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Background: Erectile dysfunction (ED) is a common disorder, which affects at least 50% of males aged 50-70 years. According to EAU Guidelines on male sexual dysfunction, implantation of an inflatable penile prosthesis (IPP) is a valid, third-line therapeutic option for treatment of ED. Objective: We conducted a retrospective single centre study to analyze mechanical reliability, complication rate, patient satisfaction and quality of life after penile prosthesis implantation. Materials and Methods: A total of 126 electronic patient files after primary implantation of an IPP during a 5-year period were investigated. A structured telephone interview concerning patient and partner satisfaction was conducted at least 1 year after implant surgery. Results: We found that 15 patients (11.9%) had revision surgery for various reasons. Mechanical failure occurred in 7.14% of the patients and was the main reason for revision surgery. Other major complications and complaints were loss of penile length (18.53%), postoperative pain (11.9%) and altered sensation (8.73%). No patients required explantation for infection, and 1 patient (0.79%) underwent revision surgery for an imminent erosion. One year or more after surgery, the patient and partner satisfaction rates, were 83.2 and 85.4%, respectively. We observed very high patient and partner satisfaction rates for the implantation of an IPP, with improvement of the general quality of life. These rates are negatively influenced by the occurrence of postoperative complications and complaints such as postoperative penile length shortening, pain and floppy glans syndrome. Most patients regain sexual function 6 weeks after surgery with no or minimal effect on the orgasm. Conclusion: The implantation of a 3-piece IPP has proven an effective, third-line treatment for patients with ED.

Purpose Antibiotic prophylaxis is standard procedure in transurethral resection of the prostate (TURP). We evaluated the necessity of antibiotic (AB) prophylaxis in TURP due to increasing microbial antibiotic resistance. Methods This is a prospective cohort study of 506 patients. Only patients with a pre-operative catheter/pyuria received ABprophylaxis. Urine analysis (pre-operative, at discharge, and 3 week post-operative) was performed next to an analysis of the blood culture/irrigation fluid and of the resected prostatic tissue. Statistical analysis was performed using Fisher's exact test. Results 67/506 (13.2%) patients received prophylactic antibiotics. 56/67 (83.5%) patients had a pre-operative catheter and 11/67 (16.4%) had pre-operative pyuria in which a fluoroquinolone-resistance (FQ-R) rate of 69.2% in Escherichia coli (EC) was observed. Clinical infectious symptoms were present in 13/439 (2.9%) patients without antibiotic prophylaxis; 12/439 (2.7%) patients had uncomplicated fever (<38.5°) during or after hospitalization and only 1/439 patient (0.2%) was high degree fever (> 38.5°) observed. Uncomplicated fever developed in 7/67 (10.4%) patients who did receive AB-prophylaxis. FQ-R was observed in 60% of the positive urine cultures at discharge and in 53.8% 3 week post-operatively. Conclusions Our data show a low infectious complication rate (2.9%) in patients without a pre-operative catheter or pyuria,undergoing TURP without AB-prophylaxis. These findings might question the current use of AB prophylaxis in TURP in patients without a pre-operative catheter or pyuria, in times of antibiotic stewardship due to the high rate of microbial-resistance in our population.

Objective: To investigate the relationship between the severity of histopathological prostatic inflammation with lower urinary tract symptoms and prostate specific antigen (PSA) levels. Methods: We prospectively included 222 consecutive patients eligible for transurethral resection of the prostate in a non-academic referral center by a single surgeon. Patients with proven urinary tract infection or prostate cancer were excluded. Preoperative assessment included PSA levels, International Prostate Symptom Score (IPSS), mean peak flow, mean resected prostate weight and post-residual volume. Finally, the presence and severity of inflammation was determined histopathologically. Results: Mean patient age was 69.1 ± 8.6 years with mean preoperative PSA levels of 4.7 ± 5.4 ng/mL and IPSS of 15.7 ± 6.9. Mean peak flow was 10.7 ± 6.5 ml/s and the mean resected prostate weight 39.4 ± 27.3 g. Positive correlations between PSA (log) and prostate weight (r = 0.54, p < 0.001) and between PSA (log) and active (r = 0.30, p < 0.0001) and chronic inflammation (r = 0.19, p = 0.005) were observed. No correlations were found between IPSS and PSA (log) (r = -0.14, p = 0.040) or between IPSS and active inflammation (p = 0.659) or chronic inflammation (p = 0.125). Conclusion: The study showed a weak correlation between PSA and the active or chronic inflammation. It also showed that there was no correlation between the active or chronic histopathological inflammation and IPSS.