<?xml version="1.0" encoding="UTF-8" ?>
<oai_dc:dc schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
<dc:title>A Novel Penile Splint as Early Traction Therapy After Grafting Techniques for Peyronie's Disease.</dc:title>
<dc:creator>Fernández Pascual, Esaú</dc:creator>
<dc:creator>Manfredi, Celeste</dc:creator>
<dc:creator>Cocci, Andrea</dc:creator>
<dc:creator>Egui Rojo, María Alejandra</dc:creator>
<dc:creator>Carballido Rodríguez, Joaquín</dc:creator>
<dc:creator>Martínez Salamanca, Juan Ignacio</dc:creator>
<dc:subject>Early Traction Therapy</dc:subject>
<dc:subject>Penile Traction Therapy</dc:subject>
<dc:subject>Penile splint</dc:subject>
<dc:subject>Peyronie’s disease</dc:subject>
<dc:subject>Penile shortening</dc:subject>
<dc:description>Background Some studies showed encouraging results on the efficacy and safety of penile traction therapy after Peyronie's disease (PD) surgery. The early traction therapy (ETT) could be an effective and safe approach to minimize penile shortening in patients undergoing PD surgery. Aim To evaluate the feasibility, efficacy, and safety of a novel penile splint as ETT in patients with PD undergoing grafting techniques. Methods Patients with PD underwent plaque incision and grafting technique; at the end of the procedure, a novel penile splint (ETT) was applied to all patient. The device consisted of 2 10CH intubating stylets, self-adapted to each patient, that kept the penis stretched with the aid of non-absorbable sutures. The total expense for the materials needed to build each penile splint was less than 15 euros. This active traction was maintained for 1–3 weeks; then, we removed the stitches leaving the device on-site for a passive traction. Within 3–4 weeks from surgery, the penile splint was replaced by a standard penile traction device. Outcomes The main outcomes evaluated at 6 months included stretched penile length (SPL), penile curvature, International Index of Erectile Function-erectile function (IIEF-EF) domain, patient satisfaction, and time to first satisfactory sexual intercourse. Results A total of 46 patients were enrolled. The median preoperative IIEF-EF, penile curvature, and SPL were 27 points, 70°, and 13 cm, respectively. The median follow-up was 15 months. The median postoperative IIEF-EF was 25 points (P < .001). The median residual penile curvature was 10° (P < .001). The median postoperative SPL was 13 cm (P = .269). 8 patients (17.4%) lost 1 cm of SPL; no shortening greater than 1 cm was recorded. The median time to first satisfactory sexual intercourse and patient satisfaction score was 6 weeks and 9 points, respectively. Clinical Implications Our results could pave the way for a new line of research, which in turn could lead to an improvement in the postoperative management of the patient undergoing surgery for PD. Strength & Limitations This is the first study evaluating the ETT after PD surgery. The main limitation of this study is the lack of a randomized control group. Other weaknesses are the small sample size and the short follow-up time. Conclusion Our novel penile splint is inexpensive, easy to assemble, and adaptable to the patient. ETT using this novel device, followed by standard traction therapy, seems to be feasible, effective, and safe.</dc:description>
<dc:description>pre-print</dc:description>
<dc:description>449 KB</dc:description>
<dc:date>2021-07-21T07:41:45Z</dc:date>
<dc:date>2021-07-21T07:41:45Z</dc:date>
<dc:date>2020</dc:date>
<dc:type>article</dc:type>
<dc:identifier>1743-6095</dc:identifier>
<dc:identifier>http://hdl.handle.net/10641/2346</dc:identifier>
<dc:identifier>10.1016/j.jsxm.2020.05.009</dc:identifier>
<dc:language>eng</dc:language>
<dc:relation>https://www.jsm.jsexmed.org/article/S1743-6095(20)30644-5/fulltext</dc:relation>
<dc:rights>Atribución-NoComercial-SinDerivadas 3.0 España</dc:rights>
<dc:rights>http://creativecommons.org/licenses/by-nc-nd/3.0/es/</dc:rights>
<dc:rights>openAccess</dc:rights>
<dc:publisher>The Journal of Sexual Medicine</dc:publisher>
</oai_dc:dc>
<?xml version="1.0" encoding="UTF-8" ?>
<d:DIDL schemaLocation="urn:mpeg:mpeg21:2002:02-DIDL-NS http://standards.iso.org/ittf/PubliclyAvailableStandards/MPEG-21_schema_files/did/didl.xsd">
<d:DIDLInfo>
<dcterms:created schemaLocation="http://purl.org/dc/terms/ http://dublincore.org/schemas/xmls/qdc/dcterms.xsd">2021-07-21T07:41:45Z</dcterms:created>
</d:DIDLInfo>
<d:Item id="hdl_10641_2346">
<d:Descriptor>
<d:Statement mimeType="application/xml; charset=utf-8">
<dii:Identifier schemaLocation="urn:mpeg:mpeg21:2002:01-DII-NS http://standards.iso.org/ittf/PubliclyAvailableStandards/MPEG-21_schema_files/dii/dii.xsd">urn:hdl:10641/2346</dii:Identifier>
</d:Statement>
</d:Descriptor>
<d:Descriptor>
<d:Statement mimeType="application/xml; charset=utf-8">
<oai_dc:dc schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
<dc:title>A Novel Penile Splint as Early Traction Therapy After Grafting Techniques for Peyronie's Disease.</dc:title>
<dc:creator>Fernández Pascual, Esaú</dc:creator>
<dc:creator>Manfredi, Celeste</dc:creator>
<dc:creator>Cocci, Andrea</dc:creator>
<dc:creator>Egui Rojo, María Alejandra</dc:creator>
<dc:creator>Carballido Rodríguez, Joaquín</dc:creator>
<dc:creator>Martínez Salamanca, Juan Ignacio</dc:creator>
<dc:subject>Early Traction Therapy</dc:subject>
<dc:subject>Penile Traction Therapy</dc:subject>
<dc:subject>Penile splint</dc:subject>
<dc:subject>Peyronie’s disease</dc:subject>
<dc:subject>Penile shortening</dc:subject>
<dc:description>Background Some studies showed encouraging results on the efficacy and safety of penile traction therapy after Peyronie's disease (PD) surgery. The early traction therapy (ETT) could be an effective and safe approach to minimize penile shortening in patients undergoing PD surgery. Aim To evaluate the feasibility, efficacy, and safety of a novel penile splint as ETT in patients with PD undergoing grafting techniques. Methods Patients with PD underwent plaque incision and grafting technique; at the end of the procedure, a novel penile splint (ETT) was applied to all patient. The device consisted of 2 10CH intubating stylets, self-adapted to each patient, that kept the penis stretched with the aid of non-absorbable sutures. The total expense for the materials needed to build each penile splint was less than 15 euros. This active traction was maintained for 1–3 weeks; then, we removed the stitches leaving the device on-site for a passive traction. Within 3–4 weeks from surgery, the penile splint was replaced by a standard penile traction device. Outcomes The main outcomes evaluated at 6 months included stretched penile length (SPL), penile curvature, International Index of Erectile Function-erectile function (IIEF-EF) domain, patient satisfaction, and time to first satisfactory sexual intercourse. Results A total of 46 patients were enrolled. The median preoperative IIEF-EF, penile curvature, and SPL were 27 points, 70°, and 13 cm, respectively. The median follow-up was 15 months. The median postoperative IIEF-EF was 25 points (P < .001). The median residual penile curvature was 10° (P < .001). The median postoperative SPL was 13 cm (P = .269). 8 patients (17.4%) lost 1 cm of SPL; no shortening greater than 1 cm was recorded. The median time to first satisfactory sexual intercourse and patient satisfaction score was 6 weeks and 9 points, respectively. Clinical Implications Our results could pave the way for a new line of research, which in turn could lead to an improvement in the postoperative management of the patient undergoing surgery for PD. Strength & Limitations This is the first study evaluating the ETT after PD surgery. The main limitation of this study is the lack of a randomized control group. Other weaknesses are the small sample size and the short follow-up time. Conclusion Our novel penile splint is inexpensive, easy to assemble, and adaptable to the patient. ETT using this novel device, followed by standard traction therapy, seems to be feasible, effective, and safe.</dc:description>
