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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↗

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↗

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↗

PubMed1991

Mechanical complications associated with mentor inflatable penile prosthesis.

The Mentor inflatable penile prosthesis was developed in an attempt to decrease the mechanical failure rate of the various prostheses' components. We herein report on the reliability of the device in 46 men implanted with the Mentor device from December 1982 to June 1987. Prior to manufacturer device modification in 1985, mechanical failure mainly attributable to input tubing cracks occurred in 10 of 30 implantations. Since device improvement in April 1985, the mechanical failure rate has decreased to 4 percent. The Mentor inflatable penile prosthesis has been a mechanically reliable device since design improvement in 1985.

Adult↗

PubMed1992

The G.F.S. Mark II inflatable penile prosthesis.

The G.F.S. Mark II inflatable penile prosthesis was implanted in 80 men who were followed for up to 27 months. In this study there have been no mechanical problems. Of the patients 6 required repositioning of the reservoir pump and 4 required postoperative addition of fluid to the reservoir pump. This study indicates that the revised connectorless G.F.S. Mark II inflatable penile prosthesis has eliminated the previous problems with connectors and tubings. The G.F.S. Mark II inflatable penile prosthesis reservoir pump provides a means of postoperative fluid adjustment within the system performed as an office procedure.

Adult↗

PubMed1989

Negative pressure devices in the explanted penile prosthesis population.

Of 402 penile prosthesis implanted at our institution between 1980 and 1987, 20 required explantation due to infection, erosion, pain or tissue necrosis. Of these 20 patients 14 were available for a prospective trial using a negative pressure device in an attempt to restore potency. Among these 14 patients 11 used the device at home for a minimum of 30 days after an acceptable office demonstration. Three patients did not desire the negative pressure device after an office visit test. Of the 11 home users 10 (91 per cent) reported at least satisfactory erections and successful intercourse. Interestingly, 5 of 6 patients in whom explantation was due to infection were able to use the negative pressure device successfully. Over-all, 10 of the 14 explant patients (71 per cent) engaged in regular successful intercourse using the device. The negative-pressure device can be a useful therapy for erectile impotence even in the sometimes challenging explant population. Despite previous corporeal infection and presumed fibrosis, negative pressure devices can provide patients with a functional erection-like state.

Consumer Behavior↗

PubMed1992

[Implantation of self-contained non-inflatable penile prosthesis in patients with organic impotence].

Between April, 1988 and August, 1990, the OmniPhase penile prosthesis, a non-inflatable self-contained penile prosthesis, was implanted in 34 patients, aged from 37 years to 79 years, averaging 54.2 years. The etiologies of the impotence were radical surgery for bladder cancer or rectal cancer in 17 patients, diabetes mellitus in 7 patients, vascular abnormality in 3 patients, spinal injury in 2 patients, penile disorders in 2 patients and others in 3 patients. Penile prosthesis was implanted by subcoronal incision under spinal or general anesthesia. Clinical results were evaluated 12 weeks after surgery. Thirty-two patients (94.1%) could have intercourse postoperatively. Eighteen patients (52.9%) were completely satisfied and 14 patients (41.2%) were satisfied, whereas one patient (2.9%) had no improvement and another patient (2.9%) deteriorated. There was no serious complication. However, prosthesis was explanted because of skin erosion in one patient. Pain, which lasted for more than 10 days, was seen in 3 patients (8.8%), penile edema in 11 patients (32.4%), and acute epididymitis in one patient. The obtained results showed that implantation of OmniPhase penile prosthesis is a safe and useful procedure for treatment of organic impotence.

Adult↗

PubMed1976

[Surgical treatment of erectile impotence using the AMS penile prosthesis].

First experiences with an AMS penile prosthesis which can hydraulically fill and empty is reported. Advantage of this prosthesis: Physiologic imitation of erection and handling this method. The best cosmetic solution of all previous types of penile prosthesis. Disadvantage: A relatively complicated system and thus liable to defects. However, repairing is, in any case, easily done. After 3 years of use, experience is showing that this method turned out to be a cosmetically and functionally satisfying operative procedure.

