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At least 145 records · Page 8Linked to original sources

PubMed1983

Inflatable penile prosthesis: experience with 100 patients.

The experience with 100 consecutive patients in whom an inflatable penile prosthesis was implanted for the treatment of chronic erectile impotence over a two-year period is reported. Each patient was thoroughly evaluated by history, physical examination psychologic investigation, and appropriate laboratory testing. Of these patients, the most common indication for prosthesis implantation was diabetes mellitus of adult onset, followed by vascular disease and radical pelvic surgery. Restoration of erectile function was accomplished in 99 patients. Mechanical complications and malfunction occurred in 12 patients; all such complications were surgically corrected in subsequent operative procedures. One diabetic patient experienced infection of the prosthesis, requiring its removal. The implantation of an inflatable penile prosthesis in properly selected patients, with careful surgical technique by a skilled and experienced surgeon, can produce excellent functional results and return of normal sexual activity.

Adult↗

PubMed1995

Mentor alpha-1 inflatable penile prosthesis cylinder aneurysm: an unusual complication.

This report describes the author's experience with Mentor Alpha-1 inflatable penile prosthesis cylinder aneurysms. In a series of 93 consecutive cases three implants developed a cylinder aneurysm. Two aneurysms developed intraoperatively and one developed 27 months postoperatively. Literature review suggests that the Mentor Alpha-1 penile prosthesis cylinders are very resistant to aneurysm formation under normal circumstances. However aneurysmal dilatation may occur if the cylinders are subjected to unusual stress.

Aged↗

PubMed1994

GFS Mark II inflatable penile prosthesis: four-year clinical study.

OBJECTIVE: The objective of the study was to evaluate the mechanical performance and the patient/partner satisfaction of the GFS Mark II inflatable penile prosthesis (IPP). METHOD: A total of 138 patients had GFS Mark II IPP implants between October 1988 and December 1991 with a follow-up of twelve to fifty months (mean 31.7 months) were studied. Each patient was evaluated for prosthesis performance and each patient/partner satisfaction was evaluated by a questionnaire and personal interview. RESULTS: There was only one prosthetic mechanical problem which involved the tubing. There were seven problems requiring explanation; two of which were postoperative infections. Thirteen patients required an addition of normal saline through the resipump as an office procedure. Ninety-three percent of the patients and 98 percent of the partners reported satisfaction with the use of the prosthesis. Men who had a previously inserted penile prosthesis replaced with the GFS Mark II IPP preferred the GFS over the malleable and the self-contained prosthesis, but there was no conclusive preference between the different IPPs. CONCLUSIONS: This study concludes that the GFS Mark II connectorless IPP has shown few mechanical problems over a four-year period and has a good patient/partner satisfaction. This prosthesis has the additional feature of the resipump to adjust the fluid volume as an office procedure when required.

Erectile Dysfunction↗

PubMed1990

Erectile response to intracavernous injection of vasoactive drugs after penile prosthesis removal.

Two patients with a history of penile prosthesis removal presented for non-prosthetic treatment of their erectile dysfunction. The first patient had a penile implant for two years before it was removed and showed extensive cavernosal fibrosis. He did not respond to intracavernosal injection of vasoactive drugs. The second patient had the prosthesis for four weeks. He showed no evidence of cavernosal fibrosis and responded well to the intracavernous injection. He has been in an intracavernous autoinjection program for more than one year without complications.

Aged↗

PubMed1996

Penile curvatures and aneurysmal defects with the Ultrex penile prosthesis corrected with insertion of the AMS700CX.

PURPOSE: We reviewed our series of patients with an AMS700 Ultrex penile prosthesis whose erectile deformities were corrected by replacement with AMS700CX cylinders. MATERIALS AND METHODS: Ultrex cylinders were replaced by AMS700CX cylinders in 7 men with erectile deformities. RESULTS: Deformities were corrected successfully in all 7 patients. The penis is completely straight in 6 patients, while a mild 30-degree ventral curvature is present in 1. CONCLUSIONS: Erectile deformities with the AMS700 Ultrex penile prosthesis can be repaired successfully by replacement with the AMS700CX cylinders.

Adult↗

PubMed1990

Penile advancement and lengthening in spinal cord injury patients with retracted phallus who have failed penile prosthesis placement alone.

Even in the presence of a penile prosthesis, a subset of spinal cord injury patients remains unable to maintain a condom catheter securely due to inadequate penile shaft length and disappearance of the corpora beneath the pubic fat pad when in the sitting position. We describe 3 patients in whom a successful resolution to this problem has been achieved with rational surgical management, including lysis of the suspensory ligament of the penis, approximation of the infrapubic soft tissues posterior to the corpora so as to advance the corpora anteriorly and buttress against posterior migration (retraction) in the sitting position, maximizing the length and fit of prosthetic rods, and, when indicated, release of infrapubic skin tethering with a modified Z-plasty technique.

Adipose Tissue↗

PubMed2006

Preservation of existing inflatable penile prosthesis pump mechanism during scrotal surgery.