<dc:date>2021-07-21T07:41:45Z</dc:date>
<dc:date>2021-07-21T07:41:45Z</dc:date>
<dc:date>2020</dc:date>
<dc:type>article</dc:type>
<dc:identifier>1743-6095</dc:identifier>
<dc:identifier>http://hdl.handle.net/10641/2346</dc:identifier>
<dc:identifier>10.1016/j.jsxm.2020.05.009</dc:identifier>
<dc:language>eng</dc:language>
<dc:relation>https://www.jsm.jsexmed.org/article/S1743-6095(20)30644-5/fulltext</dc:relation>
<dc:rights>http://creativecommons.org/licenses/by-nc-nd/3.0/es/</dc:rights>
<dc:rights>openAccess</dc:rights>
<dc:rights>Atribución-NoComercial-SinDerivadas 3.0 España</dc:rights>
<dc:publisher>The Journal of Sexual Medicine</dc:publisher>
</oai_dc:dc>
</d:Statement>
</d:Descriptor>
<d:Component id="10641_2346_1">
</d:Component>
</d:Item>
</d:DIDL>
<?xml version="1.0" encoding="UTF-8" ?>
<dim:dim schemaLocation="http://www.dspace.org/xmlns/dspace/dim http://www.dspace.org/schema/dim.xsd">
<dim:field authority="1ee9fd93-9f6b-4094-8767-72d397745af3" confidence="600" element="contributor" mdschema="dc" qualifier="author">Fernández Pascual, Esaú</dim:field>
<dim:field authority="fa299e8c-82ed-425e-adfc-1af8bfb5f412" confidence="600" element="contributor" mdschema="dc" qualifier="author">Manfredi, Celeste</dim:field>
<dim:field authority="fe4a814b-efb5-47e8-b121-16078ccbc89d" confidence="600" element="contributor" mdschema="dc" qualifier="author">Cocci, Andrea</dim:field>
<dim:field authority="1f5432dc-a409-41c8-a122-cc6c7eb823d4" confidence="600" element="contributor" mdschema="dc" qualifier="author">Egui Rojo, María Alejandra</dim:field>
<dim:field authority="7641c15d-421b-4d73-9770-57e0b016b705" confidence="600" element="contributor" mdschema="dc" qualifier="author">Carballido Rodríguez, Joaquín</dim:field>
<dim:field authority="210" confidence="600" element="contributor" mdschema="dc" qualifier="author">Martínez Salamanca, Juan Ignacio</dim:field>
<dim:field element="date" mdschema="dc" qualifier="accessioned">2021-07-21T07:41:45Z</dim:field>
<dim:field element="date" mdschema="dc" qualifier="available">2021-07-21T07:41:45Z</dim:field>
<dim:field element="date" mdschema="dc" qualifier="issued">2020</dim:field>
<dim:field element="identifier" lang="spa" mdschema="dc" qualifier="issn">1743-6095</dim:field>
<dim:field element="identifier" mdschema="dc" qualifier="uri">http://hdl.handle.net/10641/2346</dim:field>
<dim:field element="identifier" lang="spa" mdschema="dc" qualifier="doi">10.1016/j.jsxm.2020.05.009</dim:field>
<dim:field element="description" lang="spa" mdschema="dc" qualifier="abstract">Background Some studies showed encouraging results on the efficacy and safety of penile traction therapy after Peyronie's disease (PD) surgery. The early traction therapy (ETT) could be an effective and safe approach to minimize penile shortening in patients undergoing PD surgery. Aim To evaluate the feasibility, efficacy, and safety of a novel penile splint as ETT in patients with PD undergoing grafting techniques. Methods Patients with PD underwent plaque incision and grafting technique; at the end of the procedure, a novel penile splint (ETT) was applied to all patient. The device consisted of 2 10CH intubating stylets, self-adapted to each patient, that kept the penis stretched with the aid of non-absorbable sutures. The total expense for the materials needed to build each penile splint was less than 15 euros. This active traction was maintained for 1–3 weeks; then, we removed the stitches leaving the device on-site for a passive traction. Within 3–4 weeks from surgery, the penile splint was replaced by a standard penile traction device. Outcomes The main outcomes evaluated at 6 months included stretched penile length (SPL), penile curvature, International Index of Erectile Function-erectile function (IIEF-EF) domain, patient satisfaction, and time to first satisfactory sexual intercourse. Results A total of 46 patients were enrolled. The median preoperative IIEF-EF, penile curvature, and SPL were 27 points, 70°, and 13 cm, respectively. The median follow-up was 15 months. The median postoperative IIEF-EF was 25 points (P < .001). The median residual penile curvature was 10° (P < .001). The median postoperative SPL was 13 cm (P = .269). 8 patients (17.4%) lost 1 cm of SPL; no shortening greater than 1 cm was recorded. The median time to first satisfactory sexual intercourse and patient satisfaction score was 6 weeks and 9 points, respectively. Clinical Implications Our results could pave the way for a new line of research, which in turn could lead to an improvement in the postoperative management of the patient undergoing surgery for PD. Strength & Limitations This is the first study evaluating the ETT after PD surgery. The main limitation of this study is the lack of a randomized control group. Other weaknesses are the small sample size and the short follow-up time. Conclusion Our novel penile splint is inexpensive, easy to assemble, and adaptable to the patient. ETT using this novel device, followed by standard traction therapy, seems to be feasible, effective, and safe.</dim:field>
<dim:field element="description" lang="spa" mdschema="dc" qualifier="version">pre-print</dim:field>
<dim:field element="description" lang="spa" mdschema="dc" qualifier="extent">449 KB</dim:field>
<dim:field element="language" lang="spa" mdschema="dc" qualifier="iso">eng</dim:field>
<dim:field element="publisher" lang="spa" mdschema="dc">The Journal of Sexual Medicine</dim:field>
<dim:field element="rights" lang="*" mdschema="dc">Atribución-NoComercial-SinDerivadas 3.0 España</dim:field>
<dim:field element="rights" lang="*" mdschema="dc" qualifier="uri">http://creativecommons.org/licenses/by-nc-nd/3.0/es/</dim:field>
<dim:field element="rights" lang="spa" mdschema="dc" qualifier="accessRights">openAccess</dim:field>
<dim:field element="subject" lang="spa" mdschema="dc">Early Traction Therapy</dim:field>
<dim:field element="subject" lang="spa" mdschema="dc">Penile Traction Therapy</dim:field>
<dim:field element="subject" lang="spa" mdschema="dc">Penile splint</dim:field>
<dim:field element="subject" lang="spa" mdschema="dc">Peyronie’s disease</dim:field>
<dim:field element="subject" lang="spa" mdschema="dc">Penile shortening</dim:field>
<dim:field element="title" lang="spa" mdschema="dc">A Novel Penile Splint as Early Traction Therapy After Grafting Techniques for Peyronie's Disease.</dim:field>
