Regional Urology, Shreveport, LA 71106, USA.
J Sex Med. 2012 Jan;9(1):309-15. doi: 10.1111/j.1743-6109.2011.02524.x. Epub 2011 Nov 14.
Inflatable penile prosthesis (IPP) implantation is a well-established treatment for medically refractory erectile dysfunction, with long-term reliability. Overall survival is 96% at 5 years and 60% at 15 years for primary (virgin) implantation.
The aim of this study was to explore factors associated with success and complications of IPP revision surgery in a multicenter study.
Reasons for revision including mechanical issues, patient dissatisfaction, corporal deformity, and supersonic transport (SST) deformity were recorded.
At four institutions, 214 clinically uninfected IPP revisions were performed between November 2000 and November 2007. Data were incomplete for 28 cases (14%). Failure-free survival was estimated using Kaplan-Meier's Meier product limit method.
The majority of revisions were secondary to mechanical failure (N = 109; 65%) and combined erosion or infection (N = 17 + 15 = 32; 19%). Sixteen percent (N = 26) were carried out on functional uninfected prostheses secondary to patient dissatisfaction (N = 9), SST deformity (N = 10), scrotal hematoma (N = 2), or upsize revision because of corporal fibrosis (N = 5). Average age at revision was 66 years. Mean follow-up time was 55.7 months. In this study, 12 individuals required a secondary revision procedure or suffered a complication. Despite prior reports of high infection rates with revision surgery, only 5.7% of clinically uninfected and noneroded prostheses were complicated by infection or impending extrusion/erosion, following a revision washout protocol. Overall, 93% of cases were successfully revised, providing functioning IPPs.
For this study population, component exchange followed by revision washout showed a low incidence of infection and subsequent mechanical failure.
可膨胀阴茎假体（IPP）植入术是治疗医学上难治性勃起功能障碍的一种成熟方法，具有长期可靠性。初次（初治）植入的 5 年总体生存率为 96%，15 年生存率为 60%。
本研究旨在探讨多中心研究中影响 IPP 翻修手术成功和并发症的因素。
记录翻修的原因，包括机械问题、患者不满意、海绵体变形和超音速运输（SST）变形。
在 4 个机构中，2000 年 11 月至 2007 年 11 月期间共进行了 214 例临床未感染的 IPP 翻修手术。28 例（14%）数据不完整。采用 Kaplan-Meier 乘积限法估计无失败生存率。
翻修的主要原因是机械故障（N=109；65%）和联合侵蚀或感染（N=17+15=32；19%）。由于患者不满意（N=9）、SST 变形（N=10）、阴囊血肿（N=2）或因海绵体纤维化而需要加大尺寸翻修（N=5），16%（N=26）的病例对功能正常的非感染假体进行了翻修。翻修时的平均年龄为 66 岁。平均随访时间为 55.7 个月。在本研究中，12 人需要进行二次翻修手术或出现并发症。尽管先前的报告显示，翻修手术的感染率很高，但在遵循翻修冲洗方案后，只有 5.7%的临床未感染和未侵蚀的假体出现感染或即将脱出/侵蚀。总的来说，93%的病例成功翻修，获得了功能正常的 IPP。
对于本研究人群，更换部件后进行翻修冲洗显示出较低的感染率和随后的机械故障发生率。
