Outcomes and Satisfaction Rates for the Redesigned 2-Piece Penile Prosthesis

Introduction Among the many treatments for erectile dysfunction, implantation of a penile prosthesis has been associated with high patient satisfaction rates. Prosthesis replacement has become an accepted procedure in the event of device malfunction or complications, but to our knowledge, there are no data regarding the impact of implant replacement on patients and partner satisfaction. Aim The aim of our study was to assess and to compare the level of satisfaction, with a first or second penile prosthesis implantation (PPI), in men with refractory erectile dysfunction and their partners. Methods A survey study based on a five-item questionnaire was carried out at our center between January 1999 and January 2012. Main outcome measures The main outcome measure used was the level of patient and partner satisfaction with sexual intercourse after PPI. Results Of the 190 eligible patients, 149 (78%) completed the survey (110 underwent a first implant and 39 a reimplant). Seventy-nine percent of first-time implanted patients and 80% of the reimplanted patients (P > 0.05; not significant [ns]) reported satisfactory sexual intercourse (very or moderately satisfied), while 74% and 80% of their partners reported satisfactory intercourses, respectively (P > 0.05; ns). Overall, 73.7% of first implants and 70% of second implants reported that they would undergo the procedure again if the PPI failed (P > 0.05; ns). With regards to cosmetic aspects, 13% of the first implants' and 15% of second implants' partners reported either penile shortness or soft glans as the main causes of their dissatisfaction. Only 2.4% of first implants and 1% of reimplanted patients expressed difficulty in manipulating the device. Conclusions PPI is successful in returning the ability for satisfactory sexual intercourse to both first implant and reimplanted patients and their respective partners.

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“…Several articles [17,22,40–42] refer to the acceptance of a secondary implant when the first implant fails (Table ). Caire et al.…”

Section: Discussionmentioning

confidence: 99%

Penile Prosthesis First and Replacement Surgeries: Analysis of Patient and Partner Satisfaction

Lledó-García

Jara-Rascón

Iribarren

et al. 2015

The Journal of Sexual Medicine

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“…As the fluid reservoir for the Ambicor is the proximal portion of the cylinders, the continued pressure on this area led to autoinflation of the device as the fluid was forced forward into the distal cylinders. While the Ambicor has a mechanical failure rate as low as 0.7 to 2.3% in previous studies [7, 8] the condition seen in this patient is a previously unreported complication and failure. One previous report describes a failure to deflate, although this was due to a blood clot near the corporal input tubing [9].…”

Section: Discussionmentioning

confidence: 59%

Autoinflation Leading to Failure of Two-Piece Ambicor Implantable Penile Prosthesis: An Outcome from a Methodical Treatment of Recalcitrant Stuttering Priapism

Welliver

Fonseca

West

et al. 2014

Case Reports in Urology

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Introduction. We present the case of a patient who received a two-piece Ambicor penile prosthesis for idiopathic recurrent “stuttering” priapism refractory to other treatment options. The patient returned unable to deflate the device due to an interesting anatomically induced mechanical failure. Aims. To describe the method and findings of this inflatable prosthesis failure. Results. Prosthesis failure occurred due to restrictive corporal diameter and the unique characteristics of fluid reservoir location in the two-piece inflatable prosthesis. The patient was successfully converted to a semirigid prosthesis with resolution of the pain that was due to his prosthesis autoinflation. Conclusion. Stuttering priapism remains a challenging clinical problem. Penile implantation is a reasonable long-term solution in a patient refractory to less invasive options. In patients with fibrotic corpora, a malleable device should be considered (at least temporarily) if unable to dilate comfortably to 13 mm.

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“…Actually PP provides a satisfactory, definitive solution for ED. In different patient satisfaction studies it was shown that, of the PP implanted men more than 90% stated they were still using the PP for sexual intercourse with an average frequency of coitus of 5 times monthly (8)(9)(10). A recent study conducted by Escasa et al supported previous studies and confirmed that sexual activity increases testosterone level which was more prominent in participants who had sexual intercourse (7).…”

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confidence: 68%

The impact of sexual activity on serum hormone levels after penile prosthesis implantation

Cangüven

Talib

Shamsodini

et al. 2014

Arch Ital Urol Androl

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Objectives: Penile prosthesis implantation is the final treatment option for patients who have erectile dysfunction. Most of the patients use their penile prosthesis successfully and frequently for penile-vaginal intercourse. Previous literature showed that decrease in sexual activity resulted in decreased serum testosterone levels and vice versa. The aim of this study was to examine the impact of sexual activity on serum sex hormone levels after penile prosthesis usage. Material and methods: In this study, we examined sixtyseven patients for their sex hormone changes who had penile prosthesis surgery 2.7 ± 1.5 years ago. Results: Patients were using their penile prosthesis for sexual activity with a mean of 9.9 ± 5.7 times per month. Dehydroepiandrosterone sulfate was significantly higher compared to pre-surgery results (5.3 ± 2.6 vs 4.5 ± 2.9; p = 0.031). Mean serum total testosterone levels of patients before and after penile prosthesis usage were clinically significant 15.78 ± 4.8 nmol/L and 16.5 ± 6.1 nmol/L, respectively. Mean serum luteinizing hormone levels of patients before and after penile prosthesis usage were 3.98 ± 2.16 IU/L and 5.47 ± 4.76 IU/L, respectively. No statistical significance difference was observed in the mean total and free testosterone, estradiol and luteinizing hormone levels between pre-and post-surgery. Conclusion: This study results demonstrated that sexual activity changed sex hormone levels positively among those men who were implanted penile prosthesis because of erectile dysfunction. healthy men (1, 2). Testosterone, which has androgenic and anabolic effects on human body, decline gradually with aging in males. Major benefits of testosterone on sexual function, mood, and strength are well known from the ancient times. Currently, evidence supports the concept that normal testosterone levels reduce cardiovascular disease risk, decrease fat, decrease total cholesterol, increase muscular body mass, and display good glycemic control (3). Moreover, epidemiological studies imply that many important disease states and related comorbidities are linked to low testosterone levels (4). Although there are mixed results from animal studies (5), male testosterone concentrations before and after sexual activity were shown as increased in human studies (6, 7). Insertion of a penile prosthesis (PP) for men who cannot use or fail to respond to first and second line treatments is the final treatment option for ED. Actually PP provides a satisfactory, definitive solution for ED. In different patient satisfaction studies it was shown that, of the PP implanted men more than 90% stated they were still using the PP for sexual intercourse with an average frequency of coitus of 5 times monthly (8-10). A recent study conducted by Escasa et al. supported previous studies and confirmed that sexual activity increases testosterone level which was more prominent in participants who had sexual intercourse (7). The aim of this study is to examine the influence of sexual activity on serum sex hormone levels af...

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Outcomes and Satisfaction Rates for the Redesigned 2-Piece Penile Prosthesis

Abstract: The redesigned Ambicor 2-piece penile prosthesis appears to be safe and effective. It is associated with a low rate of revision as well as high patient and partner satisfaction.

Cited by 71 publications

References 16 publications

Penile Prosthesis First and Replacement Surgeries: Analysis of Patient and Partner Satisfaction

Penile Prosthesis First and Replacement Surgeries: Analysis of Patient and Partner Satisfaction

Autoinflation Leading to Failure of Two-Piece Ambicor Implantable Penile Prosthesis: An Outcome from a Methodical Treatment of Recalcitrant Stuttering Priapism

The impact of sexual activity on serum hormone levels after penile prosthesis implantation

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