<dim:field element="type" lang="spa" mdschema="dc">article</dim:field>
<dim:field element="relation" lang="spa" mdschema="dc" qualifier="publisherversion">https://www.jsm.jsexmed.org/article/S1743-6095(20)30644-5/fulltext</dim:field>
</dim:dim>
<?xml version="1.0" encoding="UTF-8" ?>
<thesis schemaLocation="http://www.ndltd.org/standards/metadata/etdms/1.0/ http://www.ndltd.org/standards/metadata/etdms/1.0/etdms.xsd">
<title>A Novel Penile Splint as Early Traction Therapy After Grafting Techniques for Peyronie's Disease.</title>
<creator>Fernández Pascual, Esaú</creator>
<creator>Manfredi, Celeste</creator>
<creator>Cocci, Andrea</creator>
<creator>Egui Rojo, María Alejandra</creator>
<creator>Carballido Rodríguez, Joaquín</creator>
<creator>Martínez Salamanca, Juan Ignacio</creator>
<subject>Early Traction Therapy</subject>
<subject>Penile Traction Therapy</subject>
<subject>Penile splint</subject>
<subject>Peyronie’s disease</subject>
<subject>Penile shortening</subject>
<description>Background Some studies showed encouraging results on the efficacy and safety of penile traction therapy after Peyronie's disease (PD) surgery. The early traction therapy (ETT) could be an effective and safe approach to minimize penile shortening in patients undergoing PD surgery. Aim To evaluate the feasibility, efficacy, and safety of a novel penile splint as ETT in patients with PD undergoing grafting techniques. Methods Patients with PD underwent plaque incision and grafting technique; at the end of the procedure, a novel penile splint (ETT) was applied to all patient. The device consisted of 2 10CH intubating stylets, self-adapted to each patient, that kept the penis stretched with the aid of non-absorbable sutures. The total expense for the materials needed to build each penile splint was less than 15 euros. This active traction was maintained for 1–3 weeks; then, we removed the stitches leaving the device on-site for a passive traction. Within 3–4 weeks from surgery, the penile splint was replaced by a standard penile traction device. Outcomes The main outcomes evaluated at 6 months included stretched penile length (SPL), penile curvature, International Index of Erectile Function-erectile function (IIEF-EF) domain, patient satisfaction, and time to first satisfactory sexual intercourse. Results A total of 46 patients were enrolled. The median preoperative IIEF-EF, penile curvature, and SPL were 27 points, 70°, and 13 cm, respectively. The median follow-up was 15 months. The median postoperative IIEF-EF was 25 points (P < .001). The median residual penile curvature was 10° (P < .001). The median postoperative SPL was 13 cm (P = .269). 8 patients (17.4%) lost 1 cm of SPL; no shortening greater than 1 cm was recorded. The median time to first satisfactory sexual intercourse and patient satisfaction score was 6 weeks and 9 points, respectively. Clinical Implications Our results could pave the way for a new line of research, which in turn could lead to an improvement in the postoperative management of the patient undergoing surgery for PD. Strength & Limitations This is the first study evaluating the ETT after PD surgery. The main limitation of this study is the lack of a randomized control group. Other weaknesses are the small sample size and the short follow-up time. Conclusion Our novel penile splint is inexpensive, easy to assemble, and adaptable to the patient. ETT using this novel device, followed by standard traction therapy, seems to be feasible, effective, and safe.</description>
<date>2021-07-21</date>
<date>2021-07-21</date>
<date>2020</date>
<type>article</type>
<identifier>1743-6095</identifier>
<identifier>http://hdl.handle.net/10641/2346</identifier>
<identifier>10.1016/j.jsxm.2020.05.009</identifier>
<language>eng</language>
<relation>https://www.jsm.jsexmed.org/article/S1743-6095(20)30644-5/fulltext</relation>
<rights>http://creativecommons.org/licenses/by-nc-nd/3.0/es/</rights>
<rights>openAccess</rights>
<rights>Atribución-NoComercial-SinDerivadas 3.0 España</rights>
<publisher>The Journal of Sexual Medicine</publisher>
</thesis>
<?xml version="1.0" encoding="UTF-8" ?>
<record schemaLocation="http://www.loc.gov/MARC21/slim http://www.loc.gov/standards/marcxml/schema/MARC21slim.xsd">
<leader>00925njm 22002777a 4500</leader>
<datafield ind1=" " ind2=" " tag="042">
<subfield code="a">dc</subfield>
</datafield>
<datafield ind1=" " ind2=" " tag="720">
<subfield code="a">Fernández Pascual, Esaú</subfield>
<subfield code="e">author</subfield>
</datafield>
<datafield ind1=" " ind2=" " tag="720">
<subfield code="a">Manfredi, Celeste</subfield>
<subfield code="e">author</subfield>
</datafield>
<datafield ind1=" " ind2=" " tag="720">
<subfield code="a">Cocci, Andrea</subfield>
<subfield code="e">author</subfield>
</datafield>
<datafield ind1=" " ind2=" " tag="720">
<subfield code="a">Egui Rojo, María Alejandra</subfield>
<subfield code="e">author</subfield>
</datafield>
<datafield ind1=" " ind2=" " tag="720">
<subfield code="a">Carballido Rodríguez, Joaquín</subfield>
<subfield code="e">author</subfield>
</datafield>
<datafield ind1=" " ind2=" " tag="720">
<subfield code="a">Martínez Salamanca, Juan Ignacio</subfield>
<subfield code="e">author</subfield>
</datafield>
<datafield ind1=" " ind2=" " tag="260">
<subfield code="c">2020</subfield>
</datafield>
<datafield ind1=" " ind2=" " tag="520">
<subfield code="a">Background Some studies showed encouraging results on the efficacy and safety of penile traction therapy after Peyronie's disease (PD) surgery. The early traction therapy (ETT) could be an effective and safe approach to minimize penile shortening in patients undergoing PD surgery. Aim To evaluate the feasibility, efficacy, and safety of a novel penile splint as ETT in patients with PD undergoing grafting techniques. Methods Patients with PD underwent plaque incision and grafting technique; at the end of the procedure, a novel penile splint (ETT) was applied to all patient. The device consisted of 2 10CH intubating stylets, self-adapted to each patient, that kept the penis stretched with the aid of non-absorbable sutures. The total expense for the materials needed to build each penile splint was less than 15 euros. This active traction was maintained for 1–3 weeks; then, we removed the stitches leaving the device on-site for a passive traction. Within 3–4 weeks from surgery, the penile splint was replaced by a standard penile traction device. Outcomes The main outcomes evaluated at 6 months included stretched penile length (SPL), penile curvature, International Index of Erectile Function-erectile function (IIEF-EF) domain, patient satisfaction, and time to first satisfactory sexual intercourse. Results A total of 46 patients were enrolled. The median preoperative IIEF-EF, penile curvature, and SPL were 27 points, 70°, and 13 cm, respectively. The median follow-up was 15 months. The median postoperative IIEF-EF was 25 points (P < .001). The median residual penile curvature was 10° (P < .001). The median postoperative SPL was 13 cm (P = .269). 8 patients (17.4%) lost 1 cm of SPL; no shortening greater than 1 cm was recorded. The median time to first satisfactory sexual intercourse and patient satisfaction score was 6 weeks and 9 points, respectively. Clinical Implications Our results could pave the way for a new line of research, which in turn could lead to an improvement in the postoperative management of the patient undergoing surgery for PD. Strength & Limitations This is the first study evaluating the ETT after PD surgery. The main limitation of this study is the lack of a randomized control group. Other weaknesses are the small sample size and the short follow-up time. Conclusion Our novel penile splint is inexpensive, easy to assemble, and adaptable to the patient. ETT using this novel device, followed by standard traction therapy, seems to be feasible, effective, and safe.</subfield>
