Chung Paul H, Siegel Jordan A, Tausch Timothy J, Klein Alexandra K, Scott Jeremy M, Morey Allen F
Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Int Braz J Urol. 2017 Sep-Oct;43(5):911-916. doi: 10.1590/S1677-5538.IBJU.2016.0528.
Many patients who undergo inflatable penile prosthesis (IPP) replacement are often upsized to larger cylinders, suggesting the IPP may serve as a tissue expander and increase internal penile length. The objective of this study is to evaluate whether cylinder length increases with subsequent IPP insertion.
We queried American Medical Systems and Coloplast Patient Information Form databases to identify patients who underwent IPP placement and replacement between 2004-2013. Patients were grouped by device type and time to replacement (<2 or ≥2 years). We selected the 2-year mark for subgroup analysis to allow time for tissue expansion to occur and to exclude patients who underwent early explantation (e.g. erosion or infection).
Two thousand, seven hundred and forty nine patients (1,532 AMS 700 LGX, 717 AMS 700 CX, and 500 Coloplast Titan) met the inclusion criteria. Mean time between implants was earlier for LGX (29 months) than CX (39 months) and Titan (48 months) patients (p<0.001). Patients who underwent device replacement at <2 years did not experience an increase in mean cylinder length. On the contrary, patients who underwent device replacement at ≥2 years did experience significant increases in mean cylinder length (LGX 1.2 cm, CX 1.1 cm, and Titan 0.9 cm, p<0.001). The mean increases in length at ≥2 years were similar between the 3 devices (p=0.20). Sixty percent of patients demonstrated increases of >0.5 cm and 40% demonstrated increases of ≥1 cm.
As demonstrated, the IPP may provide tissue expansion over time. Further evaluation is needed to determine if increased cylinder length correlates to increased functional length and patient satisfaction.
许多接受可膨胀阴茎假体（IPP）置换的患者常常会更换为更大尺寸的圆柱体，这表明IPP可能起到组织扩张器的作用并增加阴茎内部长度。本研究的目的是评估随着后续IPP植入，圆柱体长度是否会增加。
我们查询了美国美敦力公司和科洛普拉斯患者信息表数据库，以确定2004年至2013年间接受IPP植入和置换的患者。患者按设备类型和置换时间（<2年或≥2年）分组。我们选择2年这个时间点进行亚组分析，以便有时间让组织发生扩张，并排除那些接受早期取出（如侵蚀或感染）的患者。
2749名患者（1532名使用美敦力700 LGX型、717名使用美敦力700 CX型、500名使用科洛普拉斯泰坦型）符合纳入标准。LGX型患者（29个月）两次植入之间的平均时间比CX型患者（39个月）和泰坦型患者（48个月）更早（p<0.001）。在<2年时接受设备置换的患者，其平均圆柱体长度没有增加。相反，在≥2年时接受设备置换的患者，其平均圆柱体长度有显著增加（LGX型增加1.2厘米，CX型增加1.1厘米，泰坦型增加0.9厘米，p<0.001）。在≥2年时，这三种设备的长度平均增加量相似（p = 0.20）。60%的患者长度增加超过0.5厘米，40%的患者长度增加≥1厘米。
如前所示，IPP可能会随着时间推移实现组织扩张。需要进一步评估以确定圆柱体长度增加是否与功能长度增加及患者满意度相关。
