Aim: To report our experience with penile girth augmentation using liquid injectable silicone. Methods: Between August 2003 and July 2006, 324 men (mean age 35 years, range 19-65 years) received a series of liquid silicone subcutaneous injections between the penile skin and the corpora cavernosa on the dorsal and lateral aspects of the penile shaft, under local anesthesia. Digital photographs taken pre- and post-procedure (n = 324), and penile contour measurements (n = 30) yielded objective results. Subjective results were derived from patient and partner testimony of satisfaction. Follow-up averaged 20 months (range 1-36 months). Results: Three hundred and twenty-four procedures were primary augmentations. Most men (61%) were married, 7% were accompanied by their partners,and 93% were circumcised. The mean measured penile circumference was 9.5 cm (7.5-11.5 cm) pretreatment and 12.1 cm (10.3-15.3 cm) post-treatment (mean increase of 27% in circumference and 0.84 cm in diameter). Patient and partner satisfaction was already expressed after the first two treatments. Sexual activity could be resumed after 8 h. Complications (mild bruising) were easily resolved. Conclusion: Penile girth augmentation using liquid injectable silicone yields very satisfactory short-term results with no immediate or short-term complications.

Urinary stress incontinence (USI) is more common in obese women. The influence of obesity on surgical treatment for USI is controversial. We sought to determine whether obesity affects the outcome of the tension-free vaginal tape (TVT) procedure. The retrospective data of 81 women that underwent the TVT procedure between 04/1998 and 12/2000 were studied. The study cohort women (aged 37–87 years) were subdivided into three groups according to body mass index (BMI): normal (BMI = <25)—group 1, overweight (BMI = 25–29)—group 2, and obese (BMI = >30)—group 3. All women underwent preoperative examinations, including detailed medical history and physical examination with stress tests and urodynamic studies. Follow-up included post-procedure check-up meetings at 1, 3, 6, and 12 months and once yearly thereafter (minimal follow-up = 52 months). Intra- and postoperative complications and success rates were compared among the three groups. Twenty-six (32.1%) women had normal BMI, 21 (25.9%) were overweight, and 34 (42%) were obese. Six intraoperative complications were recorded, including 5 bladder injuries and 1 urethral injury, none of which required surgical re-intervention. Eight reported postoperative complications included 1 bladder erosion, 3 urethral obstructions, 4 vaginal erosions (1 patient suffered from concomitant urethral obstruction and vaginal erosion). Five patients diagnosed with postoperative surgical complications underwent corrective surgery. There were no significant inter-group differences among the complication rates. The success rates were 84.6%, 81%, and 79.4% in groups 1, 2, and 3 respectively. Increased BMI may have a slight negative impact on TVT results, but the long-term success rate of 79.4% in obese women and the lack of any direct correlation between BMI and complications sanction their undergoing TVT.

PURPOSE The tension-free vaginal tape (TVT) procedure is a recent modality for managing female stress urinary incontinence. While this procedure is rapidly gaining popularity worldwide, little has been written about its complications. We describe our experience with diagnosing and treating tape related complications following the TVT procedure. MATERIALS AND METHODS During the last 4 years 12 patients underwent and 1 is scheduled for additional surgery for complications resulting from the TVT. Another patient is only being observed. Their records were reviewed to retrieve data on presenting symptoms and signs, diagnostic tests, surgical procedures and outcomes. RESULTS One patient had tape erosion into the bladder, 5 had vaginal tape erosion (concomitant urethral obstruction in 1) and another 8 had an obstructed urethra. The more common presenting symptoms were persistent urethral pain, recurrent urinary tract infection, urgency, urge incontinence and vaginal discharge. A total of 12 patients required partial tape removal or tape incision, which was done transvaginally in 11. The remaining patient underwent cystotomy and excision of the intravesical part of an eroded tape. One patient is awaiting corrective surgery and 1 with asymptomatic vaginal erosion is only being observed. No formal urethrolysis was performed in any case. Mean followup after corrective surgery in 12 patients was 4.8 months (range 1 to 30), during which 10 remained continent and all 12 were symptom-free. CONCLUSIONS Urologists should be aware of the nature and symptoms of tape related complications associated with a TVT procedure for prompt diagnosis and appropriate postoperative management.

PURPOSE:The tension-free transvaginal tape (TVT) procedure has apparently become the most popular technique for genuine stress urinary incontinence (GSUI). Long-term followup data on the outcome of the procedure are sparse. We evaluated the long-term results of TVT for treating women with GSUI.MATERIALS AND METHODS:We performed a retrospective analysis of the records of 55 patients 37 to 83 years old (mean age 63.4) with GSUI, for which they underwent the TVT procedure at our department as of December 1999.RESULTS:Of the 52 patients who were followed a mean of 55 months (range 48 to 65) 41 (78.9%) were dry. There were 4 intraoperative complication (7.3%), including bladder injury in 3 patients and urethral injury in 1. None required surgical re-intervention. Urgency was reported in 6 women (11.5%). There were 5 postoperative tape related complications (9.6%), consisting of bladder erosion in 1 woman, vaginal erosion in 2 and an obstructed urethra in 2. Four of these 5 women underwent corrective surgery, after which all remained dry.CONCLUSIONS:TVT is a safe and effective procedure for female stress urinary incontinence with an enduring, high success rate. There is a significant rate of intraoperative complications, which do not cause further problems when identified and treated during surgery. One must be alert to the significant rate of postoperative complications that usually require repeat surgery, which is relatively simple and causes practically no long-term morbidity. It also does not influence the continence rate in most cases.

