Wayne JG Hellstrom

Tulane University Medical Center · Dept of Urology

Introduction As the population ages, the prevalence of age-related hypogonadism is expected to rise. Demand for testosterone replacement therapy (TRT) has increased, as evidenced by revenue from T prescriptions in the world increasing from $150 million USD in 2000 to $1.8 billion in 2011. A market research analysis shows the market for T was 10.9 b...

Introduction The incidence of Peyronie's disease (PD) is 4% in the U.S. male population. Many PD patients also suffer from erectile dysfunction (ED). The etiology of ED incidence in PD men is not known, although veno-occlusive dysfunction (VOD) is often suggested. It is important to appreciate the influence of VOD in PD patients with ED, especially...

Introduction The IMPRESS trial revealed that intralesional collagenase clostridium histolyticum, Xiaflex, is safe and efficacious for treating the physical and subjective effects of Peyronie’s Disease (PD). However, little is known about the other manifestations of PD, namely penile shortening and efficacy for patients of diverse racial backgrounds...

Background: Management options for Peyronie’s disease (PD) are determined by the phase of the condition. Experts counsel against surgical intervention during the active phase of PD. Patients with chronic phase of PD are offered either collagenase injections or surgical intervention. Accurately characterising a patient’s phase of PD is crucial in de...

Introduction Penile prosthesis is a durable and effective treatment for erectile dysfunction (ED). Even as other treatment options for ED have been brought to market, penile prosthetic surgery remains a mainstay for urologists treating ED. No systematic study has yet summarized the global trends in penile prosthetic surgery. Objective To systemati...

Introduction Low-intensity extracorporeal shockwave therapy (Li-ESWT) is postulated to have physiologic effects including neo-angiogenesis, upregulation of vasoactive endothelial growth factors, nerve recovery, reduction of fibrotic changes, cavernosal tissue remodeling, and reduction in sympathetic tone. To date, randomized clinical trials have fa...

Introduction Penile prosthesis is a durable and effective treatment for erectile dysfunction (ED). Even as other treatment options for ED have been brought to market, penile prosthetic surgery remains a mainstay for urologists treating ED. No systematic study has yet summarized the global trends in penile prosthetic surgery. Objective To systemati...

Introduction One of the main complaints of patients with Peyronie's Disease (PD), besides the curvature, is penile shrinkage. Both deformities result in significant distress to the patient and his partner. XIAFLEX has been developed to treat Peyronie's plaques with substantial improvement of the curvature in the IMPRESS TRIAL. Objective In this st...

Introduction Peyronie's Disease (PD) is characterized by physical deformity in the penis that often has a negative impact on the sexual relationship of the patient and his partner. The International Index of Erectile Function (IIEF) is a standardized patient questionnaire used to measure various aspects of erectile performance and the severity of e...

Introduction Peyronie's Disease (PD) is a localized disease of the Tunica albuginea (TA) characterized by the formation of fibrotic plaque. Patients with PD present with erectile dysfunction (ED) up to 32% of the time. We have presented in previous studies that the most common etiology of ED in this population is vascular leak characterized by elev...

Introduction The etiology of the uncommon presentation of persistent genital arousal disorder (PGAD) can provide an insight into the hormonal imbalances that effect sexual function and dysfunction in females. We examine, review, and analyze the correlation of the known cases of PGAD that involved hormonal imbalances with a focus on hormone imbalanc...

Introduction Low-intensity extracorporeal shockwave therapy (Li-ESWT) may have physiologic effects including neo-angiogenesis, upregulation of vasoactive endothelial growth factors, nerve recovery, reduction of fibrotic changes, cavernosal tissue remodeling, and reduction in sympathetic tone. Collagenase clostridium histolyticum (CCH) is the only U...

Introduction: Forensic urology is the sub-specialty of urology that focuses on dialectic applications of urology, especially in cases of rape and sexual offense, personal injury to the genitals, and paternity assessments.

The management of erectile dysfunction has made tremendous strides over the past four decades, owing to concomitant advances in our understanding of the complex neurovascular, hormonal, and psychologic processes involved in penile erectile. The field has transitioned from predominantly psychotherapy-based management to focused treatment modalities...

