Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Penile Prosthesis”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 91 records · Page 5Linked to original sources
PubMed2005

Retained rear-tip extenders in redo penile prosthesis surgery: a case for heightened suspicion and thorough physical examination.

INTRODUCTION: Penile Prosthesis infection is a dreaded complication that can occur after primary inflatable penile implants. Redo prosthesis operations and salvage procedures have become increasingly popular after these inflections. These operations, however, have higher rates of re-infection as compared to primary implants. AIM: We describe a patient who was referred for repeat redo penile prosthesis surgery in whom retained rear-tip extenders harboring purulent fluid was discovered during physical examination. RESULTS: The patient underwent exploration and two rear-tip extenders were removed. He later underwent redo prosthesis insertion and the device remains fully functional and infection free at follow-up. CONCLUSION: This case conveys the importance of a thorough physical examination and raises the index of suspicion for retained prosthesis fragments in patients with recurrent penile prosthesis infections.

Aged↗
PubMed1995

Experience with the penile prosthesis and artificial urinary sphincter.

The therapy of two common urologic problems, erectile dysfunction and urinary stress incontinence, has been revolutionized over the last 20 years by the incorporation of principles of hydraulic mechanics into the field of silicone prosthesis implantation. The inflatable penile prosthesis is surgically implanted into men with impotence due to organic or psychogenic etiology. The artificial urinary sphincter has found widespread use in males and females in both the adult and pediatric populations with stress incontinence from a variety of causes. Associated with these popular devices are various complications relating to the anatomic site as well as the host's immunologic response. The use of these implants, as well as the technologic innovations resulting from various adverse effects, are reviewed herein.

Erectile Dysfunction↗
PubMed2006

Outcome of penile prosthesis implantation for treating erectile dysfunction: experience with 504 procedures.

OBJECTIVE: To evaluate the outcome of penile prosthesis surgery for different types of prosthesis. PATIENTS AND METHODS: The notes of 447 men who had 504 penile prosthesis implanted between August 1975 and December 2000 were evaluated. Of the prostheses inserted, 393 were malleable, 81 were three-piece inflatable and 30 were self-contained hydraulic prostheses. The mean (range) age of the men was 52 (21-78) years; 404 men had primary implants and 43 had revision surgery after operations at other institutions. The mean follow-up was 50 (1-297) months. RESULTS: Of the 447 men, 22 were lost to follow-up immediately after surgery. The most serious postoperative complications were infection (8%) and erosion (5%), which was more common in diabetic patients (10%) and after pelvic trauma with a urethral injury (21%). Of 482 prostheses, 21 failed mechanically (4%) and revision surgery was needed for 5% of the prostheses inserted (24/482). Overall, 89% (377/425) of men could have sexual intercourse and 344 (81%) were satisfied with the results. CONCLUSIONS: Of the men implanted with a penile prosthesis, 81% were satisfied with the outcome and an even higher proportion were satisfied with the inflatable prostheses. Dissatisfaction was mainly due to complications that resulted in removal of the prosthesis.

Adult↗
PubMed1990

Management of Peyronie disease by implantation of inflatable penile prosthesis.

Sixty-seven patients with advanced Peyronie disease were treated by implantation of an inflatable penile prosthesis (IPP). Twenty-eight of the 67 patients had documented total erectile failure. The remaining 39 patients had significant penile curvature causing "mechanical impotence" due to inability to achieve adequate vaginal penetration and chose implantation of an inflatable penile prosthesis (in some cases, combined with a straightening procedure) rather than one of the standard penile straightening procedures. Currently, 63 of the 67 patients have functioning prosthetic devices; in 3 other patients the device was removed because of infection, and 1 patient was dissatisfied and had the device removed. For impotent patients with severe Peyronie disease for whom other medical or surgical treatment is neither desirable nor suitable, we recommend implantation of an inflatable penile prosthesis combined with a possible straightening procedure.

Adult↗
PubMed2006

Long-term mechanical reliability of AMS 700CX/CXM inflatable penile prosthesis.

PURPOSE: We determined the long-term mechanical reliability of the AMS 700CX/CXM inflatable penile prosthesis in men with organic erectile dysfunction. MATERIALS AND METHODS: A total of 455 consecutive patients underwent implantation of an AMS 700CX/CXM inflatable penile prosthesis between April 1986 and July 2004. Using telephone interviews and mailed questionnaires we obtained followup on 380 of 455 patients (83%). Data were obtained with regard to 2 end points, including overall failure and mechanical failure caused by any malfunctioning component. RESULTS: Followup was 0.49 to 231 months (median 91.5). Ten-year Kaplan-Meier estimates of overall and mechanical survival were 74.9% (95% CI 69.2 to 81.1) and 81.3% (95% CI 75.7 to 87.3), respectively. CONCLUSIONS: To our knowledge this is the longest followup of any inflatable penile prosthesis showing overall and mechanical survival by Kaplan-Meier estimates.

