https://doi.org/10.4081/aiua.2020.4.302

Penile prosthesis and complications: Results from 577 implants

Vol. 92 No. 4 (2020)
Submitted: June 14, 2020
Accepted: August 26, 2020
Published: December 17, 2020
Penile prosthesis surgery; Complications; Infections
Abstract Views: 1411
PDF: 661
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Authors

Diego Pozza
diegpo@tin.it
Studio di Andrologia e di Chirurgia Andrologica, Roma, Italy.
Andrea Marcantonio
Studio di Andrologia e di Chirurgia Andrologica, Roma, Italy.
Augusto Mosca
Urology and Andrology Unit, S. Sebastiano Hospital, Frascati, Italy.
Carlotta Pozza
Department of Experimental Medicine, Sapienza University, Roma, Italy.

Objective: Penile Prosthetic Surgery is already well characterized but the problems connected with possible complications still need to be evaluated and discussed.
Material and Methods: The Authors revaluated their experience in Penile Prosthetic Surgery involving 577 patients (18 - 86 years, mean age 51.3 years) operated by the same surgeon since 1984. We implanted 199 silicone-semi-rigid (Small Carrion, Implantal, Eurogest, Subrini, SSDA GS), 200 malleable (Jonas, Omniphase, Duraphase, AMS600, MentorColoplast Genesis, Vedise) and 178 inflatable (Mentor: Mark II, Alpha I, Titan OTR; AMS: mono-component Hydroflex, Dynaflex; bi-component Ambicor; multicomponent: 700 Ultrex, 700 CX, 700 LGX) prostheses. Operative, postoperative, infectious and malfunctioning complications have been recorded. A total of 156 patients drop out at follow-up and we may not exclude possible late complications treated at different hospitals.
Results: The recorded complications and the therapeutic modalities utilized to treat them are examined. Operative complications were recorded in 2 malleable prostheses (MPP) and in one inflatable prosthesis (IPP). Postoperative complications have been recorded in three cases of MPP (1.5%) and in 9 IPP (5.0%) and were strictly connected to general medical co-morbidities as diabetes mellitus (DM), coronary artery dysfunction (CAD), and Peyronie’s disease (PD). In three cases of IPP implantation, hematomas were related to the blunt surgical maneuvers utilized to insert the reservoir or the scrotal pumps. Infectious complications were mostly observed in patients with DM: 4 patients with MPP (1.0%) and 15 patients with IPP (8.4%). Malfunction rate of the prostheses in our series was really disappointing considering that 13/17 cases (77%) of mono-component IPP broke while in patients with multicomponent IPP the percentage of malfunction has been of 13/161 (8%) and malfunction was observed in only one case of MPP. We were forced to explant the prostheses in 2 patients with MPP (0.5%) and 40 with IPP (22%). However, after excluding 17 mono-component IPPs, the percentage of explants of multicomponent IPP (23 patients, 4.2%) is in line with other significative experiences.
Conclusion: The number of complications of PPS are similar to those reported by well qualified urological institutions. In our experience a scrupulous antibiotic therapeutic schedule, avoiding direct contact between the prostheses and the patient’s skin, reduced time of surgery with surgeon’s experience positively influenced the results.In a limited number of patients medical treatment or minimal surgical acts allowed to solve the complications preserving the prostheses and avoiding the prosthetic explant

