Lawrence S. Hakim's research while affiliated with Cleveland Clinic and other places

Publications (20)

Article
Introduction Infection remains a prominent concern following penile implantation. Recognition of the risk factors for infection may help to guide surgeons toward reducing the risk of prosthetic contamination. Aim To gain a further understanding of infectious adverse events following penile prosthesis, we performed a systematic literature review....
Article
Introduction: Inadequate treatment of men with erectile dysfunction (ED) subjects them and their partners to lost quality of life, yet little is known about the cause and duration of symptoms that lead to penile prosthesis (PP) placement. Aim: We performed a systematic review addressing cause and duration of symptoms before implantation. Method...
Article
Full-text available
Purpose: The purpose of this guideline is to provide a clinical strategy for the diagnosis and treatment of erectile dysfunction. Materials & methods: A systematic review of the literature using the Pubmed, Embase, and Cochrane databases (search dates 1/1/1965 to 7/29/17) was conducted to identify peer-reviewed publications relevant to the diagn...
Article
Introduction: There has been renewed interest in the use of subcutaneous testosterone pellets for the treatment of hypogonadism since the introduction of Testopel in 2008 by Slate Pharmaceuticals (Durham, NC, USA). Manufacturer guidelines recommend using two to six pellets; however, in the clinical setting, this is deemed insufficient. This has pr...
Article
Full-text available
In August 2015, an expert colloquium commissioned by the Sexual Medicine Society of North America (SMSNA) convened in Washington, DC, to discuss the common clinical scenario of men who present with low testosterone (T) and associated signs and symptoms accompanied by low or normal gonadotropin levels. This syndrome is not classical primary (testicu...
Article
Introduction: Despite recent advances in our knowledge and treatment strategies in Peyronie's Disease (PD), much remained unknown about this disease. Aim: To provide a clinical framework and key guideline statements to assist clinicians in an evidence-based management of PD. Methods: A systematic literature search was conducted to identify pub...
Article
The purpose of this guideline is to provide a clinical framework for the diagnosis and treatment of Peyronie's disease (PD). A systematic review of the literature using the Pubmed, Embase, and Cochrane databases (search dates 1/1/1965 to 1/26/15) was conducted to identify peer-reviewed publications relevant to the diagnosis and treatment of PD. The...
Article
Erectile dysfunction (ED) impacts more than 50% of men older than 40 years; Peyronie disease (PD) affects up to 10% of men, with an adverse impact on normal sexual function and overall well-being. ED can also be the first sign of other underlying disease. The office-based evaluation of ED and PD is the first step in the management of these devastat...
Article
To issue a consensus document on the prevention, management, and research of infection associated with penile prostheses, as neither professional associations nor governmental entities have issued guidelines that are specific to this infection. Sixteen North American experts on infection of penile prostheses were identified and assembled to select...
Chapter
Peyronie’s disease is a common potency-threatening condition of male sexual dysfunction, occurring in 3–8% of men. While typically thought to be a result of injury during sexual activity, the underlying cause of Peyronie’s disease can vary and is not known in every situation. Clinical presentation may include a curved or bent penis, a palpable peni...
Chapter
The ultimate goal of penile rehabilitation is to minimize the physical and emotional impact of sexual dysfunction and loss of penile length postprostatectomy. This can only be accomplished by defining optimal management strategies for the treatment and possible prevention of these significant side effects. When considering the available objective d...
Chapter
Chronic pelvic pain syndrome/chronic prostatitis (CPPS) is a common condition in men, accounting for a significant number of visits to primary care physicians and urologists. Sexual dysfunction, including erectile dysfunction or ED, painful ejaculation and poor libido, as well as male factor infertility, are also commonly seen in this population an...
Article
Erectile dysfunction is increasingly common with advancing age, yet sexual activity and intimacy are important to elderly men. To assess the efficacy and tolerability of tadalafil in men over the age of 65 years. In this multicenter open-label study, 188 men (mean age = 71.6 years) who were over age 65 and did not have diabetes mellitus or clinical...
Article
We investigated the efficacy and safety of intralesional interferon alpha-2b for the treatment of Peyronie's disease. A total of 117 consecutive patients with a mean age of 55.1 years who had Peyronie's disease were enrolled in a single-blind, multicenter, placebo controlled, parallel study to determine the efficacy and safety of intralesional inte...

