
Giulio GaraffaUniversity College London Hospitals NHS Foundation Trust | uclh · Department of Urology
Giulio Garaffa
MD PhD FECSM FRCS(Eng)
About
246
Publications
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Introduction
Additional affiliations
January 2013 - present
June 1999 - December 2001
October 2012 - December 2015
Publications
Publications (246)
Nesbit’s procedure remains a cornerstone in surgical management of Peyronie’s disease, despite the subjective loss of penile length. This retrospective study demonstrates that the perceived length loss has already occurred prior to surgery and that the Nesbit’s procedure does not produce additional loss of length. Ninety-one patients who had underg...
Peyronie’s disease (PD) is a connective tissue disorder characterized by the formation of fibrous plaques in the tunica albuginea of the penis which can result in pain, deformity and erectile dysfunction (ED). The Peyronie’s Disease Questionnaire (PDQ) assesses the severity of symptoms, including pain, penile curvature and ED, as well as the impact...
Background/objectives:
Peyronie's disease (PD) is a connective tissue disorder characterized by the formation of fibrous plaques in the tunica albuginea of the penis, resulting in pain, deformity, and erectile dysfunction. The Peyronie's Disease Questionnaire (PDQ) assesses the severity of symptoms, including pain, penile curvature, and erectile dy...
Introduction
Fournier’s Gangrene (FG) has still a mortality rate up to 45%. Several studies identified prognostic factors but there is a knowledge gap concerning procalcitonin (PCT) levels and mortality risk in FG. This study is aimed to assess the role of PCT as prognostic factor in FG.
Materials and methods
The medical records of 20 male FG pati...
Introduction and objectives
Impending erosion is an unusual complication of inflatable penile prosthesis that can strongly impact on patient’s morbidity and quality of life. In this case report we present a salvage surgery technique for impending erosion performed in a 57-year-old man.
Materials and methods
We present our surgical technique for cy...
Peyronie's disease (PD) is a condition characterized by the deposition of scar tissue in the tunica albuginea of the penis. Peyronie's disease often causes pain, worsens the quality of erections, a variable degree of penile deformation and shortening, which can cause severe distress for the patient and the partner and impact negatively on self-este...
Introduction
Patients with Peyronie's disease may experience significat distress. The choice of treatment depends on a variety of factors, including the stage of the disease, the presence of pain, severity and direction of the curvature, penile length and the quality of erectile function.
Aim
To review the evidence associated with surgical treatme...
The term scrotoplasty embraces several techniques which aim to restore a normal scrotal appearance and function. We provide here a quick reference tool to allow the urologist to select the appropriate surgical strategy among the several available options. A comprehensive research was carried out on MEDLINE/PubMed to identify relevant studies concer...
The management of loss of penile length and end-stage erectile dysfunction represents a challenge for reconstructive andrologists, as penile size is one of the main determinants of patients’ satisfaction after surgery. Different strategies for simultaneous length restoration and penile prosthesis (PP) implantation have been described so far with sa...
Vaginoplasty in Male to Female (M to F) transgenders is a challenging procedure, often accompanied by numerous complications. Nowadays the most commonly used technique involves inverted penile and scrotal flaps. In this paper the data of 47 M to F patients who have undergone sex affirmation surgery at the Department of Urology of the University of...
We aimed to provide an overview of the strategies available to manage patients concerned about their penile size and to provide useful surgical hints regarding the most common penile enlargement approaches, based on our surgical expertise in this field. A comprehensive research was carried out on MEDLINE/PubMed database to identify pertinent studie...
BACKGROUND: Abdominopelvic computer tomography (CT) is widely used in the follow up of seminoma patients after radical orchidectomy. The aim of this study is to evaluate the clinical utility of abdominopelvic computer tomography in the follow-up of patients with Stage I seminoma. METHODS: The pathological reports of all patients that have undergone...
Objective: To examine the impact and effects of the COVID-19 pandemic on urology practice around the world through
examination of published literature and personal experiences.
Subjects and methods: A literature search of EMBASE and MEDLINE was performed with search terms including “urology”,
“coronavirus”, “covid-19”, “impact” and “outcome”. All a...
Objectives
To analyze the impact of South Asia’s first cadaveric hands‐on workshop on urologists’ training in inflatable penile prosthesis surgery.
Methods
A total of 72 urologists/andrologists participated in the 2019 South Asian Society for Sexual Medicine Pre‐congress Penile Prosthesis hands‐on workshop. The workshop included 4 h of lectures an...