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Citations

Crossref
Scopus
Google Scholar
Europe PMC
Pearman RO. Insertion of a silastic penile prothesis for the treatment of organic sexual impotence. J Urol. 1972; 107:802-6 DOI: https://doi.org/10.1016/S0022-5347(17)61143-1
Scott FB, Bradley WE, Timm GW. Management of impotence erectile. Use of inflatable prostheses. Urology. 1973; 2:80-82. DOI: https://doi.org/10.1016/0090-4295(73)90224-0
Small MP, Carrion HM, Gordon JA. Small carrion penile prosthesis. New implant for management of impotence. Urology. 1975.;5:479-86 DOI: https://doi.org/10.1016/0090-4295(75)90071-0
Pozza D, Rossello Barbara M, Carrion H. L’utilizzazione del Cavernotomo di Carrion-Rossello per l’impianto di protesi intracavernose. Acta Urol Ital 1993; 2:87-8
Mulcahy JJ, Kramer A, Brant WO et al. Current management of penile implant infections device reliability, and optimizing cosmetic outcome. Curr Urol Rep. 2014; 15:413-6 DOI: https://doi.org/10.1007/s11934-014-0413-6
Ehlers M, McCormick B, Coward RM, Figler BD. Innovating Incrementally: Development of the Modern Inflatable Penile Prosthesis. Curr Urol Rep. 2019;20:4 DOI: https://doi.org/10.1007/s11934-019-0880-x
Dhabuvala C. In vitro assessment of antimicrobial properties of rifampicin-coated Titan Coloplast penile implants and comparison with inhibizone. J Sex Med. 2010; 7:3516-9 DOI: https://doi.org/10.1111/j.1743-6109.2010.01874.x
Jani K, Smith C, Delk JR 2nd et al. Infection retardant coating impact on bacterial presence in penile prosthesis surgery: a multicenter study. Urology. 2018; 119:104-8 DOI: https://doi.org/10.1016/j.urology.2018.05.028
Scherzer ND, Dick B, Gabrielson AT, Alzweri LM, Hellstrom WJG. Penile prosthesis complications. Planning, prevention and decision making. Sex Med Rev. 2018; 19:30055-6
Wilson SK, Delk JR. Historical Advances in Penile Prostheses. Int J Imp Res. 2000;12:101-7 DOI: https://doi.org/10.1038/sj.ijir.3900586
Whelan P, Levine LA. Additional procedures performer at time of penile prosthesis implantation: a review of current literature. Int J Impot Res. 2020;32:89-98 DOI: https://doi.org/10.1038/s41443-019-0118-y
Pozza D, Pozza M, Musy M, Pozza C. 500 penile prostheses implanted by a surgeon in Italy in the last 30 years. Arch Ital Urol Androl. 2015; 87:216-21 DOI: https://doi.org/10.4081/aiua.2015.3.216
Habous M, Tal R, Tealab A, Aziz M, Sherif H, Mahmoud S et al. Predictors of satisfaction in men after penile implant surgery. J Sex Med. 2018; 15:1180-6 DOI: https://doi.org/10.1016/j.jsxm.2018.05.011
Scherzer ND, Dick B, Gabrielson AT, Alzweri LM, Hallstrom WJG. Penile Prosthesis Complications: Planning, Prevention, and Decision Making. Sex Med Rev. 2019; 7:349-59 DOI: https://doi.org/10.1016/j.sxmr.2018.04.002
Hebert KJ, Kohler TS. Penile Prosthesis Infection: Myths and realities. World J Mens Health. 2019; 37:276-87 DOI: https://doi.org/10.5534/wjmh.180123
Madiraju SK, Wallen JJ, Rydelek SP, Carrion RE, Perito PE, Hakky TS. Biomechanical Studies of the Inflatable Penile Prosthesis: a Review. Sex Med Rev. 2019;7:369-75 DOI: https://doi.org/10.1016/j.sxmr.2018.11.006
Ure I, Ozen A, Can C. Life quality changes after inflatable penile prosthesis implantation. Aging Male. 2018; 27:1-7 DOI: https://doi.org/10.1080/13685538.2018.1487393
Kramer A, Goldmark E, Greenfield J. Is a closed-suction drain advantageous for penile implant surgery? The debate continues. J Sex Med. 2011; 8:601-6 DOI: https://doi.org/10.1111/j.1743-6109.2010.02088.x
Lokeshwar SD, Madhusoodanan V, Kava B, Ramasamy R. A Surgeon Guide to Various Antibiotic Dips Available during Penile Prosthesis Implantation. Curr Urol Rep. 2019; 20:11 DOI: https://doi.org/10.1007/s11934-019-0874-8
Christodoulidou M, Pearce I. Infection of penile Prostheses in patients with diabetes mellitus. Surg Infect. 2016; 17:2-8 DOI: https://doi.org/10.1089/sur.2015.164
Anafarta K, Yaman O, Aydos K. Clinical Experience with Dynaflex penile prostheses. Urology 1998; 52:1098-100 DOI: https://doi.org/10.1016/S0090-4295(98)00406-3
Diego Pozza, Studio di Andrologia e di Chirurgia Andrologica, Roma

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How to Cite

Pozza, D., Marcantonio, A., Mosca, A., & Pozza, C. (2020). Penile prosthesis and complications: Results from 577 implants. Archivio Italiano Di Urologia E Andrologia, 92(4). https://doi.org/10.4081/aiua.2020.4.302

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