A.N. Christopher

The immediate insertion of a penile prosthesis for acute ischaemic priapism.

BACKGROUNDnIschaemic priapism (IP), which is refractory to conventional medical and surgical intervention, results in necrosis of the corpus cavernosum smooth muscle. These patients eventually develop a variable degree of corporal smooth muscle fibrosis that presents as erectile dysfunction and penile shortening.nnnOBJECTIVESnTo evaluate the long-term outcome of patients who have undergone the immediate insertion of a penile prosthesis as a treatment for an acute episode of IP refractory to medical therapy or shunt surgery.nnnDESIGN, SETTING, AND PARTICIPANTSnA total of 50 patients presented with prolonged IP that was unresponsive to conventional treatment. Unsuccessful shunt surgery had been performed in 13 patients. All patients had evidence of cavernosal smooth muscle necrosis and, therefore, underwent an immediate insertion of a penile prosthesis in the acute setting.nnnMEASUREMENTSnMean age, duration of priapism in hours, intraoperative and postoperative complications, the surgical outcome, and patients satisfaction were recorded.nnnRESULTS AND LIMITATIONSnA malleable penile prosthesis was inserted in 43 patients and a three-piece inflatable implant in was inserted in 7 patients; a subsequent elective exchange of a malleable to an inflatable device was performed in 6 patients. After a median follow-up of 15.7 mo (4-60 mo), 42 patients had already resumed successful sexual intercourse. Prosthesis infection occurred in three patients (6%), which was managed by explantation and delayed reinsertion. A further six patients needed revision surgery. No patient complained of penile shortening, and the overall satisfaction rate was 96%.nnnCONCLUSIONSnThe immediate insertion of a penile prosthesis for acute refractory ischaemic priapism is a simple and successful procedure that treats the acute episode as well as the inevitable erectile dysfunction that will occur with preservation of penile length.

Ability, demography, learning style, and personality trait correlates of student preference for assessment method

More than 400 students from four universities in America and Britain completed measures of learning style preference, general knowledge (as a proxy for intelligence), and preference for examination method. Learning style was consistently associated with preferences: surface learners preferred multiple choice and group work options, and viewed essay‐type and dissertation options less favourably. Deep learners, on the other hand, favoured essay‐type and oral exams as well as final dissertations. Males favoured oral (viva voce) exams and females coursework assessment. Extraverts preferred multiple choice, oral, and group work assessment, while openness was positively associated with essays and oral exams but negatively associated with multiple choice and group work. Regression analysis showed that personality, learning style, general knowledge, and demographic factors accounted for 5–10% of the variance in preferred examination technique. Results in part replicate earlier studies and are discussed in terms of changes in examination methods.

Sleep disorders in patients with Erectile Dysfunction

To assess the prevalence of obstructive sleep apnoea (OSA) in men presenting with erectile dysfunction (ED) at a single centre.

Outcomes of inflatable penile prosthesis insertion in 247 patients completing female to male gender reassignment surgery

To assess the oucomes of penile prosthesis (PP) implantation after total phallic reconstruction secondary to gender dysphoria.