Literature DB >> 25383397

Penile prosthesis insertion in patients with refractory ischaemic priapism: early vs delayed implantation.

Evangelos Zacharakis, Gulio Garaffa, Amr A Raheem, Andrew N Christopher, Asif Muneer, David J Ralph.   

Abstract

OBJECTIVE: To compare the long-term results of early and delayed insertion of a penile prosthesis (PP) in men with refractory ischaemic priapism (IP). PATIENTS AND METHODS: Early insertion of a PP was carried out in 68 men with IP within a median of 7 days from the onset of priapism, while 27 had delayed insertion after a median of 5 months. The results for sexual ability, satisfaction and subjective penile shortening were assessed by questioning at follow-up visits.
RESULTS: In the early group, a malleable and an inflatable PP were implanted in 64 and four patients, respectively. After a median follow-up of 17 months, six patients needed revision surgery due to infection and curvature. Patient's satisfaction rate and ability to have sexual intercourse was 96%. In the delayed group, a malleable PP was inserted in 12 patients and an inflatable in the remaining 15. In all, 80% of the patients required a second corporotomy and downsized cylinders due to dense fibrosis. After a median follow-up of 21 months,seven patients required revision surgery due to infection,erosion and mechanical failure. In all, 25 patients were able to engage in sexual intercourse but the satisfaction rate was only 60% mainly due to significant penile shortening.
CONCLUSIONS: Early PP implantation should be the preferred option inpatients with IP, as the procedure is technically easier, has less complication rates and allows greater preservation of penile length.

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Year:  2014        PMID: 25383397     DOI: 10.1111/bju.12686

Source DB:  PubMed          Journal:  BJU Int        ISSN: 1464-4096            Impact factor:   5.588


  18 in total

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Review 5.  Multicenter surgical outcomes of penile prosthesis placement in patients with corporal fibrosis and review of the literature.

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