Premature ejaculation (PE) is the most common form of male sexual dysfunction across all age groups. PE is associated with negative psychological consequences including frustration, distress, and low self-confidence, which can create an obstacle while forming new partner relationships. Given the subjective and highly variable nature of sexual dysfu...

Understanding the etiology of inflatable penile prosthesis (IPP) infections can provide insight that can be utilized to develop better surgical techniques and other preventative measures to lower infection rates and reduce infection-related explantation rates. Limited data exists on the exact underlying mechanisms responsible for delayed-onset IPP...

Bioenvironmental Issues Affecting Men's Reproductive and Sexual Health is structured into two parts related to men's reproductive and sexual health with eight sections designed to enable a logical flow of such knowledge. The book is focused on the biology of key organs involved in male reproduction and the environmental influences affecting their f...

Introduction: Selective serotonin reuptake inhibitors (SSRIs) are a widely used class of drug. Post-SSRI sexual dysfunction (PSSD) is a condition in which patients continue to have sexual side effects after discontinuation of SSRI use. The prevalence of persistent sexual side effects after discontinuing SSRIs is unknown. The recognition and study...

Introduction: It is common for men to develop erectile dysfunction after radical prostatectomy. The anatomy of the rat allows the cavernous nerve (CN) to be identified, dissected, and injured in a controlled fashion. Therefore, bilateral CN injury (BCNI) in the rat model is routinely used to study post-prostatectomy erectile dysfunction. Aim: To...

Introduction: Erectile dysfunction (ED) is an important health concern that can significantly affect a man's psychosocial well-being. ED has traditionally been considered a disease of old age; however, contemporary evidence suggests a growing incidence of ED in men younger than 40 years. The process of achieving an erection is multifaceted; there...

Objective: To describe practice patterns in the diagnosis and treatment of hypogonadism, as the optimal approaches are controversial. Multiple therapeutic options are currently available for hypogonadal men and treatment patterns vary considerably. The safety of testosterone therapy (TTh) remains understudied. Methods: A 23-question survey regar...

Objective: To examine the safety of collagenase clostridium histolyticum (CCH) in adult males with penile curvature deformity <30°. Collagenase clostridium histolyticum is indicated for treatment of Peyronie's disease (PD) in adult males with palpable plaque and a penile curvature deformity ≥30° at start of therapy; however, during treatment, pati...

Objective: To elucidate patient characteristics that impact symptom-related bother and erectile function in patients with Peyronie's disease (PD). Methods: A post hoc analysis used data from patients with PD (ie, had PD symptoms ≥12 months and penile curvature deformity of 30-90 degrees) who received ≥1 injection of study medication in two phase...

Introduction: Peyronie's disease (PD) is a connective tissue disorder resulting in the abnormal accumulation of type I to III collagen, fibrin, and disorganized elastic fibers in the tunica albuginea of the penis. Many medical and non-pharmacologic modalities have been used in the treatment of PD; however, these approaches have proved largely inef...

The global prevalence of testosterone deficiency (TD) ranges from 10–40%. The actual diagnosis of TD is controversial, as a wide range of total testosterone (TT) thresholds are used for diagnosis (200–400 ng/dL), and physicians differ in their emphasis placed on clinical symptoms. There are also significant global differences in the prescription pa...

Domain 2 – penile pain.

Domain 1 – psychological and physical symptoms.

Domain 3 – symptom bother.

Introduction Peyronie's disease (PD) is a benign fibrotic disorder of the tunica albuginea of the penis, which can cause penile pain, curvature, shortening, erectile dysfunction, and psychological distress. Surgery is indicated when penile curvature prevents satisfactory sexual intercourse. Plaque incision or excision with grafting has been suggest...

Paige K Kuhlmann,1 Kenneth J DeLay,2 James Anaissie,2 Wayne JG Hellstrom,2 Faysal A Yafi3 1University of Missouri-Columbia School of Medicine, Columbia, MO, 2Department of Urology, Tulane University School of Medicine, New Orleans, LA, 3Department of Urology, University of California Irvine, Orange, CA, USA Abstract: The safety and efficacy of the...