Sarver Jordan, Emmer Eriel, Benben Alex, Skalak Matthew, Talley Daniel, Abdelhady Mazen
Urology Residency, Detroit Medical Center, Harper Professional Building 4160 John R St. Suite 1017, Detroit, Michigan 48201, USA.
Michigan State College of Osteopathic Medicine, 965 Wilson Rd, East Lansing, Michigan 48824, USA.
Case Rep Urol. 2024 Oct 15;2024:4446878. doi: 10.1155/2024/4446878. eCollection 2024.
Erectile dysfunction (ED), the impairment of achieving and maintaining an erection for satisfactory sexual intercourse, is a common pathology that men experience for a variety of different factors. Conservative treatment for ED includes changing medications, lifestyle modifications, and psychotherapy. Pharmaceutical and nonsurgical interventions include phosphodiesterase-5 inhibitors(PDE-5i), intracavernosal medication injections, and vacuum devices. Surgical treatment options for ED have evolved over time and currently include the use of inflatable penile prosthesis (IPP) and malleable penile prosthesis. IPP insertion is usually met with good patient satisfaction. However, complications of device insertion can include corporal perforation, urethral injury, cylinder erosion or extrusion, infection, and mechanical failure, to name a few. Our patient presented with device malfunction and intraoperative assessment showed the IPP tubing twisted at the levels of the reservoir on the first operation and the level of the cylinder and scrotal pump on the second operation. The twisting of the tubing resulted in a nonfunctioning IPP as the fluid was unable to fill the cylinders resulting in an erection. The patient was managed with complete device explanation and reinsertion of a new three-piece IPP per the patient and partner's request. This is the first case report highlighting this specific complication, and we hope to provide clinicians with the resources to recognize this rare complication.
勃起功能障碍（ED）是指在进行满意的性交时，难以勃起并维持勃起状态，这是一种男性因多种不同因素而出现的常见病症。ED的保守治疗包括更换药物、改变生活方式以及心理治疗。药物和非手术干预措施包括磷酸二酯酶-5抑制剂（PDE-5i）、海绵体内药物注射以及真空装置。ED的手术治疗方法随着时间不断发展，目前包括使用可膨胀阴茎假体（IPP）和可弯曲阴茎假体。插入IPP通常能让患者获得较高的满意度。然而，装置插入的并发症可能包括海绵体穿孔、尿道损伤、圆柱体侵蚀或挤出、感染以及机械故障等。我们的患者出现了装置故障，术中评估显示，第一次手术时IPP管道在贮液器水平处扭曲，第二次手术时在圆柱体和阴囊泵水平处扭曲。管道扭曲导致IPP无法正常工作，因为液体无法充满圆柱体从而无法实现勃起。根据患者及其伴侣的要求，对患者进行了完整的装置解释，并重新插入了一个新的三件式IPP。这是第一例突出这种特定并发症的病例报告，我们希望为临床医生提供识别这种罕见并发症的参考资料。
