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At least 19 recordsLinked to original sources
PubMed1988

Five-year followup of the Scott inflatable penile prosthesis and comparison with semirigid penile prosthesis.

The Scott inflatable penile prosthesis remains one of the most popular devices available for the surgical treatment of impotence despite high complication and reoperation rates. We present our 5-year followup of 116 inflatable prostheses placed before 1981 in 85 patients, with a 61 per cent overall 5-year complication rate. The incidence of complications by year after operation showed that most (22 per cent) devices failed within 1 year after implantation, with failure rates gradually decreasing to 6 and 7 per cent during years 4 and 5, respectively. Of 85 patients receiving an inflatable prosthesis 61 per cent underwent reoperation during the 5-year followup. A 5-year overall complication rate of only 14 per cent was seen in 29 Small-Carrion semirigid prostheses implanted during the same time. The results of numerous recent improvements in the design and structure of the Scott inflatable penile prosthesis to prevent mechanical device failure remain to be tested over the long term.

Adult↗
PubMed1997

The use of an external vacuum device to augment a penile prosthesis.

Although penile prostheses are highly effective in the treatment of erectile dysfunction, a small percentage of patients are dissatisfied. Serendipitously, a patient in this group found that using an external vacuum device to augment his prosthetic erection provided a dramatic objective improvement in his erection and increased his overall satisfaction with intercourse. Patients who had tried the combination of external vacuum device and penile prosthesis simultaneously were identified from our penile prosthesis population as well as the Osbon Medical Systems database. Telephone interviews were conducted to determine efficacy, satisfaction, and side effects from the combination. Twelve patients completed the telephone survey. Four patients had semirigid and eight had inflatable penile prostheses. After using the vacuum device to augment the erection, all reported increased rigidity and patient/partner satisfaction, and 11 of 12 described improved length and girth. Minimal complications were noted. Concomitant use of an external vacuum device and penile prosthesis was safe in this select population. The combination may be indicated in patients with penile prostheses who are dissatisfied with size and/or rigidity, and in those who refuse or who are poor candidates for prosthesis revision.

Aged↗
PubMed2004

Combined penile plication surgery and insertion of penile prosthesis for severe penile curvature and erectile dysfunction.

PURPOSE: For persistent penile curvature after corporeal dilation and prosthesis placement other maneuvers, such as plaque incision with or without grafting, or penile modeling, must be used to complete penile straightening. However, each of these techniques is associated with increased morbidity, which includes higher rates of infection and urethral injury. We describe a new technique for correcting severe penile curvature and erectile dysfunction using combined penile plication and placement of a 3 piece inflatable penile prosthesis. MATERIALS AND METHODS: Between February 2000 and June 2003, 5 patients with erectile dysfunction and severe curvature for which other treatment modalities had failed were treated with combined inflatable penile prosthesis and additional plication to correct the severe malformation. Detailed medical and sexual history was obtained as well as preoperative duplex ultrasound prior to surgery. RESULTS: The age range of our patient population was 22 to 55 years. In each case penile prosthesis placement was insufficient to correct the malformation and the addition of multiple plication sutures was required. The malformation in all patients was corrected with this technique. To date no patients have reported any complications with followup (range 3 to 36 months). CONCLUSIONS: In cases of severe penile deformity and curvature with erectile dysfunction the combination of penile plication and inflatable penile prosthesis placement is a method of repair that is well tolerated.

Adult↗
PubMed1994

Long-term experience with controlled expansion cylinders in the AMS 700CX inflatable penile prosthesis and comparison with earlier versions of the Scott inflatable penile prosthesis.

UNLABELLED: OBJECTIVEs. To determine complication and survival rates of the AMS 700CX penile prosthesis and to compare its reliability with earlier versions of the Scott inflatable penile prosthesis. METHODS: Retrospective chart review and telephone interviews were used. RESULTS: Actual 4-year survival of the AMS 700CX device was 85%, whereas earlier versions of the device had actual 4-year survival of 46% (p < 0.0001). The observed difference in prosthesis reliability could not be accounted for by differences in patient population, surgical technique, or incidence of infections. The most significant factor that contributed to improved prosthesis survival was the lack of cylinder complications (leaks and aneurysms). CONCLUSIONS: The controlled expansion cylinders of the AMS 700CX penile prosthesis are a significant advance in reliable, low-morbidity surgical therapy for impotence.

Actuarial Analysis↗
PubMed2001

Corporoplasty using pericardium allograft (tutoplast) with complex penile prosthesis surgery.

Penile prosthesis implantation can be challenging for such presentations as penile fibrosis and prosthesis erosion and conditions in which the corporal body is severely damaged or deficient. The technical complexity of some repairs and the infections associated with synthetic graft materials will sometimes pose limitations to using these materials. We offer a new role for Tutoplast processed pericardial allograft for complex corporoplasty during penile prosthesis surgery.

Aged↗
PubMed1993

[Approval process of "medical devices" exemplified by the penile prosthesis].