Previous studies have shown that the injection of adipose stem cells and stromal vascular fraction(SVF) into the tunica albuginea (TA) during the inflammatory phase in a rat model of Peyronie’s disease(PD) prevented the development of TA fibrosis. Our aim was to investigate whether local injection of SVF can reduce established fibrosis in a rat mod...
Purpose:
No questionnaire is currently available to evaluate sexual function after male to female (MtF) gender affirming surgery. Such a limit leads to a suboptimal evaluation in post-operative sexual function in these patients. We aimed at developing and validating a new questionnaire, the operated Male to Female Sexual Function Index (oMtFSFI),...
Purpose:
To compare the efficacy and safety of intralesional hyaluronic acid (HA) as compared with verapamil injection in patients with Peyronie's disease (PD).
Materials and methods:
Between January 2015 and December 2018, men in PD acute phase were prospectively recruited. This open-label, prospective study included 2 different protocols. Grou...
Objective
To determine those patient groupings, based on volume and risk, whose optimal urethral reconstructive management might be provided by a reorganisation of UK reconstructive surgeons.
Methods
Between 2010 and 2017, ~689 men/year were enrolled onto an online audit platform collecting data about urethral reconstruction in the UK; this accrua...
There is limited scientific literature regarding the management outcomes for end-stage erectile dysfunction (ED) following radical cystoprostatectomy (RCP). This study aims to evaluate the surgical outcomes of penile prosthesis (PP) implantation. A retrospective analysis over 17 years (2004–2017) was performed from the clinical records of patients...
To date several conditions may require a total phallic reconstruction (TPR). Among them, the most frequent are gender dysphoria, penile trauma, penile cancer and congenital micropenis.
Background:
Abdominopelvic computer tomography (CT) is widely used in the follow up of seminoma patients after radical orchidectomy. The aim of this study is to evaluate the clinical utility of abdominopelvic computer tomography in the follow-up of patients with Stage I seminoma.
Methods:
The pathological reports of all patients that have underg...
Introduction:
To date, several aspects of inflatable penile prosthesis (IPP) surgical procedure have been poorly studied.
Aim:
The aim of this study was to review the evidence associated with IPP implantation and provide clinical recommendations on behalf of the European Society for Sexual Medicine (ESSM). Overall, 130 peer-reviewed studies and...
Several strategies to optimize penile length in the presence of Peyronie’s Disease (PD) have been described so far. In case of severe curvature and preserved erectile function, plaque incision/excision (PIG/PEG) are advisable in order to maximize penile length, despite the risk of postoperative erectile dysfunction (ED), recurrent curvature, or pen...
Objective: The purpose of this study was to provide a detailed analysis of surgical and functional outcomes after correction of acquired buried penis in the adult.
Materials and Methods: From 2006 to 2016, we retrospectively reviewed 47 patients undergoing surgical treatment for the correction of buried penis. Functional and surgical outcomes, as...
Introduction:
Ischemic priapism (IP) is the most common form of priapism. In cases of priapism persisting for >36 hours, conservative management usually fails, and the patients' erectile tissue will be inevitably compromised, resulting in corporal fibrosis, shortening of the penis, and refractory erectile dysfunction. In this subset of patients, e...
Background:
The purpose of this study is to assess the impact of paternal age on the oocyte-donation outcomes in intracytoplasmic sperm injection (ICSI) cycles.
Methods:
Two hundred and seventy-eight infertile couples were retrospectively involved. Inclusion criteria were: infertility from almost 1 year, normal or sub-fertile seminal parameters,...
Objective
To assess whether the “testicular pool” could be used for histological analysis and whether it gave more accurate information than the standard testicular biopsy.
Methods
Between January 2017 and March 2018, this single-center prospective study included 60 azoospermic men undergoing conventional bilateral testicular sperm extraction. Six...
Introduction
Previous studies have shown that the injection of adipose tissue–derived stem cells (ADSCs) into the tunica albuginea (TA) during the active phase of Peyronie’s disease (PD) prevents the development of fibrosis.
Aim
To investigate, using an animal model, whether local injection of human ADSCs (hADSCs) can alter the degree of fibrosis...
Objective
To investigate whether local injection of autologous adipose stromal vascular fraction (SVF) can prevent the development of fibrosis and elastosis in the tunica albuginea (TA) using a rat model of the acute phase of Peyronie's disease (PD).
Methods
A total of 24 male 12‐week‐old Sprague–Dawley rats were divided into three equal groups: s...
Peyronie’s disease (PD) was first described by Francois de la Peyronie (1678–1747), who reported a series of patients with “rosary beads of scar tissue” causing curvature of the penis. Peyronie’s Disease is an acquired benign fibrotic disorder involving the tunica albuginea (TA) of the corpora cavernosa of the penis leading to the formation of fibr...
