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TIME TO PEAK FLOW ON PENILE DOPPLER ULTRASOUND DOES NOT PREDICT FLOW PARAMETERS
Vol. 179, No. 4, Supplement, Monday, May 19, 2008
form. These outlier patients were nevertheless included in the above analysis (Figure 1). CONCLUSIONS: Despite the fact that the IIEF covers additional domains (i.e., sexual desire) that the IIEF-5 does not, our results suggest that a clinician can infer with reasonable certainty what a patient’s IIEF score would be by administering only the IIEF-5.
THE JOURNAL OF UROLOGY®
363
not reach peak systolic velocity until 10-25 minutes. Any shortening of the test can potentially decrease accuracy in detecting PSV in many patients. Source of Funding: None
Infertility, Impotence & Erectile Dysfunction, New Technology and Didactic Urological Videos Video Session 4 Monday, May 19, 2008
Figure 1. Correlation between IIEF and IIEF-5 scores. Source of Funding: None
1053 TIME TO PEAK FLOW ON PENILE DOPPLER ULTRASOUND DOES NOT PREDICT FLOW PARAMETERS Wayland Hsiao*, Donald Pham, Chad W M Ritenour. Atlanta, GA. INTRODUCTION AND OBJECTIVE: Penile Doppler ultrasound is a common tool used in the evaluation of erectile dysfunction (ED). Traditionally, vascular measurements have been taken for a period of time after the injection of an erectogenic agent. We performed a retrospective review of patients to see if time to highest peak systolic YHORFLW\ 369 ZDVDXVHIXOSUHGLFWRURIDGHTXDWHDUWHULDOÀRZIRUHUHFWLRQ GH¿QHGDV369!FPV METHODS: We conducted a retrospective review of 63 penile Doppler ultrasounds performed for either erectile dysfunction or Peyronies 'LVHDVH 3' HYDOXDWLRQ$OOSDWLHQWVUHFHLYHGDVWDQGDUGL]HGLQMHFWLRQRI prostaglandin E1, and penile Doppler ultrasounds were performed using GE ultrasound machines with licensed ultrasonographers. RESULTS: Of the 63 patients, 18 patients (29%) had highest PSV at 1-5 minutes after injection, 13 patients (21%) at 10 minutes, 10 patients (16%) at 15 minutes, 14 patients (22%) at 20 minutes, and 8 patients (13%) at 25 minutes. Patients were divided into two groups with WKH¿UVWREWDLQLQJKLJKHVW369LQPLQXWHVRUOHVV SDWLHQWV and the second group obtaining highest PSV greater than 10 minutes after injection (32 patients, 51%). Mean ages were similar in both groups (55 years old ± 12 years, p=0.97) as was percentage of patients with 3H\URQLH¶V'LVHDVHZHUHVLPLODU :KHQÀRZFKDUDFWHULVWLFVZHUH FRPSDUHGSDWLHQWV LQWKH¿UVWJURXSDQGSDWLHQWV in the second group had highest PSV >30cm/s (p=0.35). There was no difference in mean highest PSV between the groups (42.5 cm/s vs. 42.2 cm/s for groups 1 and 2, respectively, p = 0.957) and no difference in mean dorsal vein diastolic velocity (p=0.46). Total IIEF erectile function domain score, IIEF question 3, and IIEF question 4 scores were similar in both groups (p=0.663, p=0.81 and p=0.71, respectively) and did not predict time to highest PSV. &21&/86,216 7LPH WR KLJKHVW 369 ZKHQ VWUDWL¿HG E\ less than or greater than 10 minutes did not predict cavernosal artery PSV >30 cm/s or venous leak. There was no difference in mean highest PSV between the two groups. In addition, a validated erectile function TXHVWLRQQDLUHGLGQRWVLJQL¿FDQWO\SUHGLFWWLPHWRKLJKHVW369RUSHDN ÀRZ7KHUHIRUHWLPHWRSHDNÀRZLVQRWDXVHIXOSDUDPHWHUIRUPHDVXULQJ RXWFRPHVRISHQLOH'RSSOHUXOWUDVRXQG7KRXJKWLPHWRSHDNÀRZGLG QRWVLJQL¿FDQWO\SUHGLFWÀRZYHORFLW\SDUDPHWHUVKDOIRIRXUSDWLHQWVGLG
1:00 - 3:00 pm
