penile implant bulb

OBJECTIVES: To provide an update on SpaceOAR® System, a FDA approved hydrogel indicated to create distance between the prostate and rectum which has been studied in phase 2 and 3 clinical trials. Here we review and summarize these clinical results including: the safety of prostate-rectum spacer application technique, the implant quality and resulting rectal dose reduction, acute and long term rectal, urinary and sexual toxicity as well as patient reported outcomes. METHODS: A prospective, randomized patient-blinded clinical study was performed comparing image-guided intensity modulated prostate radiotherapy (IG-IMRT) (79...

Surgical or genetic disruption of vomeronasal organ (VNO)-accessory olfactory bulb (AOB) function previously eliminated the ability of male mice to processes pheromones that elicit territorial behavior and aggression. By contrast, neither disruption significantly affected mating behaviors, although VNO lesions reduced males' investigation of nonvolatile female pheromones. We explored the contribution of VNO-AOB pheromonal processing to male courtship using optogenetic activation of AOB projections to the forebrain...

OBJECTIVE: We developed a new surgical model of penile girth enhancement in dog, with minimal damage, fewer complications, and high success rate, to enable the experimental investigation of penile implants. METHODS: We obtained materials for penile girth enhancement by processing the pericardium and blood vessel wall collected from pigs. Incisions were made at the penile bulb for the implantation of the materials, and facilitate observation and data collection, based on the anatomical features of dog's penis...

PURPOSE: Implanted tissue spacers show great promise in reducing radiation dose to organs at risk (OAR) and/or permitting dose escalation to target volumes in IMRT plans. Dosimetric benefits have been demonstrated in a randomized study of such a device despite variations in plan optimization. The purpose of this analysis was to quantify the dosimetric effect of a tissue spacer using a validated prostate DVH prediction model trained with previous high-quality clinical prostate plans. METHODS: Imaging and treatment planning for men undergoing IMRT for localized stage T1-T2 prostate cancer was performed before and after hydrogel spacer implantation between the prostate and anterior rectum...

OBJECTIVE: To define and describe a type of pseudo-malfunction of the Coloplast Titan Inflatable Penile Prosthesis (IPP) One-Touch Release (OTR) pump (Coloplast Corp, Minneapolis, MN). MATERIALS AND METHODS: We retrospectively reviewed a consecutive series of 550 patients with refractory organic erectile dysfunction who were implanted with a Coloplast Titan IPP with the OTR pump during a period of approximately 4 years. RESULTS: All patients were implanted using standard techniques through an infrapubic or penoscrotal approach...

CONTEXT: Penile allotransplantation might be a viable option for patients who need penile reconstruction. AIMS: A successful autotransplantation rat model is the first step toward proceeding for allotransplantation. We herein evaluate autotransplantation following transaction of the rat penis just distal to the urethral bulb. SETTINGS AND DESIGN: Experimental animal study. MATERIALS AND METHODS: Five Sprague-Dawely rats weighing 520 g (SD 19) were used...

PURPOSE: In this study, the authors introduce skew line needle configurations for high dose rate (HDR) brachytherapy and needle planning by integer program (NPIP), a computational method for generating these configurations. NPIP generates needle configurations that are specific to the anatomy of the patient, avoid critical structures near the penile bulb and other healthy structures, and avoid needle collisions inside the body. METHODS: NPIP consisted of three major components: a method for generating a set of candidate needles, a needle selection component that chose a candidate needle subset to be inserted, and a dose planner for verifying that the final needle configuration could meet dose objectives...

PURPOSE: Prospective evaluation of sexual outcomes after prostate brachytherapy with iodine-125 seeds as monotherapy at a tertiary cancer care center. METHODS AND MATERIALS: Subjects were 129 men with prostate cancer with I-125 seed implants (prescribed dose, 145 Gy) without supplemental hormonal or external beam radiation therapy. Sexual function, potency, and bother were prospectively assessed at baseline and at 1, 4, 8, and 12 months using validated quality-of-life self-assessment surveys...

PURPOSE: A comparative treatment planning study was conducted to analyze combined intensity-modulated radiation therapy (IMRT) vs. three-dimensional highly conformal radiotherapy (3D-hCRT) after (125)I permanent seed brachytherapy in patients with localized prostate cancer. METHODS AND MATERIALS: We optimized an IMRT and a 3D-hCRT treatment plan to 45Gy in 9 patients 2 months after (125)I seed brachytherapy (110Gy) implant. IMRT and 3D-hCRT were planned using eight and seven nonopposed coplanar fields of 6- and 23-MV...

PURPOSE: The use of stranded seeds for prostate brachytherapy has raised concern that displacement of strands, particularly in the periurethral region, may result in inadequate coverage of the prostate. We sought here to evaluate the displacement of periurethral stranded seeds after a prostate brachytherapy implant (Day 0) and its dosimetric consequences 1 month later (Day 30). METHODS AND MATERIALS: Subjects were 10 consecutive patients who underwent implantation with (125)I stranded seeds via a peripheral-loading technique...