Adult↗
PubMed1992

Management of preexisting inflatable penile prosthesis during radical retropubic prostatectomy.

A potentially difficult technical situation exists when a man with a functioning inflatable penile prosthesis elects radical prostatectomy as treatment for localized prostate cancer. Between February 1988 and June 1991 we encountered 8 men with a preexisting inflatable penile prosthesis who subsequently underwent radical retropubic prostatectomy. In 2 patients the reservoir portion of the prosthesis was in the perivesical space such that radical prostatectomy could be performed without difficulty. However, in 6 patients removal of the reservoir was necessary to complete the prostatectomy. In 3 of these 6 patients the reservoir was replaced at 3 to 6 months after radical prostatectomy and all 3 systems function well. The remaining 3 patients have not yet elected replacement of the reservoir. Only 1 patient had an infection and a complication attributable to the prosthesis. We believe that a preexisting inflatable penile prosthesis should not preclude successful radical retropubic prostatectomy, although temporary removal of the reservoir may be required.

Aged↗
PubMed1994

Unilateral unitary inflatable penile prosthesis to correct impaired tumescence and severe penile deformity resulting from traumatic rupture of 1 corpus cavernosum.

Nonsurgical management of a penile fracture can result in penile deformity due to plaque, and impaired tumescence due to corporeal fibrosis and altered erectile hemodynamics. We describe the correction of penile deformity and impaired tumescence by extensive resection of corporeal fibrosis and insertion of a unilateral unitary inflatable prosthesis. A possible role is proposed for correcting penile angulation secondary to unilateral disease using a unilateral unitary inflatable penile prosthesis.

Adult↗
PubMed2006

Evaluation of post-operative residual function of corpora cavernosa after soft penile prosthesis implant for Peyronie's disease.

OBJECTIVE: The aim of this study is to evaluate the results of surgical implant with a new soft penile prosthesis, called SSDA, without plaque surgery in the treatment of impotence associated with Peyronie's disease. MATERIALS AND METHODS: This study included 64 men with Peyronie's disease who underwent placement of a penile prosthesis. All the patients were followed for at least one year. RESULTS: The implant of this kind of prosthesis straightened the penile shaft in all cases, restoring sexual satisfaction to the couple, as described in a clinical interview. No operative or postoperative complications occurred and no further operations were needed. Ten patients underwent a further examination with basal and duplex dynamic color Doppler ultrasound to establish the residual function of the corpora cavernosa. DISCUSSION: The outcome is very positive: the penis preserves the ability to enhance the tumescence and the penile girth. We conclude that SSDA penile prosthesis are safe and effective in the treatment of Peyronie's disease associated with impotence.

Adult↗
PubMed2001

Penile prosthesis infections.

In this retrospective review we looked at infection rates and risk factors in penile prosthesis recipients. Computer registry records of patients implanted with three-piece inflatable prostheses from April 1986 to March 1999 were reviewed. Bacteriological culture report data were obtained from the medical records. There were 491 three-piece inflatable penile prosthesis recipients with follow-up ranging from 1 to 168 months (mean 83). All patients were implanted more than 1 y ago. There were 10 infections in 491 recipients (2.0%). In 285 primary prosthesis recipients there were seven infections (2.5%). In 206 secondary prosthesis recipients there were three infections (1.5%). Seven infections occurred in 354 non-diabetics (2.0%) and three infections occurred in 137 diabetics (2.2%). None of these differences were statistically significant. Explants for infection were performed in 8 weeks or less following implantation in eight patients. In two patients explants occurred at 17 and 26 months following implantation. Cultures from the periprosthetic space grew E. coli (four), Proteus mirabilis (two), Staph. aureus (two), and bacteroides (two). Infections occurred in 2.0% of three-piece inflatable penile prosthesis recipients. There were no statistically significant differences in infection rates between first time and repeat prosthesis recipients and between diabetic and non-diabetic recipients. Eight of the 10 infections occurred 8 weeks or less following implantation.

Humans↗
PubMed2000

Efficacy, safety and patient satisfaction outcomes of the AMS 700CX inflatable penile prosthesis: results of a long-term multicenter study. AMS 700CX Study Group.

