Penile Prosthesis the  BEST surgical treatment for ED in Lebanon

Penile Prosthesis the BEST surgical treatment for ED in Lebanon

Penile prosthesis

Definition

A penile prosthesis or Penile Implant is the best surgery that helps men with erectile dysfunctions when other treatments failed.

This procedure involves placing a prosthetic device or penile implant inside the penis and scrotum; so the patient can get a sufficient erection for sexual activities. And it lasts for 45 minutes to 1 hour under general or spinal anesthesia.

Penile implants are required when the medications are not efficient, and in some severe cases like Peyronie’s disease (fibrous scar tissue that develops on the penis and causes curved painful erections).

Follow the link for more information about Erectile Dysfunction.

 

Types of penile implants:

The patient should speak with his urologist to determine which implant is the best for him.

 

Type of penile implant

Advantages

Disadvantages

Three-piece inflatable

 -Natural and rigid erection.

-Provides flaccidity when deflated.

 

 -The implant may sometimes not be effective (because of the large number of its parts).

 -Requires the presence of a reservoir in the abdomen.

 

 

Two-piece inflatable

 -Provides flaccidity when deflated.

 -The fluid reservoir is part of the pump.

 -The erection is not firm enough.

Semirigid rod

 -Low chance of malfunction. ( due   to   the absence of the reservoir   and the   pump)

 – Easy to use.

 -Can be difficult to conceal under clothing.

 -a penis that is always slightly rigid.

 -possible difficulty with urination.

 

The inflatable implants required a pump inside the scrotum; so the patient should squeeze the pump to achieve an erection; the pump is located under the loose skin of the scrotal sac, between the testicles.

The device contains two chambers, and when the chambers are inflated by the pump; the patient then has an erection; when the patient is finished, he can deflate the device.

Follow the link for more details about the types of penile implants.

 

Which type of implant does the doctor choose?

There are several factors that the doctor put into consideration before deciding which implant will be the most suitable, including:

-The age of the man.

-Size of the penis, glans, and scrotum.

-Any history of previous abdominal or pelvic surgery.

-The presence of colostomy.

-A history of a kidney transplant.

-Whether or not the penis is circumcised.

-Health and well-being.

 Penile implants don’t increase sexual desire or sensation.

 

Who should not get an implant?

-patient with uncontrolled diabetes.

-presence of a pulmonary or urinary infection.

-bladder obstruction

-when the erectile dysfunction is the result of a relationship conflict (the cause should be medical).

 

Penile implant = LOW RISK

– Low risk of infection (1-3%).

-low risk of mechanical failure (95% working at 5 years).

 

Some TIPS before and after the surgery

Before the surgery you should:

– stop taking aspirin and anti-inflammatory drugs before 7 to 10 days.

– Stop eating or drinking after midnight before your surgery.

– Shave the surgery site.

After the surgery:

– Physical and sexual activities can be resumed after 4 or 6 weeks.

-the patient should take an antibiotic to prevent infection; and medications to ease the pain.

You should call your doctor if:

fresh and ongoing bleeding, significant discoloration of the penis, high fever, unable to urinate, cannot control pain, spreading redness, continuous drainage from the wound, progressive swelling of the penis, scrotum, or incision site.

 

Is the Prosthesis noticeable?

Men who have undergone the prosthesis surgery can notice the small surgical scar where the bottom of the penis meets the scrotal sac, or in the lower abdomen just above the penis, other people probably will be unable to know that a penile implant exists.

 

Finally, we believe that the penile implant is effective in its ability to restore the patient’s capacity to engage in sexual activities and regain what was lost due to a medical issue.

And the patient should not forget that ejaculation is not affected by this procedure.

 

 

 

 

 

Laparoscopic Radical Nephrectomy-14 cm tumor

This movie features a challenging laparoscopic left radical nephrectromy for a huge tumor compressing the aorta and overlying the kidney pedicle.

The procedure was successfully performed by Dr. Fouad Khoury with minimal blood loss and optimal post-operative results.

 

Fascinating Laparoscopic Sacrocolpopexy (Grade 4 Bladder Prolapse)

Fascinating Laparoscopic Sacrocolpopexy (Grade 4 Bladder Prolapse)

LAPAROSCOPIC SACROCOLPOPEXY

Laparoscopic Sacrocolpopexy, operated by Dr Fouad Khoury, in which he’s performing a laparoscopic pelvic organ prolapse repair. This video features anterior plane dissection for Grade 4 bladder prolapse using polyester mesh placement and fixation to sacral promontory.

NB: Posterior plane repair should always be done in those cases, however, in this particular case, the patient had a previous rectocele repair 2 years ago by vaginal approach with no signs of current rectocele.

For more inspiring information regarding this matter, please visit the following link to watch Bladder Prolapse.

 

 

For additional information concerning pelvic organ prolapse, please follow the link: https://moderncare.org/bladder-prolapse-lecture-afu-dr-fouad-khoury/

Extraordinary Laparoscopic Pyeloplasty (Left)

Extraordinary Laparoscopic Pyeloplasty (Left)

LAPAROSCOPIC PYELOPLASTY

Dr Fouad Khoury, a referral urologist in Lebanon and the Middle East, performing pyeloplasty for UPJ stenosis. This video features step by step approach along with captions for successful and smooth completion of pyeloplasty operation, with antegrade intra operative JJ insertion.

The procedure was performed using 2x5mm and 2x10mm trocars. Smooth dissection of colon and identification of ureter and enlarged kidney pelvis. Once the proximal ureter is dissected without jeopardizing its blood supply, division and excision of UPJ stenosis. As you see, very minimal cauterization used in order to prevent scarring and possible re stenosis at anastomosis site. Therefore working in an oozing field should be tolerated in those cases.

Meticulous anastomosis was done using vicryl 4.0 starting with the posterior plane, followed by antegrade JJ 6Fr * 26cm inserted over guidewire. Once the JJ is placed, the anterior plane is completed using vicryl 4.0.

For the full-length procedure of the mentioned pyeloplasty surgery, please check the corresponding video on our channel Laparoscopic Pyeloplasty Full Length.

For another smooth Nephro-ureterectomy, please visit the following link to watch https://moderncare.org/laparoscopic-nephroureterectomy-left/

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