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Biomedical subjects

Luis Reyes-Vallejo

Publications and source records attributed to Luis Reyes-Vallejo.

6 recordsLinked to original sources
PubMed2007

Outcomes and satisfaction rates for the redesigned 2-piece penile prosthesis.

PURPOSE: We evaluated long-term viability, quality of life and satisfaction with the redesigned 2 piece Ambicor inflatable penile prosthesis. This device underwent revision of the rear tip extender and reinforcement of the pump tubing connection to decrease fluid leak failure in 1998. MATERIALS AND METHODS: In this retrospective analysis we evaluated 146 men with erectile dysfunction at 2 centers who underwent device implantation between June 1999 and October 2004 with the redesigned prosthesis. Patient information forms were completed, including patient history, surgical information and revision data. Patients were mailed a modified Erectile Dysfunction Inventory of Treatment Satisfaction questionnaire, a modified Erectile Dysfunction Inventory of Treatment Satisfaction Partner survey and a questionnaire regarding pertinent inflatable penile prosthesis questions. RESULTS: A total of 146 men with a mean age of 58.7 years (range 25 to 78) were evaluated after inflatable penile prosthesis placement. Time from implant to followup was 3 to 73 months (mean 38). Only 1 device (0.7%) was removed due to infection. One implant (0.7%) was replaced due to fluid loss and 1 (0.7%) was revised due to improper sizing. Kaplan-Meier life table analysis indicated that the percent of patients free from reoperation was 99.2% at 12 months, 99.2% at 36 months and 91% at 48 months or greater. Of the 101 subjects completing the survey the average patient used the prosthesis 5 times monthly and 88.9% reported continued use. Of the patients 91% said that it was easy to use and 95% had little to no trouble learning to use it, while 84% stated that the inflatable penile prosthesis provided good to excellent rigidity for coitus. Overall patient and partner satisfaction was 85% and 76%, respectively. Of the patients 86% said that they would recommend the prosthesis to friends or if need be undergo the procedure again. CONCLUSIONS: The redesigned Ambicor 2-piece penile prosthesis appears to be safe and effective. It is associated with a low rate of revision as well as high patient and partner satisfaction.

Adult↗
PubMed2006

Subjective sexual response to testosterone replacement therapy based on initial serum levels of total testosterone.

INTRODUCTION: Testosterone replacement therapy (TRT) has been shown to be beneficial for men with hypogonadism. However, it is unknown how well hypogonadal men respond to TRT based on the severity of testosterone deficiency. AIM: To determine subjective sexual response rates to TRT based on initial serum testosterone values, with particular interest in men with "low-normal" levels of total testosterone (TT). MAIN OUTCOME MEASURES: Subjective responses to TRT in the domains of erectile dysfunction, libido, orgasm, and morning erections. METHODS: A retrospective study was performed of 211 men with sexual symptoms of hypogonadism who underwent TRT. All men had either low values of TT (<300 ng/dL) or free testosterone (FT) (<1.5 ng/dL). The cohort was divided into three groups based on initial TT levels: Group 1: 0-200 ng/dL (N = 26; 12.3%); Group 2: 201-300 ng/dL (N = 64; 30.3%); Group 3: 301 ng/dL or greater (N = 121; 57.3%). Improvement in erectile function was determined prior to addition of any other treatment (e.g., phosphodiesterase type 5 inhibitors). The mean follow-up was 9 months (range 3-36 months). RESULTS: The mean age was 55.2 years. Testosterone gel was used in approximately two-thirds of each group. Improvement in libido was reported in 61.5%, 96.6%, and 29.8% for Groups 1, 2, and 3, respectively (P < 0.001). Improvement in erectile function was noted in 46.2%, 45.3%, and 73.6% for Groups 1, 2, and 3, respectively (P < 0.001). At time of last follow-up, the percentage of men continuing with TRT was 73.1%, 57.8%, and 58.7% for Groups 1, 2, and 3, respectively (P = nonsignificant). CONCLUSIONS: These preliminary data suggest that men with sexual symptoms of hypogonadism respond well to TRT across a wide range of initial TT values, including men with low-normal TT levels. These men may have low bioavailable levels of testosterone that are not reflected in TT values.

Adult↗
PubMed2006

Phleboliths in varicoceles presenting as spermatic cord mass.

OBJECTIVE: To discuss the diagnosis and management of phleboliths in the dilated veins of a varicocele. DESIGN: Case report. SETTING: Two healthy patients in an academic andrology center. PATIENT(S): Two healthy patients undergoing evaluation and treatment of male factor infertility. INTERVENTION(S): Ultrasonography and varicocele repair. MAIN OUTCOME MEASURE(S): Improvement in male factor infertility. RESULT(S): One patient had a phlebolith diagnosed ultrasonographically by echogenicity and acoustic shadowing within a dilated vein of a varicocele. Another patient had a hard mass found within a dilated vein of a varicocele at the time of surgical repair. CONCLUSION(S): A hard rounded mass within a spermatic vein identified at surgery or sonographically within the veins of the spermatic cord should be considered a phlebolith. Decisions regarding treatment depend on clinical presentation.

Adult↗
PubMed2006

Wide variability in laboratory reference values for serum testosterone.

INTRODUCTION: The laboratory determination of testosterone levels consistent with a diagnosis of hypogonadism is complicated by the availability of multiple testosterone assays and varying reference ranges. AIM: To assess current laboratory practices regarding availability of testosterone assays and use of reference values. METHODS: A telephone survey of 12 academic, 12 community medical laboratories, and one national laboratory. MAIN OUTCOME MEASURES: Types of androgen assays offered and determination of reference values. RESULTS: All of the academic and eight of the community centers performed total testosterone testing. Free testosterone was performed in-house by six of the 12 academic and one community center. Testing for bioavailable testosterone, free androgen index, and percent free testosterone was performed in-house by no more than two centers. There were eight and four different assays used for total and free testosterone, respectively. One national laboratory offered equilibrium dialysis measurement of free testosterone. Of the 25 labs, there were 17 and 13 different sets of reference values for total and free testosterone, respectively. The low reference value for total testosterone ranged from 130 to 450 ng/dL (350% difference), and the upper value ranged from 486 to 1,593 ng/dL (325% difference). Age-adjusted reference values were applied in four centers for total testosterone and in seven labs for free testosterone. All reference values were based on a standard statistical model without regard for clinical aspects of hypogonadism. Twenty-three of the 25 lab directors responded that clinically relevant testosterone reference ranges would be preferable to current standards. CONCLUSIONS: Laboratory reference values for testosterone vary widely, and are established without clinical considerations.

Androgens↗
PubMed2006

Technical advances in penile prostheses.

Despite the introduction of oral phosphodiesterase inhibitors, penile prostheses continue to be an important form of treatment for erectile dysfunction (ED). Penile prostheses are associated with high satisfaction rates due to their ease of use, reliability, and ability to provide excellent rigidity. Advances over the last decade include steps to reduce mechanical failures and surface coatings to prevent prosthetic infections. These advances make the penile prosthesis an excellent option for the treatment of ED, particularly for men who fail oral therapy.

Erectile Dysfunction↗