Penile prosthesis implantation: A single center 25 years of experience.

OBJECTIVES: We analyzed the long-term results of malleable and inflatable penile prosthesis: the rates of complications, revision surgery and patient satisfaction. MATERIALS AND METHODS: Between January 1996 and December 2020, a total of 138 patients underwent implantation of a malleable or inflatable types penile prosthesis. The data of the patients were derived from the patient files and digital recording system. The patients were contacted face-to-face interaction if possible. If it is not possible, phone connection was made. RESULTS: The median age of patients was 56 (21-83) years. Fourteen (10.2%) 1-piece, 46 (33.3%) 2-piece and 78 (56.5%) 3-piece penile prosthesis were implanted. The mostly used perioperative antibiotic was teicoplanin+amikacin in 107 patients. Total complication rate was 30% (n=42). Prosthesis infection constituted 9% (n=13) of these complications. The total satisfaction rate was 89.1%. There was no correlation between the complications and antibiotic regimen or prosthesis type (P=0.488, P=0.454, respectively). The rate of infection showed a slight increase in 3-piece penile prosthesis without any statistically significance (P=0.633). The patients with complications expressed more dissatisfaction compared to those without complications (P=0.001). CONCLUSIONS: In our series, penile prosthesis implantation seems to be a recommended treatment method with high patient satisfaction in the treatment of refractory erectile dysfunction. LEVEL OF EVIDENCE: 4.

La densidad de los ganglios linfáticos en la linfadenectomía retroperitoneal como marcador novel para predecir la recurrencia en pacientes con cáncer testicular de células germinales: estudio de casos y controles y experiencia clínica a largo plazo de un hospital de referencia terciario / Lymph node density in retroperitoneal lymph node dissection as a novel marker for predicting recurrence in patients with germ cell testicular cancer: A case-control study and long-term clinical experience of a tertiary referral hospital

INTRODUCCIÓN Y OBJETIVOS: El objetivo de este estudio retrospectivo fue analizar la densidad de los ganglios linfáticos (GL) en la disección de los GL retroperitoneales (DGLRP) para evaluar la masa residual tras quimioterapia como factor predictivo de recurrencia en pacientes con cáncer testicular de células germinales (CTCG). MATERIALES Y MÉTODOS: Se revisaron retrospectivamente los datos de 185 pacientes operados por CTCG entre diciembre del 2004 y febrero del 2017. Se calculó la densidad de los GL. Los pacientes se compararon estadísticamente en términos de características demográficas, características tumorales, niveles de marcadores tumorales séricos, estrategias de tratamiento y resultados patológicos según los subtipos de CTCG. Se realizó un análisis de correlación para determinar los parámetros relacionados con la enfermedad recurrente. RESULTADOS: La mediana de seguimiento fue de 79 (31-179) meses y la mediana de edad de los pacientes fue de 23 (16-71). El tamaño medio del tumor fue de 4 (1-18) cm. Cinco (2,7%) pacientes tenían enfermedad metastásica en el momento del diagnóstico inicial. Se detectó seminoma, TCG no seminomatoso y CTCG de tipo mixto en 62 (33,5%), en 60 (32,4%) y en 63 (34,1%) pacientes, respectivamente. Tras la orquiectomía inguinal, 48 (25,9%) pacientes recibieron seguimiento, 126 (68,1%) pacientes se sometieron a quimioterapia y 11 (5,9%) pacientes recibieron radioterapia. Un total de 21 (11,4%) pacientes se sometieron a DGLRP posquimioterapia. Se observó recurrencia precoz y tardía en 3 (1,6%) y 2 (1,1%) pacientes, respectivamente. Se encontró una correlación negativa leve/moderada, pero significativa, entre la recurrencia y el número de GL con depósitos metastásicos y la densidad de los GL (r = -0,490, p = 0,024 y r = -0,450, p = 0,041, respectivamente). CONCLUSIONES: Hubo una correlación negativa entre el número de GL con depósitos metastásicos y la densidad de GL con la enfermedad recurrente

