Johnson Blake E, Langford Brian T, VanDyke Maia E, Matz Ethan L, Cook Grayden S, Franzen Bryce P, Morey Allen F
Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Int J Impot Res. 2025 Jan;37(1):66-71. doi: 10.1038/s41443-024-00962-y. Epub 2024 Aug 17.
Despite the widespread use of narrow diameter inflatable penile prosthesis (IPP) cylinders in patients with corporal fibrosis, outcomes data is sparse. We evaluated patients who underwent IPP placement with AMS™ 700 Controlled Expansion Restricted (CXR) cylinders from 2007-2021. Patient characteristics, device details, and surgical outcomes were assessed. A non-validated questionnaire was also distributed to patients to assess satisfaction. Among 982 IPPs placed over the study period at our institution, 49 (5.0%) used CXR cylinders. Indications for narrow cylinders: prior explant for infection (67.3%), ischemic priapism (16.3%), and idiopathic fibrosis (16.3%). Median corporal length was 19 cm (IQR 17-21 cm). Discordant intraoperative corporal measurements (24.5%) and RTE lengths (26.5%) were common. Post-operative complications occurred in 8 patients (16.3%) and included 3 infections (6.1%), 2 cylinder herniations (4.1%), 2 mechanical failures (4.1%), and one case of glans necrosis (2.0%). Five of these (10.2%) required explantation, while 4 (8.2%) were managed with revision. Over the follow-up period, 73.5% of patients reported satisfaction with rigidity. Primary drivers of dissatisfaction were perceived loss of penile length and girth. The AMS™ 700 CXR is a useful tool for challenging corporal fibrosis cases and shows acceptable surgical outcomes with moderate patient acceptability.
尽管窄直径可充气阴茎假体（IPP）圆柱体在患有海绵体纤维化的患者中广泛使用，但相关结果数据却很稀少。我们评估了2007年至2021年期间接受使用AMS™ 700可控扩张受限（CXR）圆柱体进行IPP植入的患者。评估了患者特征、设备细节和手术结果。还向患者发放了一份未经验证的问卷以评估满意度。在我们机构研究期间植入的982个IPP中，49个（5.0%）使用了CXR圆柱体。使用窄圆柱体的指征：既往因感染取出假体（67.3%）、缺血性阴茎异常勃起（16.3%）和特发性纤维化（16.3%）。海绵体长度中位数为19厘米（四分位间距17 - 21厘米）。术中海绵体测量不一致（24.5%）和RTE长度不一致（26.5%）很常见。8例患者（16.3%）发生术后并发症，包括3例感染（6.1%）、2例圆柱体疝出（4.1%）、2例机械故障（4.1%）和1例龟头坏死（2.0%）。其中5例（10.2%）需要取出假体，4例（8.2%）通过翻修处理。在随访期间，73.5%的患者报告对勃起硬度满意。不满意的主要原因是感觉阴茎长度和周长减少。AMS™ 700 CXR是处理具有挑战性的海绵体纤维化病例的有用工具，显示出可接受的手术结果和中等程度的患者可接受性。
