(011) PENOSCROTAL DECOMPRESSION IN REFRACTORY ISCHAEMIC PRIAPISM: A REVIEW AND PROPORTIONAL META-ANALYSIS OF A NOVEL TECHNIQUE WITH PROMISING RESULTS
Notice bibliographique
Résumé
Abstract Introduction Penoscrotal decompression (PSD) is a novel surgical technique first described by Fuchs et al. in 2018. It involves accessing the corporal bodies via a penoscrotal incision with proximal coroportomies and subsequent drainage of ischaemic blood leading to detumescence. Although PSD has been recently popularised, its outcomes have been considered encouraging when considering operative success, recurrence rates, and preservation of erectile function. Objective This review and meta-analysis aims to holistically explore all available evidence on PSD and evaluate PSD’s utility and eRicacy as a surgical approach in a) achieving detumescence, b) preventing recurrence, and c) maintaining erectile function. Methods This systematic review was done in concordance with the PRISMA guidelines. Nine databases were thoroughly searched with all literature available, excluding metaanalyses, reviews, guidelines, editorials, and expert opinions. There were no restrictions on time or language of publication. Data extraction and descriptive analysis were performed using Microsoft Excel. A meta-analysis of proportions and heterogeneity studies was carried out using R. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of studies, where applicable. A p-value of 0.05 was considered statistically significant. Results Of the 110 screened studies, 11 were eligible for further review. The studies include five case reports, four abstracts and two observational cohort studies, including data from 97 patients with refractory ischaemic priapism. Drug-induced priapism was the most common cause, and less than half of the patients (44.3%) had a distal shunt before PSD. PSD laterality was described in 69 patients, with 31 and 38 having unilateral and bilateral decompressions, respectively. Detumescence was achieved in 95 out of 97 participants with a pooled proportion of 91% (CI 95%: 0.84-0.95). Post-PSD recurrence occurred in a total of 12% (95% CI: 0.06-0.21). Erectile function was preserved in 51% of the patients with follow-up (95% CI: 0.39-0.62). Heterogeneity was low amongst the studies reporting the outcomes of interest. Limitations noted included: a) A small patient sample, b) Variability in decompression techniques, c) Unspecified rationale for choosing unilateral or bilateral decompression, and d) If bilateral decompression was used only after a failed unilateral decompression. Conclusions Early evidence suggests that PSD is a feasible and eRicacious surgical technique in RIP. It oRers high detumescence rates, with a lower risk of recurrence and a better erectile functional preservation rate in contrast to other surgical techniques. Moving forward, to further outline its long-term outcomes, we encourage prospective data collection with 1. A standardised surgical approach to decompression 2. Medium to long-term followup and 3. Exploration of alternative approaches, such as an infrapubic approach. Disclosure No.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,006 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».