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Book ; Online ; E-Book: Andrology and Sexual Medicine

Sarikaya, Selcuk / Russo, Giorgio Ivan / Ralph, David

(Management of Urology,)

2022

Abstract: Andrology & Sexual Medicine is a comprehensive source for urologists, andrologists, sexologists and general practitioners. It contains general and up-to-date information about almost all topics within andrology and sexual medicine, and is a unique source ...

Author's details	edited by Selcuk Sarikaya, Giorgio Ivan Russo, David Ralph
Series title	Management of Urology,
Abstract	Andrology & Sexual Medicine is a comprehensive source for urologists, andrologists, sexologists and general practitioners. It contains general and up-to-date information about almost all topics within andrology and sexual medicine, and is a unique source that can be used for both exams and general daily practice. Easily accessible to clinicians and researchers and specialists, it tackles the controversial and complex topics of andrology and sexual medicine for urologists.
Keywords	Urology ; Andrologia ; Malalties de l'aparell genital femení ; Malalties de l'aparell genital masculí ; Salut sexual
Subject code	359
Language	English
Size	1 online resource (444 pages)
Edition	1st ed. 2022.
Publisher	Springer International Publishing ; Imprint: Springer
Publishing place	Cham
Document type	Book ; Online ; E-Book
Remark	Zugriff für angemeldete ZB MED-Nutzerinnen und -Nutzer
ISBN	3-031-12049-3 ; 9783031120480 ; 978-3-031-12049-7 ; 3031120485
DOI	10.1007/978-3-031-12049-7
Database	ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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Article ; Online: Managing prolonged ischaemic priapism.

Ralph, David

BJU international

2020 Volume 126, Issue 4, Page(s) 407

MeSH term(s)	Decompression ; Humans ; Male ; Penis ; Priapism/etiology ; Priapism/therapy
Language	English
Publishing date	2020-10-26
Publishing country	England
Document type	Editorial ; Comment
ZDB-ID	1462191-5
ISSN	1464-410X ; 1464-4096 ; 1358-8672
ISSN (online)	1464-410X
ISSN	1464-4096 ; 1358-8672
DOI	10.1111/bju.15232
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Article ; Online: Comment on: "Current opinions on the management of prolonged ischaemic priapism: does penoscrotal decompression outperform corporoglanular tunneling?"

Lee, Wai Gin / Gobbo, Andrea / Ralph, David

International journal of impotence research

2024 Volume 36, Issue 1, Page(s) 94–95

MeSH term(s)	Male ; Humans ; Priapism/surgery ; Penis/surgery ; Decompression
Language	English
Publishing date	2024-01-17
Publishing country	England
Document type	Journal Article
ZDB-ID	1034295-3
ISSN	1476-5489 ; 0955-9930
ISSN (online)	1476-5489
ISSN	0955-9930
DOI	10.1038/s41443-024-00826-5
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Article ; Online: Statins synergize with phosphodiesterase type 5 inhibitors but not with selective estrogen receptor modulators to prevent myofibroblast transformation in an in vitro model of Peyronie's disease.

Ilg, Marcus M / Ralph, David J / Cellek, Selim

The journal of sexual medicine

2023 Volume 20, Issue 7, Page(s) 925–934

Abstract: Background: Peyronie's disease (PD) is a fibrotic disorder characterized by plaque formation in the tunica albuginea (TA) of the penis, and we have previously shown that inhibition of transformation of TA-derived fibroblasts to myofibroblasts using a ... ...

