Complications of Inflatable Penile Prostheses Implantation Classified according to the Modified Clavien System

Abstract

Introduction. In patients with erectile dysfunction (ED), inflatable penile prosthesis (IPP) surgery is regarded as the gold standard treatment in medically refractory cases or where its conservative treatment options are contraindicated. Despite improvements in surgical technique and implanted materials, IPP surgery retains a substantial complication rate. The aim of the study was to record and grade the postoperative complications of IPP implantation according to a modified Clavien system.Methods. A total of 60 three-piece IPP implantations were performed between 2007 and 2013 by a single surgeon. The primary outcome was to stratify the early (first 30 days) complications into five categories using the modified Clavien-Dindo classification system. A secondary aim was to record the long-term adverse events and to identify possible factors related to complication occurrence.Results. Overall, there were 21 (35%) postoperative complications in 17 of 60 men (28.3%), with 15 adverse events occurring early after surgery. In terms of late complications, there were six (10%) major complications managed by either revision surgery or removal of the prosthesis.Conclusion. This study utilizes a validated morbidity scale thus overcoming problems of previous studies reporting IPP surgery complications. The modified Clavien classification system easily aids in assessing and comparing accurately patients’ postoperative complications, thus improving management and prevention.

Preoperative counseling and expectation management for inflatable penile prosthesis implantation

“…Damage to the bladder is infrequent but can occur during traditional retropubic reservoir placement. Bowel perforation is also a rare complication; patients with prior pelvic surgery such as robotic prostatectomy, renal transplant, or laparoscopic inguinal hernia repair may be at greater risk due to prior disruption of the space of Retzius ( 36 ).…”

“…In a survey to the members of the SMSNA, 82% of the 81 surgeons surveyed felt that patients with a prior history of radical prostatectomy sometimes or frequently made traditional reservoir placement more difficult ( 54 ). Furthermore, reservoir placement in the retropubic space carries the risk of bladder, vascular, or hollow viscus injury ( 28 , 36 , 43 ). In the context of device selection, patients who are at elevated risk for injury during reservoir placement should understand that ectopic reservoir placement may be required.…”

Search traffic for inflatable penile prosthesis increased following the COVID-19 pandemic in the United States: a Google Trends analysis

“…Patients who may not be suitable candidates to the aforementioned treatments, or who do not find them effective, may explore newer treatment options such as shockwave therapy, stem cell therapy, and platelet-rich plasma (PRP) therapy [4]. Among these, the inflatable penile prosthesis (IPP), the most common type of penile implant, stands out as the most popular treatment choice offered to individuals with a more severe condition [5].…”

Defining the incidence and management of postoperative scrotal hematoma after primary and complex three-piece inflatable penile prosthesis surgery

“…Contemporary optimization of perioperative patient management has drastically improved device survival and minimized patient morbidity [ 3 , 4 ]. Serious adverse events can occur during or following inflatable penile prosthesis (IPP) surgery [ 5 , 6 ]. Scrotal hematoma formation after IPP surgery is a serious adverse event that remains relatively underexplored in the literature [ 7 , 8 ].…”