Validation of the Patient Global Impression of Improvement for Penile Prosthesis.

BACKGROUND: No consensus on the preferred means of evaluating patients after surgical placement of an inflatable penile prosthesis (IPP) currently exists. Many self-assessment questionnaires are available, but none specifically targets patients with IPPs. The purpose of this study was to assess the construct validity of the Patient Global Impression of Improvement (PGI-I) for evaluating patient satisfaction after placement of an IPP. METHODS: We conducted a multicenter prospective trial and enrolled patients who elected to have a 3-piece IPP surgically implanted. Postoperatively, patients completed the Sexual Health Inventory for Men (SHIM), Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS), and PGI-I at 3, 6, and 12 months. The Pearson correlation coefficient (PCC) was used to compare scores over time. RESULTS: Fifty-six patients were enrolled, and complete data were available for 39 patients. At 3 months, the PGI-I correlated with the EDITS (PCC=0.83, P<0.01) and with the SHIM (PCC=0.73, P<0.01). At 6 months, the PGI-I correlated with the EDITS (PCC=0.74, P<0.01). At 6 months, the PCC between the PGI-I and the SHIM was 0.41 (P<0.05). At 12 months, the PCC between the PGI-I and the EDITS was 0.83 (P<0.01), and the PCC between the PGI-I and the SHIM was 0.61 (P<0.01). CONCLUSIONS: Overall, the PGI-I appears to correlate with both the SHIM and EDITS and is a valid evaluation tool for use with patients after IPP placement.

Conversion of low-flow to high-flow priapism: a case report and review (CME).

Priapism is defined as an erection lasting greater than 4 hours. It is grouped into three subtypes: ischemic (low flow), nonischemic (high flow), and stuttering priapism. We present an interesting case and review of the conversion from a low-flow to a high-flow priapism. This conversion has rarely been reported. It has resulted from treatment of low-flow priapism with minimally invasive procedures including injection therapy as well as more invasive distal and proximal shunt procedures. Penile Doppler ultrasound and angiogram are particularly important to the clinician in the diagnosis and treatment of this rare entity.

10% Yb3+-Lu2O3 ceramic laser with 74% efficiency.

We demonstrate laser oscillation at 1080 nm with more than 16 W of output power and with an optical-to-optical slope efficiency of up to 74% using a 10% Yb3+ doped Lu2O3 ceramic made by hot pressing. This represents the highest output power and efficiency obtained for a Yb3+ doped Lu2O3 ceramic and demonstrates the feasibility for power scaling.