</datafield>
<datafield ind1="8" ind2=" " tag="024">
<subfield code="a">1743-6095</subfield>
</datafield>
<datafield ind1="8" ind2=" " tag="024">
<subfield code="a">http://hdl.handle.net/10641/2346</subfield>
</datafield>
<datafield ind1="8" ind2=" " tag="024">
<subfield code="a">10.1016/j.jsxm.2020.05.009</subfield>
</datafield>
<datafield ind1=" " ind2=" " tag="653">
<subfield code="a">Early Traction Therapy</subfield>
</datafield>
<datafield ind1=" " ind2=" " tag="653">
<subfield code="a">Penile Traction Therapy</subfield>
</datafield>
<datafield ind1=" " ind2=" " tag="653">
<subfield code="a">Penile splint</subfield>
</datafield>
<datafield ind1=" " ind2=" " tag="653">
<subfield code="a">Peyronie’s disease</subfield>
</datafield>
<datafield ind1=" " ind2=" " tag="653">
<subfield code="a">Penile shortening</subfield>
</datafield>
<datafield ind1="0" ind2="0" tag="245">
<subfield code="a">A Novel Penile Splint as Early Traction Therapy After Grafting Techniques for Peyronie's Disease.</subfield>
</datafield>
</record>
<?xml version="1.0" encoding="UTF-8" ?>
<mets ID=" DSpace_ITEM_10641-2346" OBJID=" hdl:10641/2346" PROFILE="DSpace METS SIP Profile 1.0" TYPE="DSpace ITEM" schemaLocation="http://www.loc.gov/METS/ http://www.loc.gov/standards/mets/mets.xsd">
<metsHdr CREATEDATE="2022-09-20T09:22:41Z">
<agent ROLE="CUSTODIAN" TYPE="ORGANIZATION">
<name>DDFV</name>
</agent>
</metsHdr>
<dmdSec ID="DMD_10641_2346">
<mdWrap MDTYPE="MODS">
<xmlData schemaLocation="http://www.loc.gov/mods/v3 http://www.loc.gov/standards/mods/v3/mods-3-1.xsd">
<mods:mods schemaLocation="http://www.loc.gov/mods/v3 http://www.loc.gov/standards/mods/v3/mods-3-1.xsd">
<mods:name>
<mods:role>
<mods:roleTerm type="text">author</mods:roleTerm>
</mods:role>
<mods:namePart>Fernández Pascual, Esaú</mods:namePart>
</mods:name>
<mods:name>
<mods:role>
<mods:roleTerm type="text">author</mods:roleTerm>
</mods:role>
<mods:namePart>Manfredi, Celeste</mods:namePart>
</mods:name>
<mods:name>
<mods:role>
<mods:roleTerm type="text">author</mods:roleTerm>
</mods:role>
<mods:namePart>Cocci, Andrea</mods:namePart>
</mods:name>
<mods:name>
<mods:role>
<mods:roleTerm type="text">author</mods:roleTerm>
</mods:role>
<mods:namePart>Egui Rojo, María Alejandra</mods:namePart>
</mods:name>
<mods:name>
<mods:role>
<mods:roleTerm type="text">author</mods:roleTerm>
</mods:role>
<mods:namePart>Carballido Rodríguez, Joaquín</mods:namePart>
</mods:name>
<mods:name>
<mods:role>
<mods:roleTerm type="text">author</mods:roleTerm>
</mods:role>
<mods:namePart>Martínez Salamanca, Juan Ignacio</mods:namePart>
</mods:name>
<mods:extension>
<mods:dateAccessioned encoding="iso8601">2021-07-21T07:41:45Z</mods:dateAccessioned>
</mods:extension>
<mods:extension>
<mods:dateAvailable encoding="iso8601">2021-07-21T07:41:45Z</mods:dateAvailable>
</mods:extension>
<mods:originInfo>
<mods:dateIssued encoding="iso8601">2020</mods:dateIssued>
</mods:originInfo>
<mods:identifier type="issn">1743-6095</mods:identifier>
<mods:identifier type="uri">http://hdl.handle.net/10641/2346</mods:identifier>
<mods:identifier type="doi">10.1016/j.jsxm.2020.05.009</mods:identifier>
<mods:abstract>Background Some studies showed encouraging results on the efficacy and safety of penile traction therapy after Peyronie's disease (PD) surgery. The early traction therapy (ETT) could be an effective and safe approach to minimize penile shortening in patients undergoing PD surgery. Aim To evaluate the feasibility, efficacy, and safety of a novel penile splint as ETT in patients with PD undergoing grafting techniques. Methods Patients with PD underwent plaque incision and grafting technique; at the end of the procedure, a novel penile splint (ETT) was applied to all patient. The device consisted of 2 10CH intubating stylets, self-adapted to each patient, that kept the penis stretched with the aid of non-absorbable sutures. The total expense for the materials needed to build each penile splint was less than 15 euros. This active traction was maintained for 1–3 weeks; then, we removed the stitches leaving the device on-site for a passive traction. Within 3–4 weeks from surgery, the penile splint was replaced by a standard penile traction device. Outcomes The main outcomes evaluated at 6 months included stretched penile length (SPL), penile curvature, International Index of Erectile Function-erectile function (IIEF-EF) domain, patient satisfaction, and time to first satisfactory sexual intercourse. Results A total of 46 patients were enrolled. The median preoperative IIEF-EF, penile curvature, and SPL were 27 points, 70°, and 13 cm, respectively. The median follow-up was 15 months. The median postoperative IIEF-EF was 25 points (P < .001). The median residual penile curvature was 10° (P < .001). The median postoperative SPL was 13 cm (P = .269). 8 patients (17.4%) lost 1 cm of SPL; no shortening greater than 1 cm was recorded. The median time to first satisfactory sexual intercourse and patient satisfaction score was 6 weeks and 9 points, respectively. Clinical Implications Our results could pave the way for a new line of research, which in turn could lead to an improvement in the postoperative management of the patient undergoing surgery for PD. Strength & Limitations This is the first study evaluating the ETT after PD surgery. The main limitation of this study is the lack of a randomized control group. Other weaknesses are the small sample size and the short follow-up time. Conclusion Our novel penile splint is inexpensive, easy to assemble, and adaptable to the patient. ETT using this novel device, followed by standard traction therapy, seems to be feasible, effective, and safe.</mods:abstract>
<mods:language>
<mods:languageTerm authority="rfc3066">eng</mods:languageTerm>
</mods:language>
<mods:accessCondition type="useAndReproduction">Atribución-NoComercial-SinDerivadas 3.0 España</mods:accessCondition>
<mods:subject>
<mods:topic>Early Traction Therapy</mods:topic>
</mods:subject>
<mods:subject>
<mods:topic>Penile Traction Therapy</mods:topic>
</mods:subject>
<mods:subject>
<mods:topic>Penile splint</mods:topic>
</mods:subject>
<mods:subject>
<mods:topic>Peyronie’s disease</mods:topic>
</mods:subject>
<mods:subject>
<mods:topic>Penile shortening</mods:topic>
</mods:subject>
<mods:titleInfo>
<mods:title>A Novel Penile Splint as Early Traction Therapy After Grafting Techniques for Peyronie's Disease.</mods:title>
</mods:titleInfo>