Citations

... Low-grade infection occurred in two (1.2%) patients. In literature, improvements of surgical techniques and appropriate antibiotic prophylaxis reduced infection risk to two-three percent in high-volume centers in low-risk patients, with further reduction of infection risk to one-two percent by implanting an antibiotic-impregnated prosthesis [14]. ...
... According to a systematic review, most men suffering from ED receiving a penile implant have an organic etiology of ED, the most common being a vasculogenic origin, diabetes, and previous pelvic surgery or trauma [9]. This correlates with the distribution in our study. ...
... The International Index of Erectile Function (IIEF) is a widely employed questionnaire in urology to assess ED in both clinical research and practice [12]. The IIEF was first developed by Rosen et al. in 1996 [13], and it consists of fifteen items, whose scores range from zero (or one) to five. ...
... The minimum effective dose of T pellets in men is around 750 mg to 900 mg, which has not been shown to be optimal for control of symptoms. 43 Also, lower dosing requires more frequent intervals of insertion, increasing patient expense, inconvenience, and discomfort. ...
... IHH is known to be a disease with complex genetics and interaction with environmental factors, which make it be variably expressed in different individuals (22,23). The mainstay treatment for patients with IHH is testosterone replacement therapy, sometimes in conjugation with other therapy like spermatogenesis-inducing therapy (12). ...
... 17,19 Over time, several authors have described different surgical approaches to address residual curvature during IPP placement. 2,17,18,[20][21][22][23][24][25] Currently, there is no a consensus on which adjuvant maneuver may guarantee the best outcomes. 17,21,23,[25][26][27] Overall, 4 categories of surgical procedures may be considered to address residual penile curvature during penile prosthesis implantation: ...
... These symptoms can have significant psychological impacts on patients, resulting in low self-esteem, relationship difficulties, and depression. 2,3 Currently, intralesional injections of collagenase Clostridium histolyticum, verapamil, and interferon α-2b are the only nonsurgical interventions recommended by the American Urological Association for patients with PD. 4 Of these, intralesional collagenase has the strongest evidence for efficacy and remains the sole injectable therapy for PD approved by the Food and Drug Administration. 4,5 Results from the IMPRESS (Investigation for Maximal Peyronie's Reduction Efficacy and Safety Studies) phase 3 clinical trials demonstrated a mean improvement in curvature deformity of 34% after a full round of 8 injections. ...
... 4 Most urologists support the logic of a combination of microtrauma during sexual activity in a susceptible case, which would lead to deregulation of the scarring process and formation of the plaque. [5][6][7] PD presents with 2 phases: the active phase, in which the penile deformity may vary with time and can last up to 18 months, and the stable phase, when the alteration of the penile form stabilizes. 8 Treatment for PD is individualized according to the phase of the disease. During the active phase, noninvasive treatments are used and a surgical procedure is reserved to treat penile deformities during the stable phase of PD. 9 Treatment choices include oral medications, topical agents, intralesional injections, mechanical stretching or vacuum devices, and recently, encouraging results from extra corporeal shockwave therapy (ESWT) and laser therapy were reported. ...
... Infection rates were 0% vs. 4% vs. 5% (p = 0.130) without post-surgical infectious complications, questioning the need for outpatient antibiotics [57]. Previous reviews mention that although in-hospital antibiotics should not last for more than 24 h, many surgeons use outpatient regimens of 5 to 14 days with different types of antibiotics such as sulfa, penicillin, quinolone, and cephalosporin [17,58]. Table 1 summarizes the most relevant aspects related to penile prosthetic infection events. ...
... 20 It is widely believed that VCD therapy is more acceptable among elderly patients with occasional sexual intimacy, as younger patients may show limited acceptance because of its perceived 'unnatural' erection. 21 Chen et al., conversely, reported that VCD therapy remained the preferred treatment option among couples who had achieved satisfactory erections with either VCDs and PDE 5 I. 22 VCD may also be used in conjunction with other therapies for synergistic effects. It has been reported that VCD therapy could be combined with PDE 5 I, 23 intracavernosal self-injection, 24,25 intraurethral therapy, 26 psychotherapy 27 and even penile prosthesis. ...