Introduction:
Peyronie's disease (PD) affects up to 9% of the male population. PD causes scarring of the tunica albuginea of the penis which leads to penile deformity making sexual intercourse difficult or impossible. PD also causes significant psychological, emotional and relationship difficulties for both patient and partner. Up until the licenc...
Background:
Collagenase Clostridium histolyticum (CCH; Xiapex) injections represent the only licensed medical treatment for Peyronie's disease (PD).
Aim:
To evaluate the efficacy and safety of CCH injections in men with stable PD, using a modified treatment protocol and to assess partners' bother improvement in a large cohort of White-European s...
Background:
Although many grafts have been used for plaque incision with grafting (PIG) and penile prosthesis (PP) implantation, there is no evidence that favors 1 specific graft over another.
Aim:
To compare fibrin-coated collagen fleece (TachoSil; Baxter International, Deerfield, IL, USA) with porcine small intestinal submucosa (SIS; Cook Biot...
Introduction:
The study was aimed to assess the presence of actual differences between the objective and the perceived magnitude of a curvature between patients affected by Peyronie's disease (PD) and congenital penile curvature (CPC).
Materials and methods:
Wee analysed a cohort of 88 consecutive patients seeking medical help for either CPC or...
This chapter gives an overview of genital reconstructive surgery that is available for trans-males in the UK, but the methods and rationales can be easily applied to any other country offering similar surgery. Some techniques that are not available in the UK have also been included for completeness. The discussion is specifically oriented to the va...
Purpose of Review
The aim of this manuscript is to systematically review the current literature on surgical management of the short penis, focusing on surgical and functional outcomes and postoperative complications.
Recent Findings
Penile size still represents a major concern among a large proportion of men regardless of age and socio-cultural ba...
Peyronie's disease (PD) is a common condition which results in penile curvature making sexual intercourse difficult or impossible. Collagenase clostridium histolyticum (CCH) is the first licensed drug for the treatment of PD and is indicated in patients with palpable plaque and curvature deformity of at least 30° of curvature. However, only few mon...
Objective
To review the current literature on early penile prosthesis implantation in patients with refractory ischemic priapism (IP).
Acquisition of evidence
A systematic search for the terms “penile prosthesis”, “priapism”, “impotence”, “fibrosis”, “downsized prosthesis cylinders”, and “patient satisfaction” has been carried out in PubMed, EMBAS...
Objectives:
To assess the oucomes of penile prosthesis (PP) implantation after total phallic reconstruction secondary to gender dysphoria (GD).
Subject/patients and methods:
We conducted a retrospective single center analysis of 247 consecutive patients. The recruitment time was between January 2001 and October 2015. A total of 328 inflatable PP...
Introduction:
Because of the low incidence of penile fracture, many aspects of the diagnostic process and of the surgical and functional outcomes are rarely reported.
Aim:
To systematically review the current literature on the surgical management of penile fracture, focusing on etiology, diagnosis, functional outcomes, and postoperative complica...
Objectives
The aim of the present manuscript is to review the current literature on priapism, focusing on the state-of-the-art knowledge of both the diagnosis and the treatment of the refractory ischemic priapism (IP).
Methods
Pubmed and EMBASE search engines were used to search for words “priapism”, “refractory priapism”, “penile prosthesis”, “di...
Objectives:
To assess the prevalence of OSA in men presenting with ED at a single centre.
Subjects and methods:
All men attending a specialised andrology outpatient department with a new diagnosis of erectile dysfunction were included in this prospective study. All patients completed 3 questionnaires: International Index of Erectile Function (II...
There are very few reported cases of traumatic amputation of the male genitalia due to animal bite. The management involves thorough washout of the wounds, debridement, antibiotic prophylaxis, tetanus and rabies immunization followed by immediate reconstruction or primary wound closure with delayed reconstruction, when immediate reconstruction is n...
Objective:
To review the current literature on early penile prosthesis implantation in patients with refractory ischemic priapism (IP).
Acquisition of evidence:
A systematic search for the terms "penile prosthesis", "priapism", "impotence", "fibrosis", "downsized prosthesis cylinders", and "patient satisfaction" has been carried out in PubMed, E...
Objective: The aim of this study was to report surgical and functional outcomes in patients who underwent immediate penile fracture repair following location of the tunical tear with ultrasonography.
Methods: Patients’ clinical notes from September 2005 to October 2015 were reviewed. The inclusion criteria were the documented presence of an albugin...