No AccessJournal of UrologyClinical Urology: Original Articles1 Feb 1999LONG-TERM INCIDENCE OF ACUTE MYOCARDIAL INFARCTION AFTER OPEN AND TRANSURETHRAL RESECTION OF THE PROSTATE FOR BENIGN PROSTATIC HYPERPLASIAis corrected byERRATUM MOSHE SHALEV, SANTIAGO RICHTER, ODED KESSLER, BARUCH SHPITZ, BRIAN FREDMAN, and ISRAEL NISSENKORN MOSHE SHALEVMOSHE SHALEV More articles by this author , SANTIAGO RICHTERSANTIAGO RICHTER More articles by this author , ODED KESSLERODED KESSLER More articles by this author , BARUCH SHPITZBARUCH SHPITZ More articles by this author , BRIAN FREDMANBRIAN FREDMAN More articles by this author , and ISRAEL NISSENKORNISRAEL NISSENKORN More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)61931-1AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Acute myocardial infarction was found to be the main cause of increased long-term mortality in patients after transurethral compared to open prostatectomy in various retrospective studies. We performed a randomized prospective study to compare morbidity and incidence of acute myocardial infarction in patients after transurethral compared to open prostatectomy for benign prostatic hyperplasia. Materials and Methods: We studied 365 patients who were assigned to transurethral (236) or open (129) prostatectomy only according to the size of the prostate and who were followed for 7 to 8 years. The clinical status of the patients in both groups before and after the operation was compared, and the rate of myocardial infarction and long-term mortality was studied. Results: More patients with a history of cerebrovascular accident (5.4 versus 0.8%) and indwelling catheters (16.3 versus 7.6%) before the operation were in the open prostatectomy group. Among the 236 patients operated on transurethrally 31 were reoperated on (6 more than once) during followup compared to 4 of the 129 patients who underwent open prostatectomy. In 15 patients from the transurethral prostatectomy group myocardial infarction developed compared to 9 patients in the open prostatectomy group. This difference was not statistically significant. The rate of acute myocardial infarction after prostatectomy, no matter which approach was used, was greater than 6% and it appeared to be higher when compared to the rate of infarction in the general population of the same age group, which is approximately 2.5% in our county. There was no statistically significant difference in the overall mortality rate between the transurethral and open prostatectomy groups, which was 14.4 and 8.5% respectively. Conclusions: Open prostatectomy is more effective in overcoming urinary obstruction than the transurethral approach. No significant differences in myocardial infarction or overall mortality rates were found between the 2 groups. References 1 : Mortality and reoperation after open and transurethral resection of the prostate for benign prostatic hyperplasia. New Engl. J. Med.1989; 320: 1120. Google Scholar 2 : An assessment of prostatectomy for benign urinary tract obstruction. Geographic variations and the evaluation of medical care outcomes. J.A.M.A.1988; 259: 3027. Google Scholar 3 : A population-based study of prostatectomy: outcomes associated with differing surgical approaches. J. Urol.1987; 137: 1184. Link, Google Scholar 4 : Further study of the increased mortality following transurethral prostatectomy: a chart-based analysis. J. Urol.1990; 144: 224. Link, Google Scholar 5 : Effect of irrigating fluids and prostatic tissue extract on isolated cardiomyocytes. Urology1995; 46: 821. Google Scholar 6 : Late cardiac effects of dotorubicin therapy for acute lymphoblastic leukemia of childhood. New Engl. J. Med.1991; 324: 808. Google Scholar 7 : Functional myocardial impairment in children treated with anthracyclines for cancer. Lancet1991; 337: 816. Google Scholar 8 : Hemoglobin, plasma lipids and coronary heart disease. Amer. Heart J.1973; 86: 842. Google Scholar 9 : Haematologic parameters as risk factors for cardiac infarct in an occupational health care setting. J. Clin. Epidemiol.1988; 41: 67. Google Scholar From the Departments of Urology and Anesthesiology, Meir General Hospital, Kfar Saba and Tel Aviv University Sackler School of Medicine, Tel-Aviv, Israel© 1999 by American Urological Association, Inc.FiguresReferencesRelatedDetailsRelated articlesJournal of Urology9 Nov 2018ERRATUM Volume 161Issue 2February 1999Page: 491-493 Advertisement Copyright & Permissions© 1999 by American Urological Association, Inc.MetricsAuthor Information MOSHE SHALEV More articles by this author SANTIAGO RICHTER More articles by this author ODED KESSLER More articles by this author BARUCH SHPITZ More articles by this author BRIAN FREDMAN More articles by this author ISRAEL NISSENKORN More articles by this author Expand All Advertisement PDF downloadLoading ...

Conclusions Open prostatectomy is more effective in overcoming urinary obstruction than the transurethral approach. No significant differences in myocardial infarction or overall mortality rates were found between the 2 groups.