Malleable Penile Implant Is an Effective Therapeutic Option in Men With Peyronie's Disease and Erectile Dysfunction

BACKGROUND: The inflatable penile prosthesis (IPP) is typically the preferred implant for Peyronie's disease (PD) and malleable penile prostheses (MPPs) have been discouraged. Aims: To evaluate the effectiveness and patient satisfaction of the MPP vs IPP in patients with PD. METHODS: Men with PD and erectile dysfunction who elected for penile implant surgery constituted the study population. Preoperatively, demographic and comorbidity parameters were recorded. Curvature was measured with a goniometer at maximum rigidity after intracavernosal injection of a vasoactive agent. Postoperatively, overall satisfaction was measured at 3, 6, 12, and 24 months on 5-point Likert scale from 1 (dissatisfied) to 5 (very satisfied). RESULTS: 166 men with a mean age of 59 ± 10 years were analyzed. The mean preoperative curvature in the entire cohort was 65° (range = 30–130°). 94% of patients with MPP had total resolution of their curvature at the end of the operation, whereas 8 patients (6%) had residual curvature (25–40°). In the IPP group 25 of 30 (83.3%) had a straight penis at the end of surgery, whereas 5 of 30 (16.7%) had residual curvature, with the mean magnitude being 33° in the MPP group and 30° in the IPP group. 86% of all patients had diabetes. There were no differences between the 2 implant groups in age, hemoglobin A1c, body mass index, or smoking status. The mean patient satisfaction was 4.42 ± 0.70 (range = 2–5) and there was no difference between the 2 groups. The mean follow-up period was 23.4 months (range = 6–29 months). CONCLUSION: We found that the MPP is as effective as the IPP in curvature correction in patients with PD, with similar patient satisfaction for the 2 groups. Habous M, Farag M, Tealab A, et al. Malleable Penile Implant Is an Effective Therapeutic Option in Men With Peyronie's Disease and Erectile Dysfunction. Sex Med 2018;6:24–29

Non-linear Autoregressive Neural Networks to Forecast Short-Term Solar Radiation for Photovoltaic Energy Predictions

Nowadays, green energy is considered as a viable solution to hinder CO2 emissions and greenhouse effects. Indeed, it is expected that Renewable Energy Sources (RES) will cover 40% of the total energy request by 2040. This will move forward decentralized and cooperative power distribution systems also called smart grids. Among RES, solar energy will play a crucial role. However, reliable models and tools are needed to forecast and estimate with a good accuracy the renewable energy production in short-term time periods. These tools will unlock new services for smart grid management. In this paper, we propose an innovative methodology for implementing two different non-linear autoregressive neural networks to forecast Global Horizontal Solar Irradiance (GHI) in short-term time periods (i.e. from future 15 to 120min). Both neural networks have been implemented, trained and validated exploiting a dataset consisting of four years of solar radiation values collected by a real weather station. We also present the experimental results discussing and comparing the accuracy of both neural networks. Then, the resulting GHI forecast is given as input to a Photovoltaic simulator to predict energy production in short-term time periods. Finally, we present the results of this Photovoltaic energy estimation discussing also their accuracy

Predictors of Satisfaction in Men After Penile Implant Surgery

Introduction: Despite the high satisfaction with penile implant (PI) surgery reported in the literature, a significant proportion of patients remain dissatisfied. Aim: To evaluate satisfaction after PI surgery, using a single question and a scoring system. Furthermore, we attempted to define factors that predicted high patient satisfaction. Methods: The study population consisted of all patients undergoing PI surgery between 2009 and 2015. Comorbidity, demographic, and implant information were recorded. Complications recorded included: minor (requiring no re-operation) such as penile or scrotal hematoma, superficial wound breakdown; major (requiring hospitalization or re-operation) such as device infection, erosion, and mechanical malfunction. Patient satisfaction was defined using a single question posed to the patient 6 months after surgery using a 5-point Likert scale (5 being the most satisfied). Descriptive statistics were used to define complication rates and multivariable analysis (MVA) was performed to define predictors of high satisfaction (score ≥ 4), including presence and degree of complications, Peyronie's disease (PD), diabetes mellitus (DM), number of vascular comorbidities, body mass index (BMI) > 30, and patient age. Main Outcome Measure: Patients with a major complication, with or without an additional minor complication, had a higher likelihood of being dissatisfied (25%) compared to patients with no complication or only minor complication 1.9% (no complications) and 3.7% (only minor complications), P <.001. Results: 902 patients were analysed. Mean age was 56.6 ± 10.6 years. Mean BMI was 30 ± 5. Comorbidity profile was diabetes 75%, dyslipidaemia 44%, hypertension 33%, cigarette smoking 32%, and PD 34%. 76% had a malleable implant (MPP) and 24% an inflatable implant (IPP). 31% had a minor complication and 9% a major complication. 93% had high satisfaction (score ≥4). Patients with any complication had a reduced rate of high satisfaction (97.5% vs 87.7%; P <.001) and even more pronounced with a major complication (96.7% vs 64.2%; P <.001). On MVA, only the absence of a major complication was a significant predictor of high satisfaction (OR 20, 95% CI 9-50, P <.001). Conclusion: A high percentage of men are satisfied after penile implant surgery. Only the presence of a major complication is linked to a lower likelihood of achieving high satisfaction. Habous M, Tal R, Tealab A, et al. Predictors of Satisfaction in Men After Penile Implant Surgery. J Sex Med 2018;15:1180–1186