ABSTRACT
For patients with moderate-to-severe erectile dysfunction, implantable penile prostheses continue to be a viable treatment. Medical device developers apply design controls during the development cycle to ensure that a product performs as intended in the final use environment. This process relies heavily on the principles of systems engineering and documents every facet of performance, unmet need, and risk. To better understand design philosophy, it is important to frame benchmarked performance outcomes in the context of the ideal state. Careful consideration of erectile anatomy and physiology, including flaccid state, transitional phases, and full tumescence, informs penile prosthesis design philosophy and provides the foundation for product advancement.
Subject(s)
Humans , Male , Biomedical Engineering , Erectile Dysfunction/surgery , Penile Implantation , Penile Prosthesis , Prosthesis Design , Systems AnalysisABSTRACT
For patients with moderate-to-severe erectile dysfunction, implantable penile prostheses continue to be a viable treatment. Medical device developers apply design controls during the development cycle to ensure that a product performs as intended in the final use environment. This process relies heavily on the principles of systems engineering and documents every facet of performance, unmet need, and risk. To better understand design philosophy, it is important to frame benchmarked performance outcomes in the context of the ideal state. Careful consideration of erectile anatomy and physiology, including flaccid state, transitional phases, and full tumescence, informs penile prosthesis design philosophy and provides the foundation for product advancement.
ABSTRACT
Penile rehabilitation after inflatable penile prosthesis (IPP) implantation for the treatment of erectile dysfunction includes leaving the device partially inflated so as to preserve the penile length and to maintain hemostasis. With a partially inflated device, the penis becomes more sensitive and more susceptible to unintended insults during the immediate postoperative management. The 'Wang Collar,' a device intended to protect the penis in the early postoperative period, is hereby described. Three hundred and forty-eight patients had the 'Wang Collar' included as part of their post-IPP management from August 2014 to February 2019. The protective collar, devised from a polystyrene cup with the bottom removed, is secured with a tape over the previously dressed and partially inflated penis. In order to evaluate the effectiveness of this device, we conducted surveys on the perioperative staff at three different institutions. The 'Wang Collar' has been found to be beneficial in the early postoperative care of patients. Based on the answers to our questionnaire, the perioperative personnel found this device to be highly protective, especially when transporting the patient after IPP surgery, easy to work with, and almost never bothersome or irritative to the patient. We present a novel penile device after IPP placement, which we have found to improve patient satisfaction in the postoperative period. In addition, it eases the care of the patient by the perioperative staff. It is now our routine to use this device after IPP surgery. Further research is necessary to evaluate whether this device can decrease postoperative wound complications.
ABSTRACT
Augmented reality is widely used in aeronautics and is a developing concept within surgery. In this pilot study, we developed an application for use on Google Glass ® optical head-mounted display to train urology residents in how to place an inflatable penile prosthesis. We use the phrase Augmented Reality Assisted Surgery to describe this novel application of augmented reality in the setting of surgery. The application demonstrates the steps of the surgical procedure of inflatable penile prosthesis placement. It also contains software that allows for detection of interest points using a camera feed from the optical head-mounted display to enable faculty to interact with residents during placement of the penile prosthesis. Urology trainees and faculty who volunteered to take part in the study were given time to experience the technology in the operative or perioperative setting and asked to complete a feedback survey. From 30 total participants using a 10-point scale, educational usefulness was rated 8.6, ease of navigation was rated 7.6, likelihood to use was rated 7.4, and distraction in operating room was rated 4.9. When stratified between trainees and faculty, trainees found the technology more educationally useful, and less distracting. Overall, 81% of the participants want this technology in their residency program, and 93% see this technology in the operating room in the future. Further development of this technology is warranted before full release, and further studies are necessary to better characterize the effectiveness of Augmented Reality Assisted Surgery in urologic surgical training.
ABSTRACT
Objective To observe the clinical efficacy of AMS three- piece inflatable penile prosthesis on erectile dysfunction (ED).Methods From Dec 2008 to Sep 2012, 7 patiens with of serve erectile dysfunction (ED),whose ages were 28~55 years (average 47 years) were implanted with AMS three- piece inflatable penile prosthesis in our hospital. The 7 patients with serve erectile dysfunction included 3 patients with neurogenic ED,2 patients with arteriovenous fistula in corpus cavernosum penis and 2 patients with fibrosis of corpus cavernosum penis. Results All of the patients were performed smoothly with implantation of AMS three- piece inflatable penile prosthesis, among them 3 cases appeared foreskin edema, but it disappeared after 2 weeks. After 6~36 months (average 18 months) follow up, there was no rejection, no implant failure, and no urethral injury in our group, all patients got satisfaction on sexual life, and one patient with arteriovenous fistula in corpus cavernosum penis after treatment made his wife pregnant. Conclusion AMS three- piece inflatable penile prosthesis is close to human physiological penis, it has good concealment, less surgical trauma , high success rate, satisfying clinical efficacy, safe and reliable mechanical behavior.
ABSTRACT
In order to compensate the disadvantage of the semirigid and three piece inflatable penile prosthesis. various simple self-contained inflatable penile prostheses have been utilized Recently new self contained inflatable penile prosthesis, Dynaflex was introduced as a modification of previous Hydroflex by AMS. In 25 cases of impotence patients. implantation of penile prosthesis with Dynaflex was performed from July, 1990 to September. 1991. Compared to Hydroflex, Dynaflex was easier to implant and also easier to inflate and deflate. There was no mechanical failure, infection or erosion during follow up period of 3 months to 1 year 6 months. All patients were satisfied with the results of implantation. However in three patients, diameter of 11mm could not be implanted due to smaller diameter of corpus cavenosum of penis. In conclusion, Dynaflex prosthesis could be an attractive alternative to other forms of prosthetic device and new device of Dynaflex is absolutely required for the impotent patient with smaller diameter of his corpus cavernosum.