Surgical Experiences with Various Penile Prosthesis

Choi, Hyung Ki; Cho, In Rae; Xin, Zhong Cheng

Abstract

Currently there are more than 10 types of penile prosthesis available today, ranging from the very simple to the very sophisticated. We review our experience with various penile prosthesis, with particular regard to the complication rate. From December. 1983 to July. 1993, we have implanted 295 penile prosthesis of eight different types. The average age of patients was 44 years. Every patient was evaluated with various multidisciplinary diagnostic approaches.The etiologies of impotence were vasculogenic 29%, diabetogenic 22%, spinal cord injury 16%, pelvic bone injury 11%, etc. The types of implanted prosthesis were AMS malleable 143, Jonas 42, Dynaflex 36, Hydroflex 8, Uni-Flate 1000 2, AMS 700 CXM 58, Ultrex 3, Mentor alpha-1 3 and the mean follow-up period was 34 months. The diameters of implanted prosthesis were from 9. 5mm to l3mm, mostly 9.5mm(52.9%) range. The length of implanted prosthesis were from 10cm to 20cm, mostly 16-l8cm( 68.8%). Cases with uneven diameters or lengths were 20(6.8 %). The intraoperative complications were 1 corporeal rupture and 1 bladder rupture, and the postoperative complications were 2 prosthesis infections, 2 mechanical failures, and 1 prosthesis infection with mechanical failure. In 4 patients reimplantations were successful. More than 99% ( 290/291) patients still have functioning prosthesis. Every prosthesis has their advantages and also disadvantages. Factors to be analysed in the selection of proper prosthesis should include patients economic status, education, personality, social activity, hand dexterity, and penile size. So far by our 10 years experience, we believe that 3-piece inflatable prosthesis especially AMS 700 CXM, which is designed to fit the orienta1 penile size, is excellent in quality and reliability.