L'impact de la pandémie COVID19 sur l'anxiété des urologues français en formation : résultats d'une enquête nationale

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Background: Some studies showed encouraging results on the efficacy and safety of penile traction therapy (PTT) after Peyronie's disease (PD) surgery. The early traction therapy (ETT) could be an effective and safe approach to minimize penile shortening in patients undergoing PD surgery. Aim:To evaluate the feasibility, efficacy, and safety of a novel penile splint as ETT in PD patients undergoing grafting techniques.Methods: PD patients underwent plaque incision and grafting (PIG) technique, at the end of the procedure a novel penile splint (ETT) was applied to all patient. The device consisted of two 10Ch intubating stylets, self-adapted to each patient, that kept the penis stretched with the aid of nonabsorbable sutures. The total expense for the materials needed to build each penile splint was less than 15 euros. This active traction was maintained for 1-3weeks, then we removed the stitches leaving the device on-site for a passive traction. Within 3-4 weeks from surgery, the penile splint was replaced by a standard penile traction device. Outcomes:The main outcomes evaluated at 6 months included stretched penile length (SPL), penile curvature, International Index of Erectile Function -Erectile Function domain (IIEF-EF), patient satisfaction, and time to first satisfactory sexual intercourse.Results: A total of 46 patients were enrolled. The median preoperative IIEF-EF, penile curvature, and SPL were 27 points, 70 degrees, and 13 cm. The median follow-up was 15 months. The median postoperative IIEF-EF was 25 points (p < 0.001). The median residual penile curvature was 10 degrees (p < 0.001). The median postoperative SPL was 13 cm (p = 0.269). Eight patients (17.4%) lose 1 cm of SPL, no shortening greater than 1 cm was recorded. The median time to first satisfactory sexual intercourse and patient satisfaction score was 6 weeks and 9 points, respectively.Clinical Implications: Our results could pave the way for a new line of research, which in turn could lead to an improvement in the postoperative management of the patient undergoing surgery for PD.Strength & Limitations: This is the first study evaluating the ETT after PD surgery. The main limitation of this study is the lack of a randomized control group. Other weaknesses are the small sample size and the short follow-up time. Conclusion:Our novel penile splint is inexpensive, easy to assemble, and adaptable to the patient. ETT using this novel device, followed by standard traction therapy, seems to be feasible, effective, and safe.

Introduction: Penile lesions often go undiagnosed and are difficult to identify for general practitioners and specialists, yet the stakes could be high. Indeed, the condition is highly varied and includes physiological variants, specific skin entities, genital dermatoses, genital ulcers, balanitis, premalignant lesions, and, finally, cancerous lesions. Knowledge of these entities can help to prevent overlooking potentially progressive lesions and diagnose cancerous lesions early so that patients can be offered conservative treatment, improving chances of survival. We review here these different lesions. Materials and methods and authors personal experience: A literature review was carried out in December 2016 using the Medline/Pubmed database, without any restrictions regarding the time period but limiting the review to studies in English or French. The main keywords used were "penile lesion", "penile cancer", "balanitis" and "premalignant lesion". A specific review was performed for each type. All the pictures and cases came from our personal practice in our specific uro-dermatological consultation. All the patients gave us their informed consent for the utilization of their pictures. Results: We studied 66 references covering the field of benign and malignant lesions and their respective treatment. It is essential to take a medical history and perform a clinical examination, despite the fact that some lesions are not specific. A biopsy must be performed systematically in the case of all suspicious lesions. Conclusion: Lesions on genital organs in men are very diverse. Some are difficult to diagnose and treat, with the main challenge being early diagnosis of lesions with a high progressive potential in order to prevent dissemination and the need for mutilating surgery.

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0.36, respectively, both p<0.001). On multivariable analysis, CSA associated with ipsilateral GFR preserved for exophytic masses (p¼0.011), but not for endophytic ones (p¼0.27). Limitations include retrospective design.CONCLUSIONS: CSA, which can be estimated preoperatively, associates with parenchymal mass and function saved after PN, although its utility appears to be greatest for exophytic rather than endophytic tumors. Further study will be required to validate the utility of CSA in different clinical settings.