Analysis of Survival Rate and Cause of Revision in Penile Prosthesis: A Single Center Long Term Follow-up Study

Yang, Kwang Mo; Choi, Hyung Ki

Abstract

PURPOSE: There are many reports on penile prosthesis implantation, but few on the natural history of prosthesis. We investigated the failure rate and causes for revision.
MATERIALS AND METHODS
We reviewed 518 cases of penile prosthesis implantation performed by the same surgeon from December, 1983 to March, 2005 at the department of urology in Yongdong Severance Hospital. The mean follow up duration was 92 months, and average age was 49.1 years. A penile prosthesis survival is defined as a prosthesis that does not need revision due to infection, mechanical dysfunction or dissatisfaction, and a patient who is able to have intercourse. Analysis was performed by Kaplan-Meier formula and Log rank test. Significance was defined as p below 0.05.
RESULTS
The survival rate of AMS 600 was significantly higher than that of the inflatable prosthesis. The survival failure rate was 22.2% in the inflatable prosthesis. Mechanical failure was the most common cause of survival failure in the inflatable prosthesis. Especially, the cylinder survival rate was lower than that of the other compartment of AMS (American medical system) 700 CXM . The AMS 700 CXM survival rate was lower in the neurogenic erectile dysfunction than the other causes of erectile dysfunction. The survival rate was reliable in the original and revised cylinder.
CONCLUSIONS
The overall survival failure rate was 16.4%. Neurogenic erectile dysfunction was the most prevalent risk factor of survival failure in AMS 700 CXM . The survival rate must be considered in neurogenic patients who want to be implanted with the inflatable prosthesis. The infection rate was not increased in AMS 700 CXM revision cases. However, further research is warranted for the development of a failure- free prosthesis.