Is there still a place for malleable penile implants in the United States? Wilson’s Workshop #18

Khera, Mohit; Mulcahy, John J.; Wen, Lexiaochuan; Wilson, Steven K.

doi:10.1038/s41443-020-00376-6

Cited by 11 publications

(4 citation statements)

References 35 publications

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“…Men with long ischemic episodes have poor erectile outcomes and dilating the corpora is a definitive way to take down priapism. 4 However, malleable devices may not be stocked in many hospitals and even in that case there can be issues with insurance coverage which may financially burden a distressed patient. This technique is traditionally employed after priapism is refractory to distal shunting leading to a high erosion risk.…”

Section: Discussionmentioning

confidence: 99%

Rapid adoption of penoscrotal decompression for ischemic priapism in private practice

Akula,

Hofer

2024

Urology Case Reports

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Section: Discussionmentioning

confidence: 99%

Rapid adoption of penoscrotal decompression for ischemic priapism in private practice

Akula,

Hofer

2024

Urology Case Reports

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“…Currently, IPP constitutes upto 90% of the PP done in the USA due to insurance coverage and better cosmetic results. 10 However, this is not the case in most developing countries, including India, as the cost of the IPP is too expensive and not covered under insurance. Hence, the SPP continues to be the major workhorse of most Andrologists in developing countries, while in developed countries its use is restricted to those who prefer a simple device or have impaired manual dexterity or for a salvage procedure (following infection or longstanding priapism).…”

Section: Discussionmentioning

confidence: 99%

Surgical Outcomes and Patient Satisfaction With the Low-Cost, Semi-Rigid Shah Penile Prosthesis: A boon to the Developing Countries

Krishnappa¹,

Tripathi

Shah

2021

Sexual Medicine

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Introduction In developing countries most patients with refractory erectile dysfunction cannot afford a penile prosthesis (PP) due to its cost and non-coverage by insurance companies. Aim To assess the patient satisfaction outcomes with a novel, low-cost, semi-rigid PP. Methods 52 patients who had received the Shah semi-rigid PP between January 2013 and December 2018 were included in this bidirectional study. Patient demographics including age, etiology, body mass index, length of PP received and post-operative complications were recorded. Patient satisfaction with the PP was evaluated using the modified Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) Questionnaire. Main outcome measures The primary outcome measures were overall satisfaction, total EDITS and mean EDITS score. The secondary outcome measures were residual penile tumescence, ease of concealment and post-operative complications. Results The mean age of the patients was 38.79 years (25–68). Overall satisfaction (EDITS Q-1) of 4 (0–4) was reported by 84.62% (44/52) of patients. There was no significant difference ( P > .7) in the total EDITS and overall satisfaction based on various etiological factors. The mean EDITS scores (0–100) were 95.67 ± 10.76, 95.53 ± 8.46 and 91.72 ± 22.42 in 52 patients with BMI <25, 25–29.9 and >30 kg/m2 respectively. During sexual arousal after PP implantation, 26 (50%), 17 (32.7%) and 9 (17.3%) patients noted “good”, “some” or “no” residual penile tumescence respectively. 47 (90.4%), 4 (7.7%) and 1 (1.9%) patients reported “good”, “fair” and “poor” concealment respectively. In the prospective group, major and minor post-operative complications were seen in 10.7% (3/28) and 21.4% (6/28) of patients respectively. Conclusion The semi-rigid Shah PP is a safe, effective and affordable option to treat patients with refractory ED. The ability to remove 1 or both sleeves in the Shah PP helps achieve a good fit with a small inventory. Krishnappa P, Tripathi A, Shah R. Surgical Outcomes and Patient Satisfaction With the Low-Cost, Semi-Rigid Shah Penile Prosthesis: A boon to the Developing Countries. Sex Med 2021;9:100399.

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“…However, IPPs, given their increased complexity, have a greater propensity for mechanical failure ( 31 ). On the other hand, erosion rates were higher for malleable prostheses compared to IPPs ( 113 ).…”

Section: Predictive Factors and Comparison Of Ipp And Malleable Prost...mentioning

confidence: 97%

Recent technological development of penile prosthesis: a literature review

Patel,

Zakkar,

Polchert

et al. 2024

Transl Androl Urol

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Background and Objective In contemporary Urology, the gold standard for treatment of erectile dysfunction refractory to medical therapy has been implantation with a penile prosthesis. The past 40 years has witnessed evolutions in technology and surgical techniques, which have led to increased patient satisfaction rates and decreased complication and infection rates. This review is an update to a prior review article that evaluates these advancements in the context of patient satisfaction and different rates of complications following surgeries. In addition, the review compares malleable and inflatable prostheses with regard to infection rate, mechanical failure rate, and erosion rate. Methods A literature search was conducted using Medline and Google Scholar to examine papers from 1973 to the present day. Keywords, such as, “penile prosthesis surgery”, “malleable penile prosthesis”, “inflatable penile prosthesis”, “two-piece Inflatable Penile Prosthesis (IPP)”, and “three-piece IPP” were utilized during the search. A total of 76 papers were included, and all were in English. Key Content and Findings Studies on the latest models of each of the three prostheses (malleable, two-piece IPP, three-piece IPP) revealed patient satisfaction ratings at or above 75%. Both types of IPPs were associated with greater satisfaction and lower erosion rates while malleable prostheses were associated with lower mechanical failure rates. Although no significant differences in infection rates were noted between the prosthesis types, a history of diabetes, obesity, and smoking were predictive of infection events. Conclusions The three-piece IPP, if indicated for a suitable patient, is generally accepted as the best type of prosthesis given its biological mimicry to an erect human penis.

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Is there still a place for malleable penile implants in the United States? Wilson’s Workshop #18

Cited by 11 publications

References 35 publications

Rapid adoption of penoscrotal decompression for ischemic priapism in private practice

Rapid adoption of penoscrotal decompression for ischemic priapism in private practice

Surgical Outcomes and Patient Satisfaction With the Low-Cost, Semi-Rigid Shah Penile Prosthesis: A boon to the Developing Countries

Recent technological development of penile prosthesis: a literature review

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