Vacuum therapy (VT) utilizes negative pressure to distend the corporal sinusoids and to increase the blood inflow to the penis. Depending on its purpose, VT could be used as vacuum constriction device (VCD), with the aid of an external constricting ring which is placed at the base of penis to prevent blood outflow, maintaining the erection for sexual intercourse. Also, as a vacuum erectile device (VED), without the application of a constriction ring, just increases blood oxygenation to the corpora cavernosa and for other purposes. The emerging of phosphodiesterase 5 inhibitors (PDE 5 I) for the treatment of erectile dysfunction (ED) eclipsed VCD as therapeutic choice for ED; however, widespread usage of VED as part of penile rehabilitation after radical prostatectomy and other purposes rekindle the interest for VT. The underlying hypothesis is that the artificial induction of erections shortly after surgery facilitates tissue oxygenation, reducing cavernosal fibrosis in the absence of nocturnal erections, and potentially increases the likelihood of preserving erectile function. Due to its ability to draw blood into the penis regardless of nerve disturbance, VED has become the centerpiece of penile rehabilitation protocols. Herein, we reviewed the history, mechanism, application, side effects and future direction of VT in ED.

Introduction Synchronous implantation of an inflatable penile prosthesis (IPP) and a bulbourethral sling single via a single perineal is a unique approach in managing erectile dysfunction and stress urinary incontinence. Aim This article describes our surgical approach and reviews the operative time, length of hospital stay (LOS), estimated blood loss (EBL), and cost of synchronous dual prosthetic implantation compared with the implants performed individually. Additionally, we review the short-term outcomes in patients with dual sling and penile prosthesis synchronous implants. Methods Fifty-eight patients with IPP, 53 slings, and eight simultaneous dual implantations between January 2000 and July 2008 were retrospectively reviewed. Operative times, EBL, length of stay, cost, and complications were compared in three groups (group 1, IPP; group 2, slings; group 3, dual implants). Additionally, we reviewed pre- and postoperative Sexual Health Inventory for Men (SHIM) scores and pad use in group 3. Main Outcome Measures Review of operative times, EBL, LOS, cost, and complications. Results Dual implantation had similar operative times compared with the total time for the individual procedures (98 ± 24 minutes for IPP; 86 ± 24 minutes for sling; 177 ± 17 minutes for dual implant, P > 0.05). EBL was reduced (57 ± 30 mL for IPP; 48 ± 59 mL for sling; 49 ± 5 mL for group 3). LOS was also reduced (1.2 ± 0.45 days for IPP, 0.7 ± 0.48 days for sling; and 1.1 ± 0.50 days for dual implant). Dual implantation was associated with approximately $9,000 in savings. With a mean follow-up of 13.6 months, group 3 reported SHIM increase from 1.3 ± 0.5 to 23.5 ± 0.6 and a decrease in pad use from three pads per day (range 2–6) down to a mean of one pad per day (range 0–2). One sling erosion and one sling infection occurred in group 2. One patient in group 3 had acute urinary retention resolved with 5 days of catheter drainage. Conclusion Dual penile prosthesis and bulbourethral sling implantation through a single perineal incision is safe, efficient, and cost-effective.

Romero, C, Ramirez-Campillo, R, Alvarez, C, Moran, J, Slimani, M, Gonzalez, J, and Banzer, WE. Effects of maturation on physical fitness adaptations to plyometric jump training in youth females. J Strength Cond Res 35(10): 2870–2877, 2021—The aim of this study was to compare the effects of maturation on physical fitness adaptations to plyometric jump training (PJT) in youth females. Jumping, sprinting, change of direction speed, endurance, and maximal strength were measured pre-post 6 weeks of PJT in 7th- and 10th-grade subjects. In the seventh grade, subjects formed a PJT group (Plyo-7, n = 10; age, 12.7 ± 0.6 years; breast maturation stages IV [n = 2], III [n = 7], and II [n = 1]) and an active control group (Con-7, n = 9; age, 12.8 ± 0.6 years; breast maturation stages IV [n = 2], III [n = 6], and II [n = 1]). In the 10th grade, subjects conformed a PJT group (Plyo-10, n = 9; age, 16.3 ± 0.5 years; breast maturation stages V [n = 5] and IV [n = 4]) and an active control group (Con-10, n = 9; age, 16.2 ± 0.5 years; breast maturation stages V [n = 5] and IV [n = 4]). Magnitude-based inferences were used for data analysis, with effect sizes (ESs) interpreted as <0.2 = trivial; 0.2–0.6 = small; 0.6–1.2 = moderate; 1.2–2.0 = large; and 2.0–4.0 = very large. The Plyo-7 and Plyo-10 showed meaningful improvements in all physical fitness measures (ES = 0.21–2.22), while Con-7 and Con-10 showed only trivial changes. The Plyo-7 and Plyo-10 showed meaningful (ES = 0.16–2.22) greater improvements in all physical fitness measures when compared with their control counterparts. The Plyo-10 showed meaningful greater improvements in 20-m sprint, 2-km running time trial, maximal strength, squat jump, and drop jump from 20 cm (ES = 0.21–0.42) when compared with Plyo-7. In conclusion, PJT is effective in improving physical fitness in younger and older female youths. However, greater adaptations were observed in more mature subjects.

Objectives To evaluate our experience with radiofrequency ablation (RFA) for renal masses and to report on clinical, radiological and post-RFA biopsy results. Patients and methods The study collected clinical, radiological and pathological data from 150 consecutive patients who were treated with RFA of a renal mass between 2002 and 2008 at a tertiary referral centre. Post-ablation biopsies were performed in patients with non-involuting lesions or suspicion of recurrence on imaging. Comparisons were performed using the Mann–Whitney U-test. Survival was estimated using the Kaplan–Meier method. Results Renal malignancy was found in 72.1% of patients based on the initial diagnostic biopsy. Median tumour size was 2.6 cm, 22.7% of patients had a solitary kidney, and most were central tumours. The mean follow-up period was 40.1 months. There was no recurrence in 96.7% of the entire cohort. Cancer-specific survival for 106 patients with sporadic, localized, biopsy proven renal malignancy was 100% at 38.5 months. Biopsies were obtained in 43 patients for a median of 21 months after RFA. Among 38 patients who had biopsy for non-involuting, non-enhancing zones of ablation, three (7.9%) were positive. Conclusions Short-term cancer-specific survival after RFA remains excellent and most cases are successful based on a combination of imaging and post-ablation biopsies performed almost 2 years after treatment. There were four out of 150 (2.7%) patients who had recurrences with tissue confirmation; one of these patients was detected on imaging and three (2%) were radiologically occult. The absence of enhancement in the setting of non-involuting lesions is not always a guarantee of a successful ablation.