Abstract	Background: Peyronie's disease (PD) is a fibrotic disorder characterized by plaque formation in the tunica albuginea (TA) of the penis, and we have previously shown that inhibition of transformation of TA-derived fibroblasts to myofibroblasts using a combination phosphodiesterase type 5 (PDE5) inhibitors and selective estrogen receptor modulators (SERMs) is effective in slowing the progression of early PD. Aim: The study sought to investigate whether combinations of statins with PDE5 inhibitors or SERMs would affect myofibroblast transformation in vitro. Methods: Primary fibroblasts were isolated from TA of patients with PD and stimulated with transforming growth factor β1 in the absence and presence of a range of concentrations of statins, PDE5 inhibitors, SERMs, and their combinations for 72 hours before quantifying α-smooth muscle actin using in-cell enzyme-linked immunosorbent assay. Outcomes: The prevention of transforming growth factor β1-induced transformation of TA-derived fibroblasts to myofibroblasts was measured in vitro. Results: Statins (simvastatin, lovastatin) inhibited myofibroblast transformation in a concentration-dependent manner with half maximal inhibitory concentration values of 0.77 ± 0.07 μM and 0.8 ± 0.13 μM, respectively. Simvastatin inhibited myofibroblast transformation in a synergistic fashion when combined with vardenafil (a PDE5 inhibitor; log alpha >0). Combination of tamoxifen (a SERM) and simvastatin did not show synergy (log alpha <0). When 3 drugs (simvastatin, vardenafil, and tamoxifen) were combined, the effect was not synergistic, but rather was additive. Clinical implications: A combination of a statin with a PDE5 inhibitor might be useful in the clinic to slow the progression of the disease in patients with early PD; however, caution should be taken with such a combination because of the reported myopathy as a side effect. Strengths and limitations: The use of primary human cells from patients with PD is a strength of this study. The mechanisms by which these drug classes exert synergy when used in combination was not investigated. Conclusion: This is the first demonstration of an antifibrotic synergy between statins and PDE5 inhibitors.
MeSH term(s)	Humans ; Male ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/pharmacology ; Myofibroblasts/metabolism ; Penile Induration/drug therapy ; Phosphodiesterase 5 Inhibitors/pharmacology ; Phosphodiesterase 5 Inhibitors/therapeutic use ; Selective Estrogen Receptor Modulators/pharmacology ; Selective Estrogen Receptor Modulators/therapeutic use ; Simvastatin/pharmacology ; Simvastatin/therapeutic use ; Tamoxifen/pharmacology ; Tamoxifen/therapeutic use ; Transforming Growth Factor beta1 ; Vardenafil Dihydrochloride/pharmacology ; Vardenafil Dihydrochloride/therapeutic use
Chemical Substances	Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Phosphodiesterase 5 Inhibitors ; Selective Estrogen Receptor Modulators ; Simvastatin (AGG2FN16EV) ; Tamoxifen (094ZI81Y45) ; Transforming Growth Factor beta1 ; Vardenafil Dihydrochloride (5O8R96XMH7)
Language	English
Publishing date	2023-03-23
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2251959-2
ISSN	1743-6109 ; 1743-6095
ISSN (online)	1743-6109
ISSN	1743-6095
DOI	10.1093/jsxmed/qdad051
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Article ; Online: Commentary: Value of prolonged scrotal drainage after penile prosthesis implantation: a multicentre prospective nonrandomized pilot study.

Lee, Wai Gin / Ralph, Philippa / Ralph, David

International journal of impotence research

2023

Language	English
Publishing date	2023-07-24
Publishing country	England
Document type	Journal Article
ZDB-ID	1034295-3
ISSN	1476-5489 ; 0955-9930
ISSN (online)	1476-5489
ISSN	0955-9930
DOI	10.1038/s41443-023-00740-2
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Article ; Online: Anterolateral Thigh Flap Phalloplasty for Individuals Assigned Female at Birth.

Christopher, Nim / Ralph, David / Lee, Wai Gin

European urology focus

2023 Volume 9, Issue 1, Page(s) 32–34

Abstract: Anterolateral thigh flap phalloplasty is a suitable alternative for individuals assigned female at birth who do not want a visible donor site, but careful patient selection is essential to reduce the risk of complications. ...

Abstract	Anterolateral thigh flap phalloplasty is a suitable alternative for individuals assigned female at birth who do not want a visible donor site, but careful patient selection is essential to reduce the risk of complications.
MeSH term(s)	Male ; Infant, Newborn ; Humans ; Female ; Thigh/surgery ; Phalloplasty ; Sex Reassignment Surgery ; Penis/surgery ; Urethra/surgery
Language	English
Publishing date	2023-01-07
Publishing country	Netherlands
Document type	Journal Article
ISSN	2405-4569
ISSN (online)	2405-4569
DOI	10.1016/j.euf.2022.12.011
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Article ; Online: Lightweight macroporous mesh can be used for corporal reconstruction during penile prosthesis surgery.