<mods:genre>article</mods:genre>
</mods:mods>
</xmlData>
</mdWrap>
</dmdSec>
<amdSec ID="TMD_10641_2346">
<rightsMD ID="RIG_10641_2346">
<mdWrap MDTYPE="OTHER" MIMETYPE="text/plain" OTHERMDTYPE="DSpaceDepositLicense">
<binData>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</binData>
</mdWrap>
</rightsMD>
</amdSec>
<amdSec ID="FO_10641_2346_1">
<techMD ID="TECH_O_10641_2346_1">
<mdWrap MDTYPE="PREMIS">
<xmlData schemaLocation="http://www.loc.gov/standards/premis http://www.loc.gov/standards/premis/PREMIS-v1-0.xsd">
<premis:premis>
<premis:object>
<premis:objectIdentifier>
<premis:objectIdentifierType>URL</premis:objectIdentifierType>
<premis:objectIdentifierValue>http://ddfv.ufv.es/bitstream/10641/2346/1/2.-%20A%20Novel%20Penile%20Splint%20as%20Early%20Traction%20Therapy%20After%20Grafting.pdf</premis:objectIdentifierValue>
</premis:objectIdentifier>
<premis:objectCategory>File</premis:objectCategory>
<premis:objectCharacteristics>
<premis:fixity>
<premis:messageDigestAlgorithm>MD5</premis:messageDigestAlgorithm>
<premis:messageDigest>e71c26a37a3f81fbdae2d45d05838722</premis:messageDigest>
</premis:fixity>
<premis:size>459305</premis:size>
<premis:format>
<premis:formatDesignation>
<premis:formatName>application/pdf</premis:formatName>
</premis:formatDesignation>
</premis:format>
</premis:objectCharacteristics>
<premis:originalName>2.- A Novel Penile Splint as Early Traction Therapy After Grafting.pdf</premis:originalName>
</premis:object>
</premis:premis>
</xmlData>
</mdWrap>
</techMD>
</amdSec>
<amdSec ID="FT_10641_2346_4">
<techMD ID="TECH_T_10641_2346_4">
<mdWrap MDTYPE="PREMIS">
<xmlData schemaLocation="http://www.loc.gov/standards/premis http://www.loc.gov/standards/premis/PREMIS-v1-0.xsd">
<premis:premis>
<premis:object>
<premis:objectIdentifier>
<premis:objectIdentifierType>URL</premis:objectIdentifierType>
<premis:objectIdentifierValue>http://ddfv.ufv.es/bitstream/10641/2346/4/2.-%20A%20Novel%20Penile%20Splint%20as%20Early%20Traction%20Therapy%20After%20Grafting.pdf.txt</premis:objectIdentifierValue>
</premis:objectIdentifier>
<premis:objectCategory>File</premis:objectCategory>
<premis:objectCharacteristics>
<premis:fixity>
<premis:messageDigestAlgorithm>MD5</premis:messageDigestAlgorithm>
<premis:messageDigest>26792ca382467e4816a45da1a54268a5</premis:messageDigest>
</premis:fixity>
<premis:size>23183</premis:size>
<premis:format>
<premis:formatDesignation>
<premis:formatName>text/plain</premis:formatName>
</premis:formatDesignation>
</premis:format>
</premis:objectCharacteristics>
<premis:originalName>2.- A Novel Penile Splint as Early Traction Therapy After Grafting.pdf.txt</premis:originalName>
</premis:object>
</premis:premis>
</xmlData>
</mdWrap>
</techMD>
</amdSec>
<fileSec>
<fileGrp USE="ORIGINAL">
<file ADMID="FO_10641_2346_1" CHECKSUM="e71c26a37a3f81fbdae2d45d05838722" CHECKSUMTYPE="MD5" GROUPID="GROUP_BITSTREAM_10641_2346_1" ID="BITSTREAM_ORIGINAL_10641_2346_1" MIMETYPE="application/pdf" SEQ="1" SIZE="459305">
</file>
</fileGrp>
<fileGrp USE="TEXT">
<file ADMID="FT_10641_2346_4" CHECKSUM="26792ca382467e4816a45da1a54268a5" CHECKSUMTYPE="MD5" GROUPID="GROUP_BITSTREAM_10641_2346_4" ID="BITSTREAM_TEXT_10641_2346_4" MIMETYPE="text/plain" SEQ="4" SIZE="23183">
</file>
</fileGrp>
</fileSec>
<structMap LABEL="DSpace Object" TYPE="LOGICAL">
<div ADMID="DMD_10641_2346" TYPE="DSpace Object Contents">
<div TYPE="DSpace BITSTREAM">
</div>
</div>
</structMap>
</mets>
<?xml version="1.0" encoding="UTF-8" ?>
<mods:mods schemaLocation="http://www.loc.gov/mods/v3 http://www.loc.gov/standards/mods/v3/mods-3-1.xsd">
<mods:name>
<mods:namePart>Fernández Pascual, Esaú</mods:namePart>
</mods:name>
<mods:name>
<mods:namePart>Manfredi, Celeste</mods:namePart>
</mods:name>
<mods:name>
<mods:namePart>Cocci, Andrea</mods:namePart>
</mods:name>
<mods:name>
<mods:namePart>Egui Rojo, María Alejandra</mods:namePart>
</mods:name>
<mods:name>
<mods:namePart>Carballido Rodríguez, Joaquín</mods:namePart>
</mods:name>
<mods:name>
<mods:namePart>Martínez Salamanca, Juan Ignacio</mods:namePart>
</mods:name>
<mods:extension>
<mods:dateAvailable encoding="iso8601">2021-07-21T07:41:45Z</mods:dateAvailable>
</mods:extension>
<mods:extension>
<mods:dateAccessioned encoding="iso8601">2021-07-21T07:41:45Z</mods:dateAccessioned>
</mods:extension>
<mods:originInfo>
<mods:dateIssued encoding="iso8601">2020</mods:dateIssued>
</mods:originInfo>
<mods:identifier type="issn">1743-6095</mods:identifier>
<mods:identifier type="uri">http://hdl.handle.net/10641/2346</mods:identifier>
<mods:identifier type="doi">10.1016/j.jsxm.2020.05.009</mods:identifier>
<mods:abstract>Background Some studies showed encouraging results on the efficacy and safety of penile traction therapy after Peyronie's disease (PD) surgery. The early traction therapy (ETT) could be an effective and safe approach to minimize penile shortening in patients undergoing PD surgery. Aim To evaluate the feasibility, efficacy, and safety of a novel penile splint as ETT in patients with PD undergoing grafting techniques. Methods Patients with PD underwent plaque incision and grafting technique; at the end of the procedure, a novel penile splint (ETT) was applied to all patient. The device consisted of 2 10CH intubating stylets, self-adapted to each patient, that kept the penis stretched with the aid of non-absorbable sutures. The total expense for the materials needed to build each penile splint was less than 15 euros. This active traction was maintained for 1–3 weeks; then, we removed the stitches leaving the device on-site for a passive traction. Within 3–4 weeks from surgery, the penile splint was replaced by a standard penile traction device. Outcomes The main outcomes evaluated at 6 months included stretched penile length (SPL), penile curvature, International Index of Erectile Function-erectile function (IIEF-EF) domain, patient satisfaction, and time to first satisfactory sexual intercourse. Results A total of 46 patients were enrolled. The median preoperative IIEF-EF, penile curvature, and SPL were 27 points, 70°, and 13 cm, respectively. The median follow-up was 15 months. The median postoperative IIEF-EF was 25 points (P < .001). The median residual penile curvature was 10° (P < .001). The median postoperative SPL was 13 cm (P = .269). 8 patients (17.4%) lost 1 cm of SPL; no shortening greater than 1 cm was recorded. The median time to first satisfactory sexual intercourse and patient satisfaction score was 6 weeks and 9 points, respectively. Clinical Implications Our results could pave the way for a new line of research, which in turn could lead to an improvement in the postoperative management of the patient undergoing surgery for PD. Strength & Limitations This is the first study evaluating the ETT after PD surgery. The main limitation of this study is the lack of a randomized control group. Other weaknesses are the small sample size and the short follow-up time. Conclusion Our novel penile splint is inexpensive, easy to assemble, and adaptable to the patient. ETT using this novel device, followed by standard traction therapy, seems to be feasible, effective, and safe.</mods:abstract>
<mods:language>
<mods:languageTerm>eng</mods:languageTerm>