V1054 PENILE PROSTHESIS PROXIMAL CROSS-OVER CASE USING “NO- TOUCH TECHNIQUE” DRAPE AND EXPOSURE Jean Francois Eid*. New York, NY. INTRODUCTION AND OBJECTIVE: To highlight merit of the 1R7RXFKWHFKQLTXHDQRYHODSSURDFKIRULQÀDWDEOHSHQLOHSURVWKHVLV implantation (IPP). Penile implant surgery has grown over the past 30 years. The concept of isolating the skin from the IPP during implantation is based on the fact that regardless on how well the skin is prepared and LQFLVLRQH[SRVXUHLVFUHDWHGVFURWDOYVLQIUDSXELFLQIHFWLRQVGRRFFXU usually due to skin bacteria. We discovered the novel technique of inserting an IPP through a small opening in a sterile drape allowing placement of an entire IPP without skin contact. The No Touch technique may assist in the reduction of IPP infection. METHODS: A decrease in bacterial count rather than the total absence of bacteria that accounts for the success of an IPP implantation. Through consistent technique and use of a 3M 1012 drape, a traditional scrotal incision is created and exposure provided, yet the patient’s skin is not exposed. This review displays a common challenge in IPP surgery the proximal crossover of an IPP. We identify the proximal crossover and are rapidly able to remove and replace cylinders with ample exposure via No Touch technique. RESULTS: This review displays ability for intra-op remedy of a proximal crossover during IPP. No additional time or instrumentation is required. Superior exposure was maintained using the No Touch technique. Commonly, during IPP implantation, adjustment or removal/repositioning of the implant may occur. In traditional cases, the prosthesis would potentially contact the skin on numerous occasions. Also, the pump (pre-connected to WKHF\OLQGHUV ZRXOGUHVWRQWKHVFURWDOVNLQIRUDVLJQL¿FDQWSHULRGZKLOH the cylinders are re-inserted and the corporotomy closed. Such exposure to skin contact is eliminated by the No Touch technique. CONCLUSIONS: The No Touch technique for IPP implantation is a useful alternative to traditional IPP operative technique and may potentially reduce opportunity for infection. Performing the procedure with intra-op challenges (such as proximal crossover), are possible with this drape and allow for complete placement of all IPP components (cylinders, pump and reservoir) to be placed without touching the skin.
Source of Funding: Coloplast Corp.
form. These outlier patients were nevertheless included in the above analysis (Figure 1). CONCLUSIONS: Despite the fact that the IIEF covers additional domains (i.e., sexual desire) that the IIEF-5 does not, our results suggest that a clinician can infer with reasonable certainty what a patient’s IIEF score would be by administering only the IIEF-5.
THE JOURNAL OF UROLOGY®
363
not reach peak systolic velocity until 10-25 minutes. Any shortening of the test can potentially decrease accuracy in detecting PSV in many patients. Source of Funding: None
Infertility, Impotence & Erectile Dysfunction, New Technology and Didactic Urological Videos Video Session 4 Monday, May 19, 2008
Figure 1. Correlation between IIEF and IIEF-5 scores. Source of Funding: None
1053 TIME TO PEAK FLOW ON PENILE DOPPLER ULTRASOUND DOES NOT PREDICT FLOW PARAMETERS Wayland Hsiao*, Donald Pham, Chad W M Ritenour. Atlanta, GA. INTRODUCTION AND OBJECTIVE: Penile Doppler ultrasound is a common tool used in the evaluation of erectile dysfunction (ED). Traditionally, vascular measurements have been taken for a period of time after the injection of an erectogenic agent. We performed a retrospective review of patients to see if time to highest peak systolic YHORFLW\ 369 ZDVDXVHIXOSUHGLFWRURIDGHTXDWHDUWHULDOÀRZIRUHUHFWLRQ GH¿QHGDV369!FPV METHODS: We conducted a retrospective review of 63 penile Doppler ultrasounds performed for either erectile dysfunction or Peyronies 'LVHDVH 3' HYDOXDWLRQ$OOSDWLHQWVUHFHLYHGDVWDQGDUGL]HGLQMHFWLRQRI prostaglandin E1, and penile Doppler ultrasounds were performed using GE ultrasound machines with licensed ultrasonographers. RESULTS: Of the 63 patients, 18 patients (29%) had highest PSV at 1-5 minutes after injection, 13 patients (21%) at 10 minutes, 10 patients (16%) at 15 minutes, 14 