Erectile Dysfunction↗

PubMed1988

42 months of experience with the Mentor inflatable penile prosthesis.

The Mentor inflatable penile prosthesis is a hydraulic device that was introduced in May 1983 for the treatment of erectile dysfunction. Since its introduction further technical modifications and improvements have been made on the product. From the onset the reliability, function and cosmetic effect of this physiological device have been excellent. The modifications have served to improve the ease of operation and to increase further the reliability as demonstrated by our progressive decrease in the incidence of mechanical failures. From May 1983 to November 1986 we implanted 137 Mentor inflatable penile prostheses. Our over-all mechanical failure rate was 7.3 per cent. As a result of the modifications, however, the mechanical failure rate decreased to 3.1 per cent during the last 38 months of that period when 129 (94 per cent) of the prostheses were implanted, and during the last 24 months of that period when 86 (63 per cent) of the prostheses were implanted the mechanical failure rate was only 1.2 per cent.

Adolescent↗

PubMed1985

Single cylinder penile prosthesis.

The single cylinder penile prosthesis is a viable procedure. It has many advantages. Its success depends on the careful selection, counseling, and follow-up of the patients and their partners.

Aged↗

PubMed1986

Operative approach for secondary placement of penile prosthesis.

Secondary placement of penile prosthesis was done in 8 patients following removal of the primarily placed prosthesis for extrusion and infection. Exposure of the corpora cavernosum along its entire length facilitated placement of semirigid prosthesis in each of these patients. The postoperative result was functional in all cases with a normal size in girth and parallel alignment of the distal tip of the prosthesis. In each case the secondarily placed prosthesis was shorter than the primarily placed prosthesis, and the amount of decrease in length appeared to be dependent on the severity of the complication that led to the removal of the primarily placed prosthesis.

Erectile Dysfunction↗

PubMed1991

Outpatient 3-piece inflatable penile prosthesis.

The 3-piece inflatable penile prosthesis was implanted in 74 consecutive organically impotent outpatients during the last 4 years. The classical infrapubic surgical approach required minor alterations to adapt to the outpatient setting. This cost-reducing technique is safe medically and cogent financially.

Adult↗

PubMed1987

Erosion of an inflatable penile prosthesis reservoir into an ileal conduit.

We report an unusual complication of an inflatable penile prosthesis. The penile prosthesis reservoir had been placed intra-abdominally and it eroded into an ileal conduit. The reservoir was removed endoscopically but the patient ultimately required creation of a new ileal conduit. Placement of reservoirs intraperitoneally risks erosion into the bowel.

Adult↗

PubMed1991

Cost-benefit analysis of pharmacologic erection program (PEP) versus penile prosthesis.

We compared the current dollar inclusive costs of the two most commonly implanted penile prostheses with our pharmacologic erection program (PEP). The inclusive cost of implantation for the inflatable penile prosthesis (IPP) is $9,000 and for the malleable penile prosthesis (MPP) $3,150. The inclusive cost of PEP at maximal dose and maximal frequency of use over a five-year period is $3,450. Penile prosthesis was found to be more cost-effective for the long-term treatment of younger impotent men, whereas in the elderly group the use of PEP over a limited time span may be equally or more cost-effective.

Cost-Benefit Analysis↗

PubMed1989

Small-bowel obstruction by an inflatable penile prosthesis reservoir.

Early experience with the inflatable penile prosthesis has been plagued with high failure rates. With improvements in design and surgical technique, the relative incidence of mechanical failures has decreased from 69.9% of all complications to 38.2%, increasing the relative importance of pathologic failures (from 27.3% to 56.4%). The overall complication rate has decreased from an initial 32.5% to 9.0% in recent series. A unique case of small-bowel obstruction caused by intraluminal migration of the reservoir of an inflatable penile prosthesis is described. It was successfully managed by resection of the affected bowel loop and extraperitoneal reimplantation of the reservoir. Although general surgeons are not involved in the placement of these devices, it is important for us to be aware of the possibility of erosion and migration of the component parts, which may result in potentially lethal gastrointestinal and other complications that we may be called on to assess.

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↗