“…The prototype was first implanted in 1996 and it evolved into its present form over the next 2 years. 3 The Shah PP was initially priced at INR 6000 and currently costs INR 23,000 (300 USD). The Implant cost of Tactra (Boston Scientific, Marlborough, MA, USA), AMS Ambicor (Boston Scientific, Marlborough, MA, USA) and AMS 700 CX (Boston Scientific, Marlborough, MA, USA) would be approximately 1800 USD, 6700 USD and 10500 USD respectively in India.…”
Section: Discussionmentioning
confidence: 99%
“…The Shah PP (G.Surgiwear, Rasoolpur, UP, India) is a low cost, non-inflatable (semi-rigid), differential rigidity (flexible) silicone implant that provides rigidity through a stiff anterior zone and concealment through a soft, central flexible hinge zone 3 ( Figure 1 ). Figure 1 Differential rigidity of Shah penile prosthesis.…”
Section: Introductionmentioning
confidence: 99%
“…The relatively high costs of the globally available SPP and IPP have resulted in PP being inaccessible to majority of the ED patients in developing countries. The Shah PP (G.Surgiwear, Rasoolpur, UP, India) is a low cost, non-inflatable (semi-rigid), differential rigidity (flexible) silicone implant that provides rigidity through a stiff anterior zone and concealment through a soft, central flexible hinge zone 3 (Figure 1).…”
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.
“…The prototype was first implanted in 1996 and it evolved into its present form over the next 2 years. 3 The Shah PP was initially priced at INR 6000 and currently costs INR 23,000 (300 USD). The Implant cost of Tactra (Boston Scientific, Marlborough, MA, USA), AMS Ambicor (Boston Scientific, Marlborough, MA, USA) and AMS 700 CX (Boston Scientific, Marlborough, MA, USA) would be approximately 1800 USD, 6700 USD and 10500 USD respectively in India.…”
Section: Discussionmentioning
confidence: 99%
“…The Shah PP (G.Surgiwear, Rasoolpur, UP, India) is a low cost, non-inflatable (semi-rigid), differential rigidity (flexible) silicone implant that provides rigidity through a stiff anterior zone and concealment through a soft, central flexible hinge zone 3 ( Figure 1 ). Figure 1 Differential rigidity of Shah penile prosthesis.…”
Section: Introductionmentioning
confidence: 99%
“…The relatively high costs of the globally available SPP and IPP have resulted in PP being inaccessible to majority of the ED patients in developing countries. The Shah PP (G.Surgiwear, Rasoolpur, UP, India) is a low cost, non-inflatable (semi-rigid), differential rigidity (flexible) silicone implant that provides rigidity through a stiff anterior zone and concealment through a soft, central flexible hinge zone 3 (Figure 1).…”
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.
“…The soft tip and a malleable hinge reduce the risk of erosions, while the addition of a removable sleeve makes it versatile and cost-efficient. [ 11 ]…”
Section: Current Status Of Prosthetics In Urologymentioning
The field of genitourinary prosthetics has evolved rapidly to become the standard of care for conditions such as incontinence and refractory erectile dysfunction. Its scope has expanded to encompass newer indications such as Peyronie's disease and gender-affirming surgeries. This review, based on the Urological Society of India's Best Essay Award 2022, aims to elaborate on the advances in the field of urological prosthetics in the past 20 years as well as to provide an insight into ongoing research and what one can expect to see in the next decade, particularly in the area of penile and testicular prosthetics as well as treatment of incontinence. A PubMed and patent search was performed to achieve these objectives. Future considerations include improving acceptance, reliability, making them more accessible for developing countries and improving training and education to improve outcomes.
“…This is amply shown by the sales figures over the years. [ 1 ] India has not seen another penile prosthesis developed during this period. The device evolved to become increasingly versatile, making one wonder as to how a pair of silicone rods could be developed into four models of differing lengths of the anterior stiff zone.…”
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