patients (22%) at 20 minutes, and 8 patients (13%) at 25 minutes. Patients were divided into two groups with WKH¿UVWREWDLQLQJKLJKHVW369LQPLQXWHVRUOHVV SDWLHQWV and the second group obtaining highest PSV greater than 10 minutes after injection (32 patients, 51%). Mean ages were similar in both groups (55 years old ± 12 years, p=0.97) as was percentage of patients with 3H\URQLH¶V'LVHDVHZHUHVLPLODU :KHQÀRZFKDUDFWHULVWLFVZHUH FRPSDUHGSDWLHQWV LQWKH¿UVWJURXSDQGSDWLHQWV in the second group had highest PSV >30cm/s (p=0.35). There was no difference in mean highest PSV between the groups (42.5 cm/s vs. 42.2 cm/s for groups 1 and 2, respectively, p = 0.957) and no difference in mean dorsal vein diastolic velocity (p=0.46). Total IIEF erectile function domain score, IIEF question 3, and IIEF question 4 scores were similar in both groups (p=0.663, p=0.81 and p=0.71, respectively) and did not predict time to highest PSV. &21&/86,216 7LPH WR KLJKHVW 369 ZKHQ VWUDWL¿HG E\ less than or greater than 10 minutes did not predict cavernosal artery PSV >30 cm/s or venous leak. There was no difference in mean highest PSV between the two groups. In addition, a validated erectile function TXHVWLRQQDLUHGLGQRWVLJQL¿FDQWO\SUHGLFWWLPHWRKLJKHVW369RUSHDN ÀRZ7KHUHIRUHWLPHWRSHDNÀRZLVQRWDXVHIXOSDUDPHWHUIRUPHDVXULQJ RXWFRPHVRISHQLOH'RSSOHUXOWUDVRXQG7KRXJKWLPHWRSHDNÀRZGLG QRWVLJQL¿FDQWO\SUHGLFWÀRZYHORFLW\SDUDPHWHUVKDOIRIRXUSDWLHQWVGLG
1:00 - 3:00 pm
V1054 PENILE PROSTHESIS PROXIMAL CROSS-OVER CASE USING “NO- TOUCH TECHNIQUE” DRAPE AND EXPOSURE Jean Francois Eid*. New York, NY. INTRODUCTION AND OBJECTIVE: To highlight merit of the 1R7RXFKWHFKQLTXHDQRYHODSSURDFKIRULQÀDWDEOHSHQLOHSURVWKHVLV implantation (IPP). Penile implant surgery has grown over the past 30 years. The concept of isolating the skin from the IPP during implantation is based on the fact that regardless on how well the skin is prepared and LQFLVLRQH[SRVXUHLVFUHDWHGVFURWDOYVLQIUDSXELFLQIHFWLRQVGRRFFXU usually due to skin bacteria. We discovered the novel technique of inserting an IPP through a small opening in a sterile drape allowing placement of an entire IPP without skin contact. The No Touch technique may assist in the reduction of IPP infection. METHODS: A decrease in bacterial count rather than the total absence of bacteria that accounts for the success of an IPP implantation. Through consistent technique and use of a 3M 1012 drape, a traditional scrotal incision is created and exposure provided, yet the patient’s skin is not exposed. This review displays a common challenge in IPP surgery the proximal crossover of an IPP. We identify the proximal crossover and are rapidly able to remove and replace cylinders with ample exposure via No Touch technique. RESULTS: This review displays ability for intra-op remedy of a proximal crossover during IPP. No additional time or instrumentation is required. Superior exposure was maintained using the No Touch technique. Commonly, during IPP implantation, adjustment or removal/repositioning of the implant may occur. In traditional cases, the prosthesis would potentially contact the skin on numerous occasions. Also, the pump (pre-connected to WKHF\OLQGHUV ZRXOGUHVWRQWKHVFURWDOVNLQIRUDVLJQL¿FDQWSHULRGZKLOH the cylinders are re-inserted and the corporotomy closed. Such exposure to skin contact is eliminated by the No Touch technique. CONCLUSIONS: The No Touch technique for IPP implantation is a useful alternative to traditional IPP operative technique and may potentially reduce opportunity for infection. Performing the procedure with intra-op challenges (such as proximal crossover), are possible with this drape and allow for complete placement of all IPP components (cylinders, pump and reservoir) to be placed without touching the skin.
Source of Funding: Coloplast Corp.