Okada Y, Kuo Y J, Hida S, Nishio Y, Yoshida O, Arai Y, Kihara Y, Mishina T
Department of Urology, Faculty of Medicine, Kyoto University.
Hinyokika Kiyo. 1987 Oct;33(10):1640-6.
Implantation surgery was performed twelve times in eleven patients with organic impotence, mainly due to radical cystectomy and prostatectomy against malignancy, between March, 1982 and April, 1987. A self-contained type prosthesis (AMS Hydroflex(TM] was used in 7 cases, reservoir type inflatable prosthesis (AMS 700TM) in 2, malleable semirigid type (ESKA-Jonas Silicon Silver(TM) Trimming Tip Version) in 2, and nonmalleable semirigid type (Fuji system Finney type) in 1 case. In the last case, the prosthesis was replaced by AMS Hydroflex 4.5 years later at patient's wish. Excellent results and good patients' acceptance were gained with inflatable-type prosthesis (AMS 700 and Hydroflex) in 7 out of 8 cases (88%), whereas concealment problems were produced by semirigid type prosthesis (Finney and Jonas). Experience with AMS Hydroflex penile implantation is reported for the first time in the Japanese literature. Intraoperatively, it was sometimes difficult to implant a pair of Hydroflex rods into both of the corpus cavernosum. Postoperative perineal pain was almost constantly seen and in one patient, penile edema continued for three weeks and subsided spontaneously in two months. In another patient, the length of the prosthesis (15 cm) was short, and exchange to the longer one (17 cm) was necessary. In this patient, the longer Hydroflex caused erosion of the glans to necessitate its removal on one side. From our experience, the diameter (11 mm) of the Hydroflex seems to be too big for the average Japanese patient. The operative procedures and results of each kind of the prostheses are briefly discussed.
1982年3月至1987年4月期间，对11例器质性阳痿患者进行了12次植入手术，主要病因是针对恶性肿瘤的根治性膀胱切除术和前列腺切除术。7例使用了自成一体型假体（美国医疗系统公司的Hydroflex™），2例使用了贮液囊型可膨胀假体（美国医疗系统公司的700™），2例使用了可塑半硬性假体（ESKA - 约纳斯硅银™修剪尖端版），1例使用了不可塑半硬性假体（富士系统芬尼型）。在最后1例中，4.5年后应患者要求将假体更换为美国医疗系统公司的Hydroflex。8例中的7例（88%）使用可膨胀型假体（美国医疗系统公司的700和Hydroflex）获得了优异效果且患者接受度良好，而半硬性假体（芬尼和约纳斯）出现了隐蔽性问题。日本文献首次报道了美国医疗系统公司的Hydroflex阴茎植入经验。术中，有时难以将一对Hydroflex杆植入双侧海绵体。术后几乎总会出现会阴部疼痛，1例患者阴茎水肿持续了3周，2个月后自行消退。另1例患者，假体长度（15厘米）较短，需要更换为更长的（17厘米）。在该患者中，较长的Hydroflex导致龟头糜烂，不得不一侧取出。根据我们的经验，Hydroflex的直径（11毫米）对日本普通患者来说似乎太大了。本文简要讨论了每种假体的手术操作及结果。
