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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. (Abstract)

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. (Abstract)

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. Penis Transplantation: First US Experience. (Abstract)

Penis Transplantation: First US Experience. We describe the first successful penis transplant in the United States in a patient with a history of subtotal penectomy for penile cancer.Penis transplantation represents a new paradigm in restoring anatomic appearance, urine conduit, and sexual function after genitourinary tissue loss. To date, only 2 penis transplants have been performed worldwide.After institutional review board approval, extensive medical, surgical, and radiological evaluations (...) allograft. Maintenance immunosuppression consisted of mycophenolate mofetil, tacrolimus, and methylprednisolone.Intraoperative, the allograft had excellent capillary refill and strong Doppler signals after revascularization. Operative reinterventions on postoperative days (PODs) 2 and 13 were required for hematoma evacuation and skin eschar debridement. At 3 weeks, no anastomotic leaks were detected on urethrogram, and the catheter was removed. Steroid resistant-rejection developed on POD 28 (Banff I

2017 Annals of Surgery

5. Revascularization surgery for penile calciphylaxis. Full Text available with Trip Pro

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.

2013 Journal of Vascular Surgery

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

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

2012 BJU international

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

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

9. Penile Prosthesis Implantation (Diagnosis)

in North America, with another 5000 worldwide. With new social awareness regarding ED, many experts believe that future device implantations will become more prevalent because of failing medical therapy. Previous Next: Problem As defined by Pearman, an early leader in this field, ED is the inability to produce and maintain a functional erection because of pathology of the nervous or vascular system or deformation of the penis. [ ] The surgical treatment of ED largely involves the placement of a penile (...) 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

2014 eMedicine.com

10. 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 (...) repair and excision of Peyronie plaque near the base of the penis, and facilitates the placement of scrotal pumps. Although many techniques exist, they generally follow the same principles. This article describes the authors' technique for penile prosthesis placement via the penoscrotal approach. Previous Next: Preoperative Details Preoperative preparation entails a detailed checklist of items. The patient should be free of infection in the urine, on the skin, or elsewhere. Perioperatively, many

2014 eMedicine.com

11. Penile Prosthesis Implantation (Overview)

in North America, with another 5000 worldwide. With new social awareness regarding ED, many experts believe that future device implantations will become more prevalent because of failing medical therapy. Previous Next: Problem As defined by Pearman, an early leader in this field, ED is the inability to produce and maintain a functional erection because of pathology of the nervous or vascular system or deformation of the penis. [ ] The surgical treatment of ED largely involves the placement of a penile (...) 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

2014 eMedicine.com

12. 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 (...) repair and excision of Peyronie plaque near the base of the penis, and facilitates the placement of scrotal pumps. Although many techniques exist, they generally follow the same principles. This article describes the authors' technique for penile prosthesis placement via the penoscrotal approach. Previous Next: Preoperative Details Preoperative preparation entails a detailed checklist of items. The patient should be free of infection in the urine, on the skin, or elsewhere. Perioperatively, many

2014 eMedicine.com

13. ESC/ESH Management of Arterial Hypertension Full Text available with Trip Pro

–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

2018 European Society of Cardiology

15. 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

16. Lichen Sclerosus

that agents with the potential of increasing epidermal CD44, like retinoids, should be tried in LS. • What treatments should be compared in a future RCT? ? Circumcision versus potent topical steroids in boys with penile LS: ? The evaluation of prospective case series with high numbers and long follow-up may replace an RCT which may prove difficult to perform? ? However, ideally a randomized study may compare potent topical steroids for three months (possibly followed by circumcision after 6 months (...) (scleros* or atrophi* or albu* or scleureu* or sclero-atrophi* or vulva* or genita*)).ab,ti. 3. "white spot* diseas*".ab,ti. 4. exp Vulvar Lichen Sclerosus/ 5. "kraurosi* vulva*".ab,ti. 6. (vulva* and (atroph* or dystroph*)).ab,ti. 7. exp Balanitis Xerotica Obliterans/ 8. balaniti* xerotic* oblitera*.ab,ti. 9. "kraurosi* peni*".ab,ti. 10. 1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9 11. Randomized Controlled Trials as Topic/ 12. randomized controlled trial/ 13. Random Allocation/ 14. Double-Blind Method

2018 European Dermatology Forum

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

18. Erectile Dysfunction

of erection due to the resolution phase, and from the refractory period, an interval after ejaculation/orgasm in which the penis will not become erect and which tends to increase in duration as a man ages. Information about changes in libido, orgasm, and penile morphology (e.g., the possible presence of PD) also is needed. The timing of specific symptoms should be ascertained in relation to the onset of ED as these symptoms may be primary causes of ED or secondary effects of the ED condition. The man's (...) should include assessment for signs of TD (e.g., gynecomastia, under-developed facial/pubic/axillary hair). Genital examination should include assessment of penile skin lesions and placement/configuration of the urethral meatus. If the man is considering penile prosthesis implantation or surgical intervention, then documentation of flaccid stretched penile length (a proxy for erect length) can be useful information to guide expectations for outcomes. Examination of the penis for occult deformities

2018 American Urological Association

19. Erectile Dysfunction

leading to subsequent loss of erection due to the resolution phase, and from the refractory period, an interval after ejaculation/orgasm in which the penis will not become erect and which tends to increase in duration as a man ages. Information about changes in libido, orgasm, and penile morphology (e.g., the possible presence of PD) also is needed. The timing of specific symptoms should be ascertained in relation to the onset of ED as these symptoms may be primary causes of ED or secondary effects (...) of the penis for occult deformities or plaque lesions should occur with the penis held stretched and palpated from the pubic bone to the coronal sulcus. 51 The presence/absence of a palpable plaque should not be taken as definitive evidence for clinically relevant penile deformity such as PD. If PD is suspected, then additional diagnostic procedures should be undertaken (i.e., an in-office ICI test; see AUA Peyronie’s Disease guideline). General consistency of the penile tissue can be assessed. Scrotal

2018 American Urological Association

20. Angioplasty and stenting to treat peripheral arterial disease causing refractory erectile dysfunction

of cardiovascular risk factors (stopping smoking, antithrombotic medication and statin treatment) and oral phosphodiesterase-5 inhibitors. In ED that has not responded to conservative treatments or phosphodiesterase-5 inhibitors, other options (including vacuum erection devices, intracavernosal or intraurethral prostaglandin, and penile prostheses) or surgical revascularisation may be considered. 3 3 The procedure The procedure 3.1 Angioplasty and stenting of atherosclerosis in the small arteries distal (...) to the internal iliac arteries aim to offer a less invasive alternative to open surgical revascularisation to patients with arteriogenic erectile dysfunction (ED) that is refractory to standard treatments. 3.2 Under local anaesthesia and using fluoroscopic guidance, a catheter is introduced percutaneously through the femoral artery and guided into the narrowed target artery (usually the internal pudendal or common penile artery). Balloon angioplasty of the narrowed artery may be done to dilate the Angioplasty

2016 National Institute for Health and Clinical Excellence - Interventional Procedures

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