When a mechanical malfunction occurs, prosthetic urologists are faced with the dilemma to revise the malfunctioning component or replace the entire device. Some in prosthetic urology advocate for the revision of only the malfunctioning component to decrease the surgical morbidity and costs associated with complete exchange. However, there are no findings within the penile prosthetic literature to support this claim.
In this study, we compared complication rates among men undergoing partial component revision to those having complete exchange for mechanical malfunction of an IPP. We found a higher rate of complications in men undergoing partial component exchange despite having a shorter time from original implant to revision. We found it interesting that there was a predilection for pump and tubing related complications in the partial exchange group. Additionally, noninfectious complications occurred in 30% of men solely undergoing pump revision. This is potentially related to the fact that pump revision requires 3 new tubing connections which may be more prone to failure. Although it is tempting to only revise the pump in the setting of obvious pump failure or tubing breakage near the pump, our findings suggest these men may be more prone to complications and may require further surgery.
Written by:
- David W. Barham, MD, Department of Urology, University of California, Irvine-Orange, CA
- Martin S. Gross, MD, Section of Urology, Dartmouth-Hitchcock Medical Center-Lebanon, NH
- Jay Simhan, MD, Department of Urology/Urologic Oncology, Fox Chase Cancer Center-Philadelphia, PA
- Faysal A. Yafi, MD, Department of Urology, University of California, Irvine-Orange, CA