INTRODUCTION: There is little reported regarding the feasibility of scrotal surgery in patients with an existing penile prosthesis. We report a series of two patients with existing inflatable penile prostheses who underwent scrotal surgery for unrelated indications in which the prosthesis pump mechanism and tubing were preserved. In both instances, damage to the prosthetic pump and tubing were avoided. AIM: To demonstrate two instances where scrotal surgery was performed successfully in the setting of a pre-existing penile prosthesis. METHODS: Two cases of patients with existing penile implant who underwent scrotal surgery for pathology unrelated to the implant are reported. CONCLUSIONS: It is possible to perform scrotal surgery in a patient who has an existing penile prosthesis without injuring or infecting the prosthesis.

Aged↗

PubMed1996

Prevention and treatment of complications of inflatable penile prosthesis surgery: a review article.

Over the last 16 years more than 3,000 procedures involving multi-component inflatable penile prosthesis have been performed. A variety of types of complications have been encountered, including mechanical problems with the prosthesis, intraoperative complications, postoperative complications, problems with infection and patient dissatisfaction. During the course of this experience we have made some observations and developed techniques to minimize and treat the complications seen with both routine and difficult inflatable penile prosthesis implantation surgery.

Humans↗

PubMed1996

Three-piece inflatable penile prosthesis implantation: a comparison of the penoscrotal and infrapubic surgical approaches.

Patient satisfaction with the three-piece inflatable penile prosthesis was evaluated in two surgical subgroups following randomized implantation: those who underwent implantation via an infrapubic (IP) approach and those via a penoscrotal (PS) incision. Follow-up questionnaires were mailed to 86 patients who had undergone implantation of a Mentor alpha-1 or AMS 700CX inflatable penile prosthesis between August 1989 and November 1992. The questionnaire (54 items) was designed to elicit both factual and perceptual information in the areas of general medical information, prosthesis usage, erectile quality, postoperative complications, and general satisfaction. Questionnaire data was enhanced by a review of the clinic and hospital records of each patient who returned the questionnaire. Patients were followed postoperatively at regular intervals for a minimum of 6 months. Results demonstrate an overall patient satisfaction of 85%. Breakdown into the two surgical subgroups revealed similar rates of satisfaction by both groups. Analysis of the 42 questionnaires returned demonstrated no statistical differences in the replies of the two groups in either the factual or perceptual data. The most common sources of dissatisfaction related to penile length, girth, and difficulty with usage. This study demonstrates no compelling advantages in employing one surgical approach over the other.

Humans↗

PubMed1987

Tunica wedge excision to correct penile curvature associated with the inflatable penile prosthesis.

We encountered 7 cases of significant penile curvature after placement of an inflatable penile prosthesis. In 3 cases curvature was present preoperatively owing to Peyronie's disease and penile trauma, while in 4 it developed postoperatively owing to improper penile positioning. Curvature was straightened successfully by removal of small elliptical wedges of tunica albuginea of the corpus cavernosum from the convex surface of the curve and closing the defects created with 3-zero polydioxanone sutures. A subjectively gratifying result was achieved in each instance.

Adult↗

PubMed1990

Early experience with the DuraPhase penile prosthesis.

A retrospective review of the medical records of 26 consecutive patients who underwent surgical implantation of the DuraPhase penile prosthesis for erectile impotence was performed. In addition, telephone interviews were used to evaluate patient and partner satisfaction with the device. Average patient age was 61 years. The presumed etiology of erectile dysfunction was vascular in 19 patients, postoperative in 4 and neurogenic in 3. Followup averaged 5 months (range 1 to 15 months). Sixteen patients and partners with a minimum of 3 months of followup were evaluated for satisfaction with the device. On a scale of 1 to 10 the average patient score was 8.6 and the average partner score was 9. Our early experience with the DuraPhase penile prosthesis has been favorable. Surgical insertion is simple, and patient and partner satisfaction has been superior. The device functions easily, can be well concealed and has excellent axial rigidity for intercourse.

Adult↗

PubMed1992

Use of a polytetrafluoroethylene tube graft as a circumferential neotunica during placement of a penile prosthesis.

Various techniques have evolved for augmentation of the tunica albuginea in cases when tunical tissue has been found deficient during penile prosthesis implantation. An intraoperative situation occurred in which the size of the tunical defect did not permit primary tunical closure or allow for approximation by placement of a tunical patch graft. In this case, to ensure satisfactory insertion of a penile prosthesis a polytetrafluoroethylene (Gore-Tex) tube graft was used as a circumferential neotunica.

Adult↗

PubMed1994

Self-contained, inflatable penile prosthesis: magnetic resonance appearance.

The appearance of an inflatable penile prosthesis, visualized on a short tau inversion recovery sequence, is reported, in a patient who had magnetic resonance imaging for pelvic pain subsequent to radical cystoprostatectomy for bladder carcinoma. With suppression of adjacent fat signal, the prosthesis is well delineated from adjacent structures. The fluid-containing cylinders of the prosthesis are of very bright signal intensity, with the relief valve assembly of low signal intensity.

Humans↗

PubMed1992

Risk factors associated with penile prosthesis infection.