PURPOSE: The purpose of this study was to evaluate the influence of potential contributing factors to the incidence of seed slippage and quality of prostate brachytherapy dosimetry comparing "coated" vs. "bare" seeds with a Mick applicator. METHODS AND MATERIALS: Two consecutive groups of 89 patients were treated with (125)I prostate brachytherapy at a high treatment volume single institution. All the patients were evaluated with Day 0 plain films of the pelvis and CT-based dosimetry analysis...

INTRODUCTION: A single-armed, prospective, multicenter study evaluated the redesigned American Medical Systems (AMS) 700 Momentary Squeeze (MS) pump inflatable penile prosthesis (IPP) with enhanced features for ease of implantation and patient manipulation. The device incorporates design changes to all components: pump, cylinders, rear-tip extenders, and reservoir. AIM: To assess physician and patient satisfaction with the new AMS 700 MS pump. METHODS: Patients were selected from the existing population experiencing erectile dysfunction (ED) without previous prosthetic implantation...

PURPOSE: We evaluated the relationship between the onset of erectile dysfunction and dose to the penile bulb and neurovascular bundles (NVBs) after real-time ultrasound-guided prostate brachytherapy. METHODS AND MATERIALS: One hundred forty-seven patients who underwent prostate brachytherapy met the following eligibility criteria: (1) treatment with 125I brachytherapy to a prescribed dose of 160 Gy with or without hormones without supplemental external beam radiation therapy, (2) identification as potent before the time of implantation based on a score of 2 or higher on the physician-assigned Mount Sinai Erectile Function Score and a score of 16 or higher on the abbreviated International Index of Erectile Function patient assessment, and (3) minimum follow-up of 12 months...

PURPOSE: Erectile dysfunction following prostate brachytherapy is reported to be related to dose received by the penile bulb. To minimise this, whilst preserving prostate dosimetry, we have developed a technique for I-125 seed brachytherapy using both stranded seeds and loose seeds delivered with a Mick applicator, and implanted via the sagittal plane on trans-rectal ultrasound. MATERIALS AND METHODS: Post-implant dosimetry and potency rates were compared in 120 potent patients...

PURPOSE: To compare contrast-enhanced, T1-weighted, three-dimensional magnetic resonance imaging (CEMR) and T2-weighted magnetic resonance imaging (T2MR) with computed tomography (CT) for prostate brachytherapy seed location for dosimetric calculations. METHODS AND MATERIALS: Postbrachytherapy prostate MRI was performed on a 1.5 Tesla unit with combined surface and endorectal coils in 13 patients. Both CEMR and T2MR used a section thickness of 3 mm. Spiral CT used a section thickness of 5 mm with a pitch factor of 1...

We developed a novel technique to simultaneously monitor micturitions and erections in rats by using pressure monitoring within the corpus spongiosum of the penis (CSP). We present data validating this technique and report pressure waveform characteristics of micturition and erectile events during four different behavioral contexts in 10 awake, freely-moving male rats. Telemetric pressure transducers were implanted in the bulb of the CSP. CSP pressure was monitored while the animals were simultaneously recorded on video for determination of presence and volume (n = 7) of micturitions and while the animals underwent behavioral tests for determination of erections...

Incidence of erectile dysfunction (ED) after radiotherapy reported in the literature varies from 7 to 72% after external-beam radiotherapy to 5-51% after brachytherapy. Most of these studies are retrospective, the definition of ED is variable and sexual functioning is frequently assessed by asking only one question. Already in the 1980's it was suggested that post-radiation ED was attributable to vascular damage. The most reliable method to assess vasculogenic ED is the use of the Doppler ultrasound. More recently, many studies have assessed the relationship between radiation dose and volume of the penile bulb and post-radiation ED, though the outcome is controversial...

PURPOSE: Although permanent seed prostate brachytherapy is associated with a low risk of serious morbidity, proctitis and prolonged irritative and obstructive urinary symptoms may occur. Data are accumulating to help establish thresholds or guidelines for minimizing toxicity, however, no uniform method of defining and calculating the dose to critical organs currently exists. We set out to examine the existing data and propose a uniform method of reporting such that results from different centers can more easily be compared...

PURPOSE: To determine predictive factors for postimplant erectile dysfunction (ED) in a cohort of patients, according to prospectively collected data; specifically, to assess the impact of penile bulb volume and D50 and D95 (dose covering 50% and 95% of the penile bulb volume, respectively) on ED. METHODS AND MATERIALS: Three hundred forty-two patients were identified who were potent before implant and who had at least 2 years' follow-up. Patient, tumor, treatment, and dosimetric data were collected on all patients...

PURPOSE: Erectile dysfunction following permanent seed brachytherapy for prostate cancer may be related to the dose to the penile bulb. We investigated anatomic and dosimetric factors that might contribute to an increased dose to the penile bulb. METHODS AND MATERIALS: One-month CT and MR images were examined for 50 consecutive patients treated with exclusive (125)I permanent seed prostate brachytherapy to a prescribed dose of 145 Gy. Implants were preplanned by transrectal ultrasound (TRUS)...