Our Summary

This research paper talks about a method used to place a reservoir (a part of a penile implant system) in men who have had pelvic surgery or radiation therapy. The researchers wanted to see how safe and accurate this method was.

The method they used is called the Direct Vision, Transfascial (DVT) approach. They looked back at the outcomes for 100 patients who had this procedure. They also used imaging to see exactly where the reservoir ended up in many of these patients.

The researchers found that there were no complications during the procedure and no issues immediately after the procedure. In the months following the procedure, a few patients did have some issues like infections, a reservoir moving out of place, and mechanical malfunctions.

When they looked at the imaging, they found that in about 80% of patients, the reservoir was exactly where it was supposed to be. However, in about 20% of patients, the reservoir was not in the expected location. This was particularly a problem for patients who had their bladder removed, as the reservoir ended up in the abdominal cavity.

The study suggests that the DVT approach is generally safe and mostly accurate, though it does carry a slightly higher risk of infection. They also suggest that doctors should inform patients about the possibility of the reservoir ending up in the wrong place, and consider using imaging to check the reservoir’s position after the procedure.

The strength of this study is that it included a large number of patients, and half of them had imaging done to check the position of the reservoir. The limitation is that this was a retrospective study, which means the researchers looked back at patient records, instead of setting up a controlled experiment. Also, the study was done at a single medical center, so the results may not be the same everywhere.

FAQs

  1. What is the Direct Vision, Transfascial (DVT) approach in penile implant surgery?
  2. What were the main findings of the study on the DVT approach?
  3. What are the strengths and limitations of this research study on the DVT approach for penile implant surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about penile implant surgery is to discuss the potential risks and complications, including the possibility of the reservoir ending up in the wrong location. Patients should be informed about the DVT approach and the importance of post-procedure imaging to ensure the correct placement of the reservoir. It is also important for patients to follow post-operative care instructions carefully to reduce the risk of infection and mechanical issues. Communication with the doctor and following their recommendations can help ensure a successful outcome from penile implant surgery.

Suitable For

Patients who are typically recommended for penile implant surgery include those who have severe erectile dysfunction that is not responsive to other treatments such as medication or vacuum erection devices. This may include patients with conditions such as diabetes, cardiovascular disease, or prior pelvic surgery or radiation therapy that have caused damage to the blood vessels or nerves in the penis.

Additionally, patients who have had prostate cancer treatment, such as a radical prostatectomy or radiation therapy, may also be candidates for penile implant surgery if they are experiencing erectile dysfunction as a result of their treatment.

Overall, penile implant surgery may be recommended for patients who have tried other treatment options without success and are looking for a more permanent solution to their erectile dysfunction. It is important for patients to discuss their options with a urologist or specialist in sexual health to determine if penile implant surgery is the right choice for them.

Timeline

Overall, the timeline of what a patient experiences before and after penile implant surgery can be summarized as follows:

Before surgery:

  1. Patient consults with a urologist to discuss treatment options for erectile dysfunction.
  2. Patient undergoes various tests and evaluations to determine if they are a suitable candidate for penile implant surgery.
  3. Patient and doctor discuss the different types of penile implants available and decide on the best option for the patient.

During surgery:

  1. The DVT approach is used to place the reservoir in the patient’s body.
  2. The surgery is performed without any complications.

After surgery:

  1. Patient may experience some discomfort and swelling in the surgical area.
  2. In the months following the surgery, some patients may experience complications such as infections, reservoir movement, or mechanical malfunctions.
  3. Patients who had imaging done may find that the reservoir is in the expected location in about 80% of cases.
  4. Patients are advised to follow up with their doctor regularly to monitor for any complications and ensure the implant is functioning properly.

In conclusion, penile implant surgery is a relatively safe and effective treatment option for erectile dysfunction, but it is important for patients to be aware of the potential risks and complications associated with the procedure. Routine follow-up appointments and imaging can help ensure the long-term success of the implant.

What to Ask Your Doctor

Some questions a patient should ask their doctor about penile implant surgery include:

  1. What is the success rate of the DVT approach for placing the reservoir in penile implant surgery?
  2. What are the potential complications or risks associated with the DVT approach?
  3. How will you ensure that the reservoir is placed in the correct location during the procedure?
  4. Will imaging be used to confirm the position of the reservoir after the surgery?
  5. How will you monitor for any post-operative complications, such as infections or mechanical malfunctions?
  6. How experienced are you in performing penile implant surgeries using the DVT approach?
  7. What alternative approaches or techniques are available for placing the reservoir in penile implant surgery?
  8. What is the recovery process like after penile implant surgery using the DVT approach?
  9. How long can I expect the penile implant to last?
  10. Are there any lifestyle changes or precautions I should take after the surgery to ensure the longevity of the implant?

Reference

Authors: Kava BR, Levine A, Hauser N, Masterson T, Ramasamy R. Journal: J Sex Med. 2022 Feb;19(2):394-400. doi: 10.1016/j.jsxm.2021.11.012. Epub 2021 Dec 27. PMID: 34969612