Lee, Wai Gin / Gordon, Patrick / Ralph, David

The journal of sexual medicine

2023 Volume 20, Issue 12, Page(s) 1446–1450

Abstract: Background: Options to reinforce or reconstruct the corpora cavernosa during penile prosthesis surgery are limited. Synthetic grafts may confer a higher infection risk. Lightweight macroporous mesh is a promising alternative due to better integration ... ...

Abstract	Background: Options to reinforce or reconstruct the corpora cavernosa during penile prosthesis surgery are limited. Synthetic grafts may confer a higher infection risk. Lightweight macroporous mesh is a promising alternative due to better integration and tissue ingrowth. Aim: The study sought to report the first experience of using lightweight mesh to reinforce or reconstruct the corpora. Methods: The medical records of all patients undergoing insertion or revision of penile prosthesis between May 2016 and May 2021 were reviewed retrospectively. Patient characteristics, management, and outcomes were extracted in which mesh was used for corporal reconstruction. Poliglecaprone-25/polypropylene mesh (UltraPro) was used in all cases. The surgical technique and alternatives were summarized. Outcomes: The outcomes were infection rate, postoperative complications by Clavien-Dindo classification, and patient-reported outcomes. Results: Mesh was required during penile prosthesis surgery in 21 men (median age 56 [range, 18-74] years). Reasons for reconstruction were severe corporal fibrosis (n = 6), impending erosion (n = 6), crossover/perforation (n = 6), congenital corporal agenesis (n = 2), and excision of Peyronie's plaque. All but 2 patients (with corporal agenesis) presented for revision penile prosthesis surgery with a median number of previous revision attempts of 2 (range, 1-5). Two (10%) patients required explant after a mean follow-up of 23 ± 8.7 months. One man developed infection of the device 2 years after surgery, translating to an infection rate of 5% despite a high prevalence of diabetes (25%) in this cohort. Another required explantation due to debilitating chronic pain after 3 months. Further revision surgery for stiction syndrome was required in a third patient. Finally, another man was not satisfied with the position of the pump within the scrotum or the axial rigidity of the device, despite a second opinion suggesting no issues with the device. All men were sexually active following surgery. Clinical implications: A lightweight mesh can be considered to reinforce or reconstruct the corpora cavernosa in complex cases in which there are no alternative techniques available. Strengths and limitations: This is the first study using a lightweight macroporous mesh for revision penile prosthesis surgery. This was a well-characterized cohort of patients. A larger cohort with 5-year follow-up would be preferable. Conclusion: These early results suggest that a lightweight macroporous mesh may be an acceptable synthetic graft for corporal reconstruction. Poliglecaprone-25/polypropylene mesh may be ideal because it is partially absorbable, easy to handle, and not bulky.
MeSH term(s)	Humans ; Male ; Middle Aged ; Penile Implantation/methods ; Penile Induration/surgery ; Penile Prosthesis/adverse effects ; Penis/surgery ; Polypropylenes ; Retrospective Studies ; Surgical Mesh ; Adolescent ; Young Adult ; Adult ; Aged
Chemical Substances	Polypropylenes
Language	English
Publishing date	2023-07-01
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2251959-2
ISSN	1743-6109 ; 1743-6095
ISSN (online)	1743-6109
ISSN	1743-6095
DOI	10.1093/jsxmed/qdad134
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Article: Insertion of inflatable penile prosthesis in the neophallus of assigned female at birth individuals: a systematic review of surgical techniques, complications and outcomes.

Pang, Karl H / Christopher, Nim / Ralph, David J / Lee, Wai Gin

Therapeutic advances in urology

2023 Volume 15, Page(s) 17562872231199584

Abstract: Devices such as inflatable penile prostheses (IPP) can be used to achieve erectile rigidity after phalloplasty in assigned female at birth (AFAB) individuals. The approach to inserting an IPP in a neophallus is different and more challenging compared to ... ...

