Clinical experience with inflatable and malleable penile implants in 104 patients

Penile prosthesis was implanted for erectile impotence of mainly organic origin in 104 patients. The AMS Dynaflex penile prosthesis was inserted in 39 cases, the AMS Malleable 600 prosthesis in 61 and the AMS Ultrex Plus prosthesis in 4. In 1 patient receiving a malleable prosthesis both rods had to be removed owing to erosion into the urethra and reimplantation was performed at the same operation. Only 1 patient who underwent implantation of the Dynaflex device had mechanical failure that necessitated surgical revision. After implantation of the new prosthesis both patients had satisfactory intercourse. One Dynaflex penile prosthesis, implanted into a juvenile-onset diabetic, became infected and required removal. Another complication was secondary to spontaneous erosion (noninfected) in 1 patient with malleable prosthesis who suffered loss of only one rod and who is still satisfied with the result. The overall complication rate in our series has been approximately 4%. The rest of the patients report satisfaction with the ability to move the penis voluntarily permitting normal sexual activities as well as normal appearance in the flaccid position. According to our experience, careful preoperative assessment from the views of both patient and device selection along with patient education, and strictly obeying the rules of sterility during implantation and applying systemic and local antimicrobial prophylaxis are essential in obtaining a successful result in prosthesis implantation for the individual patient.