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Magnetic resonance imaging to estimate tissue deformations during penile clamp application: a case series

Magnetic resonance imaging to estimate tissue deformations during penile clamp application: a case series
Magnetic resonance imaging to estimate tissue deformations during penile clamp application: a case series

Background: Penile clamps provide a means of preventing urinary incontinence in males following radical prostatectomy. In order for the devices to function, significant mechanical loads need to be applied to the penile tissues to close the urethra. However, such loads have the potential to cause damage to the vulnerable skin and underlying soft tissues. Accordingly, the study aimed to estimate the magnitudes of tissue deformations resulting from penile clamp application in three individual cases. Methods: Three individuals were recruited who currently use penile clamps to manage urinary incontinence following radical prostatectomy. Magnetic resonance images (MRI) of the penis were taken to produce a series of high contrast coronal and sagittal images both before and during the application of two commercially available clamps, modified for MRI compatibility. Tissue thickness measurements were estimated with the clamps in-situ and normalised to the unloaded baseline state. Results: The estimated magnitude of tissue deformations resulting from clamp application ranged between 68% and 84%. There were minimal differences in these deformations between the clamp designs, both of which appeared effective in closing the urethra. Local stress concentrations were observed in the tissues, which were deformed around the shape of the clamp. Conclusions: MRI enabled quantification of local tissue deformation during penile clamp application. The results revealed that clamps created large tissue deformations in all three cases, regardless of design. This information could inform the development of new clamp designs and materials to minimise the potential for tissue damage. Level of evidence: 4.

magnetic resonance imaging, Penile clamp, radical prostatectomy, urinary incontinence
2051-4158
402-406
Lemmens, Joe
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Peko Cohen, Lea
d4ca712c-f376-47c6-ad18-063209b8637b
Worsley, Peter R.
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Everitt, Chris
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Broadbridge, Jackie
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Gefen, Amit
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Rees, Rowland W.
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Drake, Marcus
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Macaulay, Margaret C.
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Fader, Mandy
c318f942-2ddb-462a-9183-8b678faf7277
Bader, Dan L.
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Lemmens, Joe
3dd930fa-c49b-4153-be26-37759369944b
Peko Cohen, Lea
d4ca712c-f376-47c6-ad18-063209b8637b
Worsley, Peter R.
6d33aee3-ef43-468d-aef6-86d190de6756
Everitt, Chris
62cd944b-84a2-441e-bab7-1e85e9156bcf
Broadbridge, Jackie
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Gefen, Amit
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Rees, Rowland W.
4180ed50-e1eb-4f41-90e8-9e9ccb0aba18
Drake, Marcus
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Macaulay, Margaret C.
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Fader, Mandy
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Bader, Dan L.
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Lemmens, Joe, Peko Cohen, Lea, Worsley, Peter R., Everitt, Chris, Broadbridge, Jackie, Gefen, Amit, Rees, Rowland W., Drake, Marcus, Macaulay, Margaret C., Fader, Mandy and Bader, Dan L. (2020) Magnetic resonance imaging to estimate tissue deformations during penile clamp application: a case series. Journal of Clinical Urology, 13 (6), 402-406. (doi:10.1177/2051415820920511).

Record type: Article

Abstract

Background: Penile clamps provide a means of preventing urinary incontinence in males following radical prostatectomy. In order for the devices to function, significant mechanical loads need to be applied to the penile tissues to close the urethra. However, such loads have the potential to cause damage to the vulnerable skin and underlying soft tissues. Accordingly, the study aimed to estimate the magnitudes of tissue deformations resulting from penile clamp application in three individual cases. Methods: Three individuals were recruited who currently use penile clamps to manage urinary incontinence following radical prostatectomy. Magnetic resonance images (MRI) of the penis were taken to produce a series of high contrast coronal and sagittal images both before and during the application of two commercially available clamps, modified for MRI compatibility. Tissue thickness measurements were estimated with the clamps in-situ and normalised to the unloaded baseline state. Results: The estimated magnitude of tissue deformations resulting from clamp application ranged between 68% and 84%. There were minimal differences in these deformations between the clamp designs, both of which appeared effective in closing the urethra. Local stress concentrations were observed in the tissues, which were deformed around the shape of the clamp. Conclusions: MRI enabled quantification of local tissue deformation during penile clamp application. The results revealed that clamps created large tissue deformations in all three cases, regardless of design. This information could inform the development of new clamp designs and materials to minimise the potential for tissue damage. Level of evidence: 4.

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Magnetic Resonance Imaging to estimate Tissue deformations during penile clamp application A case series - Accepted Manuscript
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Accepted/In Press date: 23 March 2020
e-pub ahead of print date: 7 May 2020
Published date: 1 November 2020
Keywords: magnetic resonance imaging, Penile clamp, radical prostatectomy, urinary incontinence

Identifiers

Local EPrints ID: 439001
URI: http://eprints.soton.ac.uk/id/eprint/439001
ISSN: 2051-4158
PURE UUID: 393385a3-8f5f-4d5d-9d34-16105e3f60be
ORCID for Peter R. Worsley: ORCID iD orcid.org/0000-0003-0145-5042
ORCID for Margaret C. Macaulay: ORCID iD orcid.org/0000-0003-1737-4589
ORCID for Dan L. Bader: ORCID iD orcid.org/0000-0002-1208-3507

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Date deposited: 31 Mar 2020 16:31
Last modified: 04 Aug 2022 01:55

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Contributors

Author: Joe Lemmens
Author: Lea Peko Cohen
Author: Chris Everitt
Author: Amit Gefen
Author: Rowland W. Rees
Author: Marcus Drake
Author: Mandy Fader
Author: Dan L. Bader ORCID iD

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