We reviewed all 269 patients who underwent penile prosthetic implantation during the last 10 years. The data were analyzed to determine the rate of penile prosthesis infection and to determine the risk factors associated with these infections in this group. We also examined the effect of strict surgical technique, intraoperative scrub and perioperative antibiotics on these implant infections. All patients had perioperative antibiotics, an intraoperative shave and a 15-minute intraoperative skin preparation. There were 162 semirigid and 107 inflatable prostheses inserted. Mean followup was 32 months (range 2 to 123 months). Only 6 patients had an infection, with 5 prostheses being removed. All 6 patients had a history of urinary tract infection. Furthermore, all 6 patients had either a neurogenic bladder (4), diabetes (1) or an ileal conduit (1), which increased the risk of a urinary tract infection. Cultures of the infected prostheses revealed only enteric organisms. No staphylococci were cultured. We conclude that perioperative antibiotics, intraoperative shave and scrub, and strict surgical technique resulted in a low prosthesis infection rate (1.9%) in these patients. However, a group of patients still exist that despite these precautions are at risk for infection due to conditions that may predispose them to urinary tract infections.

Humans↗

PubMed1986

Mentor inflatable penile prosthesis: a reliable mechanical device.

Forty-six patients have undergone implantation of a penile prosthesis using the Mentor inflatable device. All patients are at least six months postimplantation, with the average follow-up being twenty-one months. Six patients have required reoperation due to technical problems, but there have been no mechanical failures. This low mechanical failure rate greatly enhances the attractiveness of this type of penile prosthesis when comparing it with the semirigid devices.

Erectile Dysfunction↗

PubMed2002

Erosion of a penile prosthesis due to an indwelling urethral catheter as a late complication.

A case of erosion of a penile prosthesis caused by indwelling of a catheter in the urethra is reported. A 73-year-old man had maintained sexual intercourse with penile prostheses (Jonas prosthesis, 19 cm) for 11 years without any complications until he developed cerebral infarction. One month after starting an indwelling urethral catheter in a neurosurgery clinic, the left-side penile prosthesis eroded from the area of the fossa navicularis, and was immediately removed. This type of complication is not unusual in patients with a neurogenic bladder. However, it is not well recognized in patients who suddenly develop a neurogenic bladder following a long-term uneventful period after the implantation of penile prostheses. Therefore, urologists should inform patients who receive this type of treatment that erosion of the prosthesis may develop when they need an indwelling urethral catheter as a late complication.

Aged↗

PubMed1988

Evaluation of patients and partners 1 to 4 years after penile prosthesis surgery.

One to 4 years after penile prosthesis implantation 52 men and 22 partners were interviewed personally. All except 4 patients were having intercourse on a regular basis. A quarter of the patients reported restriction in intercourse positions, possibly because of a smaller penis postoperatively, and 15 per cent reported decreased orgasm intensity. Six men had an undiagnosed prosthesis malfunction or they used an inadequate pumping technique, suggesting that prosthesis patients should be followed on a continuing basis. The 52 men had experienced 10 malfunctions with the prosthesis. Partial erections were reported by 69 per cent of the patients but this could be confirmed in only 1 of 10 with visual sexual stimulation testing. It is suggested that differences between prosthesis models are more a result of psychological, relationship and health factors than mechanical factors. Of the patients 79 per cent would undergo the operation again but only 59 per cent of the partners had no hesitations. The longer the postoperative period the more hesitations. A satisfaction score was used to measure patient satisfaction.

Coitus↗

PubMed1986

Clinical experience with Mentor inflatable penile prosthesis in 206 patients.

The Mentor inflatable penile prosthesis (IPP) has been implanted in 206 patients with organic (95.2%) or psychologic (4.8%) impotency. The patients have been followed up for an average of 18.1 (4-42) months. A satisfactory result has been achieved in 98 per cent of these patients. A life analysis of the series shows that 88 per cent of all devices implanted will survive forty-two months without mechanical failure. One hundred sixty-four of these patients had not had previous penile surgery while 42 had had one or more penile prostheses implanted previously. The projected forty-two-month survival for the Mentor prosthesis in these subgroups is 94 per cent and 74 per cent, respectively. The improved life expectancy of the Mentor IPP, compared with the Scott IPP, is due to the superior durability of Mentor's polyurethane cylinders and to the increased reliability of the Mentor snap-on connector system. In this respect, there have been only one cylinder failure and 3 connector failures in the Mentor series. The connector failures occurred early in the series before the development of connector pliers; there have been no connector failures in the last 202 consecutive implantations. Wear-induced tubing leaks, the most common cause of device failure, occurred in 2.9 per cent of all implantations. Tubing failures were more common in patients who have had previous surgery, occurring in 9 per cent of salvage procedures and 1.3 per cent of primary implantations. The reason for the difference in tubing survival in virgin and salvage procedures is unknown; possibly the subcutaneous scar tissue present in secondary surgical procedures increases the chance of tubing segments touching and abrasing each other. Laboratory studies suggest that the nylon-reinforced tubing used in the manufacture of devices implanted since 1985 is more durable than is the standard silicone tubing used in the construction of devices implanted previously.

Adult↗