</mods:language>
<mods:accessCondition type="useAndReproduction">http://creativecommons.org/licenses/by-nc-nd/3.0/es/</mods:accessCondition>
<mods:accessCondition type="useAndReproduction">openAccess</mods:accessCondition>
<mods:accessCondition type="useAndReproduction">Atribución-NoComercial-SinDerivadas 3.0 España</mods:accessCondition>
<mods:subject>
<mods:topic>Early Traction Therapy</mods:topic>
</mods:subject>
<mods:subject>
<mods:topic>Penile Traction Therapy</mods:topic>
</mods:subject>
<mods:subject>
<mods:topic>Penile splint</mods:topic>
</mods:subject>
<mods:subject>
<mods:topic>Peyronie’s disease</mods:topic>
</mods:subject>
<mods:subject>
<mods:topic>Penile shortening</mods:topic>
</mods:subject>
<mods:titleInfo>
<mods:title>A Novel Penile Splint as Early Traction Therapy After Grafting Techniques for Peyronie's Disease.</mods:title>
</mods:titleInfo>
<mods:genre>article</mods:genre>
</mods:mods>
<?xml version="1.0" encoding="UTF-8" ?>
<atom:entry schemaLocation="http://www.w3.org/2005/Atom http://www.kbcafe.com/rss/atom.xsd.xml">
<atom:id>http://hdl.handle.net/10641/2346/ore.xml</atom:id>
<atom:published>2021-07-21T07:41:45Z</atom:published>
<atom:updated>2021-07-21T07:41:45Z</atom:updated>
<atom:source>
<atom:generator>DDFV</atom:generator>
</atom:source>
<atom:title>A Novel Penile Splint as Early Traction Therapy After Grafting Techniques for Peyronie's Disease.</atom:title>
<atom:author>
<atom:name>Fernández Pascual, Esaú</atom:name>
</atom:author>
<atom:author>
<atom:name>Manfredi, Celeste</atom:name>
</atom:author>
<atom:author>
<atom:name>Cocci, Andrea</atom:name>
</atom:author>
<atom:author>
<atom:name>Egui Rojo, María Alejandra</atom:name>
</atom:author>
<atom:author>
<atom:name>Carballido Rodríguez, Joaquín</atom:name>
</atom:author>
<atom:author>
<atom:name>Martínez Salamanca, Juan Ignacio</atom:name>
</atom:author>
<oreatom:triples>
<rdf:Description about="http://hdl.handle.net/10641/2346/ore.xml#atom">
<dcterms:modified>2021-07-21T07:41:45Z</dcterms:modified>
</rdf:Description>
<rdf:Description about="http://ddfv.ufv.es/bitstream/10641/2346/1/2.-%20A%20Novel%20Penile%20Splint%20as%20Early%20Traction%20Therapy%20After%20Grafting.pdf">
<dcterms:description>ORIGINAL</dcterms:description>
</rdf:Description>
<rdf:Description about="http://ddfv.ufv.es/bitstream/10641/2346/2/license_rdf">
<dcterms:description>CC-LICENSE</dcterms:description>
</rdf:Description>
<rdf:Description about="http://ddfv.ufv.es/bitstream/10641/2346/3/license.txt">
<dcterms:description>LICENSE</dcterms:description>
</rdf:Description>
<rdf:Description about="http://ddfv.ufv.es/bitstream/10641/2346/4/2.-%20A%20Novel%20Penile%20Splint%20as%20Early%20Traction%20Therapy%20After%20Grafting.pdf.txt">
<dcterms:description>TEXT</dcterms:description>
</rdf:Description>
<rdf:Description about="http://ddfv.ufv.es/bitstream/10641/2346/5/2.-%20A%20Novel%20Penile%20Splint%20as%20Early%20Traction%20Therapy%20After%20Grafting.pdf.jpg">
<dcterms:description>THUMBNAIL</dcterms:description>
</rdf:Description>
</oreatom:triples>
</atom:entry>
<?xml version="1.0" encoding="UTF-8" ?>
<qdc:qualifieddc schemaLocation="http://purl.org/dc/elements/1.1/ http://dublincore.org/schemas/xmls/qdc/2006/01/06/dc.xsd http://purl.org/dc/terms/ http://dublincore.org/schemas/xmls/qdc/2006/01/06/dcterms.xsd http://dspace.org/qualifieddc/ http://www.ukoln.ac.uk/metadata/dcmi/xmlschema/qualifieddc.xsd">
<dc:title>A Novel Penile Splint as Early Traction Therapy After Grafting Techniques for Peyronie's Disease.</dc:title>
<dc:creator>Fernández Pascual, Esaú</dc:creator>
<dc:creator>Manfredi, Celeste</dc:creator>
<dc:creator>Cocci, Andrea</dc:creator>
<dc:creator>Egui Rojo, María Alejandra</dc:creator>
<dc:creator>Carballido Rodríguez, Joaquín</dc:creator>
<dc:creator>Martínez Salamanca, Juan Ignacio</dc:creator>
<dc:subject>Early Traction Therapy</dc:subject>
<dc:subject>Penile Traction Therapy</dc:subject>
<dc:subject>Penile splint</dc:subject>
<dc:subject>Peyronie’s disease</dc:subject>
<dc:subject>Penile shortening</dc:subject>
<dcterms:abstract>Background Some studies showed encouraging results on the efficacy and safety of penile traction therapy after Peyronie's disease (PD) surgery. The early traction therapy (ETT) could be an effective and safe approach to minimize penile shortening in patients undergoing PD surgery. Aim To evaluate the feasibility, efficacy, and safety of a novel penile splint as ETT in patients with PD undergoing grafting techniques. Methods Patients with PD underwent plaque incision and grafting technique; at the end of the procedure, a novel penile splint (ETT) was applied to all patient. The device consisted of 2 10CH intubating stylets, self-adapted to each patient, that kept the penis stretched with the aid of non-absorbable sutures. The total expense for the materials needed to build each penile splint was less than 15 euros. This active traction was maintained for 1–3 weeks; then, we removed the stitches leaving the device on-site for a passive traction. Within 3–4 weeks from surgery, the penile splint was replaced by a standard penile traction device. Outcomes The main outcomes evaluated at 6 months included stretched penile length (SPL), penile curvature, International Index of Erectile Function-erectile function (IIEF-EF) domain, patient satisfaction, and time to first satisfactory sexual intercourse. Results A total of 46 patients were enrolled. The median preoperative IIEF-EF, penile curvature, and SPL were 27 points, 70°, and 13 cm, respectively. The median follow-up was 15 months. The median postoperative IIEF-EF was 25 points (P < .001). The median residual penile curvature was 10° (P < .001). The median postoperative SPL was 13 cm (P = .269). 8 patients (17.4%) lost 1 cm of SPL; no shortening greater than 1 cm was recorded. The median time to first satisfactory sexual intercourse and patient satisfaction score was 6 weeks and 9 points, respectively. Clinical Implications Our results could pave the way for a new line of research, which in turn could lead to an improvement in the postoperative management of the patient undergoing surgery for PD. Strength & Limitations This is the first study evaluating the ETT after PD surgery. The main limitation of this study is the lack of a randomized control group. Other weaknesses are the small sample size and the short follow-up time. Conclusion Our novel penile splint is inexpensive, easy to assemble, and adaptable to the patient. ETT using this novel device, followed by standard traction therapy, seems to be feasible, effective, and safe.</dcterms:abstract>
<dcterms:dateAccepted>2021-07-21T07:41:45Z</dcterms:dateAccepted>
<dcterms:available>2021-07-21T07:41:45Z</dcterms:available>
<dcterms:created>2021-07-21T07:41:45Z</dcterms:created>
<dcterms:issued>2020</dcterms:issued>
<dc:type>article</dc:type>
<dc:identifier>1743-6095</dc:identifier>
<dc:identifier>http://hdl.handle.net/10641/2346</dc:identifier>
<dc:identifier>10.1016/j.jsxm.2020.05.009</dc:identifier>
<dc:language>eng</dc:language>
<dc:relation>https://www.jsm.jsexmed.org/article/S1743-6095(20)30644-5/fulltext</dc:relation>
<dc:rights>http://creativecommons.org/licenses/by-nc-nd/3.0/es/</dc:rights>
