Post malleable Penile Prosthesis Satisfaction in elderly patients: Serial assessments.

Post penile implant sexual satisfaction in elderly patients is a multifactorial issue. In the present study, we investigated the possible implication of age on satisfaction after malleable penile implant surgery in elderly patients. We compared post-operative sexual satisfaction in the elderly with that of a younger age group (reference group). Patients were classified into three groups according to their ages (group I <45, group II between 45 and 65, and group III older than 65 years old). Modified Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire was used at 3, 6 and 12 months after implant surgery. EDITS scores showed statistically significant high satisfaction rates in all age groups. EDITS scores were higher in the early post-operative period in younger groups compared to elderly patients. However, the difference between groups was insignificant at 12 months post-operatively (p value = .06). Our results show that elderly patients have a high post-operative satisfaction rate close to that of younger age groups, and they are suitable candidates for penile implant surgery with good and realistic post-operative sexual satisfaction expectations.

Multiple fractional erbium: yttrium-aluminum-garnet laser sessions for upper facial rejuvenation: clinical and histological implications and expectations.

BACKGROUND: Fractional photothermolysis is a modern resurfacing technique, in which microscopic zones of thermal injury are created, stimulating turnover of both epidermis and dermis. Fractional laser rejuvenation has been developed to overcome the drawbacks of traditional ablative laser. OBJECTIVES: To objectively evaluate the effectiveness of multiple sessions of fractional Er:YAG laser rejuvenation for aging upper face clinically, histologically and immunohistochemically. PATIENTS/METHODS: Ten volunteers asking for facial rejuvenation were subjected to multiple sessions (3-5) of fractional Er:YAG laser. Clinical evaluation with both histopathological and immunohistochemical assessment for skin biopsies was carried out before, after 1 month and 6 months of laser resurfacing. Histometry for epidermal thickness and quantitative assessment for neocollagen formation, collagen I, III, and VII, elastin and tropoelastin were carried out for all skin biopsies. RESULTS: Comparing before, after 1 month and 6 months of fractional Er:YAG laser resurfacing resulted in improved clinical appearance with increased epidermal thickness (P < 0.001). Dermal collagen showed increased neocollagen formation (P = 0.006), with increased concentration of collagen types I (P < 0.001), III (P < 0.001), and VII (P = 0.001). Dermal elastic tissue studies revealed decreased elastin, while tropoelastin concentration increased after laser resurfacing (P < 0.001). An increase in collagen (I and III) and tropoelastin level and decreased elastin content was encountered with increasing the number of sessions, yet it was not significant. CONCLUSIONS: Multiple sessions are effective in rejuvenation of the aging face with high safety, short downtime, and no adverse effects. They stimulated formation of new collagen (type I, III, and VII) up to 6 months after treatment with better improvement in skin texture and fine wrinkles. The variable number of fractional Er:YAG laser sessions (3-5) showed no significant difference as regards efficacy.

Fractional versus ablative erbium:yttrium-aluminum-garnet laser resurfacing for facial rejuvenation: an objective evaluation.

BACKGROUND: Laser is one of the main tools for skin resurfacing. Erbium:yttrium-aluminum-garnet (Er:YAG) was the second ablative laser, after carbon dioxide, emitting wavelength of 2940 nm. Fractional laser resurfacing has been developed to overcome the drawbacks of ablative lasers. OBJECTIVE: We aimed to objectively evaluate the histopathological and immunohistochemical effects of Er:YAG 2940-nm laser for facial rejuvenation (multiple sessions of fractional vs single session of ablative Er:YAG laser). METHODS: Facial resurfacing with single-session ablative Er:YAG laser was performed on 6 volunteers. Another 6 were resurfaced using fractional Er:YAG laser (4 sessions). Histopathological (hematoxylin-eosin, orcein, Masson trichrome, and picrosirius red stains) and immunohistochemical assessment for skin biopsy specimens were done before laser resurfacing and after 1 and 6 months. Histometry for epidermal thickness and quantitative assessment for neocollagen formation; collagen I, III, and VII; elastin; and tropoelastin were done for all skin biopsy specimens. RESULTS: Both lasers resulted in increased epidermal thickness. Dermal collagen showed increased neocollagen formation with increased concentration of collagen types I, III, and VII. Dermal elastic tissue studies revealed decreased elastin whereas tropoelastin concentration increased after laser resurfacing. Neither laser showed significant difference between their effects clinically and on dermal collagen. Changes in epidermal thickness, elastin, and tropoelastin were significantly more marked after ablative laser. LIMITATIONS: The small number of patients is a limitation, yet the results show significant improvement. CONCLUSION: Multiple sessions of fractional laser have comparable effects to a single session of ablative Er:YAG laser on dermal collagen but ablative laser has more effect on elastic tissue and epidermis.