Penile prosthetic surgery is an effective treatment for men with erectile
dysfunction. Cancellation of surgery is disruptive and costly to patients,
physicians, and the healthcare system. This pilot study sought to analyze
surgery cancellations and implement a video-based patient education program to
decrease surgery noncompletion.Baseline penile prosthetic surgery completion, rescheduling, and cancellation
rates among consecutively scheduled surgeries were determined using a national
cohort. Selected prosthetic surgeons then implemented Vidscrip, a video-based
patient education program. Prerecorded videos were delivered via text message 14
days, 7 days, and 1 day preoperatively, as well as 1 day postoperatively.
Subsequent analysis determined noncompletion rates, reasons for noncompletion,
surgeon volume, and video utilization.Two-hundred twenty-six surgeries were scheduled in the baseline cohort; 141 were
completed, and 85 were rescheduled or canceled. Among the intervention cohort,
290 patients completed, 7 rescheduled, and 37 canceled surgery. After program
implementation, the surgery noncompletion rate was reduced compared to baseline
(13.2% vs. 37.6%, p < .05), corresponding to a number needed
to treat of 4.1. When stratified by surgeon volume, there was no difference in
noncompletion rate (>20 cases vs. ≤20 cases: 8.20% vs. 32.0%,
p = .35). Video utilization was widely variable among
practices (median viewing time 58.6 min, IQR 5.09–113).Penile prosthetic surgery is frequently rescheduled or canceled. Implementing a
video-based patient education program reduces surgery noncompletion, improving
efficiency and quality of care. Wider implementation is needed to validate these
findings, while cost-effectiveness analyses may further support their broad
adoption.
A self-induced, non-traumatic testicular torsion is a rare entity that to our knowledge has not been reported in the literature. We report the case of a 28-year-old male who caused a self-induced testicular torsion during acts associated with cross dressing. Differential diagnosis of the acute scrotum in an adult should always include testicular torsion, as outcomes in this population are worse than in younger populations. Additional unusual causes of testicular torsion are reviewed.
INTRODUCTION AND OBJECTIVES: One of the most common complains after malleable prothesis implantation(MPI) is thinning of the penis and decreasing girth. Some surgeons try to insert the largest diameter they can to improve patient satisfaction. We aimed to investigate if malleable rod diameter (MRD) has an impact on outcome and patient satisfaction.METHODS: Consecutive MPI were assessed in a high volume center over a one-year period. The same preoperative, intraoperative and postoperative protocols were used for all patients and one brand of malleable device was used only. We recorded MRD and length for all patients. All patients had data on comorbidities including glycated haemoglobin (HbA1c) and clinical Peyronie's disease (PD). Revision cases and those who lost for follow up were excluded from the study. We also excluded patients operated on by low volume surgeons. All complications, minor(edema, ecchymosis, pain) and major(infection and erosion) were recorded. After 1-year, patients were assessed and given a Likert scale from 1-5 where 5 is most satisfied about their MPI. We stratified patients according to MRD into two groups: group A for diameter 9.5 and 11 mm and group B for 13 mm. Statistical analysis was done using Statistical test: Chi-square and statistical software: Stata Release 13.RESULTS: 183 patients had full data and filled the questionnaire after 1 year follow up. All patients had Coloplast, Genesis penile implants. Major complications rate (infection, erosion and removal) was significantly higher in group B with less patient satisfaction. Results are summarized in Table 1.CONCLUSIONS: Larger diameter of malleable penile implants are associated with higher rate of complications and reoperation with less patient satisfaction.
patients due to anatomic abnormalities, an intrarenal pelvis and complex ureteral anatomy.RESULTS: There were no intraoperative complications. Double-J ureteral stents were placed intraoperatively in each patient. Mean hospital stay was 1.5 days. Stents were removed less than 7 weeks postoperatively. Postoperative ultrasound demonstrated persistent, but stable hydronephrosis, an unsurprising result given their history of longstanding obstruction and severe hydronephrosis. Two patients experienced recurrent flank pain, but renography revealed a widely patent anastomosis.CONCLUSIONS: Robotic ureterocalicostomy is a feasible and successful procedure for recurrent and severe UPJ obstruction in pediatric patients. Its versatility allows for its application for both pyeloplasty failure and as an alternative procedure for cases of challenging renal and ureteral anatomy. More data is necessary to quantify the advantages and disadvantages of the robotic approach as compared to open and laparoscopic approaches.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.