Regional Urology, Shreveport, LA, USA.
Division of Urology, Department of Surgery, Duke University, Durham, NC, USA; Department of Urology, Columbia University Medical Center, New York, NY, USA; Department of Urology, University of North Carolina, Chapel Hill, NC, USA; Institute for Urologic Excellence, Indio, CA, USA; Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR, USA; University of Maryland School of Medicine, Baltimore, MD, USA.
Inflatable penile prosthesis (IPP) implantation is a well-established treatment for medically refractory erectile dysfunction, with long-term reliability. Overall survival is 96% at 5 years and 60% at 15 years for primary (virgin) implantation.
The aim of this study was to explore factors associated with success and complications of IPP revision surgery in a multicenter study.
Reasons for revision including mechanical issues, patient dissatisfaction, corporal deformity, and supersonic transport (SST) deformity were recorded.
At four institutions, 214 clinically uninfected IPP revisions were performed between November 2000 and November 2007. Data were incomplete for 28 cases (14%). Failure-free survival was estimated using Kaplan-Meier's Meier product limit method. Results. The majority of revisions were secondary to mechanical failure (N = 109; 65%) and combined erosion or infection (N = 17 + 15 = 32; 19%). Sixteen percent (N = 26) were carried out on functional uninfected prostheses secondary to patient dissatisfaction (N = 9), SST deformity (N = 10), scrotal hematoma (N = 2), or upsize revision because of corporal fibrosis (N = 5). Average age at revision was 66 years. Mean follow-up time was 55.7 months. In this study, 12 individuals required a secondary revision procedure or suffered a complication. Despite prior reports of high infection rates with revision surgery, only 5.7% of clinically uninfected and noneroded prostheses were complicated by infection or impending extrusion/erosion, following a revision washout protocol. Overall, 93% of cases were successfully revised, providing functioning IPPs.
For this study population, component exchange followed by revision washout showed a low incidence of infection and subsequent mechanical failure.
Written by:
Henry GD, Donatucci CF, Conners W, Greenfield JM, Carson CC, Wilson SK, Delk J, Lentz AC, Cleves MA, Jennermann CJ, Kramer AC. Are you the author?
Reference: J Sex Med. 2011 Nov 14. Epub ahead of print.
doi: 10.1111/j.1743-6109.2011.02524.x
PubMed Abstract
PMID: 22082149
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