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Penile Revascularization

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1. Penile Revascularization

Penile Revascularization Penile Revascularization Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Penile Revascularization Penile (...) Revascularization Aka: Penile Revascularization From Related Chapters II. Procedure Arterial revascularization and venous ligation III. Efficacy Long term success rates 30-50% IV. Indications Very few patients are candidates for this procedure Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Penile Revascularization." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database

2018 FP Notebook

2. Penile artery shunt syndrome: a novel cause of erectile dysfunction after penile revascularization surgery. (PubMed)

Penile artery shunt syndrome: a novel cause of erectile dysfunction after penile revascularization surgery. Penile revascularization is a surgical treatment option for erectile dysfunction (ED) in healthy individuals due to a focal arterial occlusion in the absence of generalized vascular disease. Most described failures have been attributed to graft stenosis or disruption of the anastomosis.We report a novel phenomenon called Penile Artery Shunt Syndrome that contributed to persistent ED (...) anomalous anatomic considerations prior to penile revascularization and to evaluate patients with persistent postoperative ED.© 2014 International Society for Sexual Medicine.

2014 Journal Of Sexual Medicine

3. A critical analysis of candidacy for penile revascularization. (PubMed)

A critical analysis of candidacy for penile revascularization. Penile revascularization (PR) is a potentially curative procedure for young men with isolated arteriogenic erectile dysfunction. Standard preoperative evaluation is erectile hemodynamics (HDX) using duplex Doppler penile ultrasound (DUS) and/or cavernosometry (DIC) and assessment of cavernosal arterial anatomy by selective internal pudendal arteriography (SIPA).The aim of this study was to review our experience with men who sought (...) abnormal (group A). Seven percent had abnormal HDX and normal SIPA (group B). Four percent had a normal HDX study with an abnormal SIPA (group C). Repeat DIC (n = 20) was conducted in groups A + B and was normal in 70% of cases. Repeat SIPA (n = 2) was conducted in group C and was normal in both patients.Almost one half of patients had a significant discrepancy between HDX and SIPA. Of these, 73% had normal repeat studies, making them no longer candidates for penile revascularization.© 2014

2014 Journal Of Sexual Medicine

4. Revascularization surgery for penile calciphylaxis. (PubMed)

Revascularization surgery for penile calciphylaxis. Calciphylaxis, a systemic disorder seen in 1%-4% of patients with end-stage renal disease, is a cause of penile ischemic gangrene. We present a case of successful revascularization surgery for penile calciphylaxis. An arterial bypass to the deep dorsal penile vein relieved the rest pain and stopped expansion of the gangrenous lesion. Copyright © 2013 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

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2013 Journal of Vascular Surgery

5. Penile revascularization in vasculogenic erectile dysfunction (ED): long-term follow-up. (PubMed)

Penile revascularization in vasculogenic erectile dysfunction (ED): long-term follow-up. To determine the overall long-term success of penile revascularization surgery in the treatment of vasculogenic erectile dysfunction (ED) and also to investigate the effect of risk factors on the results of a modified Furlow-Fisher technique.Between 1999 and 2010, 125 men with a mean (sd, range) age of 43.2 (11.3, 23-69) years underwent penile revascularization surgery. In all, 110 men completed the long (...) -term follow-up with a mean follow-up of 73.2 months. Diagnostic evaluations, penile colour Doppler ultrasonography, corpus cavernosum electromyography, and cavernosometry, were performed in all the men before surgery. The efficacy of the surgery was assessed as improvement or failure according to the change in the five-item version of the International Index of Erectile Function (IIEF-5). A ≥5 point increase in the IIEF-5 score during the latest patient visit after surgery compared with that before

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2012 BJU international

6. Penile Revascularization

Penile Revascularization Penile Revascularization Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Penile Revascularization Penile (...) Revascularization Aka: Penile Revascularization From Related Chapters II. Procedure Arterial revascularization and venous ligation III. Efficacy Long term success rates 30-50% IV. Indications Very few patients are candidates for this procedure Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Penile Revascularization." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database

2015 FP Notebook

7. Outcome of penile revascularization for arteriogenic erectile dysfunction after pelvic fracture urethral injuries. (PubMed)

Outcome of penile revascularization for arteriogenic erectile dysfunction after pelvic fracture urethral injuries. To review our experience with penile revascularization for patients with bilateral occlusion of the deep internal pudendal arteries after pelvic fracture urethral injury (PFUI).We identified 17 patients who had undergone penile revascularization with end-to-side anastomosis of the deep inferior epigastric artery to the dorsal penile artery from July 1991 to December 2010. Success (...) with erectile dysfunction as an indication for surgery, successful erections were achieved in 11 of 13. For those who underwent revascularization to prevent ischemic stenosis of the urethral repair, 3 of 4 achieved successful erections, and all subsequent urethral surgeries were successful. The penile duplex ultrasound parameters showed clinically and statistically significant improvements after revascularization. No operative complications developed. The average hospital length of stay was 4.7 days. Four

