Dennis H. Kim

Review of the Surgical Approaches for Peyronie's Disease: Corporeal Plication and Plaque Incision with Grafting

The understanding and management of Peyronies disease (PD) has improved but elucidating the exact etiology of the disease has yet to be achieved. In this paper, we review the historical and clinical aspects of PD. We focus on the evolution of surgical management for PD and review recent published articles that compare popular surgical techniques such as plication and plaque incision with vein graft. These two techniques have been reported to be equivalent with respect to patient satisfaction; however, each technique has its own advantages and disadvantages.

Penile corporeal reconstruction during difficult placement of a penile prosthesis.

For some patients with impotence and concomitant severe tunical/corporeal tissue fibrosis, insertion of a penile prosthesis is the only option to restore erectile function. Closing the tunica over an inflatable penile prosthesis in these patients can be challenging. We review our previous study which included 15 patients with severe corporeal or tunical fibrosis who underwent corporeal reconstruction with autologous rectus fascia to allow placement of an inflatable penile prosthesis. At a mean follow-up of 18 months (range 12 to 64), all patients had a prosthesis that was functioning properly without evidence of separation, herniation, or erosion of the graft. Sexual activity resumed at a mean time of 9 weeks (range 8 to 10). There were no adverse events related to the graft or its harvest. Use of rectus fascia graft for coverage of a tunical defect during a difficult penile prosthesis placement is surgically feasible, safe, and efficacious.

Bowel perforation following blunt trauma to a vaginal vault prolapse

Vaginal vault prolapse is a type of pelvic organ hernia that can occur following hysterectomy. It is common to Wnd parts of the bladder or small bowel within the prolapse. This is then respectively called cystocele or enterocele [6]. Patients typically seek treatment for symptoms related to voiding, bowel, and/or sexual dysfunction. Additionally, patients may be alarmed by the presence of a prolapse and seek treatment. Not surprisingly, trauma to a prolapsed vaginal vault with signiWcant injury to its contents is very rare. We report a rare case of bowel perforation following blunt trauma to a chronically prolapsed vaginal vault to illustrate the need for a high index of suspicion and a systematic approach to exclude signiWcant injury even after rather seemingly minimal trauma has occurred.

Unusual Presentations of Female Urinary Incontinence

We present 2 unusual cases of severe urgency and urge in-continence resistant to conservative therapy. Detailed work-up revealed unusual bladder pathology.