Prostate cancer (PCa) is one of the most prevalent malignant tumors in men, accompanied by high incidence and mortality rates. Novel hormonal therapy (NHT) has emerged as the primary treatment for advanced PCa, providing noticeable clinical benefits. However, the diverse range of adverse events (AEs) associated with NHT may influence both treatment efficacy and patients’ quality of life. In light of the latest international clinical research evidence and recommendations from domestic and foreign guidelines, this consensus aims to provide a comprehensive overview of the common AEs experienced during NHT for advanced PCa patients. Additionally, it seeks to develop a hierarchical approach to more efficiently manage AEs, presenting valuable insights for clinical medication and adverse reaction management.
Background: Although urethral trauma may lead to serious consequences if mismanaged, treatment concepts are inconsistent. We designed a survey to investigate the current diagnosis and management of emergency blunt urethral trauma to aid future dissemination of relevant concepts.
Methods: A 15-item anonymous questionnaire was distributed via an online platform. It addressed items such as the cognition of how to diagnose of urethral trauma, optimal emergency management of a urethral trauma patient, and attitude towards early realignment for pelvic fracture urethral injuries.
Results: Of 538 respondents, 94.2% and 84.9% had received patients with straddle trauma urethral injuries or pelvic fracture urethral injuries, respectively, within the past year. In the emergency room, attempted urethral catheterization was the most selected examination method by respondents for diagnosis of both straddle injury (500/538) and pelvic fracture urethral injury (469/538). For patients with straddle injury, 41.3% of respondents performed endoscopic realignment and 31.6% preferred suprapubic cystostomy. For hemodynamically stable patients with PFUI, 42.2% of respondents preferred suprapubic cystostomy and 34.9% preferred endoscopic realignment. Most respondents felt favorably toward early realignment for pelvic fracture urethral injuries. After realignment, 61.3%, 24.5%, and 13.8% of respondents performed catheterization for 4, 8, and 12 weeks, respectively. Further, 54.6% of respondents believed catheter traction should be applied after realignment.
Conclusion: Although the number of yearly emergency urethral trauma cases was small, the opinions and practices of most urologists were consistent with guidelines. However, the significance of retrograde urethrography was not fully understood, and some respondents had incorrect views on catheter traction after realignment.
Background: Patients with inflatable penile prostheses (IPP) may experience erosions after years of use or after indwelling Foley catheter placement. IPP erosions should be managed as an infection with the entire IPP removed. Replacing IPPs in erosion patients can be challenging due to extensive scarring development. Using proper graft materials may be necessary to close and reinforce the corporal defect after difficult corporal dilation or significant scar removal for the long-term success of IPP reimplantation.
Case Presentation: Herein we report a patient with a history of IPP placement in 2007 for erectile dysfunction and Peyronie’s disease, presenting in 2018 with dysuria and a feeling of IPP displacement following Foley catheter placement for coronary artery bypass graft surgery. The left cylinder of the IPP was observed by physical examination and a defect near the fossa navicularis was discovered during office cystoscopy. A complete explantation of IPP was then performed. Reimplantation of the IPP was performed in 2021 which required excision of corporal scar tissue and repair of a left distal corporal defect using a Tutoplast® pericardium allograft. The procedure was successful with proper IPP position and good function without any penile deformity.
Conclusion: The use of graft materials in the management of corporeal defects should be considered in the setting of complex IPP revision. The Tutoplast® pericardium allograft reinforcement can provide long-term durability, flexibility, and a lower risk of infection.
Background: Whether conventional behavioral therapies for premature ejaculation can significantly improve the intravaginal ejaculatory latency time is still controversial. Prone masturbation is rare and observed in some patients with delayed ejaculation. Therefore, we tried to verify whether the regular prone masturbation training method had a therapeutic effect on premature ejaculation.
Methods: From July to December 2018, a total of 21 patients met the enrollment criteria and volunteered to participate. Participants were diagnosed with premature ejaculation with an intravaginal ejaculatory latency time of less than 3min and a Premature Ejaculation Diagnostic Tool score greater than 9. Participants performed 12-week prone masturbation training.
Results: Ten patients completed the entire treatment regimen. The mean age of the 10 participants was 30.4 ± 6.1 years, the mean frequency of sexual intercourse was 1.9 ± 0.83 times a week, and the median duration of premature ejaculation was 1.5 years. After 3 months of prone masturbation training, the median self-reported intravaginal ejaculatory latency time significantly increased from 60 to 105 s (p = 0.011), and the mean Premature Ejaculation Diagnostic Tool scores decreased from15.0 ± 3.7 to 12.7 ± 3.7 points (p = 0.119).
Conclusion: The regular prone masturbation training method, as a novel behavioral therapy, probably has a therapeutic effect on premature ejaculation.