PD46-08 EARLY VS DELAYED INSERTION OF PENILE PROSTHESIS IN PATIENTS WITH REFRACTORY PRIAPISM: A SYSTEMATIC REVIEW AND META-ANALYSIS
Bibliographic record
Abstract
You have accessJournal of UrologySexual Function/Dysfunction: Surgical Therapy I (PD46)1 May 2024PD46-08 EARLY VS DELAYED INSERTION OF PENILE PROSTHESIS IN PATIENTS WITH REFRACTORY PRIAPISM: A SYSTEMATIC REVIEW AND META-ANALYSIS Ahmed Al Saeedi, Mohamed Elmarasi, Ibrahim Elmakaty, Ibrahim Adnan, Maya Aldeeb, Kareim Khalafalla, Ahmad Majzoub, Mohamed Yamani, and Khalid Al Kubaisi Ahmed Al SaeediAhmed Al Saeedi , Mohamed ElmarasiMohamed Elmarasi , Ibrahim ElmakatyIbrahim Elmakaty , Ibrahim AdnanIbrahim Adnan , Maya AldeebMaya Aldeeb , Kareim KhalafallaKareim Khalafalla , Ahmad MajzoubAhmad Majzoub , Mohamed YamaniMohamed Yamani , and Khalid Al KubaisiKhalid Al Kubaisi View All Author Informationhttps://doi.org/10.1097/01.JU.0001008900.49567.2e.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Priapism, characterized by prolonged and painful erections, can cause erectile dysfunction (ED) due to ischemia-induced corporal tissue fibrosis, necessitating penile prosthesis (PP) surgery, yet consensus on the optimal timing remains lacking. The objective of this study was to evaluate and compare the clinical outcomes associated with early versus delayed PP implantation in individuals with priapism-induced ED. METHODS: We included studies that focused on refractory priapism leading to erectile dysfunction and its management with PP. Our search strategy covered six databases from their inception to May 6, 2023. We assessed cohort study bias with the risk of bias tool and case series bias with the modified Newcastle-Ottawa scale. Pooled odds ratios (ORs) were calculated using a fixed-effect model.The outcomes investigated included complications, patient satisfaction, sexual function restoration, prosthesis type, follow-up duration, hospital stay, surgery duration, as well as implant length and girth. RESULTS: Nine studies were included, comprising four cohort studies and five case series, involving a combined total of 278 patients. Total complications were higher in the delayed group (OR 4.16; 95% confidence interval [CI] 2.77 to 6.26). Fibrosis was significantly more pronounced in the delayed PP group, with an OR of 118.18 (95%CI 20.06 to 696.32). The odds of erosion, infections, and penile injury did not show statistically significant differences between the two groups (OR 2.52; 95%CI 0.67 to 9.49), (OR 0.89; 95%CI 0.38 to 2.10), and (OR 1.83; 95%CI 0.79 to 4.26), respectively. Patients' satisfaction resulted in a pooled OR of 0.15 (95%CI 0.04 to 0.49) in favor of the early PP insertion group. CONCLUSIONS: The findings of this study support the notion of addressing erectile dysfunction following ischemic priapism within an early window of 30 days. Nevertheless, it remains crucial to take into account patients' preferences, values, and psychological aspects in order to make a well-informed decision. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e976 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Ahmed Al Saeedi More articles by this author Mohamed Elmarasi More articles by this author Ibrahim Elmakaty More articles by this author Ibrahim Adnan More articles by this author Maya Aldeeb More articles by this author Kareim Khalafalla More articles by this author Ahmad Majzoub More articles by this author Mohamed Yamani More articles by this author Khalid Al Kubaisi More articles by this author Expand All Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.007 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".