2012 Urology

8. Penile Prosthesis Implantation (Overview)

prosthesis, although penile revascularization procedures have been described. The most fundamentally basic prosthesis is the semirigid rod prosthesis, which consists of 2 rodlike cylinders that are implanted in the corpora cavernosa. The prosthesis can have a mechanically jointed "backbone" or have a malleable one that allows the phallus to be dressed in the upward or downward position. This prosthesis is generally considered for patients who are significantly obese, who have limited manual dexterity (...) Penile Prosthesis Implantation (Overview) Penile Prosthesis Implantation: Background, History of the Procedure, Problem Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNDQ2NzYxLW92ZXJ2aWV3 processing > Penile

2014 eMedicine.com

9. Penile Prosthesis Implantation (Treatment)

on testosterone supplementation are at higher risk for developing prostate cancer. Next: Surgical Therapy The criterion standard for erectile surgery is penile prosthesis implantation. However, in the rare patient whose discrete and focal arterial lesion can be identified on arteriography, revascularization procedures may be indicated. Further considerations for optimizing outcome include selecting patients whose etiology is previous pelvic trauma and patients who are young, do not have diabetes, do not smoke (...) Penile Prosthesis Implantation (Treatment) Penile Prosthesis Implantation Treatment & Management: Medical Therapy, Surgical Therapy, Preoperative Details Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache

2014 eMedicine.com

10. Penile Prosthesis Implantation (Follow-up)

on testosterone supplementation are at higher risk for developing prostate cancer. Next: Surgical Therapy The criterion standard for erectile surgery is penile prosthesis implantation. However, in the rare patient whose discrete and focal arterial lesion can be identified on arteriography, revascularization procedures may be indicated. Further considerations for optimizing outcome include selecting patients whose etiology is previous pelvic trauma and patients who are young, do not have diabetes, do not smoke (...) Penile Prosthesis Implantation (Follow-up) Penile Prosthesis Implantation Treatment & Management: Medical Therapy, Surgical Therapy, Preoperative Details Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache

2014 eMedicine.com

11. Penile Prosthesis Implantation (Diagnosis)

prosthesis, although penile revascularization procedures have been described. The most fundamentally basic prosthesis is the semirigid rod prosthesis, which consists of 2 rodlike cylinders that are implanted in the corpora cavernosa. The prosthesis can have a mechanically jointed "backbone" or have a malleable one that allows the phallus to be dressed in the upward or downward position. This prosthesis is generally considered for patients who are significantly obese, who have limited manual dexterity (...) Penile Prosthesis Implantation (Diagnosis) Penile Prosthesis Implantation: Background, History of the Procedure, Problem Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNDQ2NzYxLW92ZXJ2aWV3 processing > Penile

2014 eMedicine.com

12. Penile revascularization for erectile dysfunction: a systematic review and meta-analysis of effectiveness and complications. (PubMed)

Penile revascularization for erectile dysfunction: a systematic review and meta-analysis of effectiveness and complications. Patients with arteriogenic erectile dysfunction (ED) caused by traumatic localized arterial lesions can be treated successfully by penile revascularization (PR) surgery. We aimed to determine the subjective and objective outcomes of PR surgery in patients with arteriogenic ED.We searched for relevant publications released up to May 2008 in the Cochrane Central Register (...) . Patient selection is vital for a successful outcome. Variations in penile vascular anatomy are also likely to be important when individualizing penile revascularization procedures. In a limited number of highly selected individuals PR can be successful for the long-term. Randomized controlled trials examining PR techniques are warranted.

2009 Urology journal

13. ESC/ESH Management of Arterial Hypertension

–creatinine ratio (30–300 mg/g; 3.4–34 mg/mmol) (preferentially on morning spot urine) Moderate CKD with eGFR >30–59 mL/min/1.73 m 2 (BSA) or severe CKD eGFR <30 mL/min/1.73 m 2 b Ankle−brachial index <0.9 Advanced retinopathy: haemorrhages or exudates, papilloedema Established CV or renal disease Cerebrovascular disease: ischaemic stroke, cerebral haemorrhage, TIA CAD: myocardial infarction, angina, myocardial revascularization Presence of atheromatous plaque on imaging Heart failure, including HFpEF (...) (30–300 mg/g; 3.4–34 mg/mmol) (preferentially on morning spot urine) Moderate CKD with eGFR >30–59 mL/min/1.73 m 2 (BSA) or severe CKD eGFR <30 mL/min/1.73 m 2 b Ankle−brachial index <0.9 Advanced retinopathy: haemorrhages or exudates, papilloedema Established CV or renal disease Cerebrovascular disease: ischaemic stroke, cerebral haemorrhage, TIA CAD: myocardial infarction, angina, myocardial revascularization Presence of atheromatous plaque on imaging Heart failure, including HFpEF Peripheral

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2018 European Society of Cardiology