INTRODUCTION AND OBJECTIVES: In this retrospective study, we aimed to evaluate lymph node (LN) density in retroperitoneal lymph node dissection (RPLND) to analyze whether residual mass after chemotherapy might behave as predicting factor for recurrence in patients with germ cell testicular cancer (GCTC). MATERIALS AND METHODS: The data of 185 patients that were operated between 12/2004 and 02/2017 because of GCTC were reviewed retrospectively. LN density was calculated. The patients were compared statistically in terms of demographic features, tumor characteristics, serum tumor marker levels, treatment strategies, and pathological results according to GCTC subtypes. Correlation analysis was performed to determine the parameters related to recurrent disease. RESULTS: The median follow-up was 79 (31-179) months and the median age of the patients was 23 (16-71). The median tumor size was 4 (1-18) cm. Five (2.7%) patients had metastatic disease at initial diagnosis. Seminoma, non-seminomatous-GCT and mix type-GCTC was detected in 62 (33.5%), 60 (32.4%) and 63 (34.1%) patients, respectively. Following inguinal orchiectomy, 48 (25.9%) patients underwent follow-up, 126 (68.1%) patients underwent chemotherapy and 11 (5.9%) patients underwent radiotherapy. A total of 21 (11.4%) patients underwent post-chemotherapy RPLND. Early and late recurrence was seen in 3 (1.6%) and 2 (1.1%) of the patients, respectively. A mild to moderate, negative, but significant correlation was found between the recurrence and the number of LNs containing metastatic deposits and LN density (r = -0.490, P = .024 and r = -0.450, P=.041, respectively). CONCLUSIONS: There was a negative correlation between the number of LNs containing metastatic deposits and LN density and recurrent disease

Lymph node density in retroperitoneal lymph node dissection as a novel marker for predicting recurrence in patients with germ cell testicular cancer: A case-control study and long-term clinical experience of a tertiary referral hospital. / La densidad de los ganglios linfáticos en la linfadenectomía retroperitoneal como marcador novel para predecir la recurrencia en pacientes con cáncer testicular de células germinales: estudio de casos y controles y experiencia clínica a largo plazo de un hospital de referencia terciario.

INTRODUCTION AND OBJECTIVES: In this retrospective study, we aimed to evaluate lymph node (LN) density in retroperitoneal lymph node dissection (RPLND) to analyze whether residual mass after chemotherapy might behave as predicting factor for recurrence in patients with germ cell testicular cancer (GCTC). MATERIALS AND METHODS: The data of 185 patients that were operated between 12/2004 and 02/2017 because of GCTC were reviewed retrospectively. LN density was calculated. The patients were compared statistically in terms of demographic features, tumor characteristics, serum tumor marker levels, treatment strategies, and pathological results according to GCTC subtypes. Correlation analysis was performed to determine the parameters related to recurrent disease. RESULTS: The median follow-up was 79 (31-179) months and the median age of the patients was 23 (16-71). The median tumor size was 4 (1-18) cm. Five (2.7%) patients had metastatic disease at initial diagnosis. Seminoma, non-seminomatous-GCT and mix type-GCTC was detected in 62 (33.5%), 60 (32.4%) and 63 (34.1%) patients, respectively. Following inguinal orchiectomy, 48 (25.9%) patients underwent follow-up, 126 (68.1%) patients underwent chemotherapy and 11 (5.9%) patients underwent radiotherapy. A total of 21 (11.4%) patients underwent post-chemotherapy RPLND. Early and late recurrence was seen in 3 (1.6%) and 2 (1.1%) of the patients, respectively. A mild to moderate, negative, but significant correlation was found between the recurrence and the number of LNs containing metastatic deposits and LN density (r= -0.490, P=.024 and r= -0.450, P=.041, respectively). CONCLUSIONS: There was a negative correlation between the number of LNs containing metastatic deposits and LN density and recurrent disease.