Dacron ingrowth during penile prosthesis revision: presentation, outcomes, and surgical management

The Boston Scientific American Medical Systems 700™ (AMS 700™, Boston Scientific Corporation, United States of America) inflatable penile prostheses feature an inner Dacron layer that facilitates controlled expansion. Over time, outer silicone rupture exposes the Dacron, allowing for tissue ingrowth and complicating explantation. We herein describe our experience managing this situation in a retrospective, single-surgeon case series. Operative reports of all AMS 700™ inflatable penile prostheses explants from 2011 to 2025 (CPT 54406, 54410, 54411, 54416, 54417) of a single surgeon at one institution were screened for "Dacron" and "ingrowth". Eleven (5.5%) of 200 AMS 700™ penile prostheses explants had Dacron ingrowth. Median implant age was 15.4 years (IQR 12.8-24.4). Ten (91%) implants were removed for mechanical failure. Median operative time was 154 min (IQR 116.5-180). Five (45%) patients had bilateral ingrowth; six (55%) had unilateral involvement. Ten (91%) cases required extended corporotomies. Three (27%) required distal penile incisions for cylinder removal. Four (67%) of six patients with unilateral ingrowth underwent immediate replacement with an inflatable penile prosthesis, one (17%) who later required Mulcahy salvage for infection. All patients with bilateral ingrowth received malleable prostheses for staged reimplantation; one (20%) patient required revision for cylinder crossover of the malleable. Overall, Dacron ingrowth is a rare but technically complex finding during long-standing AMS 700™ penile prostheses explants. Surgeons should anticipate increased operative time, potential for additional incisions, and elevated infection risk. When dissection is extensive, staged reconstruction offers a practical and safe strategy.