<dc:rights>openAccess</dc:rights>
<dc:rights>Atribución-NoComercial-SinDerivadas 3.0 España</dc:rights>
<dc:publisher>The Journal of Sexual Medicine</dc:publisher>
</qdc:qualifieddc>
<?xml version="1.0" encoding="UTF-8" ?>
<rdf:RDF schemaLocation="http://www.openarchives.org/OAI/2.0/rdf/ http://www.openarchives.org/OAI/2.0/rdf.xsd">
<ow:Publication about="oai:ddfv.ufv.es:10641/2346">
<dc:title>A Novel Penile Splint as Early Traction Therapy After Grafting Techniques for Peyronie's Disease.</dc:title>
<dc:creator>Fernández Pascual, Esaú</dc:creator>
<dc:creator>Manfredi, Celeste</dc:creator>
<dc:creator>Cocci, Andrea</dc:creator>
<dc:creator>Egui Rojo, María Alejandra</dc:creator>
<dc:creator>Carballido Rodríguez, Joaquín</dc:creator>
<dc:creator>Martínez Salamanca, Juan Ignacio</dc:creator>
<dc:subject>Early Traction Therapy</dc:subject>
<dc:subject>Penile Traction Therapy</dc:subject>
<dc:subject>Penile splint</dc:subject>
<dc:subject>Peyronie’s disease</dc:subject>
<dc:subject>Penile shortening</dc:subject>
<dc:description>Background Some studies showed encouraging results on the efficacy and safety of penile traction therapy after Peyronie's disease (PD) surgery. The early traction therapy (ETT) could be an effective and safe approach to minimize penile shortening in patients undergoing PD surgery. Aim To evaluate the feasibility, efficacy, and safety of a novel penile splint as ETT in patients with PD undergoing grafting techniques. Methods Patients with PD underwent plaque incision and grafting technique; at the end of the procedure, a novel penile splint (ETT) was applied to all patient. The device consisted of 2 10CH intubating stylets, self-adapted to each patient, that kept the penis stretched with the aid of non-absorbable sutures. The total expense for the materials needed to build each penile splint was less than 15 euros. This active traction was maintained for 1–3 weeks; then, we removed the stitches leaving the device on-site for a passive traction. Within 3–4 weeks from surgery, the penile splint was replaced by a standard penile traction device. Outcomes The main outcomes evaluated at 6 months included stretched penile length (SPL), penile curvature, International Index of Erectile Function-erectile function (IIEF-EF) domain, patient satisfaction, and time to first satisfactory sexual intercourse. Results A total of 46 patients were enrolled. The median preoperative IIEF-EF, penile curvature, and SPL were 27 points, 70°, and 13 cm, respectively. The median follow-up was 15 months. The median postoperative IIEF-EF was 25 points (P < .001). The median residual penile curvature was 10° (P < .001). The median postoperative SPL was 13 cm (P = .269). 8 patients (17.4%) lost 1 cm of SPL; no shortening greater than 1 cm was recorded. The median time to first satisfactory sexual intercourse and patient satisfaction score was 6 weeks and 9 points, respectively. Clinical Implications Our results could pave the way for a new line of research, which in turn could lead to an improvement in the postoperative management of the patient undergoing surgery for PD. Strength & Limitations This is the first study evaluating the ETT after PD surgery. The main limitation of this study is the lack of a randomized control group. Other weaknesses are the small sample size and the short follow-up time. Conclusion Our novel penile splint is inexpensive, easy to assemble, and adaptable to the patient. ETT using this novel device, followed by standard traction therapy, seems to be feasible, effective, and safe.</dc:description>
<dc:date>2021-07-21T07:41:45Z</dc:date>
<dc:date>2021-07-21T07:41:45Z</dc:date>
<dc:date>2020</dc:date>
<dc:type>article</dc:type>
<dc:identifier>1743-6095</dc:identifier>
<dc:identifier>http://hdl.handle.net/10641/2346</dc:identifier>
<dc:identifier>10.1016/j.jsxm.2020.05.009</dc:identifier>
<dc:language>eng</dc:language>
<dc:relation>https://www.jsm.jsexmed.org/article/S1743-6095(20)30644-5/fulltext</dc:relation>
<dc:rights>http://creativecommons.org/licenses/by-nc-nd/3.0/es/</dc:rights>
<dc:rights>openAccess</dc:rights>
<dc:rights>Atribución-NoComercial-SinDerivadas 3.0 España</dc:rights>
<dc:publisher>The Journal of Sexual Medicine</dc:publisher>
</ow:Publication>
</rdf:RDF>
<?xml version="1.0" encoding="UTF-8" ?>
<metadata schemaLocation="http://www.lyncode.com/xoai http://www.lyncode.com/xsd/xoai.xsd">
<element name="dc">
<element name="contributor">
<element name="author">
<element name="none">
<field name="value">Fernández Pascual, Esaú</field>
<field name="authority">1ee9fd93-9f6b-4094-8767-72d397745af3</field>
<field name="confidence">600</field>
<field name="value">Manfredi, Celeste</field>
<field name="authority">fa299e8c-82ed-425e-adfc-1af8bfb5f412</field>
<field name="confidence">600</field>
<field name="value">Cocci, Andrea</field>
<field name="authority">fe4a814b-efb5-47e8-b121-16078ccbc89d</field>
<field name="confidence">600</field>
<field name="value">Egui Rojo, María Alejandra</field>
<field name="authority">1f5432dc-a409-41c8-a122-cc6c7eb823d4</field>
<field name="confidence">600</field>
<field name="value">Carballido Rodríguez, Joaquín</field>
<field name="authority">7641c15d-421b-4d73-9770-57e0b016b705</field>
<field name="confidence">600</field>
<field name="value">Martínez Salamanca, Juan Ignacio</field>
<field name="authority">210</field>
<field name="confidence">600</field>
</element>
</element>
</element>
<element name="date">
<element name="accessioned">
<element name="none">
<field name="value">2021-07-21T07:41:45Z</field>
</element>
</element>
<element name="available">
<element name="none">
<field name="value">2021-07-21T07:41:45Z</field>
</element>
</element>
<element name="issued">
<element name="none">
<field name="value">2020</field>
</element>
</element>
</element>
<element name="identifier">
<element name="issn">
<element name="spa">
<field name="value">1743-6095</field>
</element>
</element>
<element name="uri">
<element name="none">
<field name="value">http://hdl.handle.net/10641/2346</field>
</element>
</element>
<element name="doi">
<element name="spa">
<field name="value">10.1016/j.jsxm.2020.05.009</field>
</element>
</element>
</element>
<element name="description">
<element name="abstract">
<element name="spa">
