MECHANICAL RELIABILITY, SURGICAL COMPLICATIONS, AND PATIENT AND PARTNER SATISFACTION OF THE MODERN 3-PIECE INFLATABLE PENILE PROSTHESIS

Objectives. The modern three-piece inflatable penile prosthesis (IPP) has undergone multiple revisions since its introduction in 1973. We re viewed devices placed since the last major revision by American Medica l Systems (AMS) in 1987.Methods. A retrospective chart review was refi ned with data from an independent patient and partner survey. Results. Two hundred twelve consecutive penile prosthetic devices placed by a single surgeon over an 8-year period are reviewed. One hundred sixty-n ine of the devices were three-piece inflatables with 146 being primary implants. The average device has been in place 36.5 months (range 9 t o 102). The infection rate in 146 primary three-piece devices was 2.1% . The infection rate in 46 secondary implants or revisions was 6.5%, e xcluding seven salvage attempts. Mechanical failure in 122 primary AMS devices placed was 4. 1%. Mechanical failure in 24 Mentor devices was 4.2% if one discounts connector failures that were revised in 1990. A surgical complication and revision rate of 1.4% was noted in the 146 primary implants. An independent telephone survey achieved a 57% and 2 4% response rate in patients and partners with three-piece devices pla ced. In the group of 86 patients with a primary three-piece device pla ced and complete follow-up, the probability of having a normally funct ioning device placed in a single operative procedure was 90.6% at 3 ye ars. On a to 10 scale looking at ail primary devices, secondary device s, revisions, and infections, the average and median satisfaction rate was as follows: 8.2, 8.5; 8.4, 9.0; 7.7, 7.75 for the Ultrex patients , CX 700 and Mentor patients, and all partners, respectively. Conclusi ons. The modern three-piece IPP is an excellent surgical option offeri ng a very safe, reliable return to sexual activity for our patients. U ROLOGY 52: 282-286, 1998. (C) 1998, Elsevier Science Inc. Ail rights r eserved.