14. Male Sexual Dysfunction

on Male Sexual Dysfunction. EAU Guidelines on Male Sexual Dysfunction (Erectile Dysfunction and premature ejaculation). Edn. presented at the EAU Annual congress Stockholm. 2009: Arnhem, The Netherlands. 13. Hatzimouratidis, K., et al., EAU Guidelines Panel on Male Sexual Dysfunction. EAU guidelines on Penile Curvature. Edn. presented at the EAU Annual Congress Paris. 2012: Arnhem, The Netherlands. 14. Salonia, A., et al., EAU Guidelines Panel on Male Sexual Dysfunction. EAU guidelines on priapism (...) . Edn. presented at the EAU Annual Congress Stockholm. 2014: Arnhem, The Netherlands 15. Hatzimouratidis, K., et al., EAU Guidelines Panel on Male Sexual Dysfunction. EAU guidelines on Male Sexual Dysfunction. Edn. presented at the EAU Annual Congress Munich 2016. 16. Hatzimouratidis, K., et al. Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. Eur Urol, 2010. 57: 804. 17. Hatzimouratidis, K., et al. EAU guidelines on penile curvature. Eur Urol, 2012. 62: 543. 18

2019 European Association of Urology

15. Erectile Dysfunction

of psychophysiological states that usually occur in an orderly progression. These phases were characterized by Masters and Johnson as desire, arousal, orgasm, and resolution. Erectile dysfunction (ED) can be conceptualized as an impairment in the arousal phase of sexual response and is defined as the consistent or recurrent inability to attain and/or maintain penile erection sufficient for sexual satisfaction, including satisfactory sexual performance. 1,2 The Panel believes that shared decision-making (...) injections (ICI), including discussion of benefits and risks/burdens. (Moderate Recommendation; Evidence Level: Grade C) 17. For men with ED who are considering ICI therapy, an in-office injection test should be performed. (Clinical Principle) 18. Men with ED should be informed regarding the treatment option of penile prosthesis implantation, including discussion of benefits and risks/burdens. (Strong Recommendation; Evidence Level: Grade C) 19. Men with ED who have decided on penile implantation surgery

2018 American Urological Association

16. Erectile Dysfunction

Erectile Dysfunction 1 Executive Summary The sexual response cycle is conceptualized as a sequential series of psychophysiological states that usually occur in an orderly progression. These phases were characterized by Masters and Johnson as desire, arousal, orgasm, and resolution. Erectile dysfunction (ED) can be conceptualized as an impairment in the arousal phase of sexual response and is defined as the consistent or recurrent inability to attain and/or maintain penile erection sufficient (...) injection test should be performed. (Clinical Prin- ciple) 18. Men with ED should be informed regarding the treatment option of penile prosthesis implantation, including dis- cussion of benefits and risks/burdens. (Strong Recommendation; Evidence Level: Grade C) 19. Men with ED who have decided on penile implantation surgery should be counseled regarding post-operative expectations. (Clinical Principle) 20. Penile prosthetic surgery should not be performed in the presence of systemic, cutaneous

2018 American Urological Association

17. Male Sexual Dysfunction

on Male Sexual Dysfunction. EAU Guidelines on Male Sexual Dysfunction (Erectile Dysfunction and premature ejaculation). Edn. presented at the EAU Annual congress Stockholm. 2009: Arnhem, The Netherlands. 13. Hatzimouratidis, K., et al., EAU Guidelines Panel on Male Sexual Dysfunction. EAU guidelines on Penile Curvature. Edn. presented at the EAU Annual Congress Paris. 2012: Arnhem, The Netherlands. 14. Salonia, A., et al., EAU Guidelines Panel on Male Sexual Dysfunction. EAU guidelines on priapism (...) . Edn. presented at the EAU Annual Congress Stockholm. 2014: Arnhem, The Netherlands 15. Hatzimouratidis, K., et al., EAU Guidelines Panel on Male Sexual Dysfunction. EAU guidelines on Male Sexual Dysfunction. Edn. presented at the EAU Annual Congress Munich 2016. 16. Hatzimouratidis, K., et al. Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. Eur Urol, 2010. 57: 804. 17. Hatzimouratidis, K., et al. EAU guidelines on penile curvature. Eur Urol, 2012. 62: 543. 18

2018 European Association of Urology

19. Peyronie's Disease

. Clinicians should engage in a diagnostic process to document the signs and symptoms that characterize Peyronie's disease. The minimum requirements for this examination are a careful history (to assess penile deformity, interference with intercourse, penile pain, and/or distress) and a physical exam of the genitalia (to assess for palpable abnormalities of the penis). (Clinical Principle) 2. Clinicians should perform an in-office intracavernosal injection (ICI) test with or without duplex Doppler (...) Recommendation; Evidence Strength Grade C) 8. Clinicians may administer intralesional collagenase clostridium histolyticum in combination with modeling by the clinician and by the patient for the reduction of penile curvature in patients with stable Peyronie's disease, penile curvature >30° and <90°, and intact erectile function (with or without the use of medications). (Moderate Recommendation; Evidence Strength Grade B) 9. Clinicians should counsel patients with Peyronie's disease prior to beginning

2015 American Urological Association

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