Abstract	Devices such as inflatable penile prostheses (IPP) can be used to achieve erectile rigidity after phalloplasty in assigned female at birth (AFAB) individuals. The approach to inserting an IPP in a neophallus is different and more challenging compared to that of an anatomical penis due to the absence of anatomical structures such as the corpora cavernosa, and the more tenuous blood supply of the neophallus and reconstructed urethra. In addition, the ideal surgical techniques and devices for use in the neophallus have not been defined. This review systematically summarises the literature on the insertion of IPP in the neophallus of individuals AFAB. In particular, the described techniques, types of devices used and peri-operative and patient-reported outcomes are emphasised. An initial search of the PubMed database was performed on 16 September 2022 and an updated search was performed on 26 May 2023. Overall, 185 articles were screened for eligibility and 15 studies fulfilled the inclusion criteria and were included in the analysis. Two studies reported outcomes on the zephyr surgical implant 475 FTM device and the others reported outcomes on the Boston Scientific AMS 600/700
Language	English
Publishing date	2023-09-14
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2492591-3
ISSN	1756-2880 ; 1756-2872
ISSN (online)	1756-2880
ISSN	1756-2872
DOI	10.1177/17562872231199584
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Article ; Online: A combination of phosphodiesterase type 5 inhibitor and tamoxifen for acute Peyronie's disease: the first clinical signals.

Cellek, Selim / Megson, Matthew / Ilg, Marcus M / Ralph, David J

The journal of sexual medicine

2023 Volume 20, Issue 8, Page(s) 1057–1059

MeSH term(s)	Male ; Humans ; Phosphodiesterase 5 Inhibitors/therapeutic use ; Phosphodiesterase 5 Inhibitors/pharmacology ; Tamoxifen/therapeutic use ; Penile Induration/drug therapy ; Sildenafil Citrate ; Tadalafil ; Vardenafil Dihydrochloride/therapeutic use ; Triazines/pharmacology
Chemical Substances	Phosphodiesterase 5 Inhibitors ; Tamoxifen (094ZI81Y45) ; Sildenafil Citrate (BW9B0ZE037) ; Tadalafil (742SXX0ICT) ; Vardenafil Dihydrochloride (5O8R96XMH7) ; Triazines
Language	English
Publishing date	2023-07-31
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2251959-2
ISSN	1743-6109 ; 1743-6095
ISSN (online)	1743-6109
ISSN	1743-6095
DOI	10.1093/jsxmed/qdad083
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Article: Phalloplasty following penectomy for penile cancer.

Lee, Wai Gin / Christopher, A Nim / Ralph, David J

Asian journal of urology

2022 Volume 9, Issue 4, Page(s) 460–466

Abstract: Objective: Penile reconstruction or phalloplasty following penectomy can be offered where the functional penile length is inadequate for a man to void while standing or to have sexual intercourse. Phalloplasty is usually staged due to the complex ... ...

Abstract	Objective: Penile reconstruction or phalloplasty following penectomy can be offered where the functional penile length is inadequate for a man to void while standing or to have sexual intercourse. Phalloplasty is usually staged due to the complex surgical techniques required. This narrative review describes the technical concepts and summarises the contemporary outcomes following phalloplasty in this challenging cohort. Methods: A retrospective review of the English literature was performed between January 1946 till November 2021. The data were synthesised and complemented by the expert opinion of the authors with 20 years of experience in this field. The flaps are ideally designed with an integrated urethra or alternatively, a further free flap urethroplasty can be offered. Phalloplasty is further complicated following penectomy by scarring from the previous surgery and the potential loss of structures that would normally be present at the recipient site. Results: There are limited published data with a total of 19 men recorded in the literature. Only the radial artery forearm free flap and anterolateral thigh flap have been described in this cohort of patients. Functional outcomes including standing micturition, sensation in the neophallus, and the ability to orgasm are good. Overall quality of life and satisfaction was also good despite the high risk for long-term complications of the neophallus and donor site. Conclusion: Phalloplasty following penectomy requires microsurgical transfer of a free flap or a pedicled flap to reconstruct a neophallus. An erectile device is inserted at a later stage to facilitate sexual intercourse, if desired. Surgical scarring from penectomy and the potential loss of vasculature that would normally be present at the recipient site may further complicate reconstruction. Surgical and functional outcomes are acceptable based on the limited published experience to date.
Language	English
Publishing date	2022-08-03
Publishing country	Singapore
Document type	Journal Article ; Review
ZDB-ID	2831144-9
ISSN	2214-3882
ISSN	2214-3882
DOI	10.1016/j.ajur.2022.05.005
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