Smith C P, Kraus S R, Boone T B
Scott Department of Urology, Baylor College of Medicine, Houston, Texas, USA.
J Urol. 1998 Dec;160(6 Pt 1):2037-40. doi: 10.1097/00005392-199812010-00027.
Erosion of penile prostheses can be calamitous, often leaving patients unable to accommodate further implants. There is a paucity of literature describing impending erosion of penile prosthesis. We report on 5 patients with impending erosion of a penile prosthesis who underwent polytetrafluoroethylene distal wind sock graft placement.
From 1993 to 1997, 5 patients with a mean age of 49 years and impending penile prosthesis erosion underwent 6 revisions using a polytetrafluoroethylene distal wind sock graft. Two patients underwent simultaneous bilateral grafts while 1 patient underwent separate right and left grafts 3 years apart. Indications for reconstruction included distal migration of the prosthetic cylinders into the glans in 4 patients and impingement of the distal urethra in 2. Of the patients 3 were spinal cord injured, 1 had lumbar radiculopathy and 1 had a history of pelvic irradiation. Inflatable prostheses were implanted in 4 patients, while 1 received a malleable prosthesis.
Patients underwent a mean of 1.5 penile prosthetic revisions (0 to 4) before diagnosis of impending erosion. An interval of 8 to 144 months (mean 66) elapsed from the most recent penile prosthesis insertion until distal wind sock graft placement. Mean operative time was 1 hour 51 minutes (1.3 to 2.5 hours). Mean hospital stay was 6.3 days (3 to 12). At a mean followup of 32 months (0.7 to 5.2 years) all patients had satisfactory and functional erections with no pain or evidence of impending erosion or penile prosthesis infection.
Erosion of a penile prosthesis can have disastrous consequences. We describe a safe and effective technique for managing impending penile prosthesis erosion using a polytetrafluoroethylene distal wind sock graft.
阴茎假体侵蚀可能是灾难性的，常常使患者无法接受进一步的植入。关于阴茎假体即将发生侵蚀的文献很少。我们报告5例阴茎假体即将发生侵蚀且接受聚四氟乙烯远端风袋移植的患者。
1993年至1997年，5例平均年龄49岁、阴茎假体即将发生侵蚀的患者接受了6次使用聚四氟乙烯远端风袋移植的修复手术。2例患者同时进行双侧移植，1例患者在3年的间隔期内分别进行了左右侧移植。重建的指征包括4例患者假体圆柱体向龟头远端移位，2例患者远端尿道受压迫。患者中3例为脊髓损伤，1例为腰椎神经根病，1例有盆腔放疗史。4例患者植入了可膨胀假体，1例接受了可弯曲假体。
患者在诊断阴茎假体即将发生侵蚀之前平均接受了1.5次阴茎假体修复手术（0至4次）。从最近一次阴茎假体植入到进行远端风袋移植的间隔时间为8至144个月（平均66个月）。平均手术时间为1小时51分钟（1.3至2.5小时）。平均住院时间为6.3天（3至12天）。平均随访32个月（0.7至5.2年），所有患者勃起功能均满意且正常，无疼痛，无阴茎假体即将发生侵蚀或感染的迹象。
阴茎假体侵蚀可能产生灾难性后果。我们描述了一种使用聚四氟乙烯远端风袋移植来处理阴茎假体即将发生侵蚀的安全有效的技术。