The penile prosthesis AMS Hydroflex was successfully introduced in 1985, yet only 5 years later was withdrawn from the market. The approval process of medical devices in the USA and Switzerland is critically analyzed. While the American Food and Drug Administration (FDA) is responsible for approving the marketing of medical devices in the USA no such office exists in Switzerland. In Switzerland the physician takes full responsibility when using a device. It is, however, intended to introduce similar to the USA three regulatory control categories depending upon the degree of regulation necessary to assure safety and effectiveness of each device.

Adult↗
PubMed2000

Penile prosthesis surgery under local penile block anaesthesia via the infrapubic space.

The aim of this study was to evaluate the effectiveness and patient tolerance to local penile block anaesthesia via the infrapubic space with penile prosthesis implantation. Local anaesthesia was administered using a 23-guage 1.5-inch needle. A 50-50 mixture of 0.5% bupivicaine (Marcaine) and 0.5% lidocaine (Xylocaine) without adrenaline was injected into the infrapubic space with additional subcutaneous penile ring infiltration at the level of the penile root. A total number of 159 patients underwent this technique, mean age 57 years (range 34-86). In 148 (93%) patients, no booster sedation was needed; eight (5%) patients needed a boost of the pre-operative sedative during crural dilatation; three (1.8%) patients required general anaesthesia owing to insufficiently effective local anaesthesia and unexpectedly difficult dilatation. It is concluded that local anaesthesia was effective and safe to produce a pain-free procedure in 93% of cases. However, as the need for booster sedation or general anaesthesia exists, the procedure should be performed under monitored anaesthetic care and pre-operative evaluation should be performed as for general anaesthesia.

Adult↗
PubMed1987

Penile prosthesis reimplantation.

Occasionally, penile prostheses are removed following erosion, infection or malfunction and they are not replaced immediately. Patients may present later for reimplantation of a penile prosthesis after an interval free of a device. However, no information is available as to the outcome and difficulties of such a procedure. We reviewed the charts of all 305 patients undergoing implantation of a penile prosthesis at our institution and contacted all 8 who had undergone reimplantation. Bilateral prostheses were placed in 4 patients. Unilateral prostheses only could not be implanted in either side because of extensive fibrosis. Of the 8 patients 4 are able to have intercourse (1 with difficulty) and reimplantation of the prosthesis often was difficult or impossible. We conclude that reimplantation of a penile prosthesis is beneficial for some patients but they should be informed of the possibility of unsatisfactory results.

Adult↗
PubMed2006

Determinants of patient satisfaction following penile prosthesis surgery.

PURPOSE: Penile prosthetic surgery is associated with satisfaction rates >90% for the general penile implant population. It is suggested that satisfaction rates may be lower in certain populations. This study was undertaken to define potential predictors of satisfaction. METHODS: Patients undergoing penile prosthesis surgery completed the International Index of Erectile Function (IIEF) prior to surgery, and the IIEF and Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaires at least 6 months postoperatively accompanied by a Global Satisfaction Question (GSQ). RESULTS: A total of 114 patients constituted the study population. Subgroups evaluated included patients with Peyronie's disease (PD), body mass index (BMI) > 30 kg/m2, radical prostatectomy (RP), and patient age > 70 years. The mean patient age and duration of ED were 59 +/- 14 and 3.2 +/- 1.9 years, respectively. All groups demonstrated statistically significant differences between pre- and postoperative scores for the IIEF and EDITS. Patients with PD, a history of RP, and BMI > 30 kg/m2 had significantly lower scores on the GSQ, IIEF satisfaction domain, and EDITS compared with the general implant population. Only PD impacted negatively on the postoperative IIEF erectile function domain score. On the multivariate analysis, factors associated with >or=5-point difference in the IIEF satisfaction domain score compared with the general implant population were PD (RR = 4.2), RP (RR = 2.2), and BMI > 30 (RR = 1.8). CONCLUSIONS: These data suggest that men diagnosed with PD, BMI > 30, or previous RP undergoing penile prosthesis surgery have lower satisfaction rates than the general penile implant population.

Adult↗
PubMed1988

Infectious complications of penile prosthesis surgery.

Penile prosthetic surgery has become an increasingly common procedure. However, infection of the prosthesis remains a significant complication that almost always results in loss of the device. We present our 10-year experience with 9 infected prostheses among 417 total penile implants, for an over-all incidence of infectious complications of 2.2 per cent. A strict, broad-spectrum antibiotic schedule was adhered to rigidly by all patients, beginning preoperatively and continuing for a total of 10 days of perioperative coverage. Staphylococcus species were cultured in 56 per cent of the infected patients and in 100 per cent of the patients with positive cultures. Spinal cord injury patients showed a particular predisposition to prosthetic infection, with a 15 per cent incidence of infectious complications. Two other patients became infected after dental procedures and the need for routine antibiotic prophylaxis in the penile prosthesis patient is emphasized. Urinary tract instrumentation at the time of prosthetic implantation, whether planned or incidental, also appears to add a potentially avoidable risk for subsequent infection.

Adult↗
PubMed1986

Experience with the AMS 600 malleable penile prosthesis.