PURPOSE: We performed a long-term multicenter study of the AMS 700CX 3-piece inflatable penile prosthesis, focusing on longevity, morbidity and patient satisfaction in men implanted up to 134 months with a median followup of 47.7 months. MATERIALS AND METHODS: We performed a large scale retrospective multicenter study in 2 phases. Phase 1 was a medical record review of 372 men who underwent implantation with the AMS 700CX penile prosthesis from 1987 to 1996 by 7 frequent penile prosthesis implanters. Phase 2 included a structured telephone interview of 207 patients by a neutral observer. RESULTS: For the 372 men in phase 1 mean device mechanical reliability plus or minus standard deviation was 92.1% + or - 3.3% after 3 and 86.2% + or - 4.6% after 5 years. Patient age was 21 to 79 years (mean 57.6 + or - 11.0) at implantation. The etiology of erectile dysfunction was vascular in 27.7% of the cases, Peyronie's disease in 16.9%, diabetes mellitus in 12.9% and radical surgery in 11.6%. Of the men 55.6% received previous treatment for erectile dysfunction. Postoperative infection and device malfunction developed in 3.2% and 17.5% of the cases, respectively. Of the 207 men interviewed in phase 2, 86% still had an AMS 700CX penile prosthesis implanted, including 87.1% with erection suitable for coitus. Currently 79% of those with a device use it at least twice monthly and 88.2% would recommend an implant to a relative or friend. CONCLUSIONS: The AMS 700CX penile implant produced suitable erection and excellent patient satisfaction at long-term followup in the majority of men. Implant reliability is excellent and postoperative morbidity is low.

Adult↗
PubMed1985

Sex therapy and the penile prosthesis: a synthesis.

Although the availability of the penile prosthesis has changed the evaluation and treatment of erectile dysfunction, urologists and sex therapists have not combined their skills to develop comprehensive treatment plans. This paper describes one effort to use sex therapy techniques in evaluating and treating candidates for a penile prosthesis. The preoperative assessment focuses on multiaxial diagnosis of sexual problems in patient and partner and on the effects a prosthesis might have on their sexual and marital relationship. Men at high risk for a negative psychological reaction after surgery are offered presurgical sex therapy. Routine follow-up visits are scheduled for all patients during postoperative recovery and at 2-3 months postsurgery. If sexual dysfunction or dissatisfaction persists, sex therapy is again recommended. A case history exemplifies our methods, and the issue of financial costs of counseling vs. predicted benefits in terms of patient satisfaction is discussed.

Aged↗
PubMedDate not supplied

The acceptance and satisfaction of Saudi males to vasoactive autoinjection intracavernous therapy, external negative pressure device and penile prosthesis in the treatment of erectile dysfunction.

BACKGROUND: The aim of the study was to determine the acceptance and satisfaction of Saudi impotent male patients to intracavernous vasoactive autoinjection therapy, external negative pressure device and penile prosthesis insertion in the treatment of their impotence. SUBJECTS AND METHODS: The medical records of 210 Saudi patients who presented with erectile dysfunction and were offered intracavernous vasoactive autoinjection therapy, external negative pressure device or penile prostheses for the treatment of their erectile dysfunction were retrospectively analyzed to determine the acceptance and satisfaction of their selected treatment modalities. RESULTS: Intracavernous vasoactive autoinjection therapy was the most acceptable treatment option, followed by negative pressure device, and then insertion of penile prosthesis. About 11.9% of patients refused all treatment options. Only 40% and 12% of patients who were treated with intracavernous vasoactive autoinjection therapy and external negative pressure device, respectively, were satisfied with their treatment modality. After one year of follow-up, insertion of penile prosthesis had the highest satisfaction rate among the treatment modalities, with 92% and 87% of patients being satisfied at 3 and 12 months' follow-up, respectively. CONCLUSION: Intracorporeal vasoactive autoinjection therapy had the highest acceptance rate compared with external negative pressure devices and penile prosthesis, however, it had low satisfaction rate and the dropout rate was high. External negative pressure devices are generally poorly accepted and are rarely satisfactory in our patient population. Penile prosthesis insertion is poorly accepted, however, it has the highest satisfaction rate. Such information will allow patients under treatment for impotence and their treating physicians to make better, educated choices on the mode of treatment.

Journal Article↗
PubMed1978

Surgical management of impotence using the inflatable penile prosthesis: experience with 103 patients.

