Reliability of the AMS inflatable prostheses in 444 consecutive cases.

Between February, 1981, and September, 1990, 444 men with erectile dysfunction were implanted with AMS inflatable penile prostheses. Etiology was vascular for 62% and diabetic for 22%. Ninety-three percent had a functional prosthesis at last contact. Overall, 74% of the originally-implanted cylinders were functional at last contact with no revisions; an additional 3% required one or more revisions, though no replacement, to maintain function. Of the sub-group receiving PPS cylinders as the first implant under my care, 35% have required no revision; along with 66% implanted with the thicker-walled PPT; 85% with the PND, designed to reduce stress on the tunica albuginea and prevent aneurysm formation; and 90% with the CX cylinders. This greatly improved reliability can be ascribed to (1) continued improvements by the manufacturer, (2) use of a single prosthesis type leading to improved surgical proficiency, and (3) a modified revision technique when a fluid leak has occurred, making it frequently unnecessary to replace the entire device.