. urine) due to its functionalized surface and high surface area. Moreover, its local implantation reduces adverse side effects. This tailored regenerative approach has the potential to revolutionize the treatment of ED in prostate cancer patients following radical prostatectomy, overcoming current treatment limitations.