The inflatable hydraulic penile prosthesis has been implanted in 103 patients with both organic and psychogenic impotence. The 4 failures in this series resulted from infection. Mechanical problems occurred in 27 patients, but with additional implant experience, these have been significantly induced. All mechanical complications are correctable through secondary and tertiary surgical procedures. Ninety-eight of 99 patients with a normally functioning prosthetic device had satisfactory intercourse without significant difficulty. The inflatable penile prosthesis has improved to be a highly satisfactory method of treating male impotence.

Adult↗
PubMed1990

[Critical assessment of penile prosthesis implants: indication, choice of prosthesis, surgical technique and follow-up].

The surgical techniques for penile prosthesis implantation are well known and standardized. Multicomponent hydraulic prosthesis offer, without any doubt, the best guarantees in terms of function and aesthetic results. Nevertheless their insertion is sometime troublesome and a superficial knowledge of the technical problems may lead to complete and disappointing failures. In the present work the Authors report their personal experience with various types of penile prosthesis and describe in details, the different maneuvers which are needed for their correct implantation. Some variation of the original technique will be also described. The results obtained will also be described.

Adult↗
PubMed1999

Implantation of inflatable penile prosthesis in patients with severe corporeal fibrosis: introduction of a new penile cavernotome.

PURPOSE: Implantation of penile prosthetic cylinders into scarred corpora remains a challenge in the field of prosthetic urology. We describe a new penile cavernotome, which allows for easier dilation of fibrotic corpora cavernosa and facilitates inflatable penile prosthesis cylinder insertion. MATERIALS AND METHODS: A set of 5 cavernotomes between 6 and 13 mm. in diameter are used to drill a space in fibrotic corpora with controlled 1 mm. cuts. The cavernotomes are advanced in an oscillating fashion and also allow shaving of severely stenotic areas for easier cavity development. They were used in 16 patients with fibrotic corpora secondary to different etiologies. A high transverse scrotal incision was used in all cases. Of the 16 patients 14 received downsized cylinders. RESULTS: Implantation of both cylinders of an inflatable 3-piece device was successful in all cases. Proximal crural perforation occurred intraoperatively in 5 patients and was corrected by attaching the rear tip extender to the tunica with nonabsorbable suture. Postoperatively, distal tunical perforation of the corpora in 4 patients was repaired with natural tissue. Operative time was reduced compared to our previous experience with implantation in cases of corporeal fibrosis using extensive corporotomies or the Carrion-Rossello cavernotomes. In no case was the procedure terminated for urethral laceration or inadequate dilation for cylinder insertion. No grafting materials were necessary to close the corporotomy. CONCLUSIONS: The new cavernotomes along with the high transverse scrotal incision and downsized prostheses resulted in successful implantation in all of our cases. Dilation of fibrotic corpora was easier and quicker with the new cavernotomes because extensive corporeal resection was not necessary. Complications were acceptable for these difficult cases and prosthesis survival is 100% to date.

Equipment Design↗
PubMed1985

Early problems encountered with the Mentor inflatable penile prosthesis.

We present 9 consecutive patients who underwent insertion of the Mentor inflatable penile prosthesis. Of these patients 3 had successful results after repeated problems with the Scott inflatable penile prosthesis. Complications included spontaneous inflation of the prosthesis, a tubing kink, aneurysmal cylinder ballooning and cylinder disruption. Slow deflation seems to be an inherent problem with the Mentor system. Although penile squeezing may be used to help deflation, traumatic urethritis may occur. However, concealment may not be possible without such squeezing. Interim use of a noninflatable prosthesis to treat a damaged corpus cavernosum is recommended. Although ingenious technology has enabled successful implant surgery, no penile prosthesis yet devised has proven to be ideal. Further refinements are being made. Ultimate evaluation will require years of followup in the spirit of the pre-700 series of Scott inflatable penile prostheses.

Aged↗
PubMed2001

Penile prosthesis implantation.

The development of effective systemic therapy for the treatment of erectile dysfunction has resulted in a significant increase in the number of men presenting for treatment. Not all men with erectile dysfunction will respond to systemic therapy; those who fail may be candidates for penile prosthesis implantation if second and third lines of treatment also fail or are rejected by the patient and his partner. Penile prosthesis implantation continues to play a role in the treatment of erectile dysfunction. There is a potential for the number of penile prosthesis implantation procedures to actually increase. The ideal penile prosthesis is a three-piece inflatable device that permits good penile flaccidity and increases in size and becomes rigid with inflation.

Humans↗