Penile prostheses for the management of the neuropathic bladder and sexual dysfunction in spinal cord injury patients: long term follow up. (41/43)

During the last 10 years, 90 penile prostheses were implanted in 82 patients with spinal cord injury. Surgery was done 1 month to 25 years (average 4.8 years) after the injury. The follow up period ranged from 1 to 10 years (average 4 years). A prosthesis was implanted for urinary management in 51 patients (62%), for sexual dysfunction in 10 patients (12%) and for both purposes in 21 patients (26%). Ninety-three per cent of the patients who used the implant for urinary management and 64% of the patients who used it for sexual dysfunction were satisfactory. We experienced three extrusions and nine surgical removals due to pain, difficulty of catheterisation and infection (the complication rate was 13.3%). Generally speaking, a penile prosthesis improves the quality of life of patients with spinal cord injury significantly; however, extrusion and infection are still significant problems.  (+info)

Ten years of experience with various penile prosthesis in Korean. (42/43)

Currently there are more than 10 types of penile prosthesis available, ranging from the very simple to the very sophisticated. We review our experiences with various penile prosthesis, with particular regard to the complication rate. From Dec. 1983 to Jul. 1993, we implanted 295 penile prosthesis of eight different types. The average age of patients was 44 years. Every patient was evaluated with various multidisplinary 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 9.5 mm to 13 mm, mostly 9.5 mm (52.9%). The length of implanted prosthesis were from 10 cm to 20 cm, mostly 16 approximately 18 cm (68.8%). Cases with uneven diameters or lengths were 20 (6.8%). The int aoperative 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 those 4 patients reimplantations were successful. More than 99% (290/291) patients still have functioning prosthesis. Every prosthesis has their advantages and 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.(ABSTRACT TRUNCATED AT 250 WORDS)  (+info)

Mechanical reliability of AMS hydraulic penile prostheses. (43/43)

The mechanical reliability of AMS hydraulic penile prostheses implanted in 203 patients from April 1985 to June 1995 were evaluated. AMS Hydroflex prosthesis showed the highest incidence of mechanical failure (18.8%; 6/32 patients) during a mean follow-up period of 94.5 (64-117) months. Mean functioning time of the prostheses until malfunction was 50 (0-100) months. Bilateral fractures at junction of rear reservior and inflation chamber were found in 3 patients. AMS Dynaflex had a failure rate of 2.4% (2/85 patients) for an average of 35.3 (1-59) months. One patient showed complete fracture of silicone ball covering the proximal end of rear reservior onto which rear tip extenders are snapped. Regarding 3-piece inflatable prosthesis, AMS 700, AMS 700CX and AMS Ultrex had failure rates of 11.1% (1/9 patients), 10.5% (2/19 patients) and 4.0% (1/25 patients) during a mean follow-up period of 116.4 (103-125), 79.0 (60-94) and 44.4 (22-57) months, respectively. The verified causes of the mechanical failures were a tiny rupture of the cylinder in one case of AMS 700, an incomplete fracture of input tube in one case of AMS 700CX and a pump malfunction in one case of Ultrex. However, none of 33 cases of AMS 700CXM showed mechanical failure for an average of 21.3 (2-43) months. Therefore, AMS 700CXM and Ultrex seem to be very reliable, and the reliability of AMS Dynaflex was much higher than that of AMS Hydroflex. However, the long-term reliability of these devices needs more time to be determined.  (+info)