MRI of Penile Prostheses: The Challenge of Diagnosing Postsurgical                     Complications

Uski, Ana Cláudia Vincenzi Raduan; Piccolo, Luciana Maksoud; Abud, Carolina Pereira; Pedroso, Maria Helena Naves Inácio; Albuquerque, Kamila Seidel; Gomes, Natália Borges Nunes; Fernandes, José de Ávila

doi:10.1148/rg.210075

Cited by 6 publications

(6 citation statements)

References 28 publications

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“…Although most complications are diagnosed clinically, imaging is critical in subtle and equivocal cases. MRI is the preferred modality for evaluation of penile prostheses because of its higher soft tissue resolution, absence of ionizing radiation, better assessment of the penile anatomy, and superior evaluation of the prosthesis components [4]. However, MRI is not readily available in emergency settings to some centers and requires longer acquisition times, which might not be suitable for unstable patients.…”

Section: Infectionmentioning

confidence: 99%

“…They are less expensive; however, they have a higher risk of lateral perforation and distal erosion, as well as the discomfort and embarrassment for the patient from the permanent erection caused by these rigid implants. Nonetheless, they are still utilized in patients for whom inflatable prostheses are not a viable option, including those with spinal cord injury, who have impaired manual dexterity, and pelvic organ transplant recipients, who are at increased risk of infection [4].…”

Section: Introductionmentioning

confidence: 99%

“…The reported overall penile prosthesis survival at 5 and 10 years is 83% and 78-82%, respectively [5]. Erosion is a rare complication that occurs in less than 1% of patients and is most commonly seen with non-inflatable implants or in association with device infection [4].…”

Section: Introductionmentioning

confidence: 99%

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Inflatable Penile Prosthesis Complication in the Emergency Department

Sedaghat,

Kamona

2024

Healthcare

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Inflatable penile prostheses are a widely utilized treatment for erectile dysfunction. While MRI is the optimal imaging modality for patients with suspected implant complications, it is often unavailable in the acute setting. In light of these limitations, we present a case of urethral perforation by an implanted penile cylinder and its evaluation with contrast-enhanced computed tomography (CT) in an emergent setting.

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Section: Infectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Inflatable Penile Prosthesis Complication in the Emergency Department

Sedaghat,

Kamona

2024

Healthcare

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“…As mentioned earlier, in acute infection, the diagnosis is usually based on clinical and laboratory data. In late infections, often presenting with a subclinical course that is difficult to diagnose, imaging modalities can assist in differentiating between superficial and periprosthetic infections [ 31 ]. Imaging can be carried out with ultrasound to show fluid collection or edema surrounding the prosthetic components.…”

Section: Reviewmentioning

confidence: 99%

Unveiling the Hidden Perils: A Comprehensive Review of Fungal Infections in Inflatable Penile Prosthesis Surgery

Natsos,

Tatanis,

Lekkou

et al. 2024

JPM

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Inflatable penile prosthesis (IPP) surgery is an effective treatment for erectile dysfunction (ED), but infections pose a significant threat to its success. Current guidelines lack antifungal recommendations, despite rising fungal infection rates post-IPP surgery. This review examines epidemiology, risk factors (including diabetes mellitus, immunosuppression, and obesity), and pathogenesis, highlighting the role of biofilm formation in device contamination. Clinical manifestations vary from acute to delayed, with fungal biofilms presenting challenges in diagnosis. Prophylactic strategies, including broad-spectrum antibiotics and antifungals, are crucial, with evidence suggesting a 92% reduction in infections. With fungal infections showing lower salvage rates, management involves culture-guided treatment, irrigation, and oral antibiotics. Future research aims to understand biofilm mechanisms and develop biomaterials to reduce infection rates. Implementing antifungal therapy, along with standard practices like the no-touch technique and antibiotic dips, is crucial in preventing IPP infections.

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“…Two main types of penile prostheses are presently on the market: inflatable penile prosthesis (IPP) and malleable penile prosthesis (MPP). Despite being the gold standard in terms of high satisfaction and low complication rates, IPP has been associated with urethral injury and loss of penile length [13][14][15] while MPP has been associated with penile skin perforation, erosion, and implant fracture [16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Himplant® subcutaneous penile implant improves penile appearance and erectile dysfunction after radical prostatectomy: a case series

Valenzuela,

Elist,

Moon

et al. 2024

Int J Impot Res

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Erectile dysfunction is a major postoperative complication following radical prostatectomy. Various treatments for post- radical prostatectomy erectile dysfunction including nonsurgical phosphodiesterase-5 inhibitors, intraurethral alprostadil, intracavernosal injections and penile implant prosthesis, often yield suboptimal results. In this prospective single-center case series, we examine the efficacy and outcomes of Himplant®, a subcutaneous silicone penile implant, placement in four patients with post-radical prostatectomy erectile dysfunction who experienced limited benefits with phosphodiesterase-5 inhibitors. Patient data including demographics, prostate cancer diagnoses, erectile dysfunction characteristics, previous treatments, and outcomes were collected. Himplant® placement was performed in a standardized manner through a high scrotal incision in all cases. Follow-up evaluations were conducted to assess the effectiveness of the procedure and any associated complications. Patients were contacted and asked 15 questions regarding satisfaction and erectile function with the responses recorded. This study presents findings of high patient satisfaction, increases in flaccid penile length and girth, no incidence of adverse events, and improved erectile function following Himplant® placement post-radical prostatectomy. Accordingly, we suggest Himplant® placement in patients who are frustrated by their penile appearance and suffering from erectile dysfunction after radical prostatectomy. Further multicenter studies are warranted to validate these findings and assess long-term outcomes and patient-reported satisfaction.

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MRI of Penile Prostheses: The Challenge of Diagnosing Postsurgical Complications

Cited by 6 publications

References 28 publications

Inflatable Penile Prosthesis Complication in the Emergency Department

Inflatable Penile Prosthesis Complication in the Emergency Department

Unveiling the Hidden Perils: A Comprehensive Review of Fungal Infections in Inflatable Penile Prosthesis Surgery

Himplant® subcutaneous penile implant improves penile appearance and erectile dysfunction after radical prostatectomy: a case series

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