Penile prosthesis implantation: A single center 25 years of experience.

OBJECTIVES: We analyzed the long-term results of malleable and inflatable penile prosthesis: the rates of complications, revision surgery and patient satisfaction. MATERIALS AND METHODS: Between January 1996 and December 2020, a total of 138 patients underwent implantation of a malleable or inflatable types penile prosthesis. The data of the patients were derived from the patient files and digital recording system. The patients were contacted face-to-face interaction if possible. If it is not possible, phone connection was made. RESULTS: The median age of patients was 56 (21-83) years. Fourteen (10.2%) 1-piece, 46 (33.3%) 2-piece and 78 (56.5%) 3-piece penile prosthesis were implanted. The mostly used perioperative antibiotic was teicoplanin+amikacin in 107 patients. Total complication rate was 30% (n=42). Prosthesis infection constituted 9% (n=13) of these complications. The total satisfaction rate was 89.1%. There was no correlation between the complications and antibiotic regimen or prosthesis type (P=0.488, P=0.454, respectively). The rate of infection showed a slight increase in 3-piece penile prosthesis without any statistically significance (P=0.633). The patients with complications expressed more dissatisfaction compared to those without complications (P=0.001). CONCLUSIONS: In our series, penile prosthesis implantation seems to be a recommended treatment method with high patient satisfaction in the treatment of refractory erectile dysfunction. LEVEL OF EVIDENCE: 4.

Metástasis inusual del cáncer de próstata en el cuerpo esponjoso del pene detectada mediante PET/TC con 68Ga-PSMA / An unusual metastasis of prostate cancer detected with 68Ga-PSMA PET/CT imaging: Corpus spongiosum of the radix penis

No disponible

Comparison of alfentanil and remifentanil infusions in combination with propofol for the outpatient extra-corporeal shock wave lithotripsy.

PURPOSE: The aim of this study is to compare the efficiency of propofol+remifentanil to propofol+alfentanil in reducing pain in patients with urinary system stones undergoing outpatient Extracorporeal Shock Wave Lithotripsy (ESWL). METHODS: In this prospective study, 30 patients, ASA (American Society of Anesthesiologist) I-II, who are 18-60 years old and undergoing Extracorporeal Shock Wave Lithotripsy for urinary system stones were included. Patients were randomly selected for either propofol+remifentanil (Group PR) or propofol+alfentanil treatment (Group PA). Propofol was given at a dose 1 mg/kg, and then 5mg doses were given to maintain a BIS (Bispectral Index) level 60-70. Remifentanil (0.2 microg/kg (-1) bolus dose and later 0.02 microgkg(-1) min(-1) infusions) was given to the group PR and alfentanil (bolus dose 7 microgkg(-1) and later with 0.7 microgkg(-1) min(-1) infusions) was given to the group PA. If needed, the patients might use 10 ig remifentanil and 50 ig alfentanil bolus doses in group PR and PA using patient controlled analgesia (PCA) device. ECG, SpO2, BIS levels and arterial blood pressures were monitored and recorded. Patients were evaluated with Ramsay Sedation Level Evaluation Scale and with Modified Aldrete Scoring System during and after the procedure. VAS was given to patients to mark their pain level on this scale at the end of the procedure. RESULTS: The values at pre-induction and post- induction in each group were statistically different but difference did not exist between the PR and PA groups. CONCLUSION: We concluded that both methods may be successfully used for patients undergoing ESWL (Tab. 6, Rief. 29).

Ultrastructural changes on sperm after extracorporeal shock wave lithotripsy in patients with distal ureteral stone.

Theoretically, ESWL can cause several side effects on the male reproductive system. We determined here the long-term effects of ESWL on sperm with transmission electron microscopy (TEM) in patients with distal ureteral stone. Fifteen men with stones in the distal ureter applied to our clinic formed the group of study. The other 15 men with renal or upper ureter stones formed the group of control. The ESWL sessions, including maximum 19 kW energy level and 3000 shock waves, were performed with Siemens Lithostar (electromagnetic; Siemens Medical Systems, Erlangen, Germany) lithotriptor. We examined the semen samples from all patients on the day before and 90 days after ESWL. The semen samples were examined with transmission electron microscopy (TEM) to detect ultrastructural changes on the day before and 90 days after ESWL. All the statistical analyses were realized with SPSS 10.0 (SPSS Inc., Chicago, USA) statistical package program. When the control and study groups were compared for initial and day 90 sperm concentration and motility, a significant decrease was found in the study group. Although there was no important anomaly in the control group, we determined some damage on sperm structure in 5 patients (33.3%) who are in the study group 3 months after ESWL. It can reduce sperm concentration and motility permanently. It can also cause severe ultrastructural defects on sperm after a long term period in patients with lower ureteral stone. Therefore, we suggest other treatment modalities for young men with distal ureteral stones to prevent the development of male infertility.

Effects of exposure to new inhalational anesthetics on spermatogenesis and sperm morphology in rabbits.

The effects of chronic exposure to new inhalation anesthetics (sevoflurane and isoflurane) on spermatogenesis and sperm morphology were examined in 23 rabbits, randomly divided in 3 groups. Rabbits received 20 exposure hours (four hours/day x 5 days), as follows: group I: 2.3% (1.2 MAC) sevoflurane + 2L/min oxygen, group II: 1.3% (1.2 MAC) isoflurane + 2L/min oxygen, and group III (control): 2L/min oxygen. Semen was collected on the 12th, 19th, 26th, 33rd, and 41st days of exposure. Sperm concentration, motility and morphological changes were evaluated. On the 41st day, testicular biopsies were taken and observed with light microscopy. Sperm concentration and motility significantly decreased in the sevoflurane and the isoflurane groups, compared to control. There were no significant changes in the control group. It is concluded that chronic exposure to the new inhalational anesthetics had negative effects on spermatogenesis and sperm morphology.