A malleable penile prosthesis incorporating a stainless steel core has been designed to provide a more rigid prosthesis while still ensuring concealability. A total of 56 patients in our initial series underwent implantation of this malleable penile prosthesis. Our experience indicates that this prosthesis provides ease of implantation, outstanding cosmetic results, and a much simplified and reduced inventory.

Adult↗
PubMed1975

The use of sex therapy in a patient with penile prosthesis.

An implantable penile prosthesis is being used for treatment of erectile organic impotence. A patient treated in this manner required additional therapy for the maladaptive processes in the relationship. Sex therapy including supportive psychotherapy, sex education, relationship therapy, and behavior modification was ultilized for the relationship. This therapy is compatible with the penile prosthesis and may be imperative for some patients

Behavior Therapy↗
PubMed2003

[Three-piece inflatable penile prosthesis implantation for the treatment of penile erectile dysfunction].

OBJECTIVES: To introduce the method and experience of three-piece inflatable penile prosthesis for treatment of erectile dysfunction (ED). METHODS: Both AMS700CX/CXM and MENTOR ALPHA I three-piece inflatable prosthesis were used for 48 cases of ED. RESULTS: There were no rejection, mechanical problems, urethral injury and penile skin necrosis after surgery. All patients had satisfaction of sexual life. Only one case had trauma of tunica albuginea (2.08%) and the implantation had to be cancelled. There were 2 cases of post-operative infection (4.17%), 10 cases of prepuce edema(20.8%), 8 cases of penile pain(16.67%). The effective rate was 97.9% and satisfaction rate was almost 100%. CONCLUSIONS: Three-piece inflatable penile prosthesis was more compatible to human physiology. It is natural, easy to hide and use, and it caused little trauma in surgery with high rate of successful implantation and patient satisfaction. It was indicated for all kinds of ED, especially suitable for refractory and drug incurable ED patients.

Adolescent↗
PubMed2005

Rare complication of multiple revision surgeries of penile prosthesis.

INTRODUCTION: Migration of the penile prosthesis reservoir into the bladder is rare. METHODS: A 67-year-old male was found with painful gross hematuria after two revision surgeries of the penile prosthesis. RESULTS: The inflatable penile prosthesis reservoir migrated into the bladder. A new reservoir was repositioned on the contralateral side to the erosion site with salvage surgery. CONCLUSIONS: Erosion of penile prosthesis reservoir into the bladder due to shortened tubing by multiple revision surgeries is rare. In selected cases, reposition of a new reservoir on the contralateral side to the erosion site can be used as salvage surgery.

Aged↗
PubMed2000

Intraurethral application of alprostadil in patients with failed inflatable penile prosthesis.

PURPOSE: Many men who underwent penile prosthesis implantation before the advent of oral and injection therapy present for replacement of a malfunctioning prosthesis but choose not to undergo revision surgery because of personal, medical or reimbursement issues. Others with normally functioning prostheses report significant difficulties with "cold glans," and they and their partners observe decreased engorgement and temperature of the glans penis with the inflated penile prosthesis, despite adequate stimulation. Intracorporal injection therapy is contraindicated in any patient with a penile prosthesis and use of a vacuum erection device may result in prosthesis cylinder rupture. In these patients intraurethral application of alprostadil may restore prosthesis function and permit satisfactory intercourse. We evaluate the efficacy of a medicated urethral system for erection (MUSE) using alprostadil to restore function for men with a failed prosthesis, and improve glans penis temperature sensation and engorgement for those with a functioning prosthesis. MATERIALS AND METHODS: From February 1997 to February 1998, 28 men 47 to 81 years old (mean age 61.2) with a penile prosthesis were treated with alprostadil. Of the patients 11 had penile prosthesis failure (group 1) and 17 reported decreased glans penis engorgement (group 2). In 18 cases erections were observed at the clinic. Doses of alprostadil varied from 250 to 1,000 microgm. (mean 566). RESULTS: Of the 28 patients 23 had a response to alprostadil. Erections were sufficient for intercourse in 7 of 11 group 1 patients, and 10 of 17 group 2 were satisfied with treatment. There was no device specific morbidity but 12 men discontinued use of alprostadil because of penile pain. A significant or excellent response was noted in 10 of 18 men observed at the clinic. CONCLUSIONS: Intraurethral alprostadil may be used to restore or improve function of a penile prosthesis in patients with a malfunctioning device or lack of glans penis engorgement, with low expected morbidity.

Aged↗
PubMed2000

Surgical management of penile prosthesis complications.

Penile implants are mechanical devices used to treat erectile dysfunction. Parts of the implants may wear out with time, and the implants themselves may damage the body cavities in which they have been placed, especially with excessive or aggressive use. Techniques to replace parts, repair body cavities, and deal with infection associated with prosthesis placement have been developed. Satisfaction with the resulting erections is the highest among all the modalities available for treating erectile dysfunction. International Journal of Impotence Research (2000) 12, Suppl 4, S108-S111.

Equipment Failure↗