<field name="value">Background Some studies showed encouraging results on the efficacy and safety of penile traction therapy after Peyronie's disease (PD) surgery. The early traction therapy (ETT) could be an effective and safe approach to minimize penile shortening in patients undergoing PD surgery. Aim To evaluate the feasibility, efficacy, and safety of a novel penile splint as ETT in patients with PD undergoing grafting techniques. Methods Patients with PD underwent plaque incision and grafting technique; at the end of the procedure, a novel penile splint (ETT) was applied to all patient. The device consisted of 2 10CH intubating stylets, self-adapted to each patient, that kept the penis stretched with the aid of non-absorbable sutures. The total expense for the materials needed to build each penile splint was less than 15 euros. This active traction was maintained for 1–3 weeks; then, we removed the stitches leaving the device on-site for a passive traction. Within 3–4 weeks from surgery, the penile splint was replaced by a standard penile traction device. Outcomes The main outcomes evaluated at 6 months included stretched penile length (SPL), penile curvature, International Index of Erectile Function-erectile function (IIEF-EF) domain, patient satisfaction, and time to first satisfactory sexual intercourse. Results A total of 46 patients were enrolled. The median preoperative IIEF-EF, penile curvature, and SPL were 27 points, 70°, and 13 cm, respectively. The median follow-up was 15 months. The median postoperative IIEF-EF was 25 points (P < .001). The median residual penile curvature was 10° (P < .001). The median postoperative SPL was 13 cm (P = .269). 8 patients (17.4%) lost 1 cm of SPL; no shortening greater than 1 cm was recorded. The median time to first satisfactory sexual intercourse and patient satisfaction score was 6 weeks and 9 points, respectively. Clinical Implications Our results could pave the way for a new line of research, which in turn could lead to an improvement in the postoperative management of the patient undergoing surgery for PD. Strength & Limitations This is the first study evaluating the ETT after PD surgery. The main limitation of this study is the lack of a randomized control group. Other weaknesses are the small sample size and the short follow-up time. Conclusion Our novel penile splint is inexpensive, easy to assemble, and adaptable to the patient. ETT using this novel device, followed by standard traction therapy, seems to be feasible, effective, and safe.</field>
</element>
</element>
<element name="version">
<element name="spa">
<field name="value">pre-print</field>
</element>
</element>
<element name="extent">
<element name="spa">
<field name="value">449 KB</field>
</element>
</element>
</element>
<element name="language">
<element name="iso">
<element name="spa">
<field name="value">eng</field>
</element>
</element>
</element>
<element name="publisher">
<element name="spa">
<field name="value">The Journal of Sexual Medicine</field>
</element>
</element>
<element name="rights">
<element name="*">
<field name="value">Atribución-NoComercial-SinDerivadas 3.0 España</field>
</element>
<element name="uri">
<element name="*">
<field name="value">http://creativecommons.org/licenses/by-nc-nd/3.0/es/</field>
</element>
</element>
<element name="accessRights">
<element name="spa">
<field name="value">openAccess</field>
</element>
</element>
</element>
<element name="subject">
<element name="spa">
<field name="value">Early Traction Therapy</field>
<field name="value">Penile Traction Therapy</field>
<field name="value">Penile splint</field>
<field name="value">Peyronie’s disease</field>
<field name="value">Penile shortening</field>
</element>
</element>
<element name="title">
<element name="spa">
<field name="value">A Novel Penile Splint as Early Traction Therapy After Grafting Techniques for Peyronie's Disease.</field>
</element>
</element>
<element name="type">
<element name="spa">
<field name="value">article</field>
</element>
</element>
<element name="relation">
<element name="publisherversion">
<element name="spa">
<field name="value">https://www.jsm.jsexmed.org/article/S1743-6095(20)30644-5/fulltext</field>
</element>
</element>
</element>
</element>
<element name="bundles">
<element name="bundle">
<field name="name">ORIGINAL</field>
<element name="bitstreams">
<element name="bitstream">
<field name="name">2.- A Novel Penile Splint as Early Traction Therapy After Grafting.pdf</field>
<field name="originalName">2.- A Novel Penile Splint as Early Traction Therapy After Grafting.pdf</field>
<field name="format">application/pdf</field>
<field name="size">459305</field>
<field name="url">http://ddfv.ufv.es/bitstream/10641/2346/1/2.-%20A%20Novel%20Penile%20Splint%20as%20Early%20Traction%20Therapy%20After%20Grafting.pdf</field>
<field name="checksum">e71c26a37a3f81fbdae2d45d05838722</field>
<field name="checksumAlgorithm">MD5</field>
<field name="sid">1</field>
</element>
</element>
</element>
<element name="bundle">
<field name="name">CC-LICENSE</field>
<element name="bitstreams">
<element name="bitstream">
<field name="name">license_rdf</field>
<field name="originalName">license_rdf</field>
<field name="format">application/rdf+xml; charset=utf-8</field>
<field name="size">811</field>
<field name="url">http://ddfv.ufv.es/bitstream/10641/2346/2/license_rdf</field>
<field name="checksum">4d01a8abc68801ab758ec8c2c04918c3</field>
<field name="checksumAlgorithm">MD5</field>
<field name="sid">2</field>
</element>
</element>
</element>
<element name="bundle">
<field name="name">LICENSE</field>
<element name="bitstreams">
<element name="bitstream">
<field name="name">license.txt</field>
<field name="originalName">license.txt</field>
<field name="format">text/plain; charset=utf-8</field>
<field name="size">2418</field>
<field name="url">http://ddfv.ufv.es/bitstream/10641/2346/3/license.txt</field>
<field name="checksum">8b6e3a0bc6a1ca51936267b0e6e4740c</field>
<field name="checksumAlgorithm">MD5</field>
<field name="sid">3</field>
</element>
</element>
</element>
<element name="bundle">
<field name="name">TEXT</field>
<element name="bitstreams">
<element name="bitstream">
<field name="name">2.- A Novel Penile Splint as Early Traction Therapy After Grafting.pdf.txt</field>
<field name="originalName">2.- A Novel Penile Splint as Early Traction Therapy After Grafting.pdf.txt</field>
<field name="description">Extracted text</field>
<field name="format">text/plain</field>
<field name="size">23183</field>
<field name="url">http://ddfv.ufv.es/bitstream/10641/2346/4/2.-%20A%20Novel%20Penile%20Splint%20as%20Early%20Traction%20Therapy%20After%20Grafting.pdf.txt</field>
<field name="checksum">26792ca382467e4816a45da1a54268a5</field>
<field name="checksumAlgorithm">MD5</field>
<field name="sid">4</field>
</element>
</element>
</element>
<element name="bundle">
<field name="name">THUMBNAIL</field>
<element name="bitstreams">
<element name="bitstream">
<field name="name">2.- A Novel Penile Splint as Early Traction Therapy After Grafting.pdf.jpg</field>
<field name="originalName">2.- A Novel Penile Splint as Early Traction Therapy After Grafting.pdf.jpg</field>
<field name="description">Generated Thumbnail</field>
<field name="format">image/jpeg</field>
<field name="size">1577</field>
<field name="url">http://ddfv.ufv.es/bitstream/10641/2346/5/2.-%20A%20Novel%20Penile%20Splint%20as%20Early%20Traction%20Therapy%20After%20Grafting.pdf.jpg</field>
<field name="checksum">c78aac1684e4a7c608fc4da6823224bb</field>
<field name="checksumAlgorithm">MD5</field>
<field name="sid">5</field>
</element>
</element>
</element>
</element>
<element name="others">
<field name="handle">10641/2346</field>
<field name="identifier">oai:ddfv.ufv.es:10641/2346</field>
<field name="lastModifyDate">2022-01-27 12:56:29.652</field>
</element>
<element name="repository">
<field name="name">DDFV</field>
<field name="mail">dspace@ufv.es</field>
</element>
<element name="license">
<field